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Byline: Jitin. Bajaj, Shashikant. Verma, Vivek. Chaudhary, Namrata. Khandelwal, Jayant. Patidar, Ketan. Hedaoo, Mallika. Sinha, Mukesh. Sharma, Rajeev. Kukrele, Diya. Bajaj, Nishtha. Yadav, Shailendra. Ratre, Vijay. Parihar, Prashant. Yadav, Pawan. [...]

Intracranial tumors are a common cause of mortality in the pediatric population; therefore, accurate and timely diagnosis is crucial. This article highlights the role of squash cytology in diagnosing pediatric intracranial tumors and its correlation with histopathology. A retrospective analytical study was conducted from April 2022 to August 2023. A total of 70 samples were collected for both intraoperative squash cytology and histopathology. Rapid Papanicolaou and hematoxylin-eosin staining kits were used for cytology, while hematoxylineosin staining was used for histopathological examination. To reduce bias, the histopathology reports were generated by a separate team of pathologists. Among the 70 pediatric patients with intracranial space-occupying lesions, 41 cases were neoplastic and 29 were nonneoplastic. Of the 41 neoplastic cases, 22 were supratentorial and 19 were infratentorial. Pilocytic astrocytoma was the most common pediatric intracranial tumor, followed by medulloblastoma. Squash cytology demonstrated high diagnostic accuracy, with a sensitivity of 97.60%, specificity of 96%, positive predictive value of 97.60%, negative predictive value of 96%, and overall accuracy of 97.13%. A limitation of this study was the unavailability of immunohistochemistry for all cases. Squash cytology provides valuable information about the adequacy of the sample, the etiology, and tumor grade. As a sensitive diagnostic test, squash cytology can improve the prognosis for pediatric patients with intracranial tumors in India and globally. [ABSTRACT FROM AUTHOR]

Byline: Yad. Yadav, Jitin. Bajaj, Shailendra. Ratre, Nishtha. Yadav, Vijay. Parihar Background: Endoscopic chronic subdural hematoma (CSDH) evacuation is a safe and effective alternative to the conventional burr hole technique. [...]

Squash cytology serves as a rapid intraoperative tool for the diagnosis of spinal lesions. However, the presence of fibrous elements and bony spicules can sometimes pose challenges to interpretation. Although another intraoperative diagnostic tool, frozen section, is available, the soft, friable nature and high-water content of tissue can hinder the preparation of good-quality frozen sections. This highlights the need to further explore the utility of squash cytology for the intraoperative diagnosis of spinal lesions. Our study emphasizes the importance of squash cytology in the diagnosis of spinal lesions. A retrospective analytical study was conducted at the Department of Neuropathology at a tertiary hospital in India. A total of 64 samples were collected for intraoperative squash cytology, followed by biopsies for histopathological correlation. Statistical analysis was performed, and various parameters like sensitivity, specificity, and diagnostic accuracy of squash cytology were calculated, with histopathology serving as the gold standard. Out of the 64 patients suspected of having spinal lesions, 39 cases (60.93%) were neoplastic. The mean age of presentation was 37.5 years, with no sex predilection. The most common spinal tumor was schwannoma (10 cases, 15.62%), followed by meningioma (6 cases, 9.37%). Concordance between squash cytology and histopathology was found in 60 cases (93.75%), with histopathology serving as the reference standard. The sensitivity, specificity, and diagnostic accuracy were 94.73%, 96.15%, and 95.31%, respectively. Squash cytology is a rapid, inexpensive, and reasonably accurate intraoperative diagnostic test for spinal lesions. When combined with clinical and radiological correlation, it demonstrates high diagnostic accuracy. [ABSTRACT FROM AUTHOR]

Pilocytic astrocytoma (PA) is a low-grade glial tumor and the most common pediatric intracranial tumor, typically located in the infratentorial region. The cerebellum is the most frequent site for PA, and it usually affects children and young adults. While PA can arise anywhere in the central nervous system, its occurrence in the ventricles, particularly the lateral ventricles, is exceptionally rare, accounting for approximately 4% of all pilocytic tumors. We present a series of three cases with the uncommon intraventricular location of PA and an unusual presentation in old age in one of the cases. Due to its unusual location and unexpected age of presentation, intraventricular PA (IVPA) can be misinterpreted in adults. Some IVPAs are highly vascular, and patients may experience profuse intraoperative blood loss if the tumor is not identified on preoperative imaging. Therefore, we aim to highlight the occurrence of such unusual presentations of IVPA, as very few cases have been reported in the literature. It is essential to consider IVPA in adult patients with calcified intraventricular lesions. [ABSTRACT FROM AUTHOR]

