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1دورية أكاديمية
المصدر: Pakistan Journal Of Neurological Surgery; Vol. 26 No. 1 (2022): Vol. 26 No. 1 (2022): January- March; 39-45 ; 2409-5567 ; 1995-8811
الوصف: Objective: To determine the outcome of Transpedicular Fixation via Posterior Approach for Dorsal and Lumbar Spine Tuberculosis. Material/Methods: This study was cross-sectional and conducted from 01/02/2015 to 30/7/2020 in the department of neurosurgery. A total of 36 patients with dorsal and lumbar spine tuberculosis were operated on for transpedicular fixation. Assessment scores were used pre-operative and post-operative and patients were kept on follow-up till six months after the surgical procedure. Variables like age, gender, spinal level, preoperative, and follow-up clinical status were calculated. Results: There were 19 (53%) male and 17 (47%) female patients with a mean age of 27 ± 8. Thoracolumbar was the commonest segment involved in 17 (47%) patients, followed by lower thoracic in 8 (22%) and lumbar in 7 (19%). There were 7 (19%) patients on the preoperative American Spinal Injury Association (ASIA) impairment scale in grade B, 12 (33%) in grade C, 15 (42%) in grade D, and 2 (5%) in grade E. The follow-up assessment at 6 months showed that ASIA grade B was seen in 3 (8%), grade C in 4 (11%), grade D in 16 (44%), and Grade E in 13 (36%) patients. Preoperative and follow-up scores on the ASIA impairment scale, COBS ANGLE, and ESR showed a significant difference (p-value < 0.05). Conclusion: We concluded that transpedicular fixation can restore the stability of the spine in thoracic and lumbar tuberculosis. The procedure is important for the improvement of clinical symptoms, correction of kyphosis, and stabilization of the spinal column.
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2دورية أكاديمية
المصدر: Pakistan Journal Of Neurological Surgery; Vol. 24 No. 4 (2020): October-December; 343-349 ; 2409-5567 ; 1995-8811
مصطلحات موضوعية: Normal Pressure Hydrocephalus, VP Shunt
الوصف: Objective:To determine the outcome of the ventriculoperitoneal shunt in normal pressure hydrocephalus. Material and Methods:This study was conducted at Jinnah Postgraduate Medical Centre, a tertiary care hospital in Karachi. Patients with idiopathic normal pressure hydrocephalus (NPH) were included. Gender distribution, presentation of symptoms and post-operative outcome based on the Stein Langfitt Scale were assessed. CSF was sent for microbiological and biochemical analyses. All patients were evaluated preoperatively and compared postoperatively during 6 months duration for improvement and any associated complication. Results:In this study, we had 47 patients, 38 were male and 9 were female. 22 patients presented with dementia, 18 with urinary incontinence, 17 with gait disturbance 17, while 21 had headache based on Stein and Langfitt Scale. The 78.8% patients had an excellent outcome, 17% had a good outcome and 4.2% had poor results. Conclusion:Ventriculoperitoneal (VP) shunt had promising results selected on history and examination of normal pressure hydrocephalus and improved radiological in Evan’s ratio CT brain scan. Keywords:Normal Pressure Hydrocephalus (NPH), VP Shunt, Stein and Langfitt Scale.
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3دورية أكاديمية
المصدر: Pakistan Journal Of Neurological Surgery; Vol. 25 No. 1 (2021): January – March; 2-8 ; 2409-5567 ; 1995-8811
مصطلحات موضوعية: KEYWORDS: Craniotomy, ventriculoperitoneal shunt, brain tumor, hydrocephalus
الوصف: OBJECTIVE: To determine frequency of hydrocephalus in brain tumor perioperative and and need of perment VP shunt . METHOD & MATERIAL: This was descriptive study, the ethical approval was taken from the hospital, study duration from 24-June-2014 to 30-september-2020 at JPMC, Karachi. Inclusion criteria were patient with brain tumor associated with hydrocephalus or postoperatively developed hydrocephalus within 3months of surgery and exclusion criteria were they had shunted previously due to some other reason, history of operation of brain tumor previously, history of trauma. RESULTS: We operated 156 cases of brain tumor concomitant with hydrocephalus, these included pre-operative and post-surgery development of hydrocephalus, out of that 65 (41.6%) were adult and 91 (58.33%) were children, who had hydrocephalus due to brain tumor. 90 (57.6%) were male and 66(42.3%) were female. The mean age for an adult was 34.2±8years and 8.1±4years was for a pediatric population of the patient. Patients who had preoperative hydrocephalus were 34 (21.7%) adults and 55(35.25%) pediatric and post-operative development of hydrocephalus was 28 (17.9%) in adults and 41 (26.28%) pediatric patients, CONCLUSION: The common brain tumor associate with hydrocephalus in children was craniopharyngioma and in adults it was CP angle tumor. Among 6026 cases of brain surgeries 2.6% required vp shunt dependency. Considering common cause of hydrocephalus in brain tumors, perioperative decision-making plays a pivotal role in the management of tumour-associated hydrocephalus.
