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Articles 151 - 180 of 261
Full-Text Articles in Neurosurgery
Paediatric Traumatic Brain Injury: Presentation, Prognostic Indicators And Outcome Analysis From A Tertiary Care Center In A Developing Country, Badar Uddin Ujjan, Muhammad Waqas, Muhammad Babar Khan, Dr Saqib Kamran Bakhshi, Muhammad Ehsan Bari
Paediatric Traumatic Brain Injury: Presentation, Prognostic Indicators And Outcome Analysis From A Tertiary Care Center In A Developing Country, Badar Uddin Ujjan, Muhammad Waqas, Muhammad Babar Khan, Dr Saqib Kamran Bakhshi, Muhammad Ehsan Bari
Section of Neurosurgery
Traumatic brain injury (TBI) is the leading cause of morbidity and mortality in children worldwide. This study was conducted to report the presentation, management, outcomes and prognostic indicators in a large series of patients from a tertiary care centre in a developing country. It is a review of prospectively collected data of paediatric patients with TBI admitted at our centre between July 2010 and December 2013. A total of 291 patients with a mean age of 7.2±5.0 years were dichotomised into survivors and non-survivors, and variables were compared between the two groups. The mean post-resuscitation Glasgow coma scale (GCS) score …
Paediatric Traumatic Brain Injury: Presentation, Prognostic Indicators And Outcome Analysis From A Tertiary Care Center In A Developing Country, Badar Uddin Ujjan, Muhammad Waqas, Muhammad Babar Khan, Saqib Kamran Bakhshi, Muhammad Ehsan Bari
Paediatric Traumatic Brain Injury: Presentation, Prognostic Indicators And Outcome Analysis From A Tertiary Care Center In A Developing Country, Badar Uddin Ujjan, Muhammad Waqas, Muhammad Babar Khan, Saqib Kamran Bakhshi, Muhammad Ehsan Bari
Department of Surgery Docs
Traumatic brain injury (TBI) is the leading cause of morbidity and mortality in children worldwide. This study was conducted to report the presentation, management, outcomes and prognostic indicators in a large series of patients from a tertiary care centre in a developing country. It is a review of prospectively collected data of paediatric patients with TBI admitted at our centre between July 2010 and December 2013. A total of 291 patients with a mean age of 7.2±5.0 years were dichotomised into survivors and non-survivors, and variables were compared between the two groups. The mean post-resuscitation Glasgow coma scale (GCS) score …
Co-Existing Spinal Intradural Ependymal Cyst And Sacral Tarlov Cyst In Adult-Onset Tethered Cord Syndrome With Syringomyelia: Case Report And Literature Review, Hamid H. Rai, Muhammad F. Khan, Ather Enam, Imtiaz Hashmi
Co-Existing Spinal Intradural Ependymal Cyst And Sacral Tarlov Cyst In Adult-Onset Tethered Cord Syndrome With Syringomyelia: Case Report And Literature Review, Hamid H. Rai, Muhammad F. Khan, Ather Enam, Imtiaz Hashmi
Section of Neurosurgery
Background: Synchronous spinal intradural ependymal cysts and sacral Tarlov cysts in adult onset tethered cord syndrome are extremely rare.
Case description: A 23-year-old male presented with back pain radiating into both lower extremities, accompanied by acute onset of gait difficulty and sphincter dysfunction. Magnetic resonance imaging identified a low lying conus medullaris, syringomyelia with septations extending from T12 to S1, a tethered cord, and a thickened filum terminale with a sacral Tarlov cyst. The patient underwent a L3-4 laminectomy for decompression of syringomyelia and excision/biopsy of a space occupying lesion along with S1-2 laminectomy for cord untethering and Tarlov cyst …
Management And Outcomes Of Intramedullary Spinal Cord Tumors: A Single Center Experience From A Developing Country, Dr Saqib Kamran Bakhshi, Muhammad Waqas, Baila Shakaib, Ather Enam
Management And Outcomes Of Intramedullary Spinal Cord Tumors: A Single Center Experience From A Developing Country, Dr Saqib Kamran Bakhshi, Muhammad Waqas, Baila Shakaib, Ather Enam
Section of Neurosurgery
Background: Intraoperative neurophysiology, high magnification microscopes, and ultrasonic aspirators are considered essential aid for the safe resection of intramedullary spinal cord tumors (IMSCTs). Most centers in developing countries such as Pakistan still lack these facilities. The purpose of this study was to review the management of IMSCTs at our hospital and to determine factors associated with the outcomes of surgery.
