المؤلفون: Vahora, Farahin Y., Makwana, Milan C., Kumar Mishra, Manish, Vyas, Komal M.

المساهمون: University Grants Commission

المصدر: Chemical Engineering Journal ; volume 488, page 150806 ; ISSN 1385-8947

مصطلحات موضوعية: Industrial and Manufacturing Engineering, General Chemical Engineering, Environmental Chemistry, General Chemistry

الإتاحة: https://doi.org/10.1016/j.cej.2024.150806Test
https://api.elsevier.com/content/article/PII:S1385894724022939?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S1385894724022939?httpAccept=text/plainTest

المؤلفون: Makwana, Milan, Hussain, Humaira, Merola, Joseph P., Zaben, Malik, Jesurasa, Anthony R., Patel, Chirag, Leach, Paul

الوصف: Introduction Posterior fossa (PF) tumours are associated with vasogenic oedema causing symptoms of raised intracranial pressure. Preoperatively this is managed with dexamethasone. To minimise steroid related complications, the lowest effective dose should be administered. No neurosurgical guidelines exist for pre-operative dosing of dexamethasone in PF tumours. Methods A retrospective review was performed of surgically managed cases for patients under 16 years of age between 2013 and 2018 to ascertain the initial dose of dexamethasone with symptomatic PF tumours. Results Thirty-six patients were identified of which 30 notes were available. Sixteen were male. Median age was 6 years (range 10 months − 15 years). Twenty-two (73%) were referrals from DGH and 8 (27%) presented to our neurosurgical centre. All patients presented with symptomatic PF tumours including headache (97%), vomiting (93%), gait disturbance (43%), and nystagmus (17%). Four (13%) had papilloedema. Average initial stat dexamethasone dose was 9.15 mg; 0.31 mg/kg (range 1–16.7 mg; 0.05 − 1.77 mg/kg). Stratified according to weight, average dose (and range) was 8.8 mg; 0.94 mg/kg (1–16.6 mg; 0.13 − 1.77 mg/kg) in those weighing <10 kg; 9.7 mg; 0.66 mg/kg (4–16.7 mg; 0.21 − 1.35 mg/kg) in 10–20 kg; 12.3 mg;0.52 mg/kg (8–16.7 mg; 0.27 − 0.73mg/kg) in 20–30 kg and 7.8 mg; 0.17mg/kg (2–16.7 mg; 0.0 − 0.39 mg/kg) in >30 kg up to a maximum of 16.6 mg in any 24h period. These results suggest that dosage was higher in those children weighing less. PPI was used in 24 (80%) of cases. All doses were reduced after review by the neurosurgical team and a PPI added. Conclusion Pre-operative dexamethasone dosing does not always reflect the severity of clinical symptoms for PF tumours. Guidelines are required to correlate clinical symptoms with a suggested suitable dose of dexamethasone to prevent overdose and complications associated with corticosteroid use. We recommend a weight-based regimen as provided by the Food and Drug Administration. The current ...

وصف الملف: application/pdf

العلاقة: https://orca.cardiff.ac.uk/id/eprint/151474/1/BJN%20dex%20paper%20revision%2001.01.2022.pdfTest; Makwana, Milan https://orca.cardiff.ac.uk/view/cardiffauthors/A2548137B.htmlTest, Hussain, Humaira, Merola, Joseph P. https://orca.cardiff.ac.uk/view/cardiffauthors/A043386M.htmlTest, Zaben, Malik https://orca.cardiff.ac.uk/view/cardiffauthors/A453912I.htmlTest orcid:0000-0002-7446-4532 orcid:0000-0002-7446-4532, Jesurasa, Anthony R., Patel, Chirag and Leach, Paul 2022. Pre-operative dosing of dexamethasone for the management of children with posterior fossa tumours: are we getting it right? British Journal of Neurosurgery 36 (5) , pp. 609-612. 10.1080/02688697.2022.2040948 https://doi.org/10.1080/02688697.2022.2040948Test file https://orca.cardiff.ac.uk/id/eprint/151474/1/BJN%20dex%20paper%20revision%2001.01.2022.pdfTest

الإتاحة: https://doi.org/10.1080/02688697.2022.2040948Test
https://orca.cardiff.ac.uk/id/eprint/151474Test/
https://orca.cardiff.ac.uk/id/eprint/151474/1/BJN%20dex%20paper%20revision%2001.01.2022.pdfTest

المؤلفون: Merola, Joseph, Manivannan, Susruta, Ooi, Setthasorn, Chia, Wen Li, Makwana, Milan, Lang, Jozef, Leach, Paul, Zaben, Malik J.

