Surgery for Central Nervous System Tuberculosis in Children.

Tuberculosis (TB) is the second most common cause of death due to a single infectious agent worldwide after COVID-19. Central nervous system tuberculosis is widely prevalent in the world, especially in the developing countries and continues to be a socioeconomic problem. It is highly devastating form of tuberculosis leading to unacceptable levels of morbidity and mortality despite appropriate antitubercular therapy.

Age Estimation Based on CT Chest Analysis of Ossification of the Xiphisternal Joint in a Living Population Aged 35-50 in a Tertiary Setup.

Introduction Age estimation has been an area of special interest in the medicolegal context because of its necessity in various criminal and civil cases like assaults, murders, rapes, inheritance, insurance claims, etc. While legal documents are useful in daily activities that require age identity, they cannot be relied on for criminal and civil proceedings because of being falsifiable and inaccessible to some people. Scientific methods of age determination like physical, dental, and radiological examinations are used for reliable age estimation due to their universal and non-falsifiable nature.

A Pilot, Prospective, Randomized-Controlled Study to Evaluate the Efficacy and Safety of Arsha Hita™ in the Treatment of Anal Fissures.

Introduction Anal fissures are tears in the anal canal that cause pain, bleeding, and spasms. They can be treated with non-operative options such as sitz baths, local anesthetics, topical nitrates, oral fiber, and calcium channel blockers, but some patients require surgery. Topical nitrates have side effects such as severe headaches, while topical calcium channel blockers can cause itching.

Specific Learning Disabilities in India: Current Situation and the Path Ahead.

Students with specific learning disabilities (SpLD) need timely remedial education and provisions to continue their education within the main-stream. The Government of India has enacted the Rights of Persons with Disabilities (RPwD) Act, 2016, and legitimized SpLD as a disability, nationally. This Act mandates screening of every school student for SpLD on completion of eight years of age, setting up of resource rooms for imparting remedial education in all schools, and provisions in examinations for all afflicted students.

Clinical and genetic spectrum of 104 Indian families with central nervous system white matter abnormalities.

Genetic disorders with predominant central nervous system white matter abnormalities (CNS WMAs), also called leukodystrophies, are heterogeneous entities. We ascertained 117 individuals with CNS WMAs from 104 unrelated families. Targeted genetic testing was carried out in 16 families and 13 of them received a diagnosis.

Successful Dual-Patch Closure of a Fistula between the Right Pulmonary Artery and the Left Atrium.

A fistula between the right pulmonary artery and the left atrium is a very rare congenital anomaly, for which there is no definitive embryogenetic explanation. Patients present with cyanosis or clubbing, and the treatment strategy is to close the fistula, which can be done by an open surgical technique or by percutaneous intervention. Although rare, this condition should be considered in the differential diagnosis when evaluating a patient with central cyanosis.

Is the Sac Waiting to Rupture? Sinus of Valsalva Aneurysm.

Completely asymptomatic sinus of Valsalva aneurysms are rare entities, and there is no consensus regarding their management. We present the case of a patient who underwent atrial septal defect device closure at 5 years of age and was lost to follow-up, then presented 6 years later with unruptured sinus of Valsalva aneurysm and was closely followed. The aneurysm eventually ruptured and was successfully operated on with good outcomes.

Mesial temporal lobe epilepsy - An overview of surgical techniques.

Mesial temporal lobe epilepsy is one of the commonest indications for epilepsy surgery. Presurgical evaluation for drug resistant epilepsy and identification of appropriate candidates for surgery is essential for optimal seizure freedom. The anatomy of mesial temporal lobe is complex and needs to be understood in the context of the advanced imaging, ictal and interictal Video_EEG monitoring, neuropsychology and psychiatric considerations.

Atypical rabies encephalitis in a six-year-old boy: clinical, radiological, and laboratory findings.

