Objective: The treatment of adjacent segment disease (ASD) following lumbar fusion is common and often requires reoperation. Traditionally, reoperation requires revision and exposure of prior instrumentation, and removal of this hardware increases operative time and perioperative risks. The authors report on the use of robot-assisted navigation (RAN) to accomplish minimally-invasive posterior pedicle screw fixation, including pedicle re-instrumentation when needed, to treat ASD and avoid revision and exposure of prior hardware.

Objective: To report the clinical outcome achieved through surgical clipping of ruptured cerebral aneurysms over 7 and half years period in tertiary care hospital of Pakistan. Methods: A retrospective study of Pakistani patients with ruptured intracranial aneurysms that were operated for clipping. The de- mographic details, characteristics of ruptured aneurysm, imaging of aneurysm, clinical course, progress and outcome were recorded. Fisher grading and Hunt and Hess criteria were used. Glasgow outcome scale (GOS) was used for final result. Data was recorded and analyze through SPSS version 21.

Arterial spin labeling (ASL) is an MRI perfusion technique which helps in non-invasive assessment of the cerebral blood flow (CBF). It is a technique that uses the labeled protons in the arterial blood as an endogenous tracer. Assessment of the perfusion plays a vital role in evaluation of various brain pathologies like neoplasms. Various techniques are available for assessment of the perfusion such as DSC MRI, CT perfusion imaging, SPECT, H2[15O] PET etc. which are invasive and require administration of the exogenous contrast media or use of ionizing radiation.

The United Nation (UN) and it`s agencies predict major population shifts in the rest of the 21st Century. These changes will substan- tially impact Physical and Mental Well-being of billions of people. Predictions are based on current trends and are subject to various interpretations. Assessments of current status and trends should consider uncertainties and allow for flexibility if needed. Especially culturally sensitive and subjective Psychometric data should be collected and documented with embedded metrics flexibility

Giant cell arteritis (GCA) is a systemic disease, characterized by granulomatous inflammation of the large and medium sized arter- ies. It almost exclusively affects older than 50 years and is part of the spectrum including polymyalgia rheumatica. The incidence of GCA increases with the age. Women are affected more commonly than men. It can lead to profound permanent vision loss, if not detected early due to mainly arteritic anterior ischaemic optic neuropathy.

The femoral neck anteversion is the inclination of the axis of the femoral neck with reference to the knee axis projected on a plane, perpendicular to the shaft axis. Femoral anteversion is a physiological condition, within certain variations in degrees and differences depending on age. The wide variations in angle of anteversion of the femoral neck makes it necessary to know the angle of anteversion in a particular population. The accurate estimation of femoral neck anteversion in living subjects is not only difficult but has many shortcomings and also lacks reproducibility.

Basilar artery stroke is a rare but devastating condition that requires swift diagnosis and treatment. Factor V Leiden is a hypercoagulability mutation primarily associated with venous thromboembolism, but is rarely associated with arterial athero- thrombotic events such as ischemic stroke. In young patients, the presence of a PFO and prothrombotic mutation can increase the risk of cerebrovascular accidents.

The hypophysis is a pea-sized gland located in the sella turcica. The glands primary function is to regulate the hormonal activity, which is controlled by the outputs received from the hypothalamus. These highly capable cells are derived from pituitary stem cells (PSCs) during the embryogenesis. The previous articles prove that the stem cells are a potential treatment option for a wide spectrum of pathologies. However, it is also undeniable that more research must be done to improve our knowledge of PSCs and to integrate PSCs into our treatment strategies.

New and better medications are needed since drug resistance is becoming a bigger issue. Natural products and biotherapeutics provide an enormous source of potential new drugs; however, there are difficulties associated with these fields, including the ex- pense and length of time required for conventional drug discovery processes and the subsequent lack of investment from the phar- maceutical industry