Perioperative Considerations for Revascularization and Non-Revascularization Surgeries in Moyamoya Disease

Moyamoya disease is a rare, progressive cerebrovascular occlusive disease; characterized by narrowing of the distal internal carotid arteries and their branches. The incidence is high in East Asians and most commonly presents in the first and fourth decade of life. Its symptoms are headaches, seizures, transient neurological deficits, and cognitive decline. Medical management is based on treating the symptoms and includes antiplatelet and anti-seizure medications. Surgical revascularization is the mainstay of treatment. Unique pathophysiology of moyamoya disease necessitates neuro-anesthesiologists to formulate an individualized plan perioperatively. The overriding goal of perioperative anesthetic management of moyamoya disease is to ensure optimal cerebral perfusion and protection. Maintenance of normotension, normocarbia, normo-oxygenation, normothermia, and euvolemia is the cornerstone during the perioperative period. Perioperative adequate analgesia is crucial to prevent cerebral ischemia and allows close neurological monitoring. This chapter reviews perioperative anesthetic management of patients with moyamoya disease

Principles of Anesthesia and Airway Management in Head and Neck Surgery

This topic aims to discuss key aspects of anesthetic and airway management for head and neck surgery. Airway management is a central part of patient care and management in Head and Neck Surgery. Common challenges in Head and Neck surgery are shared airway, distorted airway anatomy due to existing pathology; risk of airway obstruction, disconnection or loss of airway intra-operatively; risk of soiling of the airway due to bleeding and surgical debris; and the potential for airway compromise post-operatively. The option for airway management technique is influenced by patient’s factors, anesthetic needs, and surgical requirements. Intubation technique necessitating either a small or large cuffed tracheal tube with a throat pack provides the highest level of airway protection Non-intubation or open airway techniques involve mask ventilation, apneic techniques, and insufflation techniques, or the use of a laryngeal mask airway. Lastly, jet ventilation techniques may be conducted via a supraglottic, subglottic or transtracheal routes. It is essential to have clear airway management plans including rescue airway strategies that should be communicated with the surgeons and patients at the earliest opportunity

Lumpy skin disease of cattle : an emerging problem in the Sultanate of Oman

Lumpy skin disease (LSD) is a highly infectious disease of cattle caused by a virus belonging to the Capripoxvirus genus of the family Poxviridae. The purpose of this study is to place on record the first confirmation of LSD in the Sultanate. The disease was diagnosed and confirmed using polymerase chain reaction, histopathology, transmission electron microscopy and serum neutralization testing. The epizootic occurred in 2009 involving a large number of animals and covering a wide area including Nezwa, Alqabel, Sohar, Saham and Burimi. Morbidity and mortality rates of 29.7 and 26.3 %, and 13.6 and 15.4 % were observed at Nezwa and Sohar, respectively. The clinical signs were much more severe in Holstein–Friesian cattle compared to indigenous breeds and were characterized by multiple skin nodules covering the neck, back, perineum, tail, limbs and genital organs. Affected animals also exhibited lameness, emaciation and cessation of milk production. Oedema of limbs and brisket, and superficial lymph node enlargement were highly prominent. It is not known from where the virus originated, or how it spread to the Sultanate. The disease has become endemic in the country and is liable to extend to other Gulf Cooperation Council Countries and cause a pandemic. It is of major concern to the Omani dairy industry. Due to the widespread presence of screw worm, serious economic losses can follow outbreaks.South African ARChttp://link.springer.com/journal/11250hb201

Nanodiagnostics for tuberculosis detection

Introduction Tuberculosis (TB) is a leading killer worldwide. End TB strategy aims at ending the TB epidemic by 2030. Early, accurate, and affordable diagnosis represents a cornerstone to achieve this goal. Innovative strategies for TB diagnostics have been introduced, however the ideal assay is yet unavailable and conventional methods remain necessary for diagnosis. Unique properties of nanoparticles (NPs) have allowed their utilization in TB detection via targeting disease biomarkers. Area Covered Until now, around thirty-five TB NP-based assays have been partially or fully characterized. Accuracy, low-cost, and short time-to-result represent the common properties of proposed platforms. TB nanodiagnostics now encompass almost all clinical aspects of the disease including active TB, non-tuberculous mycobacteria, rifampicin resistant TB, TB/HIV co-infection, latent TB, and extra-pulmonary TB. This review summarizes state-of-the-art knowledge of TB nanodiagnostics for the last 10 years. Special consideration is given for fabrication concepts, detection strategies, and clinical performance using various clinical specimens. The potential of TB nanodiagnostics to fulfill the need for ideal MTB testing is assessed. Expert Commentary TB nanodiagnostics show promise to be ideal detection tools that can meet the rigorous demands to end the TB epidemic by 2030