Role Of Intra-Operative Mri (Imri) In Improving Extent Of Resection And Survival In Patients With Glioblastoma Multiforme,
2017
Aga Khan University
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,
2017
Aga Khan University
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,
2017
University of Kentucky, Lexington, KY, USA.
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,
2017
Aga Khan University
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,
2017
Aga Khan University
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, …
Multidisciplinary Approach To The Prenatal Diagnosis And Post Natal Management Of A Large Suprasellar Arachnoid Cyst: A Case Report,
2017
Aga Khan University
Multidisciplinary Approach To The Prenatal Diagnosis And Post Natal Management Of A Large Suprasellar Arachnoid Cyst: A Case Report, Omar Irfan, Heera Nand Rathore, Sarfraz Karim, Shabina Ariff, Aneela Darbar
Medical College Documents
Arachnoid cysts are intra-arachnoid sacs filled with cerebrospinal fluid representing a rare occurence in neonates. We report the case of a suprasellar arachnoid cyst diagnosed prenatally at 21 weeks gestation on routine obstetric ultrasound. A cystic lesion was picked up incidentally at routine antenatal scan. The cyst was noted to be increasing in size over a series of radiological scans. The cyst was diagnosed as a suprasellar arachnoid cyst compressing the third ventricle and bilateral lateral ventricles. A left pteryonal craniotomy for cystocisternostomy of large suprasellar cyst was performed initially. Within a month the cyst recurred with clinical and radiological …
Unmet Need For Surgery In South Asia,
2017
Jaslok Hospital and Research Centre, India
Unmet Need For Surgery In South Asia, Sanjay Nagral, Maharra Hussain, Sarder A. Nayeem, Ranjan Dias, S. Ather Enam, Samiran Nundy
Section of Neurosurgery
No abstract provided.
Noninvasive Monitoring Intracranial Pressure - A Review Of Available Modalities,
2017
Aga Khan University
Noninvasive Monitoring Intracranial Pressure - A Review Of Available Modalities, Marium Naveed Khan, Hussain Shallwani, Muhammad Ulusyar Khan, Muhammad Shahzad Shamim
Section of Neurosurgery
Background: Intracranial pressure (ICP) monitoring is important in many neurosurgical and neurological patients. The gold standard for monitoring ICP, however, is via an invasive procedure resulting in the placement of an intraventricular catheter, which is associated with many risks. Several noninvasive ICP monitoring techniques have been examined with the hope to replace the invasive techniques. The goal of this paper is to provide an overview of all modalities that have been used for noninvasive ICP monitoring to date.
Methods: A thorough literature search was conducted on PubMed, selected articles were reviewed in completion, and pertinent data was included in the …
Perioperative Steroids For Lumbar Disc Surgery: A Meta-Analysis Of Randomized Controlled Trials,
2017
Aga Khan University
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 Docs
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 …
Road Traffic Crash Related Injured And Fatal Victims In Karachi From 2007 To 2014: A Time-Series Analysis,
2017
Aga Khan University
Road Traffic Crash Related Injured And Fatal Victims In Karachi From 2007 To 2014: A Time-Series Analysis, Rashid Jooma, Masood Ali Shaikh
Section of Neurosurgery
Injuries and deaths due to road traffic crashes (RTC) are major public health concern. The Road Traffic Injury Research and Prevention Center, collects RTC data on injuries and fatalities from five emergency departments in Karachi. Data generating process (DGP) for RTC from 2007 to 2014, for monthly number of fatal and injured victims were analyzed using autoregressive integrated moving average and vector auto regression, time series models. Results provide strong evidence that the DGP for the current levels of the number of fatalities and injured owing to RTCs are significantly influenced by the own past history of the two series. …
Unmet Need For Surgery In South Asia,
2017
Jaslok Hospital and Research Centre, India
Unmet Need For Surgery In South Asia, Sanjay Nagral, Maharra Hussain, Sarder A Nayeem, Ranjan Dias, S. Ather Enam
Department of Surgery Docs
No abstract provided.
