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Articles 151 - 180 of 205
Full-Text Articles in Surgery
Diagnostic Accuracy Of Clinical Examination In Cervical Spine Injuries In Awake And Alert Blunt Trauma Patients, Manzar Hussain, Gohar Javed
Diagnostic Accuracy Of Clinical Examination In Cervical Spine Injuries In Awake And Alert Blunt Trauma Patients, Manzar Hussain, Gohar Javed
Section of Neurosurgery
Study design: Observational, case series.
Purpose: To determine the sensitivity and specificity of clinical judgment as compared to the use of X-ray images in detecting cervical spine injuries in trauma patients presenting in the emergency department of Aga Khan University Hospital, Karachi.
Overview of literature: Cross-table cervical spine views are important in patients with signs and symptoms relating to cervical spine, but asymptomatic patients constitute a different subgroup. Accuracy of clinical examination in these patients has not been subjected to scrutiny.
Methods: All patients with blunt trauma who presented to the emergency department and underwent cross-table X-rays as part of …
Intracerebral Migration Of Stray Bullet Leading To Sudden And Fatal Worsening, Manzar Hussain, Muhammad Ehsan Bari
Intracerebral Migration Of Stray Bullet Leading To Sudden And Fatal Worsening, Manzar Hussain, Muhammad Ehsan Bari
Section of Neurosurgery
Gunshot wounds to the cranium are one of the leading cause of death and disability in young adults. Stray bullets are also being increasingly seen in clinical setting. We report a case of a 14-year-old boy who sustained a stray bullet to the cranium during election festivities. He arrived at the health care facility institution nearly 24 hours after the event in good neurological condition. He remained neurologically stable for about 8 hours after his presentation and later on deteriorated due to intracranial bullet migration. This required immediate bifrontal decompressive craniotomy along with right frontal lobectomy. However, the patient could …
Disability, Depression And Disc Surgery: Lets Be Careful With The Evidence, Muhammad Shahzad Shamim
Disability, Depression And Disc Surgery: Lets Be Careful With The Evidence, Muhammad Shahzad Shamim
Section of Neurosurgery
No abstract provided.
Stem Cells For Spinal Cord Regeneration: Current Status, Zain A. Sobani, Syed A. Quadri, Ather Enam
Stem Cells For Spinal Cord Regeneration: Current Status, Zain A. Sobani, Syed A. Quadri, Ather Enam
Section of Neurosurgery
Background: Nearly 11,000 cases of spinal cord injury (SCI) are reported in the United States annually. Current management options give a median survival time of 38 years, however, no rehabilitative measures are available. Stem cells have been under constant research given their ability to differentiate into neural cell lines replacing non functional tissue. Efforts have been made to establish new synapses and provide a conducive environment, by grafting cells from autologous and fetal sources, including embryonic or adult stem cells, Schwann cells, genetically modified fibroblasts, bone stromal cells, and olfactory ensheathing cells and combinations/ variants thereof.
Methods: In order to …
Microdiscectomy For Lumbosacral Disc Herniation And Frequency Of Failed Disc Surgery, Muhammad Shahzad Shamim, Maria Adnan Parekh, Muhammad Ehsan Bari, Ather Enam, Faraz Khursheed
Microdiscectomy For Lumbosacral Disc Herniation And Frequency Of Failed Disc Surgery, Muhammad Shahzad Shamim, Maria Adnan Parekh, Muhammad Ehsan Bari, Ather Enam, Faraz Khursheed
Section of Neurosurgery
Background: Microdiscectomy for lumbosacral disc herniations is one of the most commonly performed neurosurgical procedures. The Patient demographics, symptomatology, and recovery are highly variable, and surgical outcomes depend on several factors, including Patient demographics. Failed disc surgery refers to failure of improvement in Patient's symptoms following microdiscectomy, and has been observed to occur in up to 12% of Patients. To date, no study form Pakistan has looked into Patient demographics and failed disc surgery rates within the local context.
Objective:The aim of this study was to review the demographics of the Patient population presenting for surgical treatment of lumbosacral …
Intracranial Cavernous Angiomas, Syed Faraz Kazim, Atta-Ul-Aleem Bhatti, Ather Enam
Intracranial Cavernous Angiomas, Syed Faraz Kazim, Atta-Ul-Aleem Bhatti, Ather Enam
Section of Neurosurgery
Objective: To describe the clinical presentation, diagnosis, and management of patients presenting with intracranial cavernous angiomas (CAs) at a tertiary care hospital in Pakistan.
