Background: In Southeast Asian countries, dengue is the major cause of pediatric morbidity and mortality and in that India reports the maximum number of cases. The annual incidence of dengue in India ranges from 8 to 33 million cases per year and an increased risk of dengue virus infection in children older than 5 years of age have been documented. Aim: The main objective of this study was to assess the incidence of dengue among the fever cases and to assess the clinical profile of various types of dengue fever and also to assess the predictive variables for the severity of dengue and their clinical outcomes. Methodology: A prospective longitudinal study was conducted at a pediatric hospital in a rural area of Tamil Nadu for a period of 6 months. A total of 325 patients were included in the study based on the study period and the inclusion criteria. For all the cases that were having a fever, basic blood investigations which includes hemoglobin, total count, and platelet count were performed along with peripheral smear study for malaria, dengue card test, and liver function test. Further, dengue positive patients were grouped into non-severe and severe dengue fever based on the operational definition formulated by the WHO. Results: The overall incidence of dengue among all the patients with fever was 71.3% among which 83.6% were non-severe dengue and the remaining 13.6% of the patients had severe dengue. Clinical signs such as palmar erythema, splenomegaly, and bleeding manifestations were more common in severe dengue patients than that of non-severe dengue, and this difference was found to be statistically significant. Hemoglobin and platelet count was found to be much lower among the patients with severe dengue along with raised liver enzymes (serum glutamic-oxaloacetic transaminase and serum glutamic pyruvic transaminase) than that of the non-severe dengue, and the difference was found to be statistically significant. Majority of the patients with severe dengue received crystalloid and few patients received blood products whereas only very few with non-severe dengue received crystalloids, and none of the patients in this group received blood products. Conclusion: Health-care personnel of all levels must be made aware of the clinical signs and symptoms of all dengue types. Early recognition, precise assessment and appropriate treatment with the help of the WHO revised classification and management guidelines would reduce the mortality due to dengue fever.

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Silica-based U-bent fiber optic sensor (U-FOS) probes exhibit excellent absorbance and refractive index sensitivity. They have been typically fabricated by manual means with the help of a butane flame, which is plagued by high probe-to-probe variations in the geometry, leading to rejection rates as high as 50% - 70%. In particular, fibers with 200 μm core and bend diameter as small as 1 mm pose a severe challenge. To overcome these limitations, we have developed an automated fiber bending machine (FBM) that consists of a CO2 laser as heating source with a mechanism to automate laser beam deflection for precise control of heating zones on fiber and an automated articulating arm mechanism that holds both the ends of fiber and bends them after reaching glass transition temperature of about 1200 °C. FBM is capable of fabrication of U-FOS probes as many as 60-80 probes in an hour with bend diameter down to 0.55 mm and minimal geometric deviations. The proposed design is highly rugged, and more than ten thousand probes have been fabricated with this FBM so far.

Introduction: Minimally Invasive Transforaminal Lumbar Interbody Fusion (MIS-TLIF) has been shown to offer several advantages over conventional (open) TLIF and is being increasingly employed by young surgeons early in their careers. It is important to know the appropriate technique and the correct cases to be selected in the early phase to achieve good outcomes during the learning curve. A detailed and illustrative technical note along with a guide for case selection at different phases of experience has been presented in this article. Methods: The first consecutive single surgeon series of 150 MIS-TLIF cases done over 4 years between 2012 and 2015 were considered for analysis. Demographic and peri-operative data and previously documented follow-up were collected from case records. Telephonic questionnaire and consultation were done to collect latest status, any procedures/surgeries done elsewhere for issues related to index procedure. Results were stratified as Group 1 – first 25 cases; Group 2 – 26–75 cases; Group 3 – 76–150 cases. Results: The major indication for surgery in group 1 was either Grade 1 spondylolisthesis or lumbar canal stenosis with concomitant axial symptoms. The incidence of relatively complex cases (Grade 2 or 3 listhesis; Revision cases; Multilevel cases) increased with each successive group. As expected, the operative time (calculated for only single-level cases) improved with time. The overall rate of peri-operative complications was higher in group 2 as compared to groups 1 and 3, predominantly due to an increased incidence of intra-operative dural tears in group 2. Symptomatic screw malposition was detected in five screws, all were managed conservatively. The median duration of follow-up for the entire group was 39 months (Range – 1–119 months). Eighty-two (55%) patients had follow-up of more than 1 year while 31 (20.6%) patients had follow-up of more than 7 years. Around 80–85% of patients at each point of follow-up assessment had a successful outcome (McNab 4 and 5). The re-operation rate for index level problems or adjacent segment was 2.6%, only one of which was done at the author’s center. Conclusions: Minimally invasive TLIF is a safe and effective procedure with favorable long-term results and acceptable complication rates. Though technically challenging in initial phases, a good understanding of the technique and principles of minimally invasive spine surgery along with fulfilling helpful pre-requisites and appropriate case selection as mentioned in this article, will help to smoothen the learning curve and avoid unfavorable outcomes in early stages.

There have been several reports of minimally invasive decompression for cervical canal stenosis and degenerative myelopathy. Most of these reports are for less than 4 levels and there have not been any comparative studies between Open and MIS cervical decompression for multilevel ( ≥ 4) degenerative cervical myelopathy. Methods: Twenty consecutive patients were allotted to undergo either 'Open' cervical laminectomy (n = 10) or MIS posterior cervical decompression (n = 10). All patients were evaluated for 1. Clinical, (JOA, MDI, NDI, Nurick grade, Blood loss, Duration of surgery); 2. Radiological (CSA of dural sac and Spinal cord, Muscle edema on post-op T2W MRI); 3. Laboratory (TLC, CRP, ESR, CPK) and 4. Physical (Isometric neck extensor muscle strength). Differences between Open and MIS groups were calculated with respect to above parameters. Results: The mean number of levels decompressed was 4.4 (range, 4-6). MIS group had significantly longer duration of surgery and lesser blood loss as compared to open group. The patients in open group were more disabled than MIS group pre-operatively, as evidenced by higher MDI and NDI. However, proportionate improvements were seen in both groups post-operatively in terms of all clinical parameters. Postoperative increase in CSA of spinal cord was also identical in both groups. Elevations in CRP and ESR were significantly higher in Open group post-operatively as compared to MIS group. Post-operative extensor neck muscle strength improved to a higher extent in MIS group as compared to open group though this was not statistically significant. No patient had any major post-operative complications. Conclusion: MIS posterior cervical decompression is safe and effective, can achieve similar extent of decompression and degree of clinical improvement as compared to open surgery. MIS has definite advantages of lesser blood loss, reduced tissue injury and better improvement in post-operative neck muscle strength as compared to open surgery.