Biology, Engineering, Medicine and Science Reports

What Else Do You Do? Neurosurgery and Beyond: A Perspective on Trainee and Staff Well-being and Feeling Valued

Chandrasekaran Kaliaperumal — Wed, 18 Sep 2024 00:00:00 +0000

Dear Editor-in-chief

I write this letter to focus on various aspects of valuing a team and team building in this time and age where attrition is at its peak.1,2 Since COVID-19 pandemic, the perspective of work ethos has changed with a significant rise in mental health issues, burn out and healthcare workers quitting their jobs across the globe.

After spending a decade as a Consultant Neurosurgeon in the National Health Service (NHS), I strongly feel that setting safe boundaries with colleagues and trainees, staff well-being and being valued as a member of the team are aspects that compliments delivering the best and safe neurosurgical care to the patients pari passu. As often said, it is easy to divorce one’s spouse but not your colleague (if you are in a job, with a potentially long retirement period ahead!). Read more . . .

Delayed Recovery of Bilateral Supplementary Motor Area Syndrome After the Resection of a Central Neurocytoma

Wed, 18 Sep 2024 00:00:00 +0000

Supplementary Motor Area (SMA) syndrome is a rare complication following brain tumor (localized in the supplementary motor area) removal and is characterized by temporary paralysis and mutism. These symptoms typically resolve within hours to days. This case report challenges the typical presentation of SMA Syndrome. We report a unique case where a patient developed right dense hemiplegia (severe weakness on one side of the body) and mutism after resection of an intraventricular central neurocytoma (a benign tumor within the brain's fluid-filled cavities). This deviates from the usual transient nature of SMA syndrome. This case report delves into the extended duration of these post-surgical symptoms in this patient. It compares the case with existing literature on SMA syndrome to understand the reasons behind this atypical presentation. By analysing similar cases, we aim to shed light on potential factors that might influence the severity and duration of recovery in SMA syndrome. This case highlights the importance of considering variations in SMA syndrome presentation. It emphasizes the need for further research to improve our understanding of the factors influencing recovery patterns after surgery in this region of the brain.

Neurologist and Neurosurgeon: A ‘Sine Qua Non’ in Paediatric Intracranial Pathology Management

Wed, 18 Sep 2024 00:00:00 +0000

Specialist care providers often treat complex, life-threatening intracranial paediatric pathologies and team-based clinical decisions by neurologists and neurosurgeons are vital for good clinical outcomes. We describe six scenarios highlighting multi-disciplinary team-based management of challenging paediatric conditions which provided successful outcomes. This work may aide future management of similar cases.

The Use of Non-Invasive Halo System (NIHS) in Atlantoaxial Rotatory Subluxation/Fixation in Childhood (AARS/AARF): Case Series

Hariss G Paremes Sivam, Chandrasekaran Kaliaperumal, Jothy Kandasamy — Wed, 18 Sep 2024 00:00:00 +0000

The use of conventional Halo braces was frequently accompanied by complications owing to the invasive nature of the stabilization pins. Hence interest in Non-Invasive Halo System (NIHS) gathered pace, but its therapeutic ability in providing clinically resonant stabilization with a better safety profile, remains to be established. We performed a retrospective review of 2 patients treated for Type 1 AARS/AARF in childhood with the help of immobilization provided by the NIHS and reflected on a previous case of AOD which was successfully managed with the NIHS. We reviewed the patients’ clinical and operation case notes to collect data regarding the reason for admission, indications for orthotic management, follow-up regimen, challenges associated with the NIHS and weaning plan. The NIHS was a clinically effective and safe method for realignment and stabilization of paediatric atlanto-axial and atlanto-occipital subluxation. with sustainable radiological and physical alignment, that was well tolerated by the patients. Due to the lack of invasive pins, the pressure points were instead translated to the skin on bony prominences, as our patients experienced varying degrees of compromises to their skin, hence careful attention is required for the best type of padding and pressure distribution to protect the patient’s skin.

Colchicine: A New Dawn for Preventing Complications After Heart Attack? Unveiling its Network Pharmacology and the COLD-MI Trial

Arun HS Kumar — Wed, 18 Sep 2024 00:00:00 +0000

Acute myocardial infarction, or heart attack, remains a significant cause of morbidity and mortality globally. Despite substantial advancements in acute management, the residual risk of recurrent coronary events, including myocardial infarction, stroke, and heart failure, poses a substantial challenge. This persistent threat underscores the imperative for ongoing research into novel therapeutic strategies to improve patient outcomes. The recently published COLD-MI trial results has generated significant interest by highlighting the potential of colchicine, a readily available and inexpensive medication, in preventing complications after a heart attack. This report delves into the rationale behind the COLD-MI trial, scrutinizes its findings, and explores the implications in correlation with network pharmacology of colchicine for future clinical practice.

Chiropractic - Is it Worth the Taxpayer’s Expense as an NHS Service?

Ikenna Idika Ogbu, Chandrasekaran Kaliaperumal — Wed, 18 Sep 2024 00:00:00 +0000

Chiropractic remains a service provided outside the NHS in the United Kingdom and the argument for inclusion has been ongoing since the 90’s. There are significant patient-reported benefits from chiropractic backed by evidence in specific use-cases as cervicogenic headaches and there are significant potential cost-savings from the inclusion of chiropractic as an NHS service. The evidence, however, does not particularly favour the use case of chiropractic, especially in the context of Low Back Pain (LBP) and the benefits of chiropractic are unclear. Considering the potential cost-savings for the NHS and the society, there should be consideration for its inclusion. However, the evidence will need to be clearer to argue for inclusion of chiropractic in the NHS spectrum of services, especially for spinal services.

Balancing the Risks and Benefits of GLP-1 Agonists for Weight Loss

Arun HS Kumar — Wed, 18 Sep 2024 00:00:00 +0000

The emergence of GLP-1 agonists has revolutionized the management of type 2 diabetes and obesity. Their efficacy in inducing weight loss and improving glycaemic control is undeniable. However, the rapid expansion of their use necessitates a cautious approach, given the potential for adverse effects. GLP-1 agonists mimic the actions of the incretin hormone, glucagon-like peptide-1. While their therapeutic benefits are substantial, concerns have arisen regarding the long-term safety profile of GLP-1 agonists. Gastrointestinal adverse effects, such as nausea, vomiting, and diarrhoea, are common but often resolve with continued use. However, more severe gastrointestinal complications, including pancreatitis and gallbladder disease, have been reported. Despite these potential adverse effects, GLP-1 agonists remain valuable tools in the management of type 2 diabetes and obesity. However, their use should be carefully considered on an individual basis, with regular monitoring for any adverse reactions. Healthcare providers must maintain vigilance and engage in open communication with patients to optimize treatment outcomes while minimizing risks. As our understanding of GLP-1 agonists evolves, continued research is imperative to elucidate their long-term safety profile and identify patient populations at increased risk of adverse events.