Study Design: Case series. Place and Duration of Study: Section of Neurosurgery, The Aga Khan University Hospital (AKUH), Karachi, from January 1990 to September 2008.
Methodology: A retrospective case note review of all patients diagnosed with intracranial CAs at AKUH during the study period. The studied variables included patient demographics, clinical presentation, family history of intracranial CAs or other space occupying lesions, modality of diagnosis, management, and outcome. Results were described as frequency percentages.
Results: During …
Primary Chiasmal Sarcoid Granuloma Masquerading As Glioma Of The Optic Chiasm, Muhammad Zubair Tahir, Farheen Shaikh, Arshad Ali Siddiqui
Primary Chiasmal Sarcoid Granuloma Masquerading As Glioma Of The Optic Chiasm, Muhammad Zubair Tahir, Farheen Shaikh, Arshad Ali Siddiqui
Section of Neurosurgery
A 37-year-old woman presented with a 6 months history of headaches and memory impairment. Examination showed no neurological deficit with normal vision. MRI scans showed an enlarged optic chiasm. There was no dural or leptomeningeal enhancement or hydrocephalus. Open biopsy of the suprasellar mass showed non-caseating chronic granulomatous inflammation compatible with sarcoidosis. Systemic features of sarcoid were absent. Patient showed marked improvement on steroid therapy.
Medical Ethics: A Slow But Sustained Revolution In Pakistan’S Healthcare, Muhammad Shahid Shamim, Muhammad Shahzad Shamim
Medical Ethics: A Slow But Sustained Revolution In Pakistan’S Healthcare, Muhammad Shahid Shamim, Muhammad Shahzad Shamim
Section of Neurosurgery
No abstract provided.
Craniocerebral Aspergillosis: A Review Of Advances In Diagnosis And Management, Muhammad Shahzad Shamim, Ather Enam, Rushna Ali, Saleha Anwar
Craniocerebral Aspergillosis: A Review Of Advances In Diagnosis And Management, Muhammad Shahzad Shamim, Ather Enam, Rushna Ali, Saleha Anwar
Section of Neurosurgery
Craniocerebral aspergillosis is a rare but dangerous central nervous system infection. The infection has a spectrum of presenting features, mostly affecting immunocompromised individuals. The incidence appears to be on the rise that has been especially observed in the immunocompetent population. A high index of suspicion, a comprehensive understanding of the infectious process and advanced laboratory and radiological diagnostic techniques, allow early diagnosis. Surgery, followed by systemic antifungal medications, remains the cornerstone of management. Early administration of empirical anti-fungal agents along with immunomodulators may further improve prognosis. Immunocompetent patients tend to have better outcomes as compared to those who are immunocompromised. …
Overview Of Surgical Management Of Infectious Non-Suppurative Brain Lesions (Part 2), Muhammad Shahzad Shamim, Ather Enam, Syed Faizan Ali, Rushna Pervez Ali, Mohammad Wasay
Overview Of Surgical Management Of Infectious Non-Suppurative Brain Lesions (Part 2), Muhammad Shahzad Shamim, Ather Enam, Syed Faizan Ali, Rushna Pervez Ali, Mohammad Wasay
Section of Neurosurgery
No abstract provided.
Fuzzy Logic In Neurosurgery: Predicting Poor Outcomes After Lumbar Disk Surgery In 501 Consecutive Patients, Muhammad Shahzad Shamim, Ather Enam, Uvais Qidwai
Fuzzy Logic In Neurosurgery: Predicting Poor Outcomes After Lumbar Disk Surgery In 501 Consecutive Patients, Muhammad Shahzad Shamim, Ather Enam, Uvais Qidwai
Section of Neurosurgery
Background: Despite a lot of research into Patient selection, a significant number of Patients fail to benefit from surgery for symptomatic lumbar disk herniation. We have used Fuzzy Logic-based fuzzy inference system (FIS) for identifying Patients unlikely to improve after disk surgery and explored FIS as a tool for surgical outcome prediction.