Byline: Yad. Yadav, Jitin. Bajaj, Shailendra. Ratre, Nishtha. Yadav, Vijay. Parihar, Narayan. Swamy, Ambuj. Kumar, Ketan. Hedaoo, Mallika. Sinha Background: Endoscopic third ventriculostomy (ETV) has become a proven modality for [...]

Byline: Mallika. Sinha, Jitin. Bajaj, Ambuj. Kumar, Ketan. Hedaoo, Sandeep. Sharma, Kamesh. Konchada, Shailendra. Ratre, Vijay. Parihar, Narayan. Swamy, Yad. Yadav Background: Lumboperitoneal shunt is a known procedure for communicating [...]

Byline: Jitin. Bajaj, Shailendra. Ratre, Yad. Yadav Background and Introduction: C2 transverse process exostoses are rare lesions. Due to critical structures surrounding them, their excision is challenging. There are sparse [...]

Byline: Jitin. Bajaj, Ramesh. Doddamani, Sarat. Chandra, Shailendra. Ratre, Vijay. Parihar, Yadram. Yadav, Dhananjaya. Sharma Background: Migraine is a common form of primary neurologic headache. Many patients are chronic migraineurs [...]

Byline: Shailendra. Ratre, Yad. Yadav, M. Swamy, Vijay. Parihar, Jitin. Bajaj Background and Introduction: Endoscopic anterior cervical approach has several advantages compared to conventional anterior cervical discectomy and fusion (ACDF). [...]

Byline: Yad. Yadav, Vijay. Parihar, Shailendra. Ratre, Amitesh. Dubey, Sonpal. Jindel, Mashoo. Dubey Although most of the cases of atlanto-axial dislocation (AAD) and basilar invasion can be managed by posterior [...]

Byline: Shailendra. Ratre, Nishtha. Yadav, Vijay. Parihar, Amitesh. Dubey, Yad. YadavIntroduction: Although there are controversies about the optimal management of spontaneous intracerebral hemorrhage (ICH), benefits of endoscopic procedures in ICH [...]

Byline: Yad. Yadav, Shailendra. Ratre, Vijay. Parihar, Amitesh. Dubey, Mashoo. Dubey Symptomatic ventral cervical cord compressions have been treated by anterior discectomy with fusion, anterior corpectomy and fusion, discectomy with [...]

Colloid cysts are mucous- or hyaloid-filled lesions with an outer fibrous layer. These are rare developmental and nonneoplastic malformation. They may be found incidentally, while some cases may present with intermittent headache, rapid neurologic deterioration, drop attacks, and even sudden death. Early recognition of this disease may result in lesser mortality. Here, we present a 22-year-old male with a history of fall while driving his two-wheeler. A diagnosis of colloid cyst of the third ventricle with a head injury was made. Colloid cyst presenting with a head injury is exceedingly rare with only five case reports in the literature. This report may help to support surgical intervention in an asymptomatic patient, as the cyst can predispose head injury with serious consequences. It also stresses the importance of a high degree of suspicion when there is any well-defined radiological abnormality in the region of the third ventricle. A colloid cyst may easily be confused with intracranial hemorrhage due to hyperdensity in head trauma. It can be distinguished by the presence of an accompanying traumatic lesion. The cyst usually has well-defined round margins, and the morphologic appearance and density do not change on a follow-up computed tomography (CT) scan, whereas in hemorrhage the density usually regresses with clinical improvement on serial imaging. [ABSTRACT FROM AUTHOR]

