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Articles 61 - 90 of 205
Full-Text Articles in Surgery
Development Of Criteria Highly Suggestive Of Spinal Tuberculosis, Gohar Javed, Altaf Ali Laghari, Syed Ijlal Ahmed, Sarosh Madhani, Ahmed Ali Shah, Faizuddin Najmuddin, Reehana Khawaja
Development Of Criteria Highly Suggestive Of Spinal Tuberculosis, Gohar Javed, Altaf Ali Laghari, Syed Ijlal Ahmed, Sarosh Madhani, Ahmed Ali Shah, Faizuddin Najmuddin, Reehana Khawaja
Section of Neurosurgery
Background: In a developing country there is a need for development of criteria that can be used for the diagnosis of spinal tuberculosis, which is common in that region.
Methods: Demographic, clinical, and radiologic features of spinal tuberculosis and spinal epidural tumors have been compared statistically, and inferences have been drawn in terms of P values, sensitivity, specificity, positive predictive values, and negative predictive values.
Results: A statistically significant relationship was found between spinal tuberculosis and spinal pain, fever, gradually progressive lower limb weakness, contrast-enhancing epidural ± paravertebral lesions, continuous levels affected, spinal deformity, and raised erythrocyte sedimentation rate.
Conclusions: …
Value Of Routine Preoperative Tests For Coagulation Before Elective Cranial Surgery. Results Of An Institutional Audit And A Nationwide Survey Of Neurosurgical Centers In Pakistan, Naveed Zaman, Muhammad Bilal Tariq, Saad Akhtar, Sidra Sattar, Wajeeha Tariq, Muhammad Shahzad Shamim, Samie Asghar
Value Of Routine Preoperative Tests For Coagulation Before Elective Cranial Surgery. Results Of An Institutional Audit And A Nationwide Survey Of Neurosurgical Centers In Pakistan, Naveed Zaman, Muhammad Bilal Tariq, Saad Akhtar, Sidra Sattar, Wajeeha Tariq, Muhammad Shahzad Shamim, Samie Asghar
Section of Neurosurgery
Background: Routine preoperative blood testing has become a dogma. The general practice is to order preoperative workup as a knee-jerk response rather than individualize it for each patient. The fact that the bleeding brain tends to swell, which coupled with limited options for proximal control, packing, and overall hemostasis, leads to an overemphasis on the preoperative coagulation profile.
Material and methods: This is a retrospective review of the medical records of patients admitted at Aga Khan University Hospital from January 2010 to December 2015 for an elective craniotomy. The hospital registry was used to identify files for review. Data were …
Role Of Radiosurgery In Arteriovenous Malformations, Syed Ijlal Ahmed, Gohar Javed, Syed Naseeb Uneeb, Syeda Benish Bareeqa, Manaal Haider, Syeda Sana Samar, Armighan Haider Ans, Muhammad Tayyab Shera
Role Of Radiosurgery In Arteriovenous Malformations, Syed Ijlal Ahmed, Gohar Javed, Syed Naseeb Uneeb, Syeda Benish Bareeqa, Manaal Haider, Syeda Sana Samar, Armighan Haider Ans, Muhammad Tayyab Shera
Section of Neurosurgery
Background: Intracranial arteriovenous malformations (AVMs) consist of an abnormal nidus of blood vessels that shunt blood directly from an artery to a vein and thereby bypass an intervening capillary bed. AVMs may be found as an incidental finding. They may be associated with intracranial haemorrhage, seizures, headaches or neurological deficits. There are different treatment options for AVM. These include observation, microsurgery, Stereotactic radio surgery (SRS), endovascular embolization and intensity modulated radiotherapy (IMRT).
Methods: Data was collected using searching engines like Pubmed, Google scholar, Embase, Cinahl and Medline. MeSH and Non-MeSH terms were used like Arterio-venous malformations, microsurgery, endovascular embolization.