Methods: This was a retrospective review of medical records of adult patients undergoing surgery for IMSCT over 12 years. The institutional ethical review committee approved this study. Data were collected regarding demographics, clinical and radiological features, and surgical details. Modified …
Cerebral Aspergillosis And Pulmonary Tuberculosis In A Child With Chronic Granulomatous Disease, Muhammad Waqas, Sidra Zafar, Tooba Rehman, Muhammed Riyaz, Muhammad Ehsan Bari, Romana Idress
Cerebral Aspergillosis And Pulmonary Tuberculosis In A Child With Chronic Granulomatous Disease, Muhammad Waqas, Sidra Zafar, Tooba Rehman, Muhammed Riyaz, Muhammad Ehsan Bari, Romana Idress
Section of Neurosurgery
Background: Chronic granulomatous disease (CGD) is an immune disorder that affects phagocytes. It is characterized by recurrent or persistent bacterial and fungal infections. Reports of tuberculosis (TB) in patients with CGD are rare. In developing countries, where TB is endemic, possibility of other chronic infections is often overlooked by physicians.
Case description: We report the case of a 4-year-old boy who had recurrent respiratory infections and episodes of headache. He was put on antituberculosis (ATT) drugs without microbiological or pathological evidence 2 months prior to presentation. The child did not improve and was brought to our hospital where a computed …
Acute Cerebellitis Successfully Managed With Temporary Cerebrospinal Fluid Diversion Using A Long Tunnel External Ventricular Drain: A Long-Term Radiological Follow-Up Of Two Cases, Muhammad Waqas, Yousaf Bashir Hadi, Sadaf Sheikh, Muhammad Shahzad Shamim
Acute Cerebellitis Successfully Managed With Temporary Cerebrospinal Fluid Diversion Using A Long Tunnel External Ventricular Drain: A Long-Term Radiological Follow-Up Of Two Cases, Muhammad Waqas, Yousaf Bashir Hadi, Sadaf Sheikh, Muhammad Shahzad Shamim
Section of Neurosurgery
Acute cerebellitis (AC) is a rare inflammatory childhood disorder. Although there is no consensus on standard treatment for cerebellitis, its outcome is usually favourable. We report two cases of AC in the paediatric age group, successfully managed with long tunnel external ventricular drain (EVD). The first patient was an 8-year-old boy with a history of fever and headache. Sequential MRI showed diffuse cerebellar swelling with tonsillar herniation and resulting hydrocephalus. The second patient was a 6-month-old boy who presented with high-grade fever associated with chills. CT scan of the head showed triventricular hydrocephalus with obliteration of cerebrospinal fluid spaces and …
Composite Split Cord Malformation Associated With A Dermal Sinus Tract, Dermoid Cyst, And Epidural Abscess: A Case Report And Review Of Literature, Saad Akhtar, Abdul Azeem, Muhammad Shahzad Shamim, Muhammad Zubair Tahir
Composite Split Cord Malformation Associated With A Dermal Sinus Tract, Dermoid Cyst, And Epidural Abscess: A Case Report And Review Of Literature, Saad Akhtar, Abdul Azeem, Muhammad Shahzad Shamim, Muhammad Zubair Tahir
Section of Neurosurgery
Background: Split cord malformation (SCM) is typically present at a single level but rarely, may be present at multiple levels in the spinal cord and can be associated with a wide array of lesions such as myelomeningoceles, lipomas, teratomas, and dermal sinus tracts (DSTs).
Case description: We describe a case of a 15-month-old female child who presented with high-grade fever and progressive motor weakness in the lower limbs. Magnetic resonance imaging revealed the presence of SCM along with an epidural abscess, DST, and dermoid cyst. The child underwent surgery for excision of DST along with removal of the dermoid cyst …
Providing Care Beyond The Hospital: Perspective Of A Tertiary Care Hospital From A Developing Country, Saad Akhtar, Muhammad Waqas, Badar Uddin Ujjan, Adnan Salim, Gohar Javed, Syed Ijlal Ahmed, Malikah Surani, Marium Khan
Providing Care Beyond The Hospital: Perspective Of A Tertiary Care Hospital From A Developing Country, Saad Akhtar, Muhammad Waqas, Badar Uddin Ujjan, Adnan Salim, Gohar Javed, Syed Ijlal Ahmed, Malikah Surani, Marium Khan
Section of Neurosurgery
Background: Neurorehabilitation is an important aspect of continuing care for neurosurgical patients with functional disability. In developing countries, where formal home nursing frequently is unavailable, ensuring care after discharge is a difficult task. Training attendants to provide nursing care is an alternate option. In this study, we compared the outcomes of patients nursed by family members versus those looked after by a professional nurse.
