ABSTRACT
Background:Accuracy of ventriculoperitoneal shunt with the development of frameless neuronavigationin the field neurosurgery has been validated in different parts of the world. The objective of this study was to compare the success of electromagnetic (EM) navigation system on ventriculoperitoneal (VP) shunt versus standard shunt placement in patients with hydrocephalus.Methods:This randomized controlled trial was carried out in the Department of Neurosurgery, Multan. This study was approved by the Ethical Review Committee of Nishtar Hospital Multan. Study subjects were selected after an informed consent. Patients were grouped as (A) who received EM and (B) who received routine shunt surgery. Patients with shunts were followed up at the end of 3 months and post-operative CT was performed at the end of 3 months. Both groups were compared in terms of success by using chi-square test.Results:Among 100 study cases, mean GCS was 12.30±1.85 (with minimum GCS was 9 while maximum was 15) and mean duration of hydrocephalus was noted to be 6.80±2.02 weeks. Forty five (45%) were presented with mild hydrocephalus while 55 (55%) presented with moderate hydrocephalus. Grade outcome (post-operative) was noted in 78 (78%) of our study cases, grade 2 in 18 (18%) while grade 3 (failure) was noted in only 4 (4%).Conclusions: The usage of electromagnetic (EM) navigation on ventriculoperitoneal (VP) shunt is safe and reliable which is beneficial for optimal positioning and trajectory of ventricular catheters in adult patients with hydrocephalus.
ABSTRACT
Abstract In this study for the first-time microbial communities in the caves located in the mountain range of Hindu Kush were evaluated. The samples were analyzed using culture-independent (16S rRNA gene amplicon sequencing) and culture-dependent methods. The amplicon sequencing results revealed a broad taxonomic diversity, including 21 phyla and 20 candidate phyla. Proteobacteria were dominant in both caves, followed by Bacteroidetes, Actinobacteria, Firmicutes, Verrucomicrobia, Planctomycetes, and the archaeal phylum Euryarchaeota. Representative operational taxonomic units from Koat Maqbari Ghaar and Smasse-Rawo Ghaar were grouped into 235 and 445 different genera, respectively. Comparative analysis of the cultured bacterial isolates revealed distinct bacterial taxonomic profiles in the studied caves dominated by Proteobacteria in Koat Maqbari Ghaar and Firmicutes in Smasse-Rawo Ghaar. Majority of those isolates were associated with the genera Pseudomonas and Bacillus. Thirty strains among the identified isolates from both caves showed antimicrobial activity. Overall, the present study gave insight into the great bacterial taxonomic diversity and antimicrobial potential of the isolates from the previously uncharacterized caves located in the world's highest mountains range in the Indian sub-continent.