Results: …
The Significance Of Mgmt Methylation In Glioblastoma Multiforme Prognosis, Aaida Mumtaz Rao, Ayesha Quddusi, Muhammad Shahzad Shamim
The Significance Of Mgmt Methylation In Glioblastoma Multiforme Prognosis, Aaida Mumtaz Rao, Ayesha Quddusi, Muhammad Shahzad Shamim
Section of Neurosurgery
Methylation of O6-methylguanine-DNA methyltransferase (MGMT) has been extensively studied as a biomarker in predicting the prognosis of patients with GBM (Glioblastoma multiforme). Its significance has been studied in various subgroups, including age, gender and even race. Correlation between prognosis with MGMT methylation and different treatment regimens has also been studied in detail. There are multiple techniques to analyze MGMT methylation in tumour specimen. We review the current evidence for the importance of MGMT methylation as a biomarker for prognosis in GBM patients, the techniques to analyze it and the effect of epidemiologic factors on its significance.
Factors Affecting Functional Outcome After Decompressive Craniectomy Performed For Traumatic Brain Injury: A Retrospective, Cross-Sectional Study, Farid Khan, Arif Villani, Abdul Rehman, Muhammad Ehsan Bari
Factors Affecting Functional Outcome After Decompressive Craniectomy Performed For Traumatic Brain Injury: A Retrospective, Cross-Sectional Study, Farid Khan, Arif Villani, Abdul Rehman, Muhammad Ehsan Bari
Section of Neurosurgery
Background: Factors affecting functional outcome after decompressive craniectomy (DC) performed for traumatic brain injury (TBI) remain poorly understood.
Methods: We conducted a retrospective study of all patients who underwent primary DC for TBI at our hospital between 2010 and 2014. Multivariate regression analyses were used to determine the predictors of functional outcome and overall survival.
Results: A total of 98 patients with severe (n = 81, 82.6%) or moderate (n = 17, 17.4%) TBI underwent primary DC and were included in this study. The 30-day and overall mortality rates were 15.3% and 25.5%, respectively. At a median follow-up …
Descriptive Epidemiology Of Karachi Road Traffic Crash Mortality In 2015, Rashid Jooma, Masood Ali Shaikh
Descriptive Epidemiology Of Karachi Road Traffic Crash Mortality In 2015, Rashid Jooma, Masood Ali Shaikh
Section of Neurosurgery
The Karachi city's Road Traffic Injury Research and Prevention Center (RTIRPC), collects Road Traffic Crash (RTC) data on injuries and fatalities from three major public and private hospitals' emergency departments. In the year 2015, 1021 deaths were recorded; with 871 (85.3%) deaths in males. Cumulatively, 286 (28.0%) deaths were recorded in the 21-30year age group, and for 198 (19.4%) RTC fatal victims, the primary vehicle involved was motorbike. Highest number of fatalities were recorded in the month of January i.e. 153 (15.0%), while the lowest number was recorded for June, with 47 (4.6%) fatalities. RTIRPC is a unique surveillance system …
Simpson Grading As Predictor Of Meningioma Recurrence, Ayesha Quddusi, Muhammad Shahzad Shamim
Simpson Grading As Predictor Of Meningioma Recurrence, Ayesha Quddusi, Muhammad Shahzad Shamim
Section of Neurosurgery
Meningimas are one of the commonest primary brain tumours and the commonest extra-axial primary brain tumour. Despite better understanding of the molecular pathogenesis of the tumours, surgical excision remains the treatment of choice, and in a large proportion of cases, complete excision is curative. Simpson grading for the extent of resection of meningiomas, was introduced more than six decades ago, and has stood the test of time. With modern technological advancements, however, the relevance of Simpson grading has been questioned. Herein we review the recent literature on the relevance of Simpson grading more than sixty years after its introduction.
Management Of Arachnoid Cysts: A Comprehensive Review, Fatima Mustansir, Sanaullah Bashir, Aneela Darbar
Management Of Arachnoid Cysts: A Comprehensive Review, Fatima Mustansir, Sanaullah Bashir, Aneela Darbar
Section of Neurosurgery
Arachnoid cysts are non-neoplastic, intracranial cerebrospinal fluid (CSF)-filled spaces lined with arachnoid membranes. Large arachnoid cysts are often symptomatic because they compress surrounding structures; therefore, they must be treated surgically. As several surgical management options exist, we explore the best approach according to each major type of arachnoid cyst: middle cranial fossa cyst, suprasellar cyst, intrahemispheric cyst, and quadrigeminal cyst.
