Neurosurgery and pregnancy

Pregnant patients rarely present with neurosurgical emergencies, but can cause significant morbidity and mortality to the mother and the foetus. Physiological changes of pregnancy in relevance to neurosurgery, effects of anaesthetic agents on the foetus, common neurosurgical emergencies, and anaesthetic implications both from obstetric and neurosurgical point of view are discussed in this review

Extrapulmonary tuberculosis: A retrospective study in Eastern India based on diagnostic modalities

Background: The most common site of tubercular infection is lungs, but various extrapulmonary sites also can be affected by tuberculosis (TB). Very few fine-needle aspiration-based studies supplemented by cartridge-based nucleic acid amplification test (CBNAAT) and radiology have been conducted in any center of tribal-based area situated in Eastern India. Materials and Methods: Sixty extrapulmonary TB cases (28 males and 32 females) received during 3 years (May 2018–April 2021) were included in this study. Results: Diagnoses of different extrapulmonary tubercular lesions were: lymphadenitis (n = 27), cold abscess (n = 18), breast abscess (n = 2), epididymitis (n = 4), oral cavity (n = 3), spine, long bone (n = 2 cases each) and fingertip and TB of the penis (n = 1 case each). Forty-six cases were diagnosed by fine-needle aspiration cytology. CBNAAT diagnosed ten cases where the result of aspiration cytology was inconclusive. Radiology directly diagnosed four cases, whereas it helped another seven cases indirectly to clinch the proper diagnosis of extrapulmonary tubercular lesions. Conclusion: Tuberculous lymphadenitis was the most common extrapulmonary lesion. Females outnumber male cases. Aspiration cytology aided by CBNAAT and radiology proved indispensable to diagnose extrapulmonary tubercular lesions, especially for economically constrained persons

Neurosurgery in morbidly obese patients

Obesity has significant impact on various organ systems of the body and thus needs a well-planned anaesthetic management. Obese patients with multiple co morbidities are expected to have more complications than normal individuals. Obesity may influence the risk of aneurysm formation and rupture and/or the outcome of patients who have aneurysmal SAH. Most of the neurosurgeries require different patient positions for adequate exposure of surgical site. Moreover morbidly obese patient means a huge and heavy patient who will require bigger operating table and other accessories and their implications. Confusion regarding the risks and benefits of mechanical and pharmacological prophylaxis in neurosurgical patients for DVT with risks of major and minor haemorrhage still persists. The anesthetic concerns in an obese patient undergoing neurosurgery have not been studied so far. This review aims in discussing obesity in neurosurgical patients

Resonant Enhancement of Polymer-Cell Optostimulation by a Plasmonic Metasurface

Organic semiconductors have shown great potential as efficient bioelectronic materials. Specifically, photovoltaic polymers such as the workhorse poly(thiophene) derivatives, when stimulated with visible light, can depolarize neurons and generate action potentials, an effect that has been also employed for rescuing vision in blind rats. In this context, however, the coupling of such materials with optically resonant structures to enhance those photodriven biological effects is still in its infancy. Here, we employ the optical coupling between a nanostructured metasurface and poly(3-hexylthiophene) (P3HT) to improve the bioelectronic effects occurring upon photostimulation at the abiotic-biotic interface. In particular, we designed a spectrally tuned aluminum metasurface that can resonate with P3HT, hence augmenting the effective field experienced by the polymer. In turn, this leads to an 8-fold increase in invoked inward current in cells. This enhanced activation strategy could be useful to increase the effectiveness of P3HT-based prosthetic implants for degenerative retinal disorders.</p

Resonant Enhancement of Polymer–Cell Optostimulation by a Plasmonic Metasurface

Organic semiconductors have shown great potential as efficient bioelectronic materials. Specifically, photovoltaic polymers such as the workhorse poly(thiophene) derivatives, when stimulated with visible light, can depolarize neurons and generate action potentials, an effect that has been also employed for rescuing vision in blind rats. In this context, however, the coupling of such materials with optically resonant structures to enhance those photodriven biological effects is still in its infancy. Here, we employ the optical coupling between a nanostructured metasurface and poly(3-hexylthiophene) (P3HT) to improve the bioelectronic effects occurring upon photostimulation at the abiotic–biotic interface. In particular, we designed a spectrally tuned aluminum metasurface that can resonate with P3HT, hence augmenting the effective field experienced by the polymer. In turn, this leads to an 8-fold increase in invoked inward current in cells. This enhanced activation strategy could be useful to increase the effectiveness of P3HT-based prosthetic implants for degenerative retinal disorders