The application of medical ethics in the developing countries - A neurosurgical perspective.

Introduction: Neurosurgery is one of the rapidly evolving specialities of medical science, where the neurosurgeons have to provide evidence-based interventions in life threatening conditions maintaining the ethical standards.

Research Question: This narrative review sheds light on the current hindrances of the ethical aspects of neurosurgical practice in low and middle-income countries (LMICs) and provide some feasible solutions for future.

Material And Methods: A literature search was conducted using PubMed, Scopus and ISI web of knowledge focused on articles in English with the words "medical ethics" together with the words "neurosurgery", "ethical practice", "low and middle-income countries", "surgical innovation", "randomized clinical trials" and "outcome" alone or in combination.

Trans-Oral Protrusion of the Distal End of a Ventriculoperitoneal Shunt: A Case Report of an Unusual Complication.

Ventriculoperitoneal shunting (VPS) is the surgical technique of choice to manage pediatric hydrocephalus. Despite having good results, it is prone to complications, some of which are rare. This is the case report of a 2-year-old male, with an uncomplicated VPS done at 6 months of age, presenting with vomiting, irritability, anorexia, and drooling.

The Boston Declaration 2025: Plan and Pledges for Progress in Global Neurosurgery.

Global Neurosurgery has been described as the clinical and public health practice of neurosurgery with the primary purpose of ensuring timely, safe, and affordable neurosurgical care to all who need it. Global Neurosurgery activities in the form of mission trips, educational partnerships, and research collaborations have been in place for decades. Still, there have been no central organizing efforts to improve the harmonization of these endeavors until recently.

Collaborative Initiatives in Neurosurgery Research and Publications Between High-Income and Low/Middle-Income Countries: A Bibliometric Analysis.

Despite the globalization of health information, collaborations between high-income countries (HICs) and low/middle-income countries (LMICs), while present, could still increase. This study builds on previous research highlighting LMIC underrepresentation in neurosurgery literature. We conducted a comprehensive bibliometric analysis using the Scopus database to investigate collaborative neurosurgical research between HIC institutions and those in low-income country (LIC)/LMICs.

Postgraduate Fellowships, Distant Continuing Education, and Funding in Neurosurgical Education.

Neurosurgical education and training are the essential tenets for the development of a sustainable workforce. However, opportunities for training are limited in most parts of the world due to socioeconomic constraints and an inadequate workforce. This global deficit has triggered a huge drive to expand training opportunities.

Assessing the presence of sustainability education in the curriculum of medical students and surgical trainees in Africa: A cross-sectional study.

Background And Aims: Integrating sustainability principles into medical and surgical curricula raises awareness and empowers future healthcare professionals to adopt sustainable practices, reducing the environmental impact of surgical care. This study aims to assess the presence of sustainability education in African medical schools and surgical residency curricula to inform policymakers and educators in African healthcare systems.

Methods: This cross-sectional study was undertaken through an online survey among medical students and surgical trainees in African countries to describe the presence of sustainability education in surgical training programs and medical curricula across Africa.

A guide to interpreting systematic reviews and meta-analyses in neurosurgery and surgery.

Introduction: Systematic reviews (SRs) and meta-analyses (MAs) are methods of data analysis used to synthesize information presented in multiple publications on the same topic. A thorough understanding of the steps involved in conducting this type of research and approaches to data analysis is critical for appropriate understanding, interpretation, and application of the findings of these reviews.

Methods: We reviewed reference texts in clinical neuroepidemiology, neurostatistics and research methods and other previously related articles on meta-analyses (MAs) in surgery.

The importance of social networks in neurosurgery training in low/middle income countries.

Introduction: Neurosurgery is evolving with new techniques and technologies, relies heavily on high-quality education and training. Social networks like Twitter, Facebook, Instagram and LinkedIn have become integral to this training. These platforms enable sharing of surgical experiences, fostering global knowledge-sharing and collaboration among neurosurgeons.

Marburg Virus Outbreak in Equatorial Guinea: Need for Speed.

The co-existence of deadly viral pandemics can be considered a nightmare for public health authorities. The surge of a Marburg virus disease (MVD) outbreak in Africa at a time when the coronavirus-19 (COVID-19) pandemic is partially controlled with its limited resources is an urgent call for concern. Over the past decades, several bouts of MVD outbreaks have occurred in Africa with an alarming case fatality rate.

Reducing the Gap in Neurosurgical Education in LMICs: A Report of a Non-Profit Educational Program.

Introduction: Central to neurosurgical care, neurosurgical education is particularly needed in low- and middle-income countries (LMICs), where opportunities for neurosurgical training are limited due to social and economic constraints and an inadequate workforce. The present paper aims (1) to evaluate the validity and usability of a cadaver-free hybrid system in the context of LMICs and (2) to report their learning needs and whether the courses meet those needs via a comprehensive survey.

Methods: From April to November 2021, a non-profit initiative consisting of a series of innovative cadaver-free courses based on virtual and practical training was organized.

Management and outcomes of pediatric traumatic brain injury in Africa: a systematic review.

Objective: Traumatic brain injury (TBI) carries a major global burden of disease; however, it is well established that patients in low- and middle-income countries, such as those in Africa, have higher mortality rates. Pediatric TBI, specifically, is a documented cause for concern as injuries to the developing brain have been shown to lead to cognitive, psychosocial, and motor problems in adulthood. The purpose of this study was to investigate the reported demographics, causes, management, and outcomes of pediatric TBI in Africa.

An international, prospective observational study on traumatic brain injury epidemiology study protocol: .

