Revision of percutaneous SCS systems with implantation of a new paddle lead is safe and more effective in patients who have undergone not more than 1 prior revision.

A better understanding how patient anatomy, stimulation parameters, and lead location in relation to neighboring structures influence the occurrence of side effects can be useful to inform targeting strategies.

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We present this unusual case of a 60-year-old gentleman who presented with meningism and reduced conscious level. Imaging demonstrated a perforated sigmoid colon with retroperitoneal air associated with pneumorrhachis and pneumocranium. He required a Hartmann's procedure and broad spectrum intra-thecal antibiotics which led to resolution of the pneumorrhachis and pneumocranium.

A 74 year old male presented with 1 month history of weakness in right upper limb and motor aphasia for 15 days. Magnetic resonance imaging (MRI) of the brain showed three discrete ring enhancing lesions. An image guided awake craniotomy and biopsy of a lesion was performed. The histopathological examination revealed it to be a grade III Oligodendroglioma. This was a rare case of multicentric high grade oligodendroglioma has never been reported in literature. We report such a case with relevant review of literature.

BACKGROUND: Addition of clonidine to ropivacaine (0.2%) can potentially enhance analgesia without producing prolonged motor blockade. The aim of the study was to compare the post-operative pain relieving quality of ropivacaine (0.2%) and clonidine mixture to that of plain ropivacaine (0.2%) following caudal block in children's. OBJECTIVE: In this study I examined the quality, post-operative analgesia and haemodynamics effects in children when clonidine is added to ropivacaine for urogenital surgeries in caudal anaesthesia. MATERIAL AND METHODS: In this clinical trial, 30 children's aged 1-10 years who were candidates for elective urogenital surgeries were studied. Induction and maintenance of anaesthesia were achieved using propofol, sevoflurane and nitrous oxide. Children were randomly divided into 2 groups in double blind fashion, and were given caudal block with 0.2% ropivacaine (1ml/kg) alone and ropivacaine plus clonidine 2mcg/kg. Haemodynamic parameters were observed before, during and after the surgical procedure. Postoperative analgesia evaluated using FLACC score and sedation was assessed using Ramsey sedation scale. Paracetamol was given orally for cases with FLACC score 4 or more. RESULTS: Duration of analgesia was found to be significantly longer in the group given ropivacaine plus clonidine. CONCLUSIONS: I concluded that addition of clonidine to ropivacaine prolongs the duration of postoperative analgesia without any respiratory or heamodynamic side-effects.

In this proposed paper, multicarrier sinusoidal pulse width modulation (M-SPWM) method is implemented for design of 15 level reduced switches inverter topology. This inverter topology generates 15 level output-voltage with suitablelswitching pulse production using M-SPWM and altered level of voltages are attained with distinction of modulationlindex. The split inductor is used to diminish the harmoniclcontent and flatted output current. This type of system which contains different range of different range of voltage supplies. As a result, this inverter reduces the difficulty in gating time calculation and there is no neutral point fluctuation issue. This paper illuminates the modes of switching and minimization of stress in voltage and harmonic diminution are examined. The grades of the projected multilevel inverter (MLI) system are verified using Matlab/Simulink and dsPIC controller respectively.