Low Cost Quality Initiatives For Management Of Neurosurgical Patients In Developing Nations: Perspective From A Tertiary Care Centre In Pakistan,
2017
Aga Khan University
Low Cost Quality Initiatives For Management Of Neurosurgical Patients In Developing Nations: Perspective From A Tertiary Care Centre In Pakistan, Hamid Hussain Rai, Muhammad Waqas, Muhammad Shahzad Shamim
Section of Neurosurgery
Background: Targeting resources on cost-effective care strategies is pertinent for developing nations, specifically for already burdened specialties such as neurosurgery, where without state support and insurance companies, expenses are borne by the patient themselves.
Methods: This was a descriptive review of literary work published by the section of neurosurgery at Aga Khan University Hospital, Pakistan. We searched PubMed and CiNAHL databases to identify articles, which were then critically analyzed and discussed from a perspective of low-cost quality care.
Results: We demonstrate the cost effectiveness of three initiatives, namely, blood ordering protocol for elective spine arthrodesis, nonoperative management being superior to …
Establishment Of Site Specific Multi-Disciplinary Tumour Boards In Pakistan: Sharing Experience Of Neuro Oncology Team Based At A Tertiary Care University Hospital,
2017
Aga Khan University
Establishment Of Site Specific Multi-Disciplinary Tumour Boards In Pakistan: Sharing Experience Of Neuro Oncology Team Based At A Tertiary Care University Hospital, Muhammad Waqas, Ahmed Nadeem Abbasi
Section of Neurosurgery
No abstract provided.
Preventive Gabapentin Versus Pregabalin To Decrease Postoperative Pain After Lumbar Microdiscectomy: A Randomized Controlled Trial,
2017
Aga Khan University
Preventive Gabapentin Versus Pregabalin To Decrease Postoperative Pain After Lumbar Microdiscectomy: A Randomized Controlled Trial, Mohsin Qadeer, Muhammad Waqas, Muhammad Jawad Rashid, Ather Enam, Salman Sharif, Ghulam Murtaza
Section of Neurosurgery
Study design: Randomized controlled trial.
Purpose: The purpose of this study was to compare pregabalin and gabapentin for mean postoperative visual analog score (VAS) for pain in patients undergoing single-level lumbar microdiscectomy for intervertebral disc prolapse at a tertiary care hospital.
Overview of literature: Pregabalin has a superior pharmacokinetic profile and analgesic effect at lower doses than gabapentin; however, analgesic efficacy must be established during the perioperative period after lumbar spine surgery.
Methods: This randomized controlled trial was carried out at our institute from February to October 2011 on 78 patients, with 39 participants in each study group. Patients undergoing …
Neurorobotics In Pakistan,
2017
Aga Khan University
Neurorobotics In Pakistan, Ather Enam, Muhammad Waqas
Section of Neurosurgery
No abstract provided.
Complications Of In-Patient Cerebral Angiography: Comparison Between Patients With And Without Sub Arachnoid Haemorrhage,
2017
Aga Khan University
Complications Of In-Patient Cerebral Angiography: Comparison Between Patients With And Without Sub Arachnoid Haemorrhage, Yaseen Rauf, Usman Tariq Siddiqui, Gohar Javed
Section of Neurosurgery
Objective: To compare complications of cerebral angiography among patients with and without subarachnoid haemorrhage.
Methods: This retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised records of patients undergoing inpatient therapeutic and diagnostic cerebral angiographies from 2001 to 2010. The patients were divided into subarachnoid and non-subarachnoid haemorrhage groups. During the study period no modifications were made to the operational protocol and all patients were subjected to the same procedure and prophylactic care.
