Background: Preemptive administration of single dose pregabalin reduces postoperative narcotic analgesicconsumption after abdominal hysterectomy under sub-arachnoid block. Objectives: The present study was designed to evaluate the effect of pregabalin as a preemptive agent toreduce postoperative pain. Methodology: This randomized double-blind placebo-controlled clinical trial was conducted in theDepartment of Anesthesia, Analgesia and Intensive Care Medicine at Banghabandhu Sheikh Mujib MedicalUniversity, Dhaka from July 2010 to June 2012 for a period of two years. Women aged between 40 to 60years scheduled for abdominal hysterectomy under sub-arachnoid block were selected as study population.A total of one hundred and twenty women were randomly allocated into two equal groups by cardsampling. 120 cards, 60 for each group were prepared by another person who was not aware of the study.Group A was known as study group who were received 300mg oral pregabalin one hour before performanceof SAB and group B was known as control group who were received matching placebo one hour beforeSAB.Pain in the postoperative period was assessed on visual analogue scale and managed with PCAusing morphine. Patients were visited by the investigators at ½, 1, 2, 4, 12, and 24 h after operation. Ateach visit, outcomes were measured in the following order: heart rate, mean arterial pressure, respiratoryrate, SpO2, and VAS pain score, sedation score, and any side effects which would develop. Finally, totalamount of morphine administered in 24 hour was recorded. The time since spinal anaesthesia to firstdose of analgesic was also recorded. Result: The mean 24hrs morphine consumption was 13.3 (±1.5) mg in Group-A, whereas in Group-B was29.1(±2.1) mg. The Group-A showed a significant reduction in morphine consumption then the Group-B(P<0.001). The time interval of first dose of analgesic was 5.2(±0.4) hrs in the Group-A, whereas in theGroup-B was 2.3(±0.2) hrs.The difference was significant (P<0.05).It was seen that side effects like respiratorydepression more in Group-B, dizziness and somnolence was more in Group-A than Group-B.Sedationscore was higher in Group-A than Group-B. Incedence of nausea/vomotting was same in both groups. Conclusion: It is demonstrated that preemptive use of Pregabalin led to significant reduction in narcoticanalgesic requirement and thereby a significant reduction in morphine related side effects. Beside this,pregabalin caused increased levels of sedation which may be beneficial for certain patients in earlypostoperative periods. JBSA 2017; 30(2): 66-74

Background: Anterior cervical discectomy is a common procedure for treating patients for cervical disc prolapse. This study was conducted to evaluate the surgical outcome and demographic characteristics of patients who were treated for anterior cervical disc prolapse. Methods: Study was conducted in the Department of Neurosurgery-spine, National Institute of Neurosciences and Hospital, Dhaka. Study interval was 5 years from January, 2014 to 31st December, 2019. Total numbers of patients were 215. Males were 183 (85.1%) and females were 32 (14.9%). All the patients had undergone the procedure of anterior cervical discectomy and fusion (ACDF) with RABEA Rectangular Titanium Cages (RTC). All the patients had plain MRI cervical spine done for diagnosis of anterior cervical disc prolapse. Surgical and Clinical preoperative evaluation and surgical outcomes were evaluated using pre- and postoperative Nurick, Visual Analog Scale (VAS), Neck Disability Index (NDI), for Myelopathy, overall Odoms outcome scores, postoperative surgical complications, and fusion and subsidence rates. Results: Total 215 patients underwent ACDF; the mean age of these patients was 44.66 years, and their preoperative VAS and NDI, scores were 8.09 and 35.38 respectively. Sixty seven percent of patients had one level, 25.1% had two-level, and 7.9% had three-level procedures. On preoperative Magnetic Resonance Imaging(MRI), foraminal stenosis was present in 68.4% of patients, whereas medullar stenosis was present in 43.7%. The rate of complications was 2.8%: two patients had postoperative implant migration (0.93%), three patients had postoperative transient dysphagia (1.4%) and one patients had temporary hoarseness of voice. Mean postoperative follow-up time was 6.7 months; postoperative VAS and NDI scores were 1.10 and 14.4, respectively. Postoperative fusion rate was 93.5%, and subsidence rate was 5.6%. Conclusion: Results with Rectangular Titanium Cages are expectedly good. Symptoms resolved and fusion rate was 93.5% at 1 year follow up. Bang. J Neurosurgery 2021; 10(2): 137-147

Background: Inaccurate placement of VP shunt catheter is related to shunt failure. Objective: The objective of this study was to determine the accuracy of ventricular catheter placement during ventriculoperitoneal shunt operations using the freehand technique. Methodology: This prospective observational study included all patients from a single institution who underwent a ventriculoperitoneal shunt procedure in which a new ventricular catheter was placed between September 2013 and August 2016 for a period of three (03) years. Data abstracted for each patient included age, sex, diagnosis, site and side of ventricular catheter placement. Postoperative CT scan images were reviewed for accuracy of ventricular catheter placement. Results: There were 140 patients included in the study; accuracy ventricular catheter tip placement were 55 (39.28%) using freehand technique. Conclusion: Mechanical malfunction and infection are the most significant problems associated with shunts for the treatment of hydrocephalus. Journal of National Institute of Neurosciences Bangladesh, 2019;5(1): 59-63

Ventriculoperitoneal (VP) shunt is a common procedure performed for treatinghydrocephalus. Recently, endoscopy has been used in selected cases. Proximalmigration of VP shunt is a rare complication. Complete intracranial migration of VPshunt is very rare with very few cases reported in literature. We report a case ofcomplete intracranial migration of a VP shunt which was endoscopically retrieved.The possible mechanisms causing this very uncommon complication and themanagement are explained. Bang. J Neurosurgery 2020; 9(2): 168-172

Encephalocele is defined as protrusion of cranial contents like meninges and cerebral tissue beyond the normal confines of the skull through a defect in the cranium. It is one form of a neural tube defect as are anencephaly and spina bifida. There are 2 main types of encephalomeningocele, frontoethmoidal and occipital, according to the location of the defect. The frontoethmoidal type defect, which is located in the area of the frontal and ethmoidal bones. The authors present a case of frontonasal encephalocele in a very young child.Journal of National Institute of Neurosciences Bangladesh, 2018;4(1): 58-62