Methods: This was a retrospective observational study conducted at the Aga Khan University Hospital Karachi. The study consisted of 2 groups. Group 1 (consisting of patients cared for by a professional nurse) included 94 patients and …
Long-Tunneled Versus Short-Tunneled External Ventricular Drainage: Prospective Experience From A Developing Country, Muhammad Zubair Tahir, Zain A. Sobani, Muhammed Murtaza, Ather Enam
Long-Tunneled Versus Short-Tunneled External Ventricular Drainage: Prospective Experience From A Developing Country, Muhammad Zubair Tahir, Zain A. Sobani, Muhammed Murtaza, Ather Enam
Section of Neurosurgery
Background: External ventricular drains (EVD) are commonly utilized for temporary diversion of cerebrospinal fluid (CSF). Many neurosurgeons prefer long-tunneled EVDs in their routine practice. However, it is still unclear whether this extended tunneling helps in reducing CSF infection. Keeping this in mind, we decided to compare infection rates in long-tunneled versus short-tunneled EVDs in the setting of a developing country.
Materials and methods: A prospective study of 60 patients was conducted. Consenting patients who underwent short-tunneled (Group A) or long-tunneled (Group B) EVDs between January 2008 and June 2009 were followed during the course of their inpatient care. All operational …
Response To: Computed Tomography-Guided Biopsy For Potts Disease: An Institutional Experience From An Endemic Developing Country, Muhammad Waqas, Faizuddin Najmuddin, Mohammad Ali Alvi, Muhammad Ehsan Bari
Response To: Computed Tomography-Guided Biopsy For Potts Disease: An Institutional Experience From An Endemic Developing Country, Muhammad Waqas, Faizuddin Najmuddin, Mohammad Ali Alvi, Muhammad Ehsan Bari
Section of Neurosurgery
No abstract provided.
Cerebellopontine Angle Primitive Neuroectodermal Tumor Mimicking Trigeminal Schwannoma, Saad Akhtar Khan, Badar Uddin Ujjan, Adnan Salim, Muhammad Shahzad Shamim
Cerebellopontine Angle Primitive Neuroectodermal Tumor Mimicking Trigeminal Schwannoma, Saad Akhtar Khan, Badar Uddin Ujjan, Adnan Salim, Muhammad Shahzad Shamim
Section of Neurosurgery
Background: Primitive neuroectodermal tumors (PNETs) comprise a group of aggressive, poorly differentiated embryonal tumors occurring in central nervous system as well as in peripheral locations. Primary cerebellopontine angle (CPA) PNET is an extremely rare entity. It is important to have knowledge of this pathology and to be able to differentiate it from other commonly occurring CPA tumors, such as vestibular and trigeminal schwannomas. This distinction is essential because of the difference in the overall treatment plan and prognosis.
Case description: This report describes a case of a young male presenting with diplopia and numbness of face; magnetic resonance imaging showed …
Response To The Comments: "Prospective Case Control Evaluation Of Epidural Midazolam For Improving Pain And Ambulation After Microdiscectomy", Muhammad Shahzad Shamim
Response To The Comments: "Prospective Case Control Evaluation Of Epidural Midazolam For Improving Pain And Ambulation After Microdiscectomy", Muhammad Shahzad Shamim
Section of Neurosurgery
No abstract provided.
Primary Anaplastic Pleomorphic Xanthoastrocytoma In Adults. Case Report And Review Of Literature, Usama Khalid Choudry, Saad Akhtar Khan, Amjad Qureshi, Muhammad Ehsan Bari
Primary Anaplastic Pleomorphic Xanthoastrocytoma In Adults. Case Report And Review Of Literature, Usama Khalid Choudry, Saad Akhtar Khan, Amjad Qureshi, Muhammad Ehsan Bari
Section of Neurosurgery
Background: Pleomorphic xanthoastrocytoma (PXA) classified as a low Grade (WHO II) astrocytic neoplasm. It is known for its relatively favorable prognosis. It most commonly occurs in young adults. Malignant progression in PXA has been frequently reported since its first description in 1979; however, the presentation of a primary anaplastic PXA tumor with an aggressive clinical course in adults is rare especially in the later age group.