Resolution Of Gestational Gigantomastia With Termination Of Pregnancy, Syed Sarmad Bukhari, Haris Manan, Mah Muneer Khan, Syed Shahmeer Raza
Resolution Of Gestational Gigantomastia With Termination Of Pregnancy, Syed Sarmad Bukhari, Haris Manan, Mah Muneer Khan, Syed Shahmeer Raza
Section of Neurosurgery
Less than 100 cases of gestational gigantomastia have been described in literature. The aetiology and risk factors are not well-established. Various treatments have been used with some consensus. We present the case of a 47-year-old female who presented to us with bilateral gigantomastia in her 16th week of gestation. She had massively enlarged breasts which were very painful. Relevant laboratory investigations were normal. An incisional biopsy done prior to, and two trucut samples at presentation to us, showed normal breast tissue proliferation. In the absence of adequate pain control, it was decided to electively terminate the pregnancy and give a …
Prognostic Implications Of Histological Clear Cells In High-Grade Intracranial Ependymal Tumors: A Retrospective Analysis From A Tertiary Care Hospital In Pakistan, Fauzan Alam Hashmi, Hamid Hussain Rai, Muhammad Faheem Khan, Muhammad Ehsan Bari
Prognostic Implications Of Histological Clear Cells In High-Grade Intracranial Ependymal Tumors: A Retrospective Analysis From A Tertiary Care Hospital In Pakistan, Fauzan Alam Hashmi, Hamid Hussain Rai, Muhammad Faheem Khan, Muhammad Ehsan Bari
Section of Neurosurgery
Background: Clear cell variant in ependymal tumors is rare. We aimed to compare the features and outcome of the World Health Organization (WHO) Grade 3 ependymal tumors with clear cells to the WHO Grade 3 classic anaplastic ependymoma (AE).
Materials and methods: A retrospective cohort study conducted at the Department of Neurosurgery, Aga Khan University, Pakistan, from 2003 to 2013. The medical records and radiology of patients with proven histopathology were reviewed. The analysis was done on SPSS 20.
Results: Nine cases of clear cell variant and 23 cases of classic AE were found, both of which combined equated to …
Depression In Adult Patients With Primary Brain Tumours: A Review Of Independent Risk Factors, Anum Sadruddin Pidani, Aaida Mumtaz Rao, Muhammad Shahzad Shamim
Depression In Adult Patients With Primary Brain Tumours: A Review Of Independent Risk Factors, Anum Sadruddin Pidani, Aaida Mumtaz Rao, Muhammad Shahzad Shamim
Section of Neurosurgery
Depression is considered an under-diagnosed problem, especially in patients with malignancies. Patients with brain tumours in particular, have a relatively higher risk of developing depression, which is multifactorial. Herein, the authors review the recent literature on the prevalence of depression in patients with brain tumours, and explore the various risk factors involved.
Use Of Preoperative Apparent Diffusion Coefficients To Predict Brain Tumor Grade, Aneela Darbar, Muhammad Waqas, Syed Faaiz Enam, Shaikh D. Mahmood
Use Of Preoperative Apparent Diffusion Coefficients To Predict Brain Tumor Grade, Aneela Darbar, Muhammad Waqas, Syed Faaiz Enam, Shaikh D. Mahmood
Section of Neurosurgery
Introduction: The apparent diffusion coefficient (ADC) sequence is based on the diffusion properties of water molecules within tissues and correlates with tissue cellularity. ADC may have a role in predicting tumor grade for gliomas, and may in turn assist in identifying tumor biopsy sites. The purpose of this investigation was to assess the competence of preoperative ADC values in predicting tumor grades.
