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Ghosh S, Awuah WA, Bharadwaj HR, Adebusoye FT, Ou Yong BM, Wellington J, Abdul-Rahman T, Ovechkin D. Utilizing indocyanine green video angiography to bridge intracranial aneurysm treatment gaps in low- and middle-income countries: a mini-review. J Int Med Res 2023; 51:3000605231204427. [PMID: 37862677 PMCID: PMC10590043 DOI: 10.1177/03000605231204427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 09/13/2023] [Indexed: 10/22/2023] Open
Abstract
Intracranial aneurysms, affecting 2%-5% of the population, pose a significant challenge to neurosurgeons due to their potential to cause subarachnoid haemorrhage and high mortality rates. Intraoperative angiography is necessary for effective surgical planning and indocyanine green video angiography (ICG-VA) has emerged as a useful tool for real-time visualization of aneurysmal blood flow, aiding in better planning for potential blood flow and detection of aneurysm remnants. This mini narrative review explores the application of ICG-VA in intracranial aneurysm surgery. Compared with conventional dye-based angiography, ICG-VA is safer, more effective and more cost-effective. It can assess haemodynamic parameters, cerebral flow during temporary artery occlusion, completeness of clipping and patency of branch vessels. However, implementing ICG-VA in low- and middle-income countries presents challenges such as financial constraints, limited access to training and expertise, patient selection and consent issues. Addressing these obstacles requires capacity-building, training programmes for neurosurgeons and multidisciplinary teams, technology transfer, equipment donations, public-private partnerships, continued research and development, reducing conventional dye usage, reducing ICG wastage, exploring mechanisms to reuse ICG dyes and advocating for increased government funding and healthcare budgets.
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Affiliation(s)
| | | | | | | | - Brian M. Ou Yong
- School of Medicine, College of Medical and Veterinary Life Sciences, University of Glasgow, United Kingdom
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Awuah WA, Ng JC, Mehta A, Nansubuga EP, Abdul-Rahman T, Kundu M, Ou Yong BM, Kalmanovich J, Hussain A, Jessica OU, Kamanousa K, Akilimali A, Sikora K, Isik A. The African cancer burden: what is the potential role of modern oncology innovation in reducing the continent's rapidly rising mortality? Postgrad Med J 2023; 99:941-945. [PMID: 37280156 DOI: 10.1093/postmj/qgad043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 04/28/2023] [Indexed: 06/08/2023]
Abstract
With increasing prevalence and an expected rise in disease burden, cancer is a cause of concern for African healthcare. The cancer burden in Africa is expected to rise to 2.1 million new cases per year and 1.4 million deaths annually by the year 2040. Even though efforts are being made to improve the standard of oncology service delivery in Africa, the current state of cancer care is not yet on par with the rise in the cancer burden. Cutting-edge technologies and innovations are being developed across the globe to augment the battle against cancer; however, many of them are beyond the reach of African countries. Modern oncology innovations targeted to ward Africa would be promising to address the high cancer mortality rates. The innovations should be cost-effective and widely accessible to tackle the rapidly rising mortality rate on the African continent. Though it may seem promising, a multidisciplinary approach is required to overcome the challenges associated with the development and implementation of modern oncology innovations in Africa.
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Affiliation(s)
| | - Jyi Cheng Ng
- Faculty of Medicine and Health Sciences, University of Putra Malaysia, Serdang 43400, Malaysia
| | - Aashna Mehta
- Faculty of Medicine, University of Debrecen, Debrecen 4032, Hungary
| | | | | | - Mrinmoy Kundu
- Faculty of Medicine, Institute of Medical Sciences and SUM Hospital, Bhubaneswar 751029, India
| | - Brian M Ou Yong
- School of Medicine, College of Medical & Veterinary Life Sciences, University of Glasgow, Glasgow G11 6QQ, United Kingdom
| | - Jacob Kalmanovich
- College of Medicine, Drexel University, Philadelphia, PA 19129, United States
| | - Aysha Hussain
- School of Medicine, Ross University, Bridgetown 33133, Barbados
| | | | - Karl Kamanousa
- College of Medicine, Drexel University, Philadelphia, PA 19129, United States
| | - Aymar Akilimali
- Faculty of Medicine, Official University of Bukavu, Bukavu 57010, DR Congo
| | - Kateryna Sikora
- Faculty of Medicine, Sumy State University, Sumy 40007, Ukraine
| | - Arda Isik
- Department of General Surgery, Istanbul Medeniyet University, Istanbul 34100, Turkey
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Kundu M, Ng JC, Awuah WA, Huang H, Yarlagadda R, Mehta A, Nansubuga EP, Jiffry R, Abdul-Rahman T, Ou Yong BM, Sikora V, Isik A. NeuroVerse: neurosurgery in the era of Metaverse and other technological breakthroughs. Postgrad Med J 2023; 99:240-243. [PMID: 36892407 DOI: 10.1093/postmj/qgad002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 11/18/2022] [Indexed: 03/10/2023]
Abstract
The tremendous evolution in modern technology has led to a paradigm shift in neurosurgery. The latest advancements such as augmented reality, virtual reality, and mobile applications have been incorporated into neurosurgical practice. NeuroVerse, representing the application of the metaverse in neurosurgery, brings enormous potential to neurology and neurosurgery. Implementation of NeuroVerse could potentially elevate neurosurgical and interventional procedures, enhance medical visits and patient care, and reshape neurosurgical training. However, it is also vital to consider the challenges that may be associated with its implementation, such as privacy issues, cybersecurity breaches, ethical concerns, and widening of existing healthcare inequalities. NeuroVerse adds phenomenal dimensions to the neurosurgical environment for patients, doctors, and trainees, and represents an incomparable advancement in the delivery of medicine. Therefore, more research is needed to encourage widespread use of the metaverse in healthcare, particularly focusing on the areas of morality and credibility. Although the metaverse is expected to expand rapidly during and after the COVID-19 pandemic, it remains to be seen whether it represents an emerging technology that will revolutionize our society and healthcare or simply an immature condition of the future.
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Affiliation(s)
- Mrinmoy Kundu
- Faculty of Medicine, Institute of Medical Sciences and SUM Hospital, Bhubaneswar 751003, India
| | - Jyi Cheng Ng
- Faculty of Medicine and Health Sciences, University of Putra Malaysia, Serdang 43400, Malaysia
| | | | - Helen Huang
- Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin 10250, Ireland
| | - Rohan Yarlagadda
- School of Osteopathic Medicine, Rowan University, Stratford, NJ 08807, United States
| | - Aashna Mehta
- Faculty of Medicine, University of Debrecen, Debrecen 4026, Hungary
| | | | - Riaz Jiffry
- Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin 10250, Ireland
| | | | - Brian M Ou Yong
- School of Medicine, College of Medical & Veterinary Life Sciences, University of Glasgow, Glasgow G116QQ, United Kingdom
| | | | - Arda Isik
- Department of General Surgery, Istanbul Medeniyet University, Istanbul 34100, Turkey
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