Case description: We present a case of primary anaplastic PXA in a 53 year old male that manifested with an early recurrence pattern at 9 weeks. Treatment performed was surgical excision and external beam …
Ependymal Tumors With Oligodendroglioma Like Clear Cells: Experience From A Tertiary Care Hospital In Pakistan, Fauzan Alam Hashmi, Muhammad Faheem Khan, Saad Akhtar Khan, Muhammad Waqas, Muhammad Ehsan Bari, Arsalan Ahmed
Ependymal Tumors With Oligodendroglioma Like Clear Cells: Experience From A Tertiary Care Hospital In Pakistan, Fauzan Alam Hashmi, Muhammad Faheem Khan, Saad Akhtar Khan, Muhammad Waqas, Muhammad Ehsan Bari, Arsalan Ahmed
Section of Neurosurgery
Background: Ependymal tumors with oligodendroglioma like clear cells have never been reported from Pakistan. We aimed to see the features and outcomes of this rare entity.
Methods: It was retrospective cohort conducted at the Department of Neurosurgery, Aga Khan University from 2003 to 2013. The medical records and radiology of patients with proven histopathology were reviewed. Analysis was done on SPSS 20.
Results: Eleven cases of ependymal tumors with clear cells were found, which equated to 1.5% of the total tumor burden in 11 years. The median age was 49 years. Most common presenting symptom was headache 54.5%. Out of …
Surveillance In The Service Of Safety, Rashid Jooma
Surveillance In The Service Of Safety, Rashid Jooma
Section of Neurosurgery
The World Report on Road Traffic Injury Prevention of 2004 recommended that the newly motorizing countries establish road injury surveillance to define the burden, identify highrisk groups, plan intervention and monitor their impact. Despite its stated importance in the literature, very few examples of sustained surveillance systems are reported from low income countries. This presentation shares the results of an urban RTI surveillance program that has been running for the past 8 years since 2007 in the emergency departments of five major hospitals in Karachi, Pakistan. We describe the process of establishing the road injury surveillance system incorporating a multi-institution …
Bicompartmental Decompressive Craniectomy: Report Of Two Cases, Saad Akhtar, Badar Uddin Ujjan, Muhammad Waqas, Muhammad Waqas Khan Waqas Khan, Gohar Javed
Bicompartmental Decompressive Craniectomy: Report Of Two Cases, Saad Akhtar, Badar Uddin Ujjan, Muhammad Waqas, Muhammad Waqas Khan Waqas Khan, Gohar Javed
Section of Neurosurgery
A recent study of randomized controlled trials showed favorable outcomes with use of decompressive craniectomy in managing and treating uncontrolled intracranial pressures accompanied with cerebral edema due to trauma. We present the details of bicompartmental decompressive craniectomy on two patients who presented with severe head trauma of supra- and infratentorial pathologies. The surgical management techniques and long-term follow-up are discussed in detail.
Neurofibromatosis Type 2 Patient Presenting With Medulloblastoma, Jan Kalimullah, Abdul Malik Amir Humza Sohail, Rai Shahjehan, Sabeehuddin Siddique, Muhammad Ehsan Bari
Neurofibromatosis Type 2 Patient Presenting With Medulloblastoma, Jan Kalimullah, Abdul Malik Amir Humza Sohail, Rai Shahjehan, Sabeehuddin Siddique, Muhammad Ehsan Bari
Section of Neurosurgery
Background: Neurofibromatosis type 2 (NF2) is an autosomal dominant syndrome with a frequency of 1 in 25,000 live births and a penetrance of almost 100% by the sixth decade of life. The main tumors occurring in NF2 patients are bilateral vestibular schwannomas, other peripheral, cranial and spinal nerve schwannomas, intracranial and intraspinal meningiomas, ependymomas, and gliomas.
