Progress made by materials scientists in recent years has greatly helped the field of ultra-precision manufacturing. Ranging from healthcare to electronics components, phenomena such as twinning, dislocation nucleation, and high-pressure phase transformation have helped to exploit plasticity across a wide range of metallic and semiconductor materials. One current problem at the forefront of the healthcare sector that can benefit from these advances is that of bacterial infections in implanted prosthetic devices. The treatment of implant infections is often complicated by the growth of bacterial biofilms on implant surfaces, which form a barrier that effectively protects the infecting organisms from host immune defenses and exogenous antibiotics. Further surgery is usually required to disrupt the biofilm, or to remove the implant altogether to permit antibiotics to clear the infection, incurring considerable cost and healthcare burdens. In this review, we focus on elucidating aspects of bactericidal surfaces inspired by the biological world to inform the design of implant surface treatments that will suppress bacterial colonization. Alongside manufacturing and materials related challenges, the review identifies the most promising natural bactericidal surfaces and provides representative models of their structure, highlighting the importance of the critical slope presented by these surfaces. The scalable production of these complex hierarchical structures on freeform metallic implant surfaces has remained a scientific challenge to date and, as identified by this review, is one of the many 21 st -century puzzles to be addressed by the field of applied physics.

Background and Aims:Identification of subarachnoid space in pregnant patients can pose a great challenge to anaesthesiologists. This study was designed to compare conventional landmark technique with pre-procedural ultrasonography-assisted midline approach for identification of the subarachnoid space in elective caesarean section.Methods:After institute ethics committee approval and written informed consent, 100 parturients scheduled for elective caesarean section under spinal anaesthesia were included in this prospective randomised control trial and divided into Group L (n = 50) (landmark technique) and Group U (n = 50) (ultrasound-guided technique). Parameters such as time taken for the identification of the interspace, distance between skin and dura mater, number of insertion attempts (the primary outcome), number of passes and time taken were recorded in both the groups. Statistical analysis was done using SPSS software 16.Results:Demographic profiles of both groups were comparable. The number of attempts for needle insertion (1.04 ± 0.19 vs. 1.97 ± 0.77), number of passes in the same interspinous space (1.26 ± 0.44 vs. 1.90 ± 0.51) and the total time for successful lumbar puncture (31.90 ± 6.30 vs. 51.80 ± 12.28 s) were significantly less in Group U as compared to Group L, but the time of identification of interspinous space was significantly more in Group U (56.70 ± 13.08 s) as compared to Group L (47.10 ± 10.45 s).Conclusion:Pre-procedural ultrasound is a useful tool for successful lumbar puncture in parturients as it reduces the number of attempts with fewer side effects as compared to conventional landmark technique.

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