A 6-year-old boy from India developed an atypical form of rabies following a stray dog bite and as a consequence of not receiving the standard World Health Organization recommended post-exposure prophylaxis for category III wounds. Serial rising rabies virus neutralizing antibody titres in serum and cerebrospinal fluid by rapid fluorescent focus inhibition test helped confirm the diagnosis of rabies. The child has survived for 4 months since the onset of illness, albeit with neurological sequelae.

Atlas shrugged: cervical myelopathy caused by congenital atlantoaxial dislocation aggravated by child labor.

Background: Symptomatic atlantoaxial dislocation is common in predisposing genetic or acquired disorders. However, an isolated atlantoaxial dislocation frequently is congenital and silent unless discovered during course of evaluation for neurological symptoms of cervical spinal cord injury attributed to minor or chronic, repetitive trauma.

Patient: A 12-year-old girl working as a farm laborer developed calf pain provoked by walking, which increased in severity and progressed to involve the upper limbs.

Medulloblastoma in childhood-King Edward Memorial hospital surgical experience and review: Comparative analysis of the case series of 365 patients.

Aim: Medulloblastoma is one of the most common posterior fossa tumors in childhood. The treatment-related side effects as well as predictive outcome still remain as a major challenge. The improved understanding of the disease and advances in molecular biology is changing the treatment paradigms from Chang's staging system to molecular risk stratification.

Brain abscess: an overview.

Intracranial abscess is a formidable entity. Despite the advent of newer antibiotics and surgical strategies, the overall outcome and quality of life issues in brain abscess patients still remain a continuous challenge for the neurosurgical community. It is a direct interplay between the virulence of the offending microorganism and the immune response of the host.

Massive benign osteoblastoma of the suboccipital bone and foramen magnum region.

Benign osteoblastoma is an uncommon primary bone tumor frequently found in the vertebral column and long tubular bones, and rarely occurring in the calvarium. A case of a massive benign osteoblastoma of the suboccipital bone and foramen magnum region in a 9-year-old boy is reported. He presented with progressively worsening nuchal pain and headaches secondary to a bony lesion in the suboccipital and foramen magnum region.

Tuberculous temporal brain abscess mimicking otogenic pyogenic abscess.

Tuberculous brain abscess is a rare manifestation of central nervous system tuberculosis. We report the case of a tuberculous temporal lobe abscess in a 14-year-old female child that mimicked an otogenic pyogenic brain abscess. The patient had no prior history of tuberculosis.

Supratentorial convexity dural-based cavernous hemangioma mimicking a meningioma in a child.

A case of a convexity dural-based cavernous hemangioma in a 15-year-old male child is reported. The child presented only with headaches and had no neurological deficits. MRI features were suggestive of a meningioma.

Immediate postoperative regression of retroodontoid pannus after lateral mass reconstruction in a patient with rheumatoid disease of the craniovertebral junction. Case report.

The authors report the case of a 35-year-old man who had polyarthritic affliction with rheumatoid disease. He presented with complaints of quadriparesis that had progressed over the course of 2 years. Investigations revealed telltale evidence of rheumatoid disease of the craniovertebral junction with retroodontoid pannus, basilar invagination, and "fixed" atlantoaxial dislocation.

Intramedullary cervical neurenteric cyst mimicking an abscess.

We describe a cervical intramedullary neurenteric cyst in a 12-year-old male patient who presented with gradual onset and progressively worsening neck pain, spastic quadriparesis and impaired sensation in the C(2) dermatome. MR imaging revealed a well-defined peripherally enhancing cystic intramedullary lesion with a posteroinferior enhancing nodule at the C(2)-C(3) level mimicking an abscess. There was no evidence of spinal dysraphism.

Posterior fossa dermoid cyst in a patient with Goldenhar syndrome.

A 7-year-old boy with Goldenhar syndrome was diagnosed to have a posterior cranial fossa dermoid cyst. The presence of such a combination of clinical entities has not been reported earlier. The embryonic dysgenesis causing midline posterior fossa dermoid and other anomalies observed in Goldenhar syndrome occur between the third and fifth week of intrauterine life and are probably interrelated.