Case description: We report the case of a 6-year-old boy who presented with a 1-month history of nausea and recurrent vomiting. Physical examination was positive for ataxic gait and left-sided facial nerve palsy. Family history was positive for NF2 in the patient's father and …
Fasting Headache, A Cross-Sectional Study, Adnan Salim, Muhammad Ahmed Ilyas, Mehwish Rizvi, Arzlan Ullaha Baig, Syed Hassaan Ahmed, Zuha Pandit, Muhammad Saleem Ilyas
Fasting Headache, A Cross-Sectional Study, Adnan Salim, Muhammad Ahmed Ilyas, Mehwish Rizvi, Arzlan Ullaha Baig, Syed Hassaan Ahmed, Zuha Pandit, Muhammad Saleem Ilyas
Section of Neurosurgery
Headache is a predominant disorder in general population and is classified into primary and secondary forms by the International Headache Society. Fasting headache is currently classified in Group 10 of ICHD-III as “Headache attributed to disorders of homeostasis”. In spite of continuing research, there is still indistinctness regarding the exact cause of fasting headache. Hypoglycaemia, previous history of headache, stress, caffeine withdrawal, lack of sleep and female gender have been speculated as causative factors. Our rationale for this study is to find out what percentage of the population experiences fasting headache and to find out any link between the occurrence …
Multiple Cerebral Hydatid Cysts In 8-Year-Old Boy: A Case Report And Literature Review Of A Rare Presentation, Muhammad Baba Khan, Muhammad Riaz, Muhammad Ehsan Bari
Multiple Cerebral Hydatid Cysts In 8-Year-Old Boy: A Case Report And Literature Review Of A Rare Presentation, Muhammad Baba Khan, Muhammad Riaz, Muhammad Ehsan Bari
Section of Neurosurgery
Background: Multiple cerebral hydatid cysts are very rare with only a few reports in the literature detailing diagnostic workup, medical management, surgical techniques, possible complications, and outcomes.
Case description: We present the case of an 8-year-old boy who presented with progressively worsening headaches, vomiting, and intermittent fever since 20 days. Diagnostic workup was performed, and magnetic resonance imaging revealed multiple intracranial cysts predominantly in the right frontal region with significant mass effect. A total of 19 intracranial cysts were removed surgically, and the child recovered uneventfully.
Conclusions: Neurosurgeons should keep hydatidosis in the list of differentials when evaluating patients with …
Epilepsy In Pakistan: National Guidelines For Clinicians, Fowzia Siddiqui, Tipu Sultan, Shahid Mustafa, Sarwar Jamil Siddiqui, Shaukat Ali, Abdul Malik, Zafar Sajjad, Saleem Barech, Rashid Jooma
Epilepsy In Pakistan: National Guidelines For Clinicians, Fowzia Siddiqui, Tipu Sultan, Shahid Mustafa, Sarwar Jamil Siddiqui, Shaukat Ali, Abdul Malik, Zafar Sajjad, Saleem Barech, Rashid Jooma
Section of Neurology
Introduction: Epilepsy is one of the most common chronic neurological disorders requiring prolonged treatments and drugs. According to The World Health Organization (WHO), epilepsy is one of those serious brain disorders that affect not only the individual but has a deep impact on the family and society in general. Approximately 50 million people are affected with epilepsy around the world36, though proper epidemiological studies do not exist for Pakistan it is estimated that the prevalence of epilepsy is 9.99/1000. Highest prevalence is seen in people younger than 30 years of age, i.e. about 2 million people and 1/10th of the …
Computed Tomography-Guided Biopsy For Potts Disease: An Institutional Experience From An Endemic Developing Country, Muhammad Waqas, Mohsin Qadeer, Faizuddin Faiz, Mohammad Ali Alvi, Muhammad Ehsan Bari
Computed Tomography-Guided Biopsy For Potts Disease: An Institutional Experience From An Endemic Developing Country, Muhammad Waqas, Mohsin Qadeer, Faizuddin Faiz, Mohammad Ali Alvi, Muhammad Ehsan Bari
Section of Neurosurgery
Study design: A retrospective chart review.
Purpose: In endemic resource poor countries like Pakistan, most patients are diagnosed and treated for Potts disease on clinical and radiological grounds without a routine biopsy. The purpose of this study was to evaluate the use and effect of computed tomography (CT)-guided biopsy in the management of Potts disease since the technique is becoming increasingly available.
Overview of literature: CT-guided biopsy of spinal lesions is routinely performed. Literature on the utility of the technique in endemic resource poor countries is little.