Results: Of the 93 patients, 42(45.2%) were women and 51(54.8%) were men. The overall mean age was 45.27±16.15 years (range: 4-80 years). The …
Chronic Inflammation And Apoptosis Propagate In Ischemic Cerebellum And Heart Of Non-Human Primates,
2017
University of South Florida
Chronic Inflammation And Apoptosis Propagate In Ischemic Cerebellum And Heart Of Non-Human Primates, Sandra A. Acosta, Sherwin Mashkouri, Diana Nwokoye, Jea Y. Lee, Cesar V. Borlongan
Neurosurgery and Brain Repair Faculty Publications
The major pathological consequences of cerebral ischemia are characterized by neurological deficits commonly ascribed to the infarcted tissue and its surrounding region, however, brain areas, as well as peripheral organs, distal from the original injury may manifest as subtle disease sequelae that can increase the risks of co-morbidities complicating the disease symptoms. To evaluate the vulnerability of the cerebellum and the heart to secondary injuries in the late stage of transient global ischemia (TGI) model in non-human primates (NHP), brain and heart tissues were collected at six months post-TGI. Unbiased stereological analyses of immunostained tissues showed significant Purkinje cells loss …
Updates On And Advances In Therapeutic Strategies For Traumatic Brain Injury,
2017
University of South Florida
Updates On And Advances In Therapeutic Strategies For Traumatic Brain Injury, Samantha M. Portis, Paul R. Sanberg
Neurosurgery and Brain Repair Faculty Publications
No abstract provided.
Hippocampal Cholinergic Neurostimulating Peptide As A Possible Modulating Factor Against Glutamatergic Neuronal Disability By Amyloid Oligomers,
2017
Nagoya City University
Hippocampal Cholinergic Neurostimulating Peptide As A Possible Modulating Factor Against Glutamatergic Neuronal Disability By Amyloid Oligomers, Toyohiro Sato, Yoshiaki Ohi, Daisuke Kato, Masayuki Mizuno, Hiroshi Takase, Tetsuko Kanamori, Cesar V. Borlongan, Akira Haji, Noriyuki Matsukawa
Neurosurgery and Brain Repair Faculty Publications
Despite having pathological changes in the brain associated with Alzheimer's disease (AD), some patients have preserved cognitive function. A recent epidemiological study has shown that diet, exercise, cognitive training, and vascular risk monitoring interventions may reduce cognitive decline in at-risk elderly people in the general population. However, the details of molecular mechanisms underlying this cognitive function preservation are still unknown. Previous reports have demonstrated that enriched environments prevent the impairment of hippocampal long-term potentiation (LTP) through β2-adrenergic signals, when LTP is incompletely suppressed by synthetic amyloid-β (Aβ) oligomers. The cholinergic network from the medial septal nucleus (MSN) is also a …
Genetic And Histological Alterations Reveal Key Role Of Prostaglandin Synthase And Cyclooxygenase 1 And 2 In Traumatic Brain Injury–Induced Neuroinflammation In The Cerebral Cortex Of Rats Exposed To Moderate Fluid Percussion Injury,
2017
University of Yamanashi
Genetic And Histological Alterations Reveal Key Role Of Prostaglandin Synthase And Cyclooxygenase 1 And 2 In Traumatic Brain Injury–Induced Neuroinflammation In The Cerebral Cortex Of Rats Exposed To Moderate Fluid Percussion Injury, Hideki Shojo, Cesar V. Borlongan, Tadashi Mabuchi
Neurosurgery and Brain Repair Faculty Publications
After the initial insult in traumatic brain injury (TBI), secondary neurodegeneration occurs that is intimately associated with neuroinflammation. Prostaglandin (PG) synthases and cyclooxygenase (COX) 1 and 2 may contribute to inflammation in the brain. Temporal and spatial expression features of PG and COX1 and 2 following trauma may guide the development of antineuroinflammation strategies. Here, we examined PG synthase signaling and COX1 and 2 gene expression levels and COX-1- and 2-positive cell types and their temporal localization in TBI-induced brain in an effort to reveal their participation in the disease’s evolving neuroinflammation. Using brain samples from the cerebral cortex of …
