Surgical removal of an ectopic haemodialysis catheter in the brachiocephalic artery: a case report.

Percutaneous central vein catheterization is commonly performed to access venous circulation for various clinical indications. However, unintentional arterial puncture may occur which can result in catastrophic complications. We report a case of an inadvertent right brachiocephalic artery cannulation in a 77-year-old lady planned for haemodialysis via a percutaneous internal jugular vein vascular access performed under ultrasound guidance. As an intravascular stent is not favourable in view of the close proximity of the right common carotid artery to the site of puncture as well as the risk of massive bleeding upon simple removal of the catheter, an open surgical removal via a median sternotomy was performed. Acquiring the competency in procedural skills, an understanding of the surgical anatomy and anticipating impending complications are of paramount importance in preventing as well as in mitigating the above complication.

Operative challenges in a gigantic ganglioneuroma of the posterior mediastinum with mediastinal compression.

Symptomatic giant ganglioneuromas with mediastinal compression are rare, complicating its management with significant morbidity and mortality risks. A meticulous multidisciplinary preoperative planning is pivotal in ensuring success. We describe a case of a 30-year-old man with a giant posterior mediastinal mass with compression and displacement of the mediastinal structures. Biopsy confirmed a ganglioneuroma and patient underwent excision. Surgery was challenging in view of the size and adherence to the local structures. Haemodynamic instabilities were encountered necessitating a pre-emptive femoral-femoral cannulation for CPB. A piece-meal debulking of the tumour was performed, complicated with massive haemorrhage requiring autologous blood transfusion using an intraoperative blood salvage device. The patient recovered and was discharged home well at Day 8. A thorough pre-operative planning involving a multidisciplinary approach, an understanding of the surgical anatomy as well as anticipating impending complications is of paramount importance  in the management of this particular case.

Application of Conductive Hydrogels on Spinal Cord Injury Repair: A Review.

Spinal cord injury (SCI) causes severe motor or sensory damage that leads to long-term disabilities due to disruption of electrical conduction in neuronal pathways. Despite current clinical therapies being used to limit the propagation of cell or tissue damage, the need for neuroregenerative therapies remains. Conductive hydrogels have been considered a promising neuroregenerative therapy due to their ability to provide a pro-regenerative microenvironment and flexible structure, which conforms to a complex SCI lesion. Furthermore, their conductivity can be utilized for noninvasive electrical signaling in dictating neuronal cell behavior. However, the ability of hydrogels to guide directional axon growth to reach the distal end for complete nerve reconnection remains a critical challenge. In this Review, we highlight recent advances in conductive hydrogels, including the incorporation of conductive materials, fabrication techniques, and cross-linking interactions. We also discuss important characteristics for designing conductive hydrogels for directional growth and regenerative therapy. We propose insights into electrical conductivity properties in a hydrogel that could be implemented as guidance for directional cell growth for SCI applications. Specifically, we highlight the practical implications of recent findings in the field, including the potential for conductive hydrogels to be used in clinical applications. We conclude that conductive hydrogels are a promising neuroregenerative therapy for SCI and that further research is needed to optimize their design and application.

Synthesis, Characterisation and Antibacterial Properties of Silicone-Silver Thin Film for the Potential of Medical Device Applications.

Silver (Ag) particles have sparked considerable interest in industry and academia, particularly for health and medical applications. Here, we present the "green" and simple synthesis of an Ag particle-based silicone (Si) thin film for medical device applications. Drop-casting and peel-off techniques were used to create an Si thin film containing 10-50% (v/v) of Ag particles. Electro impedance spectroscopy (EIS), X-ray diffraction analysis (XRD), scanning electron microscopy (SEM), energy dispersive X-ray (EDX), and tensile tests were used to demonstrate the electrical conductivity, crystallinity, morphology-elemental, and mechanical properties, respectively. The oriented crystalline structure and excellent electronic migration explained the highest conductivity value (1.40 × 10-5 S cm-1) of the 50% Ag-Si thin film. The findings regarding the evolution of the conductive network were supported by the diameter and distribution of Ag particles in the Si film. However, the larger size of the Ag particles in the Si film resulted in a lower tensile stress of 68.23% and an elongation rate of 68.25% compared to the pristine Si film. The antibacterial activity of the Ag-Si film against methicillin-resistant Staphylococcus aureus (MRSA), Bacillus cereus (B. cereus), Klebsiella pneumoniae (K. pneumoniae), and Pseudomonas aeruginosa (P. aeruginosa) was investigated. These findings support Si-Ag thin films' ability to avoid infection in any medical device application.