Medicine and Health Sciences Commons^™

Immunohistochemical Detection And Prognostic Significance Of P53, Epidermal Growth Factor Receptor, Murine Double Minute 2, And Isocitrate Dehydrogenase 1 In Glioblastoma Multiforme Patients Of Pakistan, Syed Muhammad Adnan Ali, Muhammad Shahzad Shamim, Syed Ather Enam, Zubair Ahmad, Yumna Adnan, Hasnain Ahmed Farooqui

Department of Surgery

Introduction: Glioblastoma multiforme (GBM) is one of the deadliest cranial tumors occurring in adults. Various biomarkers have been tested for their significance in diagnosis, prognosis, and treatment of GBM. Some well-studied markers in GBM are Isocitrate dehydrogenase 1 (IDH1), Murine double minute 2 (MDM2), Epidermal Growth Factor Receptor (EGFR), and p53. The aim of this study was to investigate the protein expression of these markers in GBM patients of Pakistan.
Methods: A total of 102 surgically resected formalin-fixed paraffin-embedded specimens from patients diagnosed and treated at Aga Khan University Hospital were included in this study. Immunohistochemistry (IHC) for IDH1, MDM2, …

Translation And Validation Of The Urdu Version Of The European Organization For Research And Treatment Of Cancer Core Quality Of Life Questionnaire (Eortc Qlq-C30) And Brain Module (Qlq-Bn20) In Primary Brain Tumor Patients, Nida Zahid, Russell S. Martins, Wajeeha Zahid, Wardah Khalid, Syed Iqbal Azam, Shireen Shehzad Bhamani, Nargis Asad, Khabir Ahmad, Adnan Abdul Jabbar, Muhammad Shahzad Shamim, Rashid Jooma, Gohar Javed, Muhammad Ehsan Bari, Ather Enam

Department of Surgery

Introduction: This study translated and validated the Urdu version of the European Organization for Research and Treatment of Cancer Quality of Life (QoL) Questionnaire (EORTC QLQ-C30) and Brain Module (QLQ-BN20) amongst patients with primary brain tumors (PBT) in Pakistan, and assessed the correlation of QoL with resilience, depression, and anxiety.
Methods: Translation of the EORTC QLQ-C30 and QLQ-BN20 was performed as per EORTC guidelines. A survey comprising of Urdu translations of EORTC QLQ-C30, QLQ-BN20, Wagnild and Young Resilience Scale (RS-14) and Hospital Anxiety and Depression Scale was administered to patients with PBT at a tertiary care hospital in Pakistan. Reliability …

Human Papillomavirus And Human Cytomegalovirus Infection And Association With Prognosis In Patients With Primary Glioblastoma In Pakistan, Syed Adnan Ali, Yumna Mirza, Zubair Ahmad, Nida Zahid, Ather Enam

Department of Surgery

Objective: Glioblastoma multiforme (GBM) is the most common adult primary brain tumor. Human cytomegalovirus (HCMV) has been studied for the past decade, and conflicting results have been reported with no conclusive role established yet. Human papillomavirus (HPV) is involved in the pathogenesis of many cancers and has a high prevalence in patients with cervical and oral cancer in Pakistan. The objective of our study was to identify the prevalence of HCMV and HPV in Pakistani patients with primary GBM.
Methods: In total, 112 primary GBM biopsies were analyzed. HCMV and HPV infection was investigated using nested and conventional polymerase chain …

Role Of Surgery In Brain Metastases, Altaf Ali Laghari, Syed Ijlal Ahmed, Muhammad Shahzad Shamim

Department of Surgery

Abstract Brain metastases remain the commonest type of brain tumour, being four times more common than primary brain tumours. Although surgical intervention may be recommended for one of various reasons in the management of these tumours, including but not limited to conformation of diagnosis, relief of mass effect, improvement of neurological status and prolongation of survival, the guidelines for management of brain metastases remain largely subjective and therefore controversial. Herein the authors have attempted to review some of the existing evidence on role of surgery in the management of brain metastases and have presented their selected guidelines for the readers.