Methods: Data of 501 Patients were retrospectively reviewed for 54 independent variables. Sixteen variables were short-listed based on heuristics and were further classified into memberships with degrees of membership within each. A set of 11 rules was formed, and the rule base used individual membership degrees and their …
Cost-Effectiveness Of Clipping Vs Coiling Of Intracranial Aneurysms After Subarachnoid Hemorrhage In A Developing Country-A Prospective Study, Muhammad Zubair Tahir, Ather Enam, Rushna Pervez Ali, Atta Bhatti, Tanveer Ul Haq
Cost-Effectiveness Of Clipping Vs Coiling Of Intracranial Aneurysms After Subarachnoid Hemorrhage In A Developing Country-A Prospective Study, Muhammad Zubair Tahir, Ather Enam, Rushna Pervez Ali, Atta Bhatti, Tanveer Ul Haq
Section of Neurosurgery
Background: Endovascular coil treatment is being used increasingly as an alternative to clipping for some ruptured intracranial aneurysms. The relative benefits of these 2 approaches have yet to be fully established. The aim of this study was to compare the clinical outcome, resource consumption, and cost-effectiveness of endovascular. treatment vs surgical clipping in a developing country.
Methods: The study population consisted of 55 Patients with aneurysmal subarachnoid hemorrhage (SAH) identified prospectively from January 2004 to June 2007. Of the 55 Patients with ruptured intracranial aneurysms, 31 underwent surgical clipping, whereas 24 were treated via interventional coils. Clinical outcome at 6 …
Orbital Aspergillus Infection Mimicking A Tumour: A Case Report, Muhammad Ahsan Zafar, Syeda Sidra Waheed, Ather Enam
Orbital Aspergillus Infection Mimicking A Tumour: A Case Report, Muhammad Ahsan Zafar, Syeda Sidra Waheed, Ather Enam
Section of Neurosurgery
A 14-year-old male presented to the neurosurgical clinic with swelling just above the right eye which had been growing slowly for the last eight years. The swelling first appeared following a non-penetrating trauma eight years ago. On examination it was a non-tender, non-erythematous, firm, round swelling causing marked proptosis and diplopia on downward gaze only. The visual acuity was intact. MRI showed an intraorbital, extraconal mass isointense on T1 and hypointense on T2 imaging. A diagnosis of orbital tumor was made. A white, friable mass consistent with meningioma was resected. However histopathology report later showed it to be an Aspergilloma. …
Overview Of Surgical Management Of Infectious Non-Suppurative Brain Lesions (Part 1), Muhammad Shahzad Shamim, Ather Enam, Rushna Pervez Ali, Syed Faizan Ali, Mohammad Wasay
Overview Of Surgical Management Of Infectious Non-Suppurative Brain Lesions (Part 1), Muhammad Shahzad Shamim, Ather Enam, Rushna Pervez Ali, Syed Faizan Ali, Mohammad Wasay
Section of Neurosurgery
No abstract provided.
Vocal Fold Granuloma After Prolonged Neurosurgical Procedure With Wire Reinforced Endotracheal Tube, Muhammad Zubair Tahir, Muhammad Shahzad Shamim, Rashid Jooma
Vocal Fold Granuloma After Prolonged Neurosurgical Procedure With Wire Reinforced Endotracheal Tube, Muhammad Zubair Tahir, Muhammad Shahzad Shamim, Rashid Jooma
Section of Neurosurgery
No abstract provided.
Follicular Thyroid Carcinoma Presenting As Solitary Skull Metastasis: Report Of Two Cases, Muhammad Shahzad Shamim, Faraz Khursheed, Muhammad Ehsan Bari, Khalid Naseem Chisti, Ather Enam
Follicular Thyroid Carcinoma Presenting As Solitary Skull Metastasis: Report Of Two Cases, Muhammad Shahzad Shamim, Faraz Khursheed, Muhammad Ehsan Bari, Khalid Naseem Chisti, Ather Enam
Section of Neurosurgery
We report two otherwise healthy patients with no prior history of thyroid cancer, who presented to us with a solitary scalp lump. Neuroimaging of both patients showed osteolytic lesions involving the cranium which were subjected to complete excision biopsy and cranioplasty. Histopathological examination revealed metastases from well differentiated follicular thyroid carcinoma (FTC). Subsequent workup confirmed occult primary carcinoma of the thyroid gland in both patients.
