Avoidance and Management of Complications in Retrosigmoid Approach to Vestibular Schwannomas.

An experience with two rare complications during surgery of vestibular schwannomas (VSs) is presented, and measures to avoid and manage the complications are discussed.Case A: Spinal cord ischemia in semi-sitting position: A 47-year-old with a giant vestibular schwannoma (VS) underwent surgery through a retrosigmoid approach in the semi-sitting position. The intraoperative phase was uneventful, except for an episode of moderate hypotension.

Thoracic Epidural Chronic Inflammatory Lesion: A Case Report and Review of Literature.

Chronic inflammatory lesions (CIL) in the body are rare and inflammatory pseudotumor (IPT) is a subtype of CIL. Spine is an uncommon location of CIL, with most cases reported in the thoracic spine. Our objective was to review the current literature on IPT.

Nail Society of India Recommendations for Treatment of Onychomycosis in Special Population Groups.

Onychomycosis (OM) is a difficult-to-treat condition, especially considering the limited armamentarium of antifungal drugs, need for prolonged treatment, and poor compliance. This problem is further confounded while treating OM in special populations such as children, elderly, immunosuppressed patients, pregnant or lactating women, and patients with chronic liver or kidney disease. In the absence of standardized treatment guidelines, the antifungal therapy is either withheld or compromised, as it is largely governed by personal preferences or based on anecdotal reports.

Treatment Strategies and Current Results of Petroclival Meningiomas.

Petroclival meningiomas (PCMs) are complex skull-base tumors that continue to pose a formidable surgical challenge to neurosurgeons because of their deep-seated location/intimate relationship with the brainstem and neurovascular structures. The advent of stereotactic radiosurgery (SRS), along with the shifting of management goals from complete radiological cure to maximal preservation of the patient's quality of life (QOL), has further cluttered the topic of "optimal management" in PCMs. Not all patients with PCM need treatment ("watchful waiting").

Nail Society of India (NSI) Recommendations for Pharmacologic Therapy of Onychomycosis.

Onychomycosis (OM) is the commonest cause of dystrophic nails, responsible for upto 50% of cases. Apart from significantly damaging the nails, quality of life, and self-image of the sufferer, it also acts as a reservoir of fungal infections carrying important implications for emerging recalcitrant dermatophytoses. Treatment of OM is based on guidelines released almost a decade back, in addition to published literature and personal preferences.

Tuberculosis of the Spinal Cord.

Tuberculosis involving the spinal cord is associated with high mortality and disabling long-term sequelae. Although tuberculous radiculomyelitis is the most frequent complication, pleomorphic clinical manifestations exist. Diagnosis can be challenging among patients with isolated spinal cord tuberculosis due to diverse clinical and radiological presentations.

SRS for Vestibular Schwannomas - Current Status.

Stereotactic radiosurgery (SRS) is an established modality of treatment for vestibular schwannomas (VS). We aim to summarize the evidence-based use of SRS in VSs and address the specific considerations pertaining to the same, along with our own clinical experiences. A thorough review of the literature was done to gather evidence regarding the safety and efficacy of SRS in VSs.

Significance of Dosimetric Parameters in Patients Undergoing Gamma Knife Radiosurgery for Vestibular Schwannoma.

Unlabelled: Vestibular schwannoma (VS) is a benign, encapsulated, and slow-growing tumor of the myelin-forming cells of the 8th cranial nerve. Gamma Knife radiosurgery (GKRS) has become a widely accepted primary treatment modality for small- to medium-sized VSs. In the case of VS, highly conformal, precisely focused radiation is delivered to the acoustic tumor in a single session under the direct supervision of a radiosurgery team.

Targeted exome sequencing in South Indian patients with Familial hypercholesterolemia.

Background: Familial hypercholesterolemia (FH) is an autosomal dominant genetic disorder with elevated LDL-C levels which can ultimately lead to premature Coronary Artery Disease (CAD).

Objectives: In presence of limited genetic data on FH in India, the present study was aimed to determine the mutation spectrum in Indian FH patients using a targeted exome sequencing.

Methods: 54 FH cases (31 index cases + 23 extended family members) were categorized according to Dutch Lipid Clinic Network Criteria (DLCNC).

Intensive Care in India in 2018-2019: The Second Indian Intensive Care Case Mix and Practice Patterns Study.

Background: We aimed to study organizational aspects, case mix, and practices in Indian intensive care units (ICUs) from 2018 to 2019, following the Indian Intensive Care Case Mix and Practice Patterns Study (INDICAPS) of 2010-2011.

Methods: An observational, 4-day point prevalence study was performed between 2018 and 2019. ICU, patient characteristics, and interventions were recorded for 24 hours, and ICU outcomes till 30 days after the study day.

Microsurgery of Giant Intracranial Aneurysm: A Single Institution Outcome Study.

Background: Giant intracranial aneurysms (GIAs) are treacherous lesions and in spite of the many advances, endovascular therapy (EVT) of GIAs is challenging.

Objective: A retrospective analysis of our results with microsurgery of GIAs is presented to examine the role of microsurgery in the current trend of EVT.

Materials And Methods: Between 1996 and 2019, 134 patients with 147 GIAs had microsurgery by the senior author in a single institute.