Methods: This was a retrospective investigation. We calculated the ADC values in the areas of greatest restriction in solid tumor components, and we recorded the pattern of contrast enhancement. Pathology reports masked to the imaging results were reviewed …
Robotics In Neurosurgery: A Literature Review, Syed Ijlal Ahmed, Gohar Javed, Bakhtawar Mubeen, Syeda Beenish Bareeqa, Hiba Rasheed, Alizay Rehman, Masroor Mubeen Phulpoto, Syeda Sana Samar, Kashif Aziz
Robotics In Neurosurgery: A Literature Review, Syed Ijlal Ahmed, Gohar Javed, Bakhtawar Mubeen, Syeda Beenish Bareeqa, Hiba Rasheed, Alizay Rehman, Masroor Mubeen Phulpoto, Syeda Sana Samar, Kashif Aziz
Section of Neurosurgery
Robotic surgery has been the forte of minimally invasive stereo-tactic procedures for some decades now. Ongoing advancements and evolutionary developments require substantial evidence to build the consensus about its efficacy in the field of neurosurgery. Main obstacle in obtaining successful results in neurosurgery is fine neural structures and other anatomical limitations. Currently, human rationalisation and robotic precision works in symbiosis to provide improved results. We reviewed the current data about recent interventions. Robots are capable of providing virtual data, superior spatial resolution and geometric accuracy, superior dexterity, faster manoeuvring and non-fatigability with steady motion. Robotic surgery also allows simulation of …
High-Intensity Focused Ultrasound: Past, Present, And Future In Neurosurgery, Syed A. Quadri,, Muhammad Waqas, Inamullah Khan, Muhammad Adnan Khan, Sajid S. Suriya, Mudassir Farooqui, Brian Fiani
High-Intensity Focused Ultrasound: Past, Present, And Future In Neurosurgery, Syed A. Quadri,, Muhammad Waqas, Inamullah Khan, Muhammad Adnan Khan, Sajid S. Suriya, Mudassir Farooqui, Brian Fiani
Section of Neurosurgery
Since Lynn and colleagues first described the use of focused ultrasound (FUS) waves for intracranial ablation in 1942, many strides have been made toward the treatment of several brain pathologies using this novel technology. In the modern era of minimal invasiveness, high-intensity focused ultrasound (HIFU) promises therapeutic utility for multiple neurosurgical applications, including treatment of tumors, stroke, epilepsy, and functional disorders. Although the use of HIFU as a potential therapeutic modality in the brain has been under study for several decades, relatively few neuroscientists, neurologists, or even neurosurgeons are familiar with it. In this extensive review, the authors intend to …
Prognostic Value Of 1p/19q Chromosomal Codeletion In Patients With Oligodendroglioma, Altaf Ali Laghari, Muhammad Usman Khalid, Namra Qadeer, Muhammad Shahzad Shamim
Prognostic Value Of 1p/19q Chromosomal Codeletion In Patients With Oligodendroglioma, Altaf Ali Laghari, Muhammad Usman Khalid, Namra Qadeer, Muhammad Shahzad Shamim
Section of Neurosurgery
Oligodendrogliomas are common intra-axial primary brain tumours, and carry special significance due to several key features, which when present provide better prognosis compared to other intra-axial tumours. One of these features is presence of 1p/19q chromosomal codeletion that seems to not only be a marker of better prognosis but also signifies better response to chemotherapy. Herein the authors review the literature for evidence of the prognostic value of 1p/19q codeletion in OD.
Spatial Distribution Of Road Traffic Crash Fatalities In Karachi: Perspective From 2008-2012, Rashid Jooma, Mir Shabbar Ali, Masood Ali Shaikh
Spatial Distribution Of Road Traffic Crash Fatalities In Karachi: Perspective From 2008-2012, Rashid Jooma, Mir Shabbar Ali, Masood Ali Shaikh
Section of Neurosurgery
Road Traffic Crash (RTC) mortality and morbidity is one of the major public health problems in Karachi. In this study we used geographic information systems (GIS) to visualize and quantify the spatial distribution of RTC mortality and yearly trend from 2008 to 2012, for all 24 administrative subdivisions of Karachi, using Road Traffic Injury Research and Prevention Center's (RTIRPC) data. Cumulatively, 6040 deaths were recorded by RTIRPC, out of which we were able to map 4657 (77.1%) deaths based on location information available in the database. During the 5-year period, highest number of cumulative RTC fatalities were recorded for Kemari, …
Survival Benefit Of Surgery In Recurrent Glioblastoma Multiforme, Usama Khalid Choudry, Saad Akhtar Khan, Muhammad Shahzad Shamim
Survival Benefit Of Surgery In Recurrent Glioblastoma Multiforme, Usama Khalid Choudry, Saad Akhtar Khan, Muhammad Shahzad Shamim
Section of Neurosurgery
There is an ongoing debate regarding role of surgery for recurrent glioblastoma multiforme (GBM). Older literature hinted at only modest survival benefits with surgery and a high rate of morbidity. However, more recent literature suggests better survival that may be attributed to better surgical techniques and better options in adjuvant treatment. Herein the authors review recent literature with regards to the possible role of surgery in recurrent GBM and also look into the key factors impacting second surgery.