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4دورية أكاديمية
المؤلفون: KALHORO, AURANGZEB, SATTAR M. HASHIM, A.
المصدر: Pakistan Journal Of Neurological Surgery; Vol. 24 No. 3 (2020): July-September; 243 – 247 ; 2409-5567 ; 1995-8811
مصطلحات موضوعية: Craniosynostosis, strip craniectomy
الوصف: Objective:Craniosynostosis presents sclerosis cranial sutures, ossification and fusion involving the vault of the base, sutures involved can be one or more sutures. This study aimed to determine the surgical outcome of craniosynostosis. Material and Method:The prospective study was conducted at the neuro spinal and cancer care institute, Karachi. Patients presented with sagittal, metopic, unicoronal, lambdoid, bicoronal craniosynostosis were included in the study, while patients with coagulopathy, previously operated cases were excluded from the study. Results:We had 26 children in our study, age range about 1–3 years. Patients were cleaved into groups depending on their age. Most of the children 15 (57.6%) were in 1–2 years age group and 11 (42.3%) were in 2-3 years of age. Boys were 18 (69.2%) and girls were 8(30.7%). Coronal 11 (42.3%) was the most common suture involved, followed by sagittal 9 (34.6%). Lambdoid suture 3 (11.5%), metopic 2 (7.6%) and 3 (11.5%) case presented with raised intracranial pressure with multiple sutures closed involved. Strip craniectomy was done in all cases. We did bicoronal flap and Scalp flap turned into a supraorbital region while in metopic suture Fronto-orbital advancement and remodeling approach were used. No major complication was observed. Conclusion:Cases which are managed early age have given good acceptable results in follow up, proper surgical expertise, perioperative management of temperature, blood loss, relieving the restriction of sutures and normalizing raised intracranial pressure can decrease the morbidity and mortality.
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5دورية أكاديمية
المؤلفون: KALHORO, AURANGZEB, SALEEM, ABID, ATTAR M. HASHIM, ABDUL S
المصدر: Pakistan Journal Of Neurological Surgery; Vol. 24 No. 3 (2020): July-September; 225 – 230 ; 2409-5567 ; 1995-8811
مصطلحات موضوعية: Essential Tremor, Stereotactic Thalamotomy, Nucleus Ventralis Intermedius
الوصف: Objective:Objective of study is to identify the effects of Stereotactic thalamotomy of the nucleus ventral intermediate (VIM) for treatment of essential tremor. Material and Methods:This is a descriptive study.It was performed at NCCI, Karachi, duration of study was 7 years, from 2-10-2012 to 7-10-2019. Those patients were included who were with tremors refractory to medication, their duration of disease was > 3 years, and with grade 4 tremors. The thalamotomy was performed in all cases, and follow-up was conducted at 3, 6, and 12 months respectively. The success of the surgery was measured in the form of a reduction in medication number and reduction in dose >50% and by calculating the Essential Tremor Rating Assessment Scale (tetras). Results:Total of 26 patients were included. All patients showed remarkable improvement post-procedure at 12 month follow-up. 20 (77%) patient required no medications. In 6 (23%) patients, the dose of medication was reduced to less than half post-treatment. The tetras score showed marked improvement in all a patient; 4 (15%) patients who had grade 4 tremor, showed the symptoms of minimal tremors graded 0.5 on last visit 3rd visit. Side effect post-procedure were mild transient numbness on the contralateral side was observed in 11 (42.3%) patient, 1 (3.8%) patient had dysarthria. Conclusion:We concluded that stereostatic Ventral intermedius nucleus thalamotomy was effective in reducing tremor grades and improved all functionality with few mild side effects.
