An acute increase in intracranial pressure (ICP) has been shown to affect cardiac function due to brain ischemia and the associated increased sympathetic activity. However, there is limited literature on the changes in cardiac function in clinical scenarios where there is a gradual and progressive increase in ICP, such as in brain tumors. We aimed to assess and compare the cardiac function in patients with primary supratentorial brain tumors presenting with and without raised ICP for neurosurgery.
View Article and Find Full Text PDFIntroduction: Mannitol is widely used in neurosurgical units to mitigate raised intracranial pressure and cerebral edema, crucial in postoperative management. Its hyperosmolar properties reduce brain extracellular fluid, thereby altering cerebral perfusion and cardiac dynamics. However, the temporal and combined effects of mannitol on cardiovascular and cerebrovascular parameters remain inadequately explored in postoperative settings.
View Article and Find Full Text PDFThe treatment of infections caused by carbapenem-resistant organisms is challenging. Carbapenems in combination with vaborbactam and relebactam are recommended to treat infections caused by extensively drug-resistant organisms including carbapenemase-producing isolates, while ceftazidime-avibactam plus aztreonam, or cefiderocol is recommended for infections caused by New Delhi metallo beta-lactamase (NDM)-producing . As, in India, except for ceftazidime-avibactam and aztreonam, the other drugs are not approved for marketing, in this case report, the role of a double carbapenem regimen (ertapenem plus meropenem) in the treatment of carbapenem-resistant infections has been presented.
View Article and Find Full Text PDFObjectives: Nursing postoperative neurosurgical patients with head of bed (HOB) elevation beyond 30° might be desired at times to prevent pulmonary complications. Due to the paucity of studies determining the effect of HOB beyond 30° on cerebral perfusion pressure (CPP), cerebral blood flow (CBF), and regional cerebral oxygenation (rSO2), this study was designed.
Methods: A total of 40 patients following elective neurosurgery for supratentorial tumors were studied in the neurosurgical intensive care unit three hours following admission.
Background: During transnasal transsphenoidal pituitary surgery (TNTSS), the primary objective is to maintain stable hemodynamics while ensuring ideal surgical conditions. This study aimed to investigate the effect of nebulized dexmedetomidine on hemodynamic parameters and the quality of the surgical field during TNTSS.
Methods: Seventy-five patients scheduled for TNTSS were randomized into three groups of 25 each and received preoperative nebulization with 5 mL of nebulizing fluid consisting of 1.
Objectives: The utility of intraoperative electrocorticography (ECoG)-guided resective surgery for pediatric long-term epilepsy-associated tumors (LEATs) with antiseizure medication (ASM) resistant epilepsy is not supported by robust evidence. As epilepsy networks and their ramifications are different in children from those in adults, the impact of intraoperative ECoG-based tailored resections in predicting prognosis and influencing outcomes may also differ. We evaluated this hypothesis by comparing the outcomes of resections with and without the use of ECoG in children and adults by a randomized study.
View Article and Find Full Text PDFJ Clin Monit Comput
June 2024
Purpose: Cerebral arteriovenous malformations (AVM) represent focal abnormal areas of low resistance circulation which render the peri-nidal neuronal tissue susceptible to ischemia. The post-excision cerebral perfusion surge can result in hyperaemic complications.We hypothesised that Near Infrared Spectroscopy (NIRS)-guided perioperative management can aid in the prediction and prevention of perioperative complications in patients presenting for surgical excision of cerebral AVMs.
View Article and Find Full Text PDFBackground: Some patient positions employed to facilitate neurosurgery can compromise cerebral venous drainage and lead to increased intracranial pressure, intraoperative bleeding, and brain bulge. This study evaluated the impact of different surgical positions on internal jugular vein (IJV) flow as a measure of cerebral venous drainage and on optic nerve sheath diameter (ONSD) as an indirect assessment of intracranial pressure.
Methods: Ninety patients scheduled for elective primary brain tumor resection surgery were included in 3 groups of 30 each according to the surgical position: supine, prone, or lateral.
In India, rice ( L.) is cultivated under a variety of climatic conditions. Due to the fragility of the coastal ecosystem, rice farming in these areas has lagged behind.
