Browsing by Author "Vilanilam, GC"

Now showing 1 - 8 of 8
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    Are Indian neuroscience clinicians perishing without publishing?
    (NEUROLOGY INDIA, 2015) Vilanilam, GC; Sudhir, BJ; Kumar, KK; Abraham, MA; Nair, SN
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    BEYOND THE LEARNING CURVE IN EPILEPSY SURGERY: THE INSTITUTIONAL AND INDIVIDUAL PERSPECTIVE
    (EPILEPSIA, 2011) Vilanilam, GC; Abraham, M; Menon, G; Rao, RM; Nair, S; Radhakrishnan, K
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    Cited heavily, taken lightly, matters hardly
    (NEUROLOGY INDIA, 2016) Vilanilam, GC; Gopalakrishnan, MS; Misra, S; Chatterjee, N
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    Development and Evaluation of Expandable Brain Retractor with Tunable Expansion Ratio
    (Trends in Biomaterial and Artificial Organs, 2022-01) Prajapati, AK; Vilanilam, GC; Muraleedharan, CV
    The brain tumor treatment is challenging and requires highly skilled neurosurgeon. These tumors are surgically excised by isolating them from normal tissue using surgical retractors. The retractors provide maximal and safe exposure of the surgical field to the surgeon, which is evolved from the handheld retraction system. The majority of brain surgeries use Leyla and Greenberg retract. This traditional retractor induced ischemia, edema and parenchymal trauma are well known, which result in brain tissue injury in up to 29% of cases. The authors conceptualized a single unit circumferential 360-degree expansion mechanism to reduce brain injuries. Further, the surface area is optimized to keep brain tissue retraction pressure within the limit of Leyla retractor. The design equations are derived for smooth manufacturing and a simple locking mechanism maintains retractor to certain deployed diameter in a stable and steady manner. The device is prototyped, and the concept is verified against analytical models. It is conceived as a cost-effective, efficient, and easily manufacturable concept using design equations. The findings demonstrate the advantage of the proposed retractor over existing retractors. The retractor aims to provide optimal retraction pressure, facile handling, universal size, and workspace between the retractor flanges. Its applications may also extend to other surgical specialities and visceral organ sites.
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    Subclinical respiratory dysfunction in chronic cervical cord compression: a pulmonary function test correlation
    (Neurosurgical Focus, 2016) Bhagavatula, ID; Bhat, DI; Sasidharan, GM; Mishra, RK; Maste, PS; Vilanilam, GC; Sathyaprabha, TN
    OBJECTIVE Respiratory abnormalities are well documented in acute spinal cord injury; however, the literature available for respiratory dysfunction in chronic compressive myelopathy (CCM) is limited. Respiratory dysfunction in CCM is often subtle and subclinical. The authors studied the pattern of respiratory dysfunction in patients with chronic cord compression by using spirometry, and the clinical and surgical implications of this dysfunction. In this study they also attempted to address the postoperative respiratory function in these patients. METHODS A prospective study was done in 30 patients in whom cervical CCM due to either cervical spondylosis or ossification of the posterior longitudinal ligament (OPLL) was diagnosed. Thirty age-matched healthy volunteers were recruited as controls. None of the patients included in the study had any symptoms or signs of respiratory dysfunction. After clinical and radiological diagnosis, all patients underwent pulmonary function tests (PFTs) performed using a standardized Spirometry Kit Micro before and after surgery. The data were analyzed using Statistical Software SPSS version 13.0. Comparison between the 2 groups was done using the Student t-test. The Pearson correlation coefficient was used for PFT results and Nurick classification scores. A p value < 0.05 was considered significant. RESULTS Cervical spondylotic myelopathy (prolapsed intervertebral disc) was the predominant cause of compression (n = 21, 70%) followed by OPLL (n = 9, 30%). The average patient age was 45.06 years. Degenerative cervical spine disease has a relatively younger onset in the Indian population. The majority of the patients (n = 28, 93.3%) had compression at or above the C-5 level. Ten patients (33.3%) underwent an anterior approach and discectomy, 11 patients (36.7%) underwent decompressive laminectomy, and the remaining 9 underwent either corpectomy with fusion or laminoplasty. The mean preoperative forced vital capacity (FVC) (65%) of the patients was significantly lower than that of the controls (88%) (p < 0.001). The mean postoperative FVC (73.7%) in the patients showed significant improvement compared with the preoperative values (p = 0.003). The mean postoperative FVC was still significantly lower than the control value (p = 0.002). The mean preoperative forced expiratory volume in 1 second (FEV1) (72%) of the patients was significantly lower than that of the controls (96%) (p < 0.001). The mean postoperative FEV1 (75.3%) in the cases showed no significant improvement compared with the preoperative values (p = 0.212). The mean postoperative FEV1 was still significantly lower than the control value (p < 0.001). The mean postoperative FEV1/FVC was not significantly different from the control value (p = 0.204). The mean postoperative peak expiratory flow rate was significantly lower than the control value (p = 0.01). The mean postoperative maximal voluntary ventilation was still significantly lower than the control value (p < 0.001). On correlating the FVC and Nurick scores using the Pearson correlation coefficient, a negative correlation was found. CONCLUSIONS There is subclinical respiratory dysfunction and significant impairment of various lung capacities in patients with CCM. The FVC showed significant improvement postoperatively. Respiratory function needs to be evaluated and monitored to avoid potential respiratory complications.
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    The Effect of Gabapentin Premedication on Postoperative Nausea, Vomiting, and Pain in Patients on Preoperative Dexamethasone Undergoing Craniotomy for Intracranial Tumors
    (JOURNAL OF NEUROSURGICAL ANESTHESIOLOGY, 2013) Misra, S; Parthasarathi, G; Vilanilam, GC
    Background:In patients undergoing craniotomy, the incidence of postoperative nausea and vomiting (PONV) is 55% to 70% and that of moderate to severe postoperative pain is 60% to 84%. We hypothesized that gabapentin plus dexamethasone would be superior, compared with placebo and dexamethasone in reducing the incidences of PONV and pain after craniotomy.Methods:Patients undergoing craniotomy received either placebo (group D) or gabapentin (600 mg) (group GD) premedication orally, 2 hours before induction of anesthesia. In addition, all patients received 4 mg of intravenous dexamethasone on the morning of surgery and continued receiving it after every 8 hours. The 24-hour incidence of nausea, emesis, or PONV (nausea, emesis, or both) (primary outcome) and postoperative pain scores (secondary outcome) were analyzed with the (2) test and the Wilcoxon rank-sum test as applicable.Results:A significant difference was observed between the groups in the incidence of nausea (odds ratio [OR], 0.23; 95% confidence interval [CI], 0.07, 0.80; P=0.02), PONV (OR, 0.3; 95% CI, 0.08, 0.8; P=0.02), and the requirement for antiemetics (OR, 0.30; 95% CI, 0.09, 0.9; P=0.03). The number of emetic episodes were also reduced in group GD, but this did not assume statistical significance (OR, 0.34; 95% CI, 0.10, 1.1; P=0.06). However, there was no significant difference in either the postoperative pain scores or the opioid consumption between the 2 groups.Conclusions:A dosage of 600 mg of gabapentin plus 4 mg of dexamethasone significantly reduced the 24-hour incidence of nausea and PONV. However, there was no reduction in either the postoperative pain scores or opioid consumption.
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    Women and Neuroscience Publishing: Is the Gender Gap closing in?
    (NEUROLOGY INDIA, 2016) Vilanilam, GC; Easwer, HV; Vimala, S; Radhakrishnan, A; Devi, BI; Nair, SN