Background: With the growing incidence of liver cirrhosis among Asians, the use of a biomarker such as prolactin indicates the severity of the disease, its complications, and serves as a tool for the early intervention. Aims and Objectives: The aims of this study were to assess the correlation of serum prolactin level to the Child-Pugh Scoring System in liver cirrhosis patients and to find out its prognostic importance in liver cirrhosis. Materials and Methods: This is a cross-sectional study including 60 patients of liver cirrhosis. Complete history taking, physical examination, and relevant investigations were done. Frequency and percentage were calculated and Chi-square test was applied for significance. Correlation was assessed using Spearman’s correlation coefficient. Results: Mean age was 44±12.8 years. Cirrhosis was alcohol induced in 55%, hepatitis B related in 18.3%, and other causes related in 7.8%. Mean prolactin levels were 18.1±11.3 μg/l. Strong positive correlation was found between prolactin level and bilirubin level (rs=0.372, P=0.003) and prolactin level and prothrombin time (rs=0.490, P=0.003). Statistically significant association was found between Child-Pugh score and prolactin level (x2=12.2, P=0.003). We found no significant association of prolactin level with age, albumin, creatinine, ascites, esophageal varices, etiology of cirrhosis, and hepatic encephalopathy. Conclusion: We observed that there was a strong correlation between Child- Pugh score and serum prolactin level. Although, Child-Pugh scoring system is a predictor of morbidity in liver cirrhosis patients, serum prolactin level can also be used as an indicator for predicting patients at high risk of developing complications and mortality due to liver cirrhosis. [ABSTRACT FROM AUTHOR]

Background: Epilepsy carries a lifetime risk of seizure-related accidents. The risk varies according to the socioeconomic profile of a place. Sufficient data is lacking for epilepsy-related accidents in the pediatric population.Objective: We aimed to identify the proportion of pediatric epileptic patients who met with accidents and their associated factors.Methods: A prospective study was done. Patients of less than 18 years with epilepsy of more than 1-year duration were included and were given a questionnaire modified for the pediatric population. The demography of accidents during seizures and drugs taken were recorded.Results: 135 epileptic children were included. 70.4% of patients suffered seizure-related accidents ranging from 1-10 accidents in their epilepsy duration. Falls (83.15%) were the most common, 25.26% of them required hospitalization. Accidents due to missing of drug dosage were observed in 23% patients.Conclusion: Seizure-related accidents are common in the pediatric population, and may lead to major accidents. Better epilepsy management with extra care for high-risk epilepsy patients may decrease their incidents. [ABSTRACT FROM AUTHOR]

Background Surgery for thalamic lesions has been considered challenging due to their deep-seated location. Endoscopic excision of deep-seated brain tumors using tubular retractor has been shown to be safe and effective in prior studies; however, there are limited reports regarding its use for thalamic tumors. We present our experience of endoscope-controlled resection of thalamic tumors using a tubular retractor. Material and Methods This was a prospective observational case series done at a tertiary center specialized for endoscopic neurosurgery during the period from 2010 to 2019. Surgeries were performed under the endoscopic control using a silicon tubular retractor. Lesions were approached transcortically or trans-sulcally. Data were collected for the extent of resection, amount of blood loss, operative time, need for conversion to microscopy, and complications. Results Twenty-one patients of thalamic masses of 14- to 60-year age underwent the surgeries. Pathologies ranged from grade I to IV gliomas. Gross total and near-total resection could be done in 42.85% of cases for each group. The average blood loss and operative time were164.04 ± 83.63 mL and 157.14 ± 28.70 minutes, respectively. Complications included a small brain contusion, two transient hemipareses, and one transient speech deficit. Conclusion Endoscopic excision of thalamic tumors using a tubular retractor was found to be a safe and effective alternative to microscopic resection. [ABSTRACT FROM AUTHOR]

Byline: Yad. Yadav, Shailendra. Ratre, Vijay. Parhihar, Amitesh. Dubey, Neil. Dubey Although posterior approaches are being used frequently in most atlantoaxial dislocations (AAD), anterior decompression is also required in some [...]

Byline: Yad. Yadav, Vijay. Parihar, Shailendra. Ratre, Yatin. Kher, Pushp. Bhatele Background: Cervical spondylotic myelopathy, radiculopathy and myeloradiculopathy can be managed by laminoforaminotomy, or bilateral decompression using posterior approach in [...]

Byline: Yad. Yadav, Vijay. Parihar, Shailendra. Ratre, Yatin. Kher Background: Although microscopic anterior cervical discectomy with or without fusion are common surgical procedures for treatment of cervical herniated discs, loss [...]