Rapid Shallow Breathing Index and Ultrasonographic Diaphragmatic Parameters as Predictors of Weaning Outcome in Critically Ill Patients on Mechanical Ventilation.

Background: Successful weaning is a crucial element in care toward critically ill patients on mechanical ventilation. An attempt was made to propose and assess a reliable predictor of weaning outcome.

Materials And Methods: A prospective observational study was conducted on 76 patients on mechanical ventilation, assessed by Acute Physiology and Chronic Health Evaluation II (APACHE II) score.

Expanded phenotypic spectrum in MODY 5 patients with 17q12 deletion syndrome: experience from an Indian tertiary care hospital.

Objectives: To study the clinical and genotypic spectrum of patients with deletions (MODY 5) at a tertiary care hospital.

Methods: This study included four patients from the Department of Endocrinology at Sher-i-Kashmir Institute of Medical Sciences Srinagar with a strong clinical suspicion of MODY 5. Genetic analysis, including a monogenic gene panel comprising 78 genes associated with MODY and other similar forms of monogenic diabetes, was done.

Diagnosis and management of pediatric acute liver failure: consensus recommendations of the Indian Society of Pediatric Gastroenterology, Hepatology, and Nutrition (ISPGHAN).

Timely diagnosis and management of pediatric acute liver failure (PALF) is of paramount importance to improve survival. The Indian Society of Pediatric Gastroenterology, Hepatology, and Nutrition invited national and international experts to identify and review important management and research questions. These covered the definition, age appropriate stepwise workup for the etiology, non-invasive diagnosis and management of cerebral edema, prognostic scores, criteria for listing for liver transplantation (LT) and bridging therapies in PALF.

A survey of the prevalence and patterns of neuropsychological assessment practices across epilepsy surgery centers in India: Toward establishing a national guideline.

Neuropsychology plays an important role in optimizing epilepsy management, but there are no practice guidelines for low- and middle-income countries with emerging services. The National Epilepsy Surgery Support Activity Network (NESSAN), a national working group that supports and optimizes epilepsy surgery programs in India, explored the present status of pre- and post epilepsy surgery neuropsychological assessment practices across India as an initial step in developing national evidence-based test guidelines. An online survey was conducted using two questionnaires, one for neurologists and the second for neuropsychologists and speech-language pathologists working in epilepsy surgery centers.

Facial nerve electrical motor evoked potential in cerebellopontine angle tumors for its anatomical and functional preservation.

Background: Among the technical measures to preserve facial nerve (FN) function, intraoperative neuromonitoring has become mandatory and is constantly being scrutinized. Hence, to determine the efficacy of FN motor evoked potentials (FNMEPs) in predicting long-term motor FN function following cerebellopontine angle (CPA) tumor surgery, an analysis of cases was done.

Methods: In 37 patients who underwent CPA surgery, FNMEPs through corkscrew electrodes positioned at C5-C6 and C6-C5 (C is the central line of the brain as per 10-20 EEG electrode placement) were used to deliver short train stimuli and recorded from the orbicularis oculi, oris, and mentalis muscles.

Clinical, Microbiological Profile, and Treatment Response to Intraventricular Antibiotics in the Management of Postneurosurgical Meningitis: A Single-Center Experience.

Background:  Postneurosurgical meningitis (PNM) is a serious medical condition with high mortality and morbidity caused by Gram positive organisms like and Gram-negative organisms like . Optimum concentration of antibiotics in the cerebrospinal fluid (CSF) to treat these infections is difficult to achieve. Intraventricular antibiotic administration bypasses the blood-brain barrier and can achieve high CSF concentration without causing systemic toxicity.

A Case Report of Caudal Migration of a Lumbar Epidural Catheter Confirmed by Doppler Ultrasound: Ultrasound to the Rescue!

Combined spinal-epidural anaesthesia is an excellent technique for providing intraoperative and postoperative analgesia in patients undergoing total knee arthroplasty. Epidural catheters threaded through a Tuohy needle with a cephalad needle bevel orientation follow a winding pattern within the epidural space. Caudal or downward migration of an epidural catheter may lead to unsatisfactory anaesthesia and epidural failure.

Author Response.

Vaithialingam B, Gopal S, Masapu D. Author Response. Indian J Crit Care Med 2024;28(1):87-88.

Correlation between choroid plexus carcinoma and Li-Fraumeni syndrome: implications of TP53 mutations and management strategies-a case-based narrative review.

Background: Choroid plexus carcinomas (CPCs) are rare, aggressive grade 3 tumors of the central nervous system associated with Li-Fraumeni syndrome (LFS) in a notable percentage of cases due to TP53 germline mutations. Understanding the correlation between CPCs and LFS is crucial for tailored management strategies. However, distinguishing CPCs from benign choroid plexus papillomas (CPPs) remains challenging, relying largely on histologic features.

Spring-Assisted Cranial Expansion for Multisuture Craniosynostosis: First Case Report from the Indian Subcontinent.

We present a first use case report from the Indian subcontinent of a 5-month-old child with multisuture craniosynostosis with raised intracranial pressure managed by spring-assisted cranial expansion followed by traditional fronto-orbital advancement and cranial vault remodeling. We emphasize the advantages of spring-assisted cranial expansion in extremely young infants with raised intracranial pressure over posterior vault distraction osteogenesis and open posterior vault remodeling.

Intra-operative Safety of an Autonomous Robotic System for Total Knee Replacement: A Review of 500 Cases in India.

Background: Manual total knee arthroplasty (TKA) has been documented several times for their safety and complications data. In contrast, there is a limited evidence-based analysis for safety and complications of autonomous robotic-assisted (RA)-TKA. This study aimed to evaluate the safety features and intra-operative surgical complications associated with the use of Cuvis Joint™ autonomous robotic system for TKA.

An Approach to Investigations of Chronic Liver Disease.

Chronic liver disease (CLD) in children is more diverse compared to adults with respect to the etiology, progression and response to therapy. After history and clinical examination, the first step is to confirm the presence of CLD with basic blood investigations and ultrasonography. Markers of portal hypertension are splenomegaly, increased portal vein diameter, thrombocytopenia and presence of varices on endoscopy.

"Locked-in State" Following Anterior Circulation Aneurysmal Subarachnoid Hemorrhage.

Vaithialingam B, Gopal S, Masapu D. "Locked-in State" Following Anterior Circulation Aneurysmal Subarachnoid Hemorrhage. Indian J Crit Care Med 2023;27(8):601-602.

Comparison of hands-free Trans-nasal Humidified Rapid Insufflation Ventilatory Exchange (THRIVE) with conventional facemask ventilation technique for oxygenation in patients undergoing electroconvulsive therapy - A cross over study.

Objectives: Modified ECT is routinely conducted using face mask (FM) and bag ventilation technique. Trans-nasal Humidified Rapid Insufflation Ventilatory Exchange (THRIVE) is a novel hands-free insufflation technique that provides oxygenation and prolongs apnoea time. There is limited literature comparing the two techniques.