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6دورية أكاديمية
المؤلفون: KALHORO, AURANGZEB, M. HASHIM, A. SATTAR
المصدر: Pakistan Journal Of Neurological Surgery; Vol. 24 No. 2 (2020): April-June; 121 – 126 ; 2409-5567 ; 1995-8811
مصطلحات موضوعية: Stereotactic surgery, framed based
الوصف: stereotactic biopsy. The study was conducted at the Neurospinal & Cancer Care Institute Karachi. Material and Methods:After the approval from the ethical hospital committee, the study was conducted on 34 patients, in which 9 (26.4%) were females, and 25 (73.5%) were males. 34 consecutive patients with biopsy inclusion deep seated lesion, mid line pathology, eloquent area and operated surgery, previous radiation treatment were excluded, and after that, the biopsy report based surgery or radiotherapy treatment was decided. Result:The biopsy underwent histopathological diagnosis proving Astrocytoma in 7 (20.5%) patients out of which four were in the Eloquent area, tuberculosis diagnosed in 5 (14.7%) patient, Oligodendroglioma diagnosed in 3 (8.8%) patients, metastasis in 5 (14.7%), Abscess in 4 (11.7%) patient which was aspirated to maximum and sent for culture, Malignant tumor (grade 3 & 4) 5 (14.7%), Lymphoma in 2 (5.8%) patient both were given radiation therapy Tumor necrosis 1 (2.9%) case, and No tissue obtained in 2 (5.8%) which was repeated later. No major complication or side effects were observed in the patient. Conclusion:Stereotactic Framed biopsy is safe and accurate and can be used in deep seated lesions with high success rate, minimal complication and decrease surgical morbidity for patients, and it is comparable to updated methods.
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7دورية أكاديمية
المصدر: Pakistan Journal Of Neurological Surgery; Vol. 24 No. 2 (2020): April-June; 102–107 ; 2409-5567 ; 1995-8811
مصطلحات موضوعية: Craniopharyngioma, Ommaya Reservoir, Stereotactic, Gama Knife Radiosurgery Surgery
الوصف: Objective:The objective of this present study was to assess the accuracy, result, and safety measures of stereotactic biopsy. The study was conducted at the Neurospinal & Cancer Care Institute Karachi. Material and Methods:After the approval from the ethical hospital committee, the study was conducted on 34 patients, in which 9 (26.4%) were females, and 25 (73.5%) were males. 34 consecutive patients with biopsy inclusion deep seated lesion, mid line pathology, eloquent area and operated surgery, previous radiation treatment were excluded, and after that, the biopsy report based surgery or radiotherapy treatment was decided. Result:The biopsy underwent histopathological diagnosis proving Astrocytoma in 7 (20.5%) patients out of which four were in the Eloquent area, tuberculosis diagnosed in 5 (14.7%) patient, Oligodendroglioma diagnosed in 3 (8.8%) patients, metastasis in 5 (14.7%), Abscess in 4 (11.7%) patient which was aspirated to maximum and sent for culture, Malignant tumor (grade 3 & 4) 5 (14.7%), Lymphoma in 2 (5.8%) patient both were given radiation therapy Tumor necrosis 1 (2.9%) case, and No tissue obtained in 2 (5.8%) which was repeated later. No major complication or side effects were observed in the patient. Conclusion:Stereotactic Framed biopsy is safe and accurate and can be used in deep seated lesions with high success rate, minimal complication and decrease surgical morbidity for patients, and it is comparable to updated methods
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8دورية أكاديمية
المؤلفون: KALHORO, AURANGZEB, M. HASHIM, A. SATTAR, SALEEM, ABID
المصدر: Pakistan Journal Of Neurological Surgery; Vol. 24 No. 1 (2020): January-March; 77-81 ; 2409-5567 ; 1995-8811
مصطلحات موضوعية: Cervical discectomy, Cloward procedure