Perioperative Steroids For Lumbar Disc Surgery: A Meta-Analysis Of Randomized Controlled Trials, Muhammad Waqas, Hussain Shallwani, Muhammad Shahzad Shamim, Khabir Ahmed

Department of Surgery

Background: Our review question was "Does perioperative steroids administration, in comparison with other treatments or placebo, improve either postoperative pain control, length of hospital stay, or return to work in patients undergoing lumbar disc surgery?"
Methods: We searched PubMed, CINAHL PLUS, and Cochrane databases for randomized control trials (RCTs) studying the role of steroids for lumbar disc surgery. Studies that compared perioperative steroids with other treatments or placebo were included. Study outcomes included postoperative back pain, leg pain, length of hospital stay, and return to work. Data was extracted through a proforma. Means and mean differences were calculated for continuous …

Vulnerable Road Users Are At Greater Risk During Ramadan -- Results From Road Traffic Surveillance Data., Amber Mehmood, Anoosh Moin, Irum Qamar Khan, Mohammad Umer Mir, Rashid Jooma

Department of Surgery

Abstract

OBJECTIVE:

To assess how the frequency, nature and outcome of road traffic crashes differ during the fasting month of Ramadan.

METHODS:

The retrospective study was conducted in Karachi and comprised data from the Road Traffic Injury Surveillance Project which entailed information on all road traffic injury victims presenting to Emergency Departments in the city between September 2006 and September 2011. Data was analysed to find the frequency of road traffic crashes according to time of incident, road user group and survival. Ramadan and Non-Ramadan groups were compared with respect to time and frequency of incidents, road user group and …

Establishment Of A Comprehensive Epilepsy Center In Pakistan: Initial Experiences, Results, And Reflections, Muhammad Z Tahir, Z A. Sobani, S. A. Quadri, S. Nizam Ahmed, Fowzia Siddiqui, Syed Enam Enam

Department of Surgery

Background. Developing countries, home to 80% of epilepsy patients, do not have comprehensive epilepsy surgery programs. Considering these needs we set up first epilepsy surgery center in Pakistan. Methods. Seventeen teleconferences focused on setting up an epilepsy center at the Aga Khan University (AKU), Karachi, Pakistan were arranged with experts from the University of Alberta Hospital, Alberta, Canada and the University of West Virginia, USA over a two-year period. Subsequently, the experts visited the proposed center to provide hands on training. During this period several interactive teaching sessions, a nationwide workshop, and various public awareness events were organized. …

Assessment Of Knowledge & Practice Of Contraceptives In Females Of Reproductive Age Group At A Tertiary Care Hospital, Nabeela Fazal Babar, Mahmood Ahmed, Muhammad Babar Khan, Muhammad Wasif Khan

Department of Surgery

Abstract

Objectives: To assess the knowledge & practice of contraceptives in females of reproductive age group.
Study Design: Cross sectional descriptive.
Place and Duration of Study: OPD of Fauji Foundation Hospital from February 2008 – September 2008.
Subjects and Method: 339 Females of age b/w of 15 – 49 years attending OPD of Fauji Foundation Hospital were included in study. A structured questionnaire was used to collect data.
Results: Eighty eight percent of the females in our study sample were familiar with one or more methods of contraception (72.7%were familiar with combined oral contraceptive pill (COCP), 60.7% were aware of …

Role Of Surgery In Cerebral Venous Sinus Thrombosis, S. Ather Enam

Department of Surgery

Cerebral venous sinus thrombosis (CVST) usually is taken care of by medical management or neuro-interventional vascular techniques. Some cases of CVST may take a malignant course if the intracranial pressure increases excessively. This increase in pressure is because of oedema in brain tissue due to impediment in venous return and/or intracerebral haemorrhage. Neurosurgical experience has shown remarkable recovery in these moribund patients if appropriate surgical intervention is done within reasonable time. Emergent decompressive craniotomy or other neurosurgical interventions are the only appropriate treatment in these malignant forms of CVST to prevent mortality and severe morbidity.

Dural Metastases Presenting As An Extradural Hematoma: A Rare Presentation, Muhammad Shahzad Shamim, Muhammad Ehsan Bari, S. Ather Enam

Department of Surgery

Abstract

We report a case of an elderly man who presented with hemiparesis and plain CT scan findings highly suggestive of an extradural hematoma as the underlying cause. This patient was later found to have dural metastases secondary to bronchogenic carcinoma. Dural metastases are rare, usually presenting as dural mass, but may also present as chronic subdural or extradural hematoma on non contrast CT scan, leading to an erroneous diagnosis in the unsuspecting.