'To reveal or to conceal'- Disclosure strategies in parents of children with epilepsy in India.

Purpose: Disclosure of epilepsy is a relevant but under-researched topic in epilepsy research. This study was done to assess the disclosure strategies in parents of CWE in a developing country with conservative culture. The study also assessed the influence of demographic factors and seizure characteristics on the choice of disclosure.

Diagnosis and Management of Osteoarticular Tuberculosis: A Drastic Change in Mind Set Needed-It is Not Enough to Simply Diagnose TB.

Background: In the era of increasing drug resistance in pulmonary tuberculosis (TB), it is prudent to assess causes of poor response to anti tubercular therapy (ATT) and drug sensitivity pattern (DSP) in osteoarticular TB.

Materials And Methods: As a part of Bombay Orthopaedic society's research project, members were asked to refer non responders to ATT to our institute. Cases were enrolled from October 2010 to March 2014.

Society of Onco-Anesthesia and Perioperative Care (SOAPC) advisory regarding perioperative management of onco-surgeries during COVID-19 pandemic.

Coronavirus disease 2019 (COVID-19) has gripped the world and is evolving day by day with deaths every hour. Being immunocompromised, cancer patients are more susceptible to contract the infection. Onco-surgeries on such immunocompromised patients have an increased risk of infection of COVID-19 to patients and health care workers.

Meningioma in a patient with Werner syndrome.

Werner syndrome (WS), also known as adult progeria, is extremely rare, with about 1300 known cases in the world, with over 1000 of these in Japan. It occurs due to loss of function mutations in the WRN gene located on chromosome 8p12. WS is characterized by premature aging and increased risk of neoplasms, with meningiomas being the commonest intracranial tumor.

Indian consensus on gastroesophageal reflux disease in adults: A position statement of the Indian Society of Gastroenterology.

The Indian Society of Gastroenterology developed this evidence-based practice guideline for management of gastroesophageal reflux disease (GERD) in adults. A modified Delphi process was used to develop this consensus containing 58 statements, which were generated by electronic voting iteration as well as face-to-face meeting and review of the supporting literature primarily from India. These statements include 10 on epidemiology, 8 on clinical presentation, 10 on investigations, 23 on treatment (including medical, endoscopic, and surgical modalities), and 7 on complications of GERD.

Indian consensus on chronic constipation in adults: A joint position statement of the Indian Motility and Functional Diseases Association and the Indian Society of Gastroenterology.

The Indian Motility and Functional Diseases Association and the Indian Society of Gastroenterology developed this evidence-based practice guideline for management of chronic constipation. A modified Delphi process was used to develop this consensus containing 29 statements, which were generated by electronic voting iteration as well as face to face meeting and review of the supporting literature primarily from India. These statements include 9 on epidemiology, clinical presentation, and diagnostic criteria; 8 on pathophysiology; and the remaining 12 on investigations and treatment.

Fosfomycin Susceptibility in Urinary Tract Enterobacteriaceae.

Introduction: Antibiotic treatment of Urinary Tract Infections (UTI) is becoming increasingly difficult due to emergence of multi-drug resistant (ESBLs, AmpC, CRE) uropathogens. Fosfomycin is an old antibiotic that has evoked renewed interest with unique properties of not sharing any structural similarity and lack of cross-resistance with other antimicrobial agents. Our aim is to evaluate in-vitro activity of Fosfomycin against urinary tract Enterobacteriaceae.

Emergency Surgery for Refractory Status Epilepticus.

Background: Management of refractory status epilepticus in children is extremely challenging.

Case Characteristics: Two children with medically refractory status epilepticus, both of whom had lesional pathology on MRI and concordant data on EEG and PET scan.

Intervention: Emergency hemispherotomy performed in both patients.

Unusual Asymptomatic Fluorodeoxyglucose Avid Pheochromocytoma in a Case of Myxoid Liposarcoma of the Extremity on -F Fluorodeoxyglucose Positron Emission Tomography-computed Tomography.

Sarcomas are a heterogeneous group of rare tumors and arise either from soft tissue or from bone. Soft-tissue sarcomas (STSs) initially metastasize to the lungs. Metastases to extrapulmonary sites such as liver, brain, and soft tissue distant from primary tumor usually develop later.

Importance of Therapeutic Drug Monitoring of Rifampicin.

Therapeutic Drug Monitoring (TDM) is a routinely practised clinical laboratory technique which aids the clinicians with a clear clinical judgement of the drug therapy and optimize the doses if necessary. Rifampicin is the most important and potent component of first line therapy of tuberculosis (TB). Several factors like age, weight, gender, doses and formulations, gastro-intestinal disorders, ethnicity etc alter the absorption and bioavailability of rifampicin thus altering the drug levels.

Musculoskeletal melioidosis: An under-diagnosed entity in developing countries.

Background: Melioidosis is a saprophytic infectious disease caused by Gram-negative soil-dwelling bacillus Burkholderia pseudomallei.

Materials & Methods: We report three cases of musculoskeletal melioidosis that are presented to our department from 2011 to 2013.

Results: One of the patients died due to post-septicemic ARDS.