Background: The epidemiology of traumatic brain injury (TBI) is unclear - it is estimated to affect 27-69 million individuals yearly with the bulk of the TBI burden in low-to-middle income countries (LMICs). Research has highlighted significant between-hospital variability in TBI outcomes following emergency surgery, but the overall incidence and epidemiology of TBI remains unclear. To address this need, we established the Global Epidemiology and Outcomes following Traumatic Brain Injury (GEO-TBI) registry, enabling recording of all TBI cases requiring admission irrespective of surgical treatment.

Consensus-Based Development of a Global Registry for Traumatic Brain Injury: Establishment, Protocol, and Implementation.

Background And Objectives: Global disparity exists in the demographics, pathology, management, and outcomes of surgically treated traumatic brain injury (TBI). However, the factors underlying these differences, including intervention effectiveness, remain unclear. Establishing a more accurate global picture of the burden of TBI represents a challenging task requiring systematic and ongoing data collection of patients with TBI across all management modalities.

Authorship Disparities in International Neurosurgical Research Collaborations: A Bibliometric Analysis.

Background: Research is pivotal to neurosurgical training and practice. The objectives of this study were to quantify neurosurgical research output by authors from low-income countries (LICs), using author affiliation as a proxy, and to understand the patterns of collaboration between LIC authors and their international partners.

Methods: PubMed, CINAHL, and EMBASE were searched for neurosurgical literature published by authors from the 27 World Bank LICs from 2010 to 2020.

Epidemiology and etiology of brain cancer in Africa: A systematic review.

Background: Cancer is a significant threat to public health and a leading cause of morbidity across the globe. Of all cancers, brain cancer can be particularly catastrophic as treatment often fails to achieve the desired degree of effectiveness and diagnosis remains associated with a high mortality rate. Africa, as a continent with resource-limited countries, needs to allocate the necessary proper healthcare infrastructure to significantly reduce cancer rates and improve patient survival.

Needs, Roles, and Challenges of Young Asian Neurosurgeons.

Background: Asia has a marked shortage of neurosurgical care, with approximately 2.5 million critical cases left untreated. The Young Neurosurgeons Forum of the World Federation of Neurosurgical Societies surveyed Asian neurosurgeons to identify research, education, and practice.

Assessing the impact of neurosurgery and neuroanatomy simulation using 3D non-cadaveric models amongst selected African medical students.

Background: Laboratory dissections are essential to acquire practical skills to perform neurosurgical procedures. Despite being traditionally done on cadavers, they are often unavailable and suffer from cultural barriers in the African context. Non-cadaveric UpSurgeOn neurosurgery models have been developed to bridge this barrier, providing an almost similar experience with the human body.

Needs, Roles, and Challenges of Young Latin American and Caribbean Neurosurgeons.

Background: Barriers to neurosurgery training and practice in Latin American and Caribbean countries (LACs) have been scarcely documented. The World Federation of Neurosurgical Societies Young Neurosurgeons Forum survey sought to identify young neurosurgeons' needs, roles, and challenges. We present the results focused on Latin America and the Caribbean.

Variation in postoperative outcomes of patients with intracranial tumors: insights from a prospective international cohort study during the COVID-19 pandemic.

Background: This study assessed the international variation in surgical neuro-oncology practice and 30-day outcomes of patients who had surgery for an intracranial tumor during the COVID-19 pandemic.

Methods: We prospectively included adults aged ≥18 years who underwent surgery for a malignant or benign intracranial tumor across 55 international hospitals from 26 countries. Each participating hospital recorded cases for 3 consecutive months from the start of the pandemic.

Historical determinants of neurosurgical inequities in Africa and the African diaspora: A review and analysis of coloniality.

The movement to decolonize global health challenges clinicians and researchers of sub-disciplines, like global neurosurgery, to redefine their field. As an era of racial reckoning recentres the colonial roots of modern health disparities, reviewing the historical determinants of these disparities can constructively inform decolonization. This article presents a review and analysis of the historical determinants of neurosurgical inequities as understood by a group of scholars who share Sub-Saharan African descent.

Awake Craniotomy in Africa: A Scoping Review of Literature and Proposed Solutions to Tackle Challenges.

Background: Awake craniotomy (AC) is a common neurosurgical procedure for the resection of lesions in eloquent brain areas, which has the advantage of avoiding general anesthesia to reduce associated complications and costs. A significant resource limitation in low- and middle-income countries constrains the usage of AC.

Objective: To review the published literature on AC in African countries, identify challenges, and propose pragmatic solutions by practicing neurosurgeons in Africa.

Tranexamic acid for patients with aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis of 2991 patients.

Objective: We aimed to synthesize evidence from published clinical trials on the efficacy and safety of tranexamic acid (TXA) administration in patients with aneurysmal subarachnoid hemorrhage (aSAH).

Methods: We followed the standard methods of the Cochrane Handbook of Systematic Reviews for interventions and the PRISMA statement guidelines 2020 when conducting and reporting this study. A computer literature search of PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials was conducted from inception until 1 January 2022.

Biochemical profile of paediatric adamantinomatous craniopharyngiomas: A prospective cohort study.

Introduction: Craniopharyngioma is a rare brain tumour. Despite being histologically benign, it behaves aggressively and is often difficult to manage. Descriptive epidemiological data on the tumour is lacking in sub-Saharan Africa, and there is none for Zimbabwe.

Neurotrauma clinicians' perspectives on the contextual challenges associated with traumatic brain injury follow up in low-income and middle-income countries: A reflexive thematic analysis.

Background: Traumatic brain injury (TBI) is a major global health issue, but low- and middle-income countries (LMICs) face the greatest burden. Significant differences in neurotrauma outcomes are recognised between LMICs and high-income countries. However, outcome data is not consistently nor reliably recorded in either setting, thus the true burden of TBI cannot be accurately quantified.