View Article and Find Full Text PDFNeurosurgical patients with cervical spine pathologies, craniofacial and craniovertebral junction anomalies, recurrent cervical spine, and posterior fossa surgeries frequently present with an airway that is anticipated to be difficult. Although the routine physical evaluation is nonaerosol-generating, Mallampati scoring, mouth opening, and assessment of lower cranial nerve function could potentially generate aerosols, imposing a greater risk of acquiring severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection. Moreover, airway evaluation requires the patient to remove the mask, thereby posing a greater risk to the assessing anesthesiologist.
View Article and Find Full Text PDFThree species of Malaysian edible seaweed () were analyzed for their carotenoid composition using a combination of high-performance thin layer chromatography (HPTLC) and ultra-high-performance liquid chromatography-electrospray ionization-tandem mass spectrometry (UHPLC-ESI-MS/MS), while the antioxidant capacities were determined by 2,2-diphenyl-1-picrylhydrazyl (DPPH) and oxygen radical absorbance capacity (ORAC) assays. The HPTLC analysis exhibited a distinct carotenoid pattern among the three seaweed groups. The UHPLC-ESI-MS/MS analysis showed fucoxanthin as the major carotenoid present in while lutein and zeaxanthin in .
View Article and Find Full Text PDFBrain abscess is a rare neurological complication in patients with congenital cyanotic heart disease (CCHD). Perioperative complications are high in patients with CCHD. We evaluated incidence of and risk factors for perioperative complications and their impact on clinical outcomes in patients with CCHD undergoing brain abscess surgery with monitored anesthesia care (MAC) or general anesthesia (GA).
View Article and Find Full Text PDFDexmedetomidine could be a suitable adjuvant in neuroanesthesia due to its analgesic and anesthetic-sparing properties with the added advantage of facilitating intraoperative neuromonitoring. However, its recovery profile is still debated upon, as in neuroanesthesia, a prompt recovery is essential for postoperative neurologic assessment. We designed this study to evaluate the effect of dexmedetomidine on the anesthetic and recovery profile of patients presenting for supratentorial neurosurgeries.
View Article and Find Full Text PDFBackground: The cardiovascular complications associated with type 2 diabetes mellitus could be attributed to changes in myocardial mitochondrial metabolism. Though it is a known fact that permeabilized cardiac muscle fibers and isolated mitochondria are metabolically compromised in the Caucasian population, studies of Asian Indian myocardial mitochondrial function are lacking. Thus, the objective of the present study is to analyze if there is altered cardiac mitochondrial substrate utilization in diabetic Asian Indians.
View Article and Find Full Text PDFObjective: Pharmacologically induced electroencephalogram (EEG) silence increases tolerance of ischemic period by reducing cerebral metabolism. We hypothesized that sevoflurane, a cerebral vasodilator, will maintain cerebral blood flow (CBF) and cerebral metabolic rate of oxygen (CMRO) better than propofol, a cerebral vasoconstrictor, during EEG silence. To validate this, we compared the effect of sevoflurane and propofol on CBF and CMRO during surgical plane of anasthesia (SP) and burst suppression on EEG (BS).
View Article and Find Full Text PDFPatients with acute aneurysmal subarachnoid hemorrhage (aSAH) experience excruciating headache that is difficult to manage in resource-constrained settings. Pregabalin's (β-isobutyl-GABA) analgesic, antiepileptic, and antiemetic properties make it an attractive adjuvant in pain management for these patients. We conducted a double-blind, placebo-controlled, randomized clinical trial on 40 aSAH patients undergoing aneurysmal clipping to assess the effect of perioperative pregabalin in decreasing perioperative headache, anesthetic, and opioid requirement.
View Article and Find Full Text PDFJ Neurosurg Anesthesiol
April 2019
Morphology influences the functionality of covalent organic networks and determines potential applications. Here, we report for the first time the use of Zincke reaction to fabricate, under either solvothermal or microwave conditions, a viologen-linked covalent organic network in the form of hollow particles or nanosheets. The synthesized materials are stable in acidic, neutral, and basic aqueous solutions.
View Article and Find Full Text PDFComposites of calamitic and bent-core nematic molecules exhibiting a nematic to nematic-gel transformation have been investigated using thermal, electrical, X-ray, and mechanical probes. The studies focusing on the Frank elastic behavior show a surprising result that the thermal behavior of the threshold voltage and the dependent splay elastic constant (K11) are remarkably different in temperature regions identified as weak and strong gels. In the former gel, the parameters exhibit values significantly smaller than the higher-temperature fluid nematic, effectively canceling out the underlying thermal variation due to the order parameter.
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