Methods: This study was conducted at the Neurosurgery section of Aga Khan University …
Clinical Outcome And Cost Effectiveness Of Early Tracheostomy In Isolated Severe Head Injury Patients, Usman Tariq Siddiqui, Muhammad Zubair Tahir, Muhammad Shahzad Shamim, S. Ather Enam
Clinical Outcome And Cost Effectiveness Of Early Tracheostomy In Isolated Severe Head Injury Patients, Usman Tariq Siddiqui, Muhammad Zubair Tahir, Muhammad Shahzad Shamim, S. Ather Enam
Section of Neurosurgery
Background: Early tracheostomy (ET) has been shown to be effective in reducing complications associated with prolong mechanical ventilation. The study was carried out to evaluate the role of ET in reducing the duration of mechanical ventilation, duration of intensive care unit (ICU) stay, ICU-related morbidities, and its overall effect on outcome, in patients with isolated severe traumatic brain injury (TBI).
Methods: This 7-year review included 100 ICU patients with isolated severe TBI requiring mechanical ventilation. ET was defined as tracheostomy within 7 days of TBI, and prolonged endotracheal intubation (EI) as EI exceeding 7 days of TBI. Of 100 patients, …
Clinoidal Meningioma Associated With An Internal Carotid Artery Aneurysm, Muhammad Waqas, Yousuf Bashir Hadi, Badar Uddin Ujjan, Gohar Javed
Clinoidal Meningioma Associated With An Internal Carotid Artery Aneurysm, Muhammad Waqas, Yousuf Bashir Hadi, Badar Uddin Ujjan, Gohar Javed
Section of Neurosurgery
Coexistence of primary brain neoplasms with intracranial aneurysms is rare but presents a diagnostic and therapeutic challenge to healthcare providers. We describe the case of a 60-year-old woman who had a left internal carotid artery aneurysm with a small ipsilateral clinoidal meningioma. The meningioma was an unexpected finding encountered during the surgery for aneurysmal clipping. Both the lesions were dealt with simultaneously.
Factors Affecting Ventriculoperitoneal Shunt Survival In Adult Patients, Farid Khan, Abdul Rehman, Muhammad Shahzad Shamim, Muhammad Ehsan Bari
Factors Affecting Ventriculoperitoneal Shunt Survival In Adult Patients, Farid Khan, Abdul Rehman, Muhammad Shahzad Shamim, Muhammad Ehsan Bari
Section of Neurosurgery
Background: Ventriculoperitoneal (VP) shunt insertion remains the mainstay of treatment for hydrocephalus despite a high rate of complications. The predictors of shunt malfunction have been studied mostly in pediatric patients. In this study, we report our 11-year experience with VP shunts in adult patients with hydrocephalus. We also assess the various factors affecting shunt survival in a developing country setting.
Methods: A retrospective chart analysis was conducted for all adult patients who had undergone shunt placement between the years 2001 and 2011. Kaplan-Meier curves were used to determine the duration from shunt placement to first malfunction and log-rank (Cox-Mantel) tests …
Impacts Of Signal Free Corridors On The Incidence Of Road Traffic Accidents In Karachi, Salman Zubair, Jamil H. Kazm, Syed Shahid Ali, Rashid Jooma, Zeeshan Akhtar
Impacts Of Signal Free Corridors On The Incidence Of Road Traffic Accidents In Karachi, Salman Zubair, Jamil H. Kazm, Syed Shahid Ali, Rashid Jooma, Zeeshan Akhtar
Section of Neurosurgery
Increase in road Traffic Accidents is a global phenomenon and Pakistan is no exception. In Karachi, this problem becomes severe due to rapid growth of population. This menace is ruining the lives of thousands of people and making Karachi a worrisome place to live. Recent road geometrical transitions in the city with insufficient accessories have been reducing the problem of traffic congestion to a limited extent. On the contrary, this has erupted as a problem of Road Traffic Accidents which is reaching out of proportions. Recently, induction of a unique feature named, Signal Free Corridor in Karachi has cost many …
Polio Eradication And Health Systems In Karachi: Vaccine Refusals In Context, Svea Closser, Rashid Jooma, Emma Varley, Naina Qayyum, Sonia Rodrigues, Akasha Sarwar, Patricia Omidian
Polio Eradication And Health Systems In Karachi: Vaccine Refusals In Context, Svea Closser, Rashid Jooma, Emma Varley, Naina Qayyum, Sonia Rodrigues, Akasha Sarwar, Patricia Omidian
Section of Neurosurgery
