Preoperative coil localization for spinal surgery is accurate, safe and effective: a single-centre initial experience.

OBJECTIVE AND STUDY DESIGN: This is a retrospective, descriptive study of consecutive patients undergoing novel preoperative pushable coil localization for spinal surgery, in order to evaluate its feasibility, safety and accuracy. METHODS: Consecutive patients who underwent pre-operative coil marking for spinal surgery at our institution from May 2018 to July 2021 were included. Data were collected for coil placement, accuracy, complications and fluoroscopy usage. Patient demographic and relevant perioperative and procedural data were also collected. RESULTS: A total of 34 patients were identified of which 32 (94%) had complete data and imaging at last clinical follow up, with a mean duration of 13.9 months. There were no incorrect level surgeries performed. There were no coil-related complications found in our cohort. CONCLUSIONS: Preoperative coil placement is an accurate, safe and well-tolerated method for level localization in spinal surgeries.

The utility of arterial spin labelled perfusion-weighted magnetic resonance imaging in measuring the vascularity of high grade gliomas - A prospective study.

Background: Dynamic susceptibility contrast (DSC) perfusion weighted imaging (PWI) currently remains the gold standard technique for measuring cerebral perfusion in glioma diagnosis and surveillance. Arterial spin labelling (ASL) PWI is a non-invasive alternative that does not require gadolinium contrast administration, although it is yet to be applied in widespread clinical practice. This study aims to assess the utility of measuring signal intensity in ASL PWI in predicting glioma vascularity by measuring maximal tumour signal intensity in patients based on pre-operative imaging and comparing this to maximal vessel density on histopathology. Methods: Pseudocontinuous ASL (pCASL) and DSC images were acquired pre-operatively in 21 patients with high grade gliomas. The maximal signal intensity within the gliomas over a region of interest of 100 mm2 was measured and also normalised to the contralateral cerebral cortex (nTBF-C), and cerebellum (nTBF-Cb). Maximal vessel density per 1 mm2 was determined on histopathology using CD31 and CD34 immunostaining on all participants. Results: Using ASL, statistically significant correlation was observed between maximal signal intensity (p < 0.05) and nTBF-C (p < 0.05) to maximal vessel density based on histopathology. Although a positive trend was also observed nTBF-Cb, this did not reach statistical significance. Using DSC, no statistically significant correlation was found between signal intensity, nTBF-C and nTBF-Cb. There was no correlation between maximal signal intensity between ASL and DSC. Average vessel density did not correlate with age, sex, previous treatment, or IDH status. Conclusions: ASL PWI imaging is a reliable marker of evaluating the vascularity of high grade gliomas and may be used as an adjunct to DSC PWI.

Removal of Biomass and Nutrients by Weeds and Direct-Seeded Rice under Conservation Agriculture in Light-Textured Soils of North-Western India.

The escalating scarcity of irrigation water, transplantation of rice on light-textured soils and labour cost acted as major drivers for the transition towards direct-seeded rice (DSR) cultivation from the conventionally flooded transplanting system. Despite these advantages, DSR is a challenge in light texture soil due to heavy weed infestation and a slight decline in crop yield. The weeds compete for nutrients and have an adverse effect on the growth and yield of crops. Hence, to assess the removal of macro and micronutrients by weeds and direct-seeded rice, a field experiment was carried out on sandy loam soil for two consecutive Kharif seasons (2018 and 2019). Three treatments from rice, namely: DSR under zero tillage (DSR-ZT), DSR under conventional tillage (DSR-CT) and DSR under reduced tillage (DSR-RT) were taken as main plots with three tillage treatments in wheat, namely: Conventional tillage without rice straw (CTW-R), Zero tillage without rice straw (ZTW-R) and Zero tillage with straw as mulch using Happy Seeder (ZTW+R) as subplots, replicated thrice. Among the rice establishment methods, DSR-RT showed an edge in terms of rice grain and straw yield (6.18 and 8.14 Mg ha-1, respectively) as well as macro- and micronutrient uptake by rice. Under management practices, ZTW+R proved as an efficient strategy in terms of yield and nutrient uptake by crops. The contribution of weeds towards biomass production was maximum under the ZTW-R (9.44%) treatment followed by DSR-ZT (7.72%). The nutrient budgeting showed that macro- and micronutrient removal by weeds was minimum under reduced tillage (24.51 and 50.35%, respectively), whereas it was 21.88 and 44.87% when wheat was grown under conventional tillage without rice straw. In overall, the research study concluded that weeds on an average remove 25.65 % macronutrients (N, P, K) and 51.47% of micronutrients (Zn, Cu, Fe and Mn) in DSR under rice-wheat cropping system.

Early postoperative colonic ventriculoperitoneal shunt migration with trans-anal protrusion: A unique case report.

INTRODUCTION AND IMPORTANCE: Colonic ventriculoperitoneal shunt (VPS) migration with trans-anal protrusion remains uncommon. Patients may be asymptomatic, and diagnosis may only be made on visualization of the prolapsed catheter from the anus. This unique case of early post-operative trans-anal shunt protrusion highlight the possibility of this rare complication specially when shunt revision accompanies bowel surgery. CASE PRESENTATION: The authors present a case of early postoperative colonic shunt migration in a thirteen-year-old female with who underwent Malone Antegrade Continence Enema (MACE) with concomitant revision of the distal part of the peritoneal catheter. She presented two weeks post operatively with shunt catheter protruding from the anus. This was noticed by her carer and she was asymptomatic on her presentation. CLINICAL DISCUSSION: Delayed post-operative shunt related bowel perforation and trans-anal shunt protrusion is an uncommon complication after ventriculoperitoneal shunting. Most cases present months after surgery and majority are asymptomatic on presentation. The exact pathophysiology is not established, and mechanisms have been proposed. Early post -operative trans-anal shunt protrusion is rare and suggests inadvertent occult bowel injury especially when shunt placement or revision accompanies extensive bowel surgery. CONCLUSION: The authors recommended shunt imaging within the first two to three weeks after shunt revision in patient who undergo concomitant bowel surgery with risk of inadvertent bowel injury to identify early colonic migration and avoid its potentially fatal sequelae.