Reading Between The Joints-Using Spinal Magnetic Resonance Imaging For Evaluation Of Instability, Komal Naeem, S. Ather Enam
Reading Between The Joints-Using Spinal Magnetic Resonance Imaging For Evaluation Of Instability, Komal Naeem, S. Ather Enam
Section of Neurosurgery
No abstract provided.
Comparison Between Endoscopic And Microscopic Approaches For Surgery Of Pituitary Tumours, Inamullah Khan, Muhammad Shahzad Shamim
Comparison Between Endoscopic And Microscopic Approaches For Surgery Of Pituitary Tumours, Inamullah Khan, Muhammad Shahzad Shamim
Section of Neurosurgery
Surgical techniques for resection of pituitary tumours have come a long way since it was first introduced in late 18th century. Nowadays, most pituitary surgeries are performed through trans-nasal trans-sphenoidal approach either using a microscope, or an endoscope. Herein the authors review the literature and compare these two instruments with regards to their outcomes when used for resection of pituitary tumours. .
Delayed Spinal Cord Infarction Following Anterior Cervical Surgical Decompression, Muhammad Faheem Khan, Rashid Jooma, Fauzan Alam Hashmi, Muhammad Faraz Raghib
Delayed Spinal Cord Infarction Following Anterior Cervical Surgical Decompression, Muhammad Faheem Khan, Rashid Jooma, Fauzan Alam Hashmi, Muhammad Faraz Raghib
Section of Neurosurgery
Anterior cervical discectomy and fusion (ACDF) for cord compression is a safe and effective procedure with good outcomes. However, worsening of myelopathy is the most feared adverse event of the surgery. We report the case of a 36-year-old male patient who presented with an acute non-traumatic C5-6 cervical disc herniation causing incomplete quadriparesis. He underwent an uncomplicated ACDF at C5-6, and after an initial period of improvement, he developed a delayed onset of an anterior cord syndrome on day 3, without any discerning cause. We have reviewed similar cases reported in the literature and believe that our patient's postsurgical course …
Role Of 5-Ala In Improving Extent Of Tumour Resection In Patients With Glioblastoma Multiforme, Muhammad Waqas, Inamullah Khan, Muhammad Shahzad Shamim
Role Of 5-Ala In Improving Extent Of Tumour Resection In Patients With Glioblastoma Multiforme, Muhammad Waqas, Inamullah Khan, Muhammad Shahzad Shamim
Section of Neurosurgery
Goal of surgery for patients with Glioblastoma Multiforme (GBM) is gross total resection with no new neurological deficits. Surgical resection is often restricted due the difficulty in differentiating the tumour from surrounding normal brain using either naked eye, or standard intra-operative white light microscopy. GBM uptakes orally administered 5-ALA becomes fluorescent when viewed by a special light, and this property has been used to improve intra-operative tumour identification. This technique should therefore allow better extent of tumour resection. The hypothesis has been tested through several studies and even though most studies are of low quality, they strongly favour the use …
Video Microscope Robotic Arm-Assisted, Neuronavigation-Guided Glioma Resection And Regional Sampling, Muhammad Waqas, Ather Enam, Fauzan A Hashmi, Fatima Mubarak, Fazal Arain
Video Microscope Robotic Arm-Assisted, Neuronavigation-Guided Glioma Resection And Regional Sampling, Muhammad Waqas, Ather Enam, Fauzan A Hashmi, Fatima Mubarak, Fazal Arain
Section of Neurosurgery
High-grade gliomas possess internal pathological heterogeneity. Selective sampling of different tumor regions can help in the study of this heterogeneity. In this report, we have described the use of a novel navigation and optical system for the selective regional sampling of a high-grade glioma lesion. A 45-year-old gentleman presented to us with complaints of intermittent frontal headaches for past eight months. On examination, he had subtle pyramidal weakness in left upper and lower extremities. Magnetic resonance imaging (MRI) showed a large contrast-enhancing, space-occupying lesion in the right frontal lobe causing perilesional edema and midline shift. We marked four different regions …
Diffusion Tensor Imaging For Ruptured Cerebral Arteriovenous Malformation, Muhammad Waqas, Ayesha Siddiqui, Fatima Mubarak, Ather Enam
Diffusion Tensor Imaging For Ruptured Cerebral Arteriovenous Malformation, Muhammad Waqas, Ayesha Siddiqui, Fatima Mubarak, Ather Enam
Section of Neurosurgery
