In this Issue…

You are never given a dream without also being given the power to make it true. You may have to work for it, however.
Richard Bach

Finally a new journal in Neuroscience from Nepal! In this editorial I will first discuss how we came to this stage of publication of the Journal and secondly, I will discuss the salient features of the articles in this January issue.

I

Why a new journal

There are several multispeciality journals from Nepal with a long history and a strong academic track record (Journal of Nepal Medical Association, Journal of Institute of Medicine to name just two). There are also a few journals related to particular subspecialties (Journal of Society of Surgeons of Nepal, Nepalese Journal of Psychiatry, Nepal Journal of Dermatology, Venereology & Leprology to name a few). Neuroscience is the meeting point of many specialties and subspecialties and an academic ‘ Chautari’ has long been felt by many who have been doing work in this field in Nepal. At one point we realized that just bringing out a new journal does not serve create an academic environment in the country especially when most of the journals are struggling for indexing. On the other hand we strongly felt that, as the number of people interested in this field is increasing, a journal devoted to neuroscience is the call of the time.

Can we succeed?

This is the question we have been asked by our well wishers in Nepal and abroad ever since we came up with the idea of this journal. As Sir Arthur Conan Doyle said, “Once you eliminate the impossible, whatever remains, no matter how improbable, must be the truth.” We strongly believe in this statement and we will work to our capacity to make this a journal of acceptable standard.
      I sincerely request our teachers, colleagues, residents and other well wishers to help us achieve this. At this point we feel confident that we will be able to fulfill our modest target of bringing out two issues a year.

II

     In this issue we present a collection of articles - review and original articles and case reports related to all fields of Neuroscience. In the special review article, Bezruchka discusses the socioeconomic impact of Neuroscience in the overall health of Nepalese people. Stephen Bezruchka, an international figure in travel medicine, an expert in international health and a strong critique of money equating with health discusses how neuroscience can serve as a model for the 21st century health in Nepal. His thought-provoking article makes one believe why just buying a latest ‘Health Machine’ will not increase the health standard of the country.
     Dr. Stevenson’s well-written article on pediatric brain tumors outlines the epidemiology, clinical features, management, controversies, and future directions in this unfortunately common heterogeneous condition. This article is a good reference especially for many non-neurosurgeons who do not have access to pediatric neurosurgery literature.
     With the number of operations for cerebral aneurysms increasing and with no endovascular treatment available in Nepal in the foreseeable future, the article by Upadhyaya et al. will benefit a lot of readers. They provide us with a succinct review of the perioperative management of aneurysm. This will be of immense help to the surgery and anesthesiology residents rotating through neuroanesthesiology.
     An article by someone of Prof. A. K. Banskota’s experience is very timely. His article outlines the important steps in the management of patients with structural spinal disorders. Despite a lot of challenges, the impressive result his group has been able to achieve in managing spinal disorders is noteworthy.
Shakya, et al., provide us for the first time data on isolated lateral rectus palsy in the Nepalese population. What we know now is the relative uselessness of getting imaging study on these patients.
     Thapa, et al., choose to write on a topic, which is long overdue. What are our baseline data for intracranial complications of suppurative ear infection - a common condition encountered by the ENT surgeons and dreaded by the neurologists and neurosurgeons? In a review of forty-four cases just over three years (this shows the magnitude of the problem) they found that brain abscess was the commonest one.
     Gurung et al., in their review of patients with intracranial hemorrhage undergoing cerebral angiograms at TU Teaching Hospital over a year, describe the demographic, radiological, and angiographic parameters of patients with intracranial hemorrhage. The strength of this paper is that, for the first time, it analyzes this patient population in our community. This will pave the way for future research in this area.
     Shilpakar, et al., review the management of encephaloceles in a series of 16 patients at TU Teaching Hospital. As the incidence of Neural tube defect is high in Nepal, this article is believed to provide useful information on the management of this congenital entity.
     In the Neuro View box, Dr. Ghimire provides us a rare opportunity to see the CT scan of head of a woman with 8 intracranial tumors.
     In the 3 case reports in this issue, Lohani in her report on fusiform middle cerebral artery aneurysm reviews the clinical, angiographic and management aspect of this rare condition. Bhattarai et al. review a rare case of a pregnant woman with Japanese encephalitis who also had superior sagittal sinus thrombosis. Lakhey et al. describe a seldom seen case of autonomic dysreflexia they were able to document in a woman with incomplete spinal injury at first lumbar vertebral level.
     Thapalia in the ‘Scientific Round-up’ has distilled the relevant scientific information from the leading journals around the world over the last 6 months. Scientific Round-up will be a regular feature of our journal, which we think will be of great benefit to busy readers.
      Happy New Year 2004!

Mohan R. Sharma
Kathmandu, Nepal