الوصف: Background: Intracranial arachnoid cysts (AC) are benign, cerebrospinal fluid filled spaces within the arachnoid layer of the meninges. Neurosurgical intervention in children and young adults has been extensively studied, but the optimal strategy in the elderly remains unclear. Therefore, we performed a single center retrospective study combined with a systematic review of the literature to compare cystoperitoneal (CP) shunting with other surgical approaches in the elderly cohort. Methods: Retrospective neurosurgical database search between January 2005 and December 2018, and systematic review of the literature using PRISMA guidelines were performed. Inclusion criteria: Age 60 years or older, radiological diagnosis of intracranial AC, neurosurgical intervention, and neuroradiological (NOG score)/clinical outcome (COG score). Data from both sources were pooled and statistically analyzed. Results: Our literature search yielded 12 studies (34 patients), which were pooled with our institutional data (13 patients). CP shunts (7 patients; 15%), cyst fenestration (28 patients; 60%) and cyst marsupialisation/resection (10 patients; 21%) were the commonest approaches. Average duration of follow-up was 23.6, 26.9, and 9.5 months for each approach, respectively. There was no statistically significant association between choice of surgical intervention and NOG score (P = 0.417), COG score (P = 0.601), or complication rate (P = 0.955). However, CP shunting had the lowest complication rate, with only one patient developing chronic subdural haematoma. Conclusion: CP shunting is a safe and effective surgical treatment strategy for ACs in the elderly. It has similar clinical and radiological outcomes but superior risk profile when compared with other approaches. We advocate CP shunting as first line neurosurgical intervention for the management of intracranial ACs in the elderly.

وصف الملف: application/pdf

العلاقة: https://orca.cardiff.ac.uk/id/eprint/145478/1/SNI-12-624.pdfTest; Merola, Joseph https://orca.cardiff.ac.uk/view/cardiffauthors/A25568238.htmlTest, Manivannan, Susruta, Ooi, Setthasorn, Chia, Wen Li, Makwana, Milan https://orca.cardiff.ac.uk/view/cardiffauthors/A2548137B.htmlTest, Lang, Jozef, Leach, Paul https://orca.cardiff.ac.uk/view/cardiffauthors/A065325Y.htmlTest and Zaben, Malik J. https://orca.cardiff.ac.uk/view/cardiffauthors/A453912I.htmlTest orcid:0000-0002-7446-4532 orcid:0000-0002-7446-4532 2021. The efficacy of cysto-peritoneal shunting for the surgical management of intracranial arachnoid cysts in the elderly: a systematic review of the literature. Surgical Neurology International 12 , 624. 10.25259/SNI_463_2021 https://doi.org/10.25259/SNI_463_2021Test file https://orca.cardiff.ac.uk/id/eprint/145478/1/SNI-12-624.pdfTest

الإتاحة: https://doi.org/10.25259/SNI_463_2021Test
https://orca.cardiff.ac.uk/id/eprint/145478Test/
https://orca.cardiff.ac.uk/id/eprint/145478/1/SNI-12-624.pdfTest

المؤلفون: Mannivannan, Susruta, Makwana, Milan, Ahmed, Aminul Islam, Zaben, Malik

الوصف: Traumatic brain injury (TBI) poses a major public health problem on a global scale. Its burden results from high mortality and significant morbidity in survivors. This stems, in part, from an ongoing inadequacy in diagnostic and prognostic indicators despite significant technological advances. Traumatic axonal injury (TAI) is a key driver of the ongoing pathological process following TBI, causing chronic neurological deficits and disability. The science underpinning biomarkers of TAI has been a subject of many reviews in recent literature. However, in this review we provide a comprehensive account of biomarkers from animal models to clinical studies, bridging the gap between experimental science and clinical medicine. We have discussed pathogenesis, temporal kinetics, relationships to neuro-imaging, and, most importantly, clinical applicability in order to provide a holistic perspective of how this could improve TBI diagnosis and predict clinical outcome in a real-life setting. We conclude that early and reliable identification of axonal injury post-TBI with the help of body fluid biomarkers could enhance current care of TBI patients by (i) increasing speed and accuracy of diagnosis, (ii) providing invaluable prognostic information, (iii) allow efficient allocation of rehabilitation services, and (iv) provide potential therapeutic targets. The optimal model for assessing TAI is likely to involve multiple components, including several blood biomarkers and neuro-imaging modalities, at different time points.