Non-ruptured arteriovenous malformations (AVMs) rarely cause tract disruption. Few studies have described how ruptured AVMs influence white matter (WM) tract morphology. We reviewed consecutive AVM cases treated at a tertiary care hospital where diffusion tensor imaging (DTI) tractography was obtained preoperatively. DTI was performed using the Synaptive Plan (Synaptive Medical Inc., Toronto, Canada). Quality control was performed by clinical application specialist. Perinidal fractional anisotropy (FA) value of corticospinal tracts (CST) was obtained. A reference FA value was obtained from the corresponding area on the contralateral side. Images were evaluated by a consultant neuroradiologist. Radiological findings were correlated with clinical findings. …
Self‑Resolving Prepontine Cyst, Muhammad Waqas, Inamullah Khan, Reehana Khawaja, Ayesha Quddusi, Ather Enam
Self‑Resolving Prepontine Cyst, Muhammad Waqas, Inamullah Khan, Reehana Khawaja, Ayesha Quddusi, Ather Enam
Section of Neurosurgery
Background: Intracranial prepontine cysts are rare and include epidermoid cysts, arachnoid cysts, and neurenteric cysts. Symptomatic prepontine cysts may require surgical intervention. Reports of spontaneous resolution of cysts are rare.
Case description: We describe the case of a young gentleman who presented with headache and fever. Magnetic resonance imaging of the brain identified a prepontine lesion with features consistent with epidermoid cyst. During admission, the patient received symptomatic management in addition to empirical antibiotic therapy and dexamethasone. The patient improved symptomatically in the next 48 hours and was discharged. Follow-up imaging at 6 months and 1 year showed significant reduction …
Ruptured Mycotic Aneurysms: Report And Outcomes Of Two Surgically Managed Patients, Aleena Khan, Muhammad Waqas, Waseem Mehmood Nizamani, Muhammad Ehsan Bari
Ruptured Mycotic Aneurysms: Report And Outcomes Of Two Surgically Managed Patients, Aleena Khan, Muhammad Waqas, Waseem Mehmood Nizamani, Muhammad Ehsan Bari
Section of Neurosurgery
Background: Mycotic aneurysm is a rare potentially life-threatening complication of infective endocarditis (IE). Little data is available on the management and outcomes of ruptured mycotic aneurysms with large intracerebral hematoma. Few cases have been described on the management of mycotic aneurysm in the presence of life-threatening hematoma and mass effect.
Case description: We are presenting two cases of ruptured mycotic aneurysm with intracerebral hematoma and impending brain herniation. Both patients had signs of high intracranial pressure and required urgent surgical evacuation of clot. One patient survived while the other patient expired soon after surgery.
Conclusion: Mycotic aneurysm of middle cerebral …
Role Of Intra-Operative Mri (Imri) In Improving Extent Of Resection And Survival In Patients With Glioblastoma Multiforme, Inamullah Khan, Muhammad Waqas, Muhammad Shahzad Shamim
Role Of Intra-Operative Mri (Imri) In Improving Extent Of Resection And Survival In Patients With Glioblastoma Multiforme, Inamullah Khan, Muhammad Waqas, Muhammad Shahzad Shamim
Section of Neurosurgery
Multiple intraoperative aids have been introduced to improve the extent of resection (EOR) in Glioblastoma Multiforme (GBM) patients, avoiding any new neurological deficits. Intraoperative MRI (iMRI) has been debated for its utility and cost for nearly two decades in neurosurgical literature. Review of literature suggests improved EOR in GBM patients who underwent iMRI assisted surgical resections leading to higher overall survival (OS) and progression free survival (PFS). iMRI provides real time intraoperative imaging with reasonable quality. Higher risk for new postoperative deficits with increased EOR is not reported in any study using iMRI. The level of evidence regarding prognostic benefits …
Outcomes Of Post-Neurosurgical Ventriculostomy-Associated Infections, Muhammad Ehsan Bari, Ghani Haider, Komail Malik, Muhammad Waqas, Syed Faisal Mahmood, Mubbashira Siddiqui
Outcomes Of Post-Neurosurgical Ventriculostomy-Associated Infections, Muhammad Ehsan Bari, Ghani Haider, Komail Malik, Muhammad Waqas, Syed Faisal Mahmood, Mubbashira Siddiqui
Section of Neurosurgery
Background: Ventriculostomy-associated infection (VAI) is a major concern to physicians. Limited studies have looked at the outcomes of external ventricular drain (EVD) infection and predictors of unfavorable outcomes. In this study, we assessed the outcomes of EVD infection and predictors of unfavorable outcomes.