الوصف: Objectives: To analyze the surgical outcome of cervical spine osteo-facetectomy discectomy, and modifiedCloward procedure.Materials and Methods: A prospective study was conducted at the Neurospinal & cancer care institute, Karachi.The duration of study was from 1st June 2017 to 25th November 2019. Patients having prolapsed intervertebralcervical discs included in the study, while those with trauma, cervical radiation, previous cervical surgery andmultiple level involvement were excluded. Pre and post-surgical data was collected. Titanium Hashmi cage wasused in all operated patients at single level instrumentation.Results: A total of 113 patients satisfied the inclusion criteria and were considered in the study. Among them, 77patients were male and 36 were female. The age range from 26 to 65 with a base age of 53 years ± 2.5. C5 – C6was the commonest level for fusion C6 – C7, C3 – C4 and C4 – C5 were less common. For the outcome of theprocedure Odom’s criteria, was followed the results showed excellent improvement in 88 (77.87%), Good resultsin 18 (15.9%), fair in 5 (4.42%) and 2 patient had Poor (1.76%) results. Fusion was seen in 86 patients,superficial infection in two cases.Conclusion: Patients with single-level degenerative disc and treated with modified titanium Hashmi cageprovided a good fusion with the relief of upper limb pain without donor site morbidity at anterior iliac spine.
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9دورية أكاديمية
المؤلفون: Kalhoro, Aurangzeb1 draurangzebkalhoro@gmail.com, Hashim, Abdul Sattar M.2
المصدر: Pakistan Journal of Medical Sciences. Jul/Aug2023, Vol. 39 Issue 4, p1018-1023. 6p.
مصطلحات موضوعية: *DEEP brain stimulation, *PARKINSON'S disease, *THERAPEUTICS, *PARKINSONIAN disorders, *MENTAL illness, *MOVEMENT disorders
مصطلحات جغرافية: PAKISTAN
مستخلص: Objective: To assess the effectiveness and accuracy of deep brain stimulation in Parkinsonian Disease (PD). Methods: This study was a descriptive prospective study, and patients were treated at Neurospinal and Cancer Care Institute Karachi, from February 1, 2016, to June 30, 2020. We had 21 cases of parkinsonian disease. Inclusion criteria was Idiopathic Parkinson's disease, marked motor fluctuations against the response to dopaminergic therapy, UPDRSIII scores, which is 30 or higher, with a duration of disease of five years or longer, developing dyskinesia while the exclusion criteria was patient with known comorbid or active psychiatric disease Results: Mean age of patient was 64 years. The standard deviation was 1.11697. The male patients' mean, median and mode had a standard deviation of 0.3. For the duration of disease, the mean was 1.4, the median 1 (5-6 years) and mode one. The standard deviation was 0.51177. The primary symptoms' mean was 2.2857, the median was 2.0, and the mode was two (tremor). The mean on medication (age) was 2 (45-49), and the median and mode were the same. Conclusion: Deep brain stimulation (DBS) is an effective treatment option for a carefully selected patient. DBS improves tremors, dyskinesias, rigidity, motor fluctuations and bradykinesia. DBS is unlikely to benefit Autonomic dysfunction, cognitive disorders, hypophonia, and postural instability. Although it is an expensive treatment compared to lesioning or gamma knife, it is reversible. [ABSTRACT FROM AUTHOR]
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10دورية أكاديمية
المؤلفون: Kalhoro, Aurangzeb1 draurangzebkalhoro@gmail.com, Hashim, Abdul Sattar M.2
المصدر: Pakistan Journal of Medical Sciences. Jan/Feb2023, Vol. 39 Issue 1, p46-49. 4p.
مستخلص: Objective: Glomus jugulare tumor are benign vascular tumors and surgical resection is almost impossible. We have treated these tumors by Gamma knife radiosurgery and share our experience. Methods: This study was conducted at the Neurospinal and Cancer Care Institute, Karachi from January 2010 to May 2020. Thirty-four patients with glomus jugulare tumors treated with gamma knife radiosurgery were included in the study. The comprehensive clinical and demographic characteristics of all