The Trauma Centre: What It Should Mean, Rashid Jooma, Sabeena Jalal Khan, Junaid Razzak
The Trauma Centre: What It Should Mean, Rashid Jooma, Sabeena Jalal Khan, Junaid Razzak
Section of Neurosurgery
No abstract provided.
Role Of Neurosurgery In The Management Of Stroke, Gohar Javed, Muhammad Zubair Tahir, Ather Enam
Role Of Neurosurgery In The Management Of Stroke, Gohar Javed, Muhammad Zubair Tahir, Ather Enam
Section of Neurosurgery
Stroke is the second leading cause of death worldwide. The aim of treatment in stroke patients is to prevent further neurologic deterioration and prevent recurrence. Despite all advances in medical treatment, morbidity and mortality in stroke patients is still very high. The other alternative is surgical treatment, which still lacks class 1 evidence. However there is recent reconsideration of this form of treatment and ongoing trials are showing some promising results. In this review the recent advances in surgical treatment of stroke will be discussed along with recommendations from the latest randomized trials.
Management Of Myelomeningocele, A Sattar M. Hashim, Shahid Ahmed, Rashid Jooma
Management Of Myelomeningocele, A Sattar M. Hashim, Shahid Ahmed, Rashid Jooma
Section of Neurosurgery
Objective: T To find out best possible protocol to provide productive life to children born with myelomeningocele.
Study design: Descriptive study.
Place & Duration of study: Department of Neurosurgery, Jinnah Postgraduate Medical Centre Karachi from December 2001 to December 2006.
Patients and Methods: The medical record of 415 children with myelomeningocele operated at our center was reviewed retrospectively. The surgical & medical management protocol used for different sites of myelomeningocele was studied.
Results: The age of most of the patients at the time of myelomeningocele repair was between 25-30 days; however, children with ruptured myelomeningocele were consistently repaired early. All …
Traumatic Carotid-Cavernous Fistula: Clinical Presentation And Outcome, Atta A. Bhatti, S. Soulat Raza, Muhammad Ehsan Bari, S. Ather Enam, Tanveer Ul Haq, Zafar Sajjad
Traumatic Carotid-Cavernous Fistula: Clinical Presentation And Outcome, Atta A. Bhatti, S. Soulat Raza, Muhammad Ehsan Bari, S. Ather Enam, Tanveer Ul Haq, Zafar Sajjad
Section of Neurosurgery
Objective:To evaluate the presentation, clinical course and outcome of traumatic carotid-cavernous fistula (CCF) withendovascular treatment at our institution during the last five years.
Design: Retrospective descriptive study.
Setting: The study included patients seen at Aga Khan University Hospital from January 2000 to December 2005.
Methods: Retrospective analysis based on data retrieval from medical records using ICD coding system. Only those cases who had traumatic CCF and underwent endovascular treatment were included in the study.
Results: A total of 8 patients were diagnosed with post-traumatic CCF and 11 procedures were done. Mean age at presentation was 35.6 years; …
Neurosurgical Training In Pakistan, Ather Enam
Neurosurgical Training In Pakistan, Ather Enam
Section of Neurosurgery
No abstract provided.
Re: Various Irrigation Fluids Affect Postoperative Brain Edema And Cellular Damage During Experimental Neurosurgery In Rats, Syed Faraz Kazim, Ather Enam
Re: Various Irrigation Fluids Affect Postoperative Brain Edema And Cellular Damage During Experimental Neurosurgery In Rats, Syed Faraz Kazim, Ather Enam
Section of Neurosurgery
No abstract provided.