Methods: This was a retrospective medical chart review, conducted at the Aga Khan University Hospital. All the patients irrespective of age and gender, fulfilling the diagnostic criteria of VAI were included. Patients with preexisting bacterial meningitis or ventriculitis were excluded from the study. Outcome assessment was based on Glasgow outcome scale (GOS) at 1 and 3 months …
Extent Of Resection And Timing Of Surgery In Adult Low Grade Glioma, Farhan A. Mirza, Muhammad Shahzad Shamim
Extent Of Resection And Timing Of Surgery In Adult Low Grade Glioma, Farhan A. Mirza, Muhammad Shahzad Shamim
Section of Neurosurgery
Low grade glioma is a group of WHO grade II tumours including diffuse astrocytoma, oligodendroglioma, and oligoastrocytoma. Strong evidence exists in literature now to support early surgery and higher extent of safe resection in improving outcomes. In this review, we are highlighting some of the important studies done in the last few years specifically addressing timing of surgery and extent of resection.
Prognostic Significance Of Idh 1 Mutation In Patients With Glioblastoma Multiforme, Inamullah Khan, Muhammad Waqas, Muhammad Shahzad Shamim
Prognostic Significance Of Idh 1 Mutation In Patients With Glioblastoma Multiforme, Inamullah Khan, Muhammad Waqas, Muhammad Shahzad Shamim
Section of Neurosurgery
Focus of brain tumour research is shifting towards tumour genesis and genetics, and possible development of individualized treatment plans. Genetic analysis shows recurrent mutation in isocitrate dehydrogenase (IDH1) gene in most Glioblastoma multiforme (GBM) cells. In this review we evaluated the prognostic significance of IDH 1 mutation on the basis of published evidence. Multiple retrospective clinical analyses correlate the presence of IDH1 mutation in GBM with good prognostic outcomes compared to wild-type IDH1. A systematic review reported similar results. Based on the review of current literature IDH1 mutation is an independent factor for longer overall survival (OS) and progression free …
Quality Of Life In Individuals Surgically Treated For Congenital Hydrocephalus During Infancy: A Single-Institution Experience, Saad Akhtar Khan, Muhammad Faheem Khan, Saqib Kamran Bakhshi, Omar Irfan, Hamza Abdur Rahim Khan, Asad Abbas, Safia Awan, Muhammad Ehsan Bari
Quality Of Life In Individuals Surgically Treated For Congenital Hydrocephalus During Infancy: A Single-Institution Experience, Saad Akhtar Khan, Muhammad Faheem Khan, Saqib Kamran Bakhshi, Omar Irfan, Hamza Abdur Rahim Khan, Asad Abbas, Safia Awan, Muhammad Ehsan Bari
Section of Neurosurgery
Background: Congenital hydrocephalus (CH) is a frequently encountered birth anomaly that can hinder long-term neurologic maturity and social well-being of affected children. This study was undertaken to assess quality of life (QOL) 10-15 years after surgical treatment for primary CH during infancy at a tertiary care hospital in a developing country.
Methods: This retrospective cohort study included individuals who presented to Aga Khan University Hospital, Karachi, Pakistan, between 1995 and 2005 at QOL.
Results: Of 118 patients, 90 patients participated in the study. Mean age at first admission was 6.2 months. Mean length of follow-up was 5.4 years. Of these, …