Community and health worker engagement will be key to polio eradication in Karachi, Pakistan. In this study, the authors conducted participant observation, interviews, and a document review in SITE Town, Karachi, an area that in recent years has harbored poliovirus. SITE’s diverse population includes large numbers of internally displaced persons who are disproportionately affected by polio and are more likely than other populations to refuse the polio vaccine. Vaccine acceptance and worker motivation in SITE Town were shaped by the discrepancy in funding and attention for polio eradication campaigns as compared with routine services. Parental vaccine refusals stemmed from a …
A Unique Mri Presentation Of Fungal Infection In The Brain, Muhammad Bilal Salman Khan, Saad Shafqat, Ather Enam
A Unique Mri Presentation Of Fungal Infection In The Brain, Muhammad Bilal Salman Khan, Saad Shafqat, Ather Enam
Section of Neurology
Fungal infections of CNS are common in certain geographic locations. MRI with or without contrast is a useful prediagnostic tool. However, the findings may sometimes be misleading. In this case report, the authors present unusual imaging findings in the MRI of fungal infection in an immunocompetent host, whereby hyper-intense signals were seen on T2-weighted images and patchy post-contrast enhancement was observed with surrounding edema. These findings were suggestive of a neoplastic lesion but it was identified as aspergillosis on subsequent histopathology. This unusual MRI finding of CNS highlights the need to consider fungal infection as a differential diagnosis of all …
Prospective Validation Of A Blood Ordering Protocol For Elective Spine Arthrodesis And Its Impact On Cost Reduction, Muhammad Waqas, Muhammad Shahzad Shamim, Badar Uddin Ujjan, Saqib Kamran Bakhshi
Prospective Validation Of A Blood Ordering Protocol For Elective Spine Arthrodesis And Its Impact On Cost Reduction, Muhammad Waqas, Muhammad Shahzad Shamim, Badar Uddin Ujjan, Saqib Kamran Bakhshi
Section of Neurosurgery
Background: On the basis of an institutional audit, the authors published an individual patient-based protocol for preoperative arrangement of blood products in patients undergoing elective spine arthrodesis. The present study was conducted for the prospective validation of the proposed protocol in reducing cross match to transfusion ratio, and its implications on overall cost.
Methods: This cross-sectional study was conducted over 1 year (2012). All adult patients who underwent elective spinal arthrodesis were included and prospectively observed. The actual transfusion index was calculated for individual patients with the formula C1/T, where C1 is the number of units of packed RBCs cross …
Lumbar Morphometry: A Study Of Lumbar Vertebrae From A Pakistani Population Using Computed Tomography Scans, Muhammad M. Alam, Muhammad Waqas, Hussain Shallwani, Gohar Javed
Lumbar Morphometry: A Study Of Lumbar Vertebrae From A Pakistani Population Using Computed Tomography Scans, Muhammad M. Alam, Muhammad Waqas, Hussain Shallwani, Gohar Javed
Section of Neurosurgery
Study design: A cross-sectional study.
Purpose: To describe the characteristics of lumbar vertebrae of Pakistani patients reporting at a tertiary care hospital and compare with studies from other populations.
Overview of literature: Several studies have been conducted to determine morphometry of lumbar vertebrae. Most of the studies involve Caucasian populations, still data on other populations still sparse. This is the first study describing lumbar morphometry of a Pakistani population.
Methods: An observational study was conducted based on a review of thin-cut (3 mm) computed topographic images of lumbar vertebrae. Two-hundred and twenty vertebrae from forty-nine patients were studied, and various …
Polio Travel Restrictions: A Sledgehammer To Crack A Nut?, Rashid Jooma
Polio Travel Restrictions: A Sledgehammer To Crack A Nut?, Rashid Jooma
Section of Neurosurgery
Imposition by WHO of mandatory vaccination for international travelers from Pakistan has caused confusion and panic amongst travelers besides the adverse effect on the country's image from the widely reported statement. It is felt that the announced measure is not primarily supported by science but is rather a response to disillusionment in the donors about the repeatedly missed eradication targets set by WHO. In the past few years, exportation of poliovirus from Pakistan has caused outbreaks in China, Iraq and Syria besides the ongoing two way transmission with Afghanistan, but the carriers in these spreads are mainly land route travelers. …