وصف الملف: application/pdf

العلاقة: https://orca.cardiff.ac.uk/id/eprint/111506/8/1-s2.0-S0303846718301999-main.pdfTest; Mannivannan, Susruta, Makwana, Milan, Ahmed, Aminul Islam and Zaben, Malik https://orca.cardiff.ac.uk/view/cardiffauthors/A453912I.htmlTest orcid:0000-0002-7446-4532 orcid:0000-0002-7446-4532 2018. Profiling biomarkers of traumatic axonal injury: from mouse to man. Clinical Neurology and Neurosurgery 171 , pp. 6-20. 10.1016/j.clineuro.2018.05.017 https://doi.org/10.1016/j.clineuro.2018.05.017Test file https://orca.cardiff.ac.uk/111506/8/1-s2.0-S0303846718301999-main.pdfTest

الإتاحة: https://doi.org/10.1016/j.clineuro.2018.05.017Test
https://orca.cardiff.ac.uk/id/eprint/111506Test/
https://orca.cardiff.ac.uk/id/eprint/111506/8/1-s2.0-S0303846718301999-main.pdfTest

المؤلفون: Manivannan, Susruta, Makwana, Milan, Ahmed, Aminul Islam, Zaben, Malik

المصدر: Clinical Neurology and Neurosurgery ; volume 171, page 6-20 ; ISSN 0303-8467

مصطلحات موضوعية: Neurology (clinical), General Medicine, Surgery

الإتاحة: https://doi.org/10.1016/j.clineuro.2018.05.017Test
https://api.elsevier.com/content/article/PII:S0303846718301999?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S0303846718301999?httpAccept=text/plainTest

المؤلفون: Makwana, Milan¹ (AUTHOR), Merola, Joseph P.¹ (AUTHOR), Bhatti, Imran¹ (AUTHOR), Patel, Chirag K.¹ (AUTHOR), Leach, Paul A.¹ (AUTHOR)

المصدر: British Journal of Neurosurgery. Feb2023, Vol. 37 Issue 1, p45-48. 4p. 1 Chart.

مصطلحات موضوعية: *SUPPURATION, *CRANIOTOMY, *OTITIS media, *TREATMENT effectiveness, *BRAIN abscess, *HOSPITAL rounds, *CENTRAL nervous system, *EMPYEMA

مصطلحات جغرافية: SOUTH Wales, WALES

مستخلص: Spontaneous central nervous system (CNS) infections in children are rare. Treatment involves surgical intervention and antibiotic therapy. We describe a single centre experience of managing this condition in South Wales. We performed a retrospective review of surgically managed cases in our unit for patients under 18 years of age between 2008 and 2018. Data were collected regarding aetiology, location, microbiology examination, treatment and outcomes. Twenty-six patients were identified of which 25 case notes were available. Fifteen were male and 10 were female. Median age was 12 years (age range 0.3–17 years). Seven patients (28%) had a burr-hole aspiration and 18 (72%) underwent craniotomy. A second procedure was performed in 10 (40%) and a third procedure in two (8%). Fourteen (56%) had a brain abscess, 10 (40%) had subdural empyema (one was bilateral) and one (4%) had an extradural empyema. Fifteen (60%) had a raised WCC (>11.5 × 109/L) and 22 (88%) had a CRP of >10 mg/L at presentation. Three (12%) patients had a normal WCC and CRP at presentation. Overall, 12 (48%) were secondary to sinus infection, with the most common organism being Streptococcus. Seven (28%) were due to otitis media or mastoiditis, six (24%) had no cause identified. The mean number of CT/MRI scans was 6.7 (range 3–13). The mean follow-up period was 16.7 months (range 1–117 months). At last follow up, 19 (76%) had a GOS of 5, five (20%) had a GOS of 4 and one (12%) had GOS of 3. There were no deaths. In Wales, outcomes have improved over time in keeping with other paediatric neurosurgical units in England. Increased availability of imaging resources in our hospital and use of neuro-navigation for all cases in our unit as well as earlier identification of sepsis, communication with microbiologists with dedicated ward rounds and, enhanced identification of causative organisms and contemporary anti-microbials have also contributed towards the improved management of this condition. [ABSTRACT FROM AUTHOR]

المؤلفون: Merola, Joseph, Manivannan, Susruta, Ooi, Setthasorn, Chia, Wen Li, Makwana, Milan, Lang, Jozef, Leach, Paul, Zaben, Malik J.

المصدر: Surgical Neurology International

مصطلحات موضوعية: Endoscopic fenestration, Cystoperitoneal shunt, Surgery, Neurology (clinical), Review Article, Marsupialisation, Intracranial arachnoid cysts