Craniocerebral Aspergillosis In Immunocompetent Hosts: Surgical Perspective, Muhammad Shahzad Shamim, Arshad A. Siddiqui, Ather Enam, Ahmed Ali Shah, Rashid Jooma, Saleha Anwar
Craniocerebral Aspergillosis In Immunocompetent Hosts: Surgical Perspective, Muhammad Shahzad Shamim, Arshad A. Siddiqui, Ather Enam, Ahmed Ali Shah, Rashid Jooma, Saleha Anwar
Section of Neurosurgery
Craniocerebral aspergillosis is a rare but dangerous variety of central nervous system infections. Surgery is being widely recognized as the cornerstone of management. Due to the rarity of the disease, difficulty and delay in diagnosis and poor outcome, there is very little in the literature regarding the various surgical strategies that may be adopted in these patients. Early aggressive surgery followed by chemotherapy offers the best chances. Surgical planning would depend upon the type and location of the disease process as well as the condition of the patient. Perioperative care holds immense importance and knowledge of possible complications is essential. …
Role Of Surgery In The Management Of Low Grade Glioma, Faraz Kazim, Ather Enam
Role Of Surgery In The Management Of Low Grade Glioma, Faraz Kazim, Ather Enam
Section of Neurosurgery
No abstract provided.
History Of Epilepsy Surgery, Ather Enam
Spectrum Of Intracranial Pathology: Tumors Versus Infections At A Tertiary Care Hospital, Muhib Alam Khan, Sukaina Aijazali Panju, Ather Enam
Spectrum Of Intracranial Pathology: Tumors Versus Infections At A Tertiary Care Hospital, Muhib Alam Khan, Sukaina Aijazali Panju, Ather Enam
Section of Neurosurgery
Introduction: Aga Khan University Hospital Neurosurgery Department has evolved into a high-volume centre for treatment of neurosurgical diseases. We aimed to compare the relative outcomes of intracranial tumors and CNS infections seen at our facility.
Methods: Hospital records of patients admitted under the neurosurgery service between 1994-2003 were evaluated. Cases with a principal diagnosis of an intracranial lesion were identified for further study. Demographic, clinical,and surgical variables were extracted from the medical record. Length of hospital stay, ICU utilization, and in-hospital mortality were the primary outcome indicators. Data were analyzed through descriptive statistics and comparisons of meansand proportions. …
Neurosurgeons And Electrocautery, S. Ather Enam
Neurosurgeons And Electrocautery, S. Ather Enam
Section of Neurosurgery
Abstract are not provided by the author/publisher
Towards A Cure For Traumatic Paraplegia - Is There Cause For Hope?, Rashid Jooma
Towards A Cure For Traumatic Paraplegia - Is There Cause For Hope?, Rashid Jooma
Section of Neurosurgery
In the past decade, great strides have been made in the field of CNS tissue repair and expectations have been raised that a cure of spinal paralysis is at hand. The two broad categories of investigational approaches to spinal regeneration are: (1) Enhancing the Regenerative Milieu of the Cord and (2) Cellular and Tissue Transplantation. Amongst the latter approaches, the early use of foetal cord tissue has given way to the more sophisticated studies on stem cell therapy and the implants of olfactory ensheating cells. These have engendered considerable public interest and are being offered as commercially available therapies in …
Surgery For Prolactinomas, Ashfaq A. Razzaq, Rashid Jooma
Surgery For Prolactinomas, Ashfaq A. Razzaq, Rashid Jooma
Section of Neurosurgery
A large proportion of prolactin secreting tumours of the pituitary gland are treatable by dopamine agonist drugs. however certain subgroups of these patients are better managed by surgical excision. the indications for surgery in prolactinomas remain controversial and this paper attempts to clarify these with illustrative cases. the factors favouring a surgical approach include poor tolerance of long term medical therapy, progression of visual deficits or recurrence while on medical treatment, cystic change in the tumour with pressure effects, csf fistula secondary to tumour shrinkage and prophylactic surgery in tumours anticipated to cause csf leak following medical therapy. the size …
Trans-Mastoid Approach To Otogenic Brain Abscess, Ashfaq A. Razzaq, Rashid Jooma, Shahid Ahmed
Trans-Mastoid Approach To Otogenic Brain Abscess, Ashfaq A. Razzaq, Rashid Jooma, Shahid Ahmed
Section of Neurosurgery
The treatment of otogenic brain abscess initially involves excision or aspiration of the abscess through a temporal or sub-occipital route depending on its location. This is followed by a mastoidectomy by the ENT surgeon to eradicate the primary source of infection. During the last three years, we have approached such lesions through a mastoidectomy followed by excision of the abscess through the same approach. This trans-mastoid approach is technically feasible in following the tract of suppuration, and clearing the cause and effect of pathology, at the same sitting. This paper describes our initial experience with the trans-mastoid approach to otogenic …