There is no doubt that many synthetic materials used in cranioplasty have given good result regarding patient's calvarial shape. However, the use of these materials is costly to the patient and requires complex intraoperative process. There has been a long history regarding the use of acrylic bone cement called as polymethyl-methacrylate (PMMA) as an implant due to its desirable properties. Here, we present three cases of simple, cost effective manually sculpted calvarial defect using three-dimensional (3D) printer. Sharing the achievement and challenges, we want to focus that the 3D customized implant of PMMA can be used as bone substitute.

Introduction: The main aim of this study is to determine the anterior commissure-posterior commissure (AC-PC) distance in Nepalese cohort and has comparison of intercommissural distance of Nepalese cohort with some other races. Materials and Methods: The 47 patients, with mean age of 50 years, included in the study had undergone DBS or lesioning (Pallidotomy). Data were collected through the magnetic resonance imaging under DBS protocol and the manipulation, marking of AC and PC was done in Inomed Planning Software (IPS). Results: The data revealed average AC-PC distance of Nepalese cohort to be 24.86 ± 2.08 mm, ranging from 16 mm to 30 mm. The study among 29 males and 18 females illustrated male to have longer AC-PC as compared to female (25.38 mm male and 24.02 mm female). The results also confirmed age related changes in AC-PC distance which was linearly increasing with the age. Conclusion: Comparison of data from other studies revealed Nepalese cohort to have almost similar AC-PC distance with Asian population, while that was longer in Caucasian and shorter in Hispanic Population.

Biomedical engineering is the blend of engineering and medical science, professional with a combination of knowledge of various engineering discipline to improve health care and quality of life. While biomedical engineering formally came up as major course in 1950s, the course started in Nepal just a decade back with its importance being acknowledged and biomedical engineers have been recruited by various institutes. Accounting for artificial intelligence, robotic surgery, 3-d printing, which are believed to be the future of medical science, it is necessary to strengthen the biomedical engineering. This article aims to highlight the overview as well as opportunities and challenges of biomedical engineering in Nepal.

Various intraoperative neurophysiological monitoring (IONM) helps in assessing the integritry of neural pathways during the surgical treatment. IONM is an assistive tool to preserve the fuction of brain, brainstem, cranial nerve, spinal cord and peripheral nerves and a great assest for neurosurgeons. Different application of IONM includes: MEP, SSEP, ABR, VEP, BCR and AMR. Intraoperative neuromonitoring has become an integral part of the neurosurgery and is being routinely used in various operative cases. This paper discusses the application and benefit of IONM, with its role in delivering a high quality intra operative care to detect and prevent neurological deficits.

Introduction: Modern technology engineered and developed with artificial intelligence have significantly improved the nature of diagnosis and treatment of patients. Healthcare facility has changed significantly in the past few decades because of technological developments. Neurosurgery has been able to practise and enjoy a lot of technologically advanced tools in the past few decades. In context of Nepal, technologically sophisticated devices and tools ranging from neuro navigation, high speed cutting drills, intra operative neuro monitoring, deep brain stimulation, to high resolution magnetic resonance imaging are already introduced. In this paper, the literature review on currently available technologies used in neurosurgery, their significance in delivering a better health care and their usage in Nepal has been discussed.