الوصف: Background: Intracranial arachnoid cysts (AC) are benign, cerebrospinal fluid filled spaces within the arachnoid layer of the meninges. Neurosurgical intervention in children and young adults has been extensively studied, but the optimal strategy in the elderly remains unclear. Therefore, we performed a single center retrospective study combined with a systematic review of the literature to compare cystoperitoneal (CP) shunting with other surgical approaches in the elderly cohort. Methods: Retrospective neurosurgical database search between January 2005 and December 2018, and systematic review of the literature using PRISMA guidelines were performed. Inclusion criteria: Age 60 years or older, radiological diagnosis of intracranial AC, neurosurgical intervention, and neuroradiological (NOG score)/clinical outcome (COG score). Data from both sources were pooled and statistically analyzed. Results: Our literature search yielded 12 studies (34 patients), which were pooled with our institutional data (13 patients). CP shunts (7 patients; 15%), cyst fenestration (28 patients; 60%) and cyst marsupialisation/resection (10 patients; 21%) were the commonest approaches. Average duration of follow-up was 23.6, 26.9, and 9.5 months for each approach, respectively. There was no statistically significant association between choice of surgical intervention and NOG score (P = 0.417), COG score (P = 0.601), or complication rate (P = 0.955). However, CP shunting had the lowest complication rate, with only one patient developing chronic subdural haematoma. Conclusion: CP shunting is a safe and effective surgical treatment strategy for ACs in the elderly. It has similar clinical and radiological outcomes but superior risk profile when compared with other approaches. We advocate CP shunting as first line neurosurgical intervention for the management of intracranial ACs in the elderly.

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9ab60bd4593db96ac86aa23d1dbb7e43Test
https://pubmed.ncbi.nlm.nih.gov/34992940Test

المؤلفون: Makwana, Milan, Merola, Joseph P., Bhatti, Imran, Patel, Chirag K., Leach, Paul A.

المصدر: British Journal of Neurosurgery ; volume 37, issue 1, page 45-48 ; ISSN 0268-8697 1360-046X

الإتاحة: https://doi.org/10.1080/02688697.2020.1868403Test

المؤلفون: Makwana, Milan, Werner, Alexander, Acosta‐Saltos, Alejandro, Gonitel, Roman, Pararajasingham, Abirami, Ruff, Crystal, Rumajogee, Prakasham, Cuthill, Dan, Galiano, Mathias, Bohatschek, Marion, Wallace, Adam S., Anderson, Patrick N., Mayer, Ulrike, Behrens, Axel, Raivich, Gennadij

المصدر: Journal of Comparative Neurology ; volume 520, issue 8 ; ISSN 0021-9967 1096-9861

الإتاحة: https://doi.org/10.1002/cne.23113Test

المؤلفون: Ruff, Crystal A., Staak, Nils, Patodia, Smriti, Kaswich, Mark, Rocha‐Ferreira, Eridan, Da Costa, Clive, Brecht, Stephan, Makwana, Milan, Fontana, Xavier, Hristova, Mariya, Rumajogee, Prakasham, Galiano, Matthias, Bohatschek, Marion, Herdegen, Thomas, Behrens, Axel, Raivich, Gennadij

المصدر: Journal of Neurochemistry ; volume 121, issue 4, page 607-618 ; ISSN 0022-3042 1471-4159

الوصف: J. Neurochem. (2012) 121 , 607–618. Abstract Although neural c‐Jun is essential for successful peripheral nerve regeneration, the cellular basis of this effect and the impact of c‐Jun activation are incompletely understood. In the current study, we explored the effects of neuron‐selective c‐Jun deletion, substitution of serine 63 and 73 phosphoacceptor sites with non‐phosphorylatable alanine, and deletion of Jun N‐terminal kinases 1, 2 and 3 in mouse facial nerve regeneration. Removal of the floxed c‐jun gene in facial motoneurons using cre recombinase under control of a neuron‐specific synapsin promoter (junΔS) abolished basal and injury‐induced neuronal c‐Jun immunoreactivity, as well as most of the molecular responses following facial axotomy. Absence of neuronal Jun reduced the speed of axonal regeneration following crush, and prevented most cut axons from reconnecting to their target, significantly reducing functional recovery. Despite blocking cell death, this was associated with a large number of shrunken neurons. Finally, junΔS mutants also had diminished astrocyte and microglial activation and T‐cell influx, suggesting that these non‐neuronal responses depend on the release of Jun‐dependent signals from neighboring injured motoneurons. The effects of substituting serine 63 and 73 phosphoacceptor sites (junAA), or of global deletion of individual kinases responsible for N‐terminal c‐Jun phosphorylation were mild. junAA mutants showed decrease in neuronal cell size, a moderate reduction in post‐axotomy CD44 levels and slightly increased astrogliosis. Deletion of Jun N‐terminal kinase (JNK)1 or JNK3 showed delayed functional recovery; deletion of JNK3 also interfered with T‐cell influx, and reduced CD44 levels. Deletion of JNK2 had no effect. Thus, neuronal c‐Jun is needed in regeneration, but JNK phosphorylation of the N‐terminus mostly appears to not be required for its function.

الإتاحة: https://doi.org/10.1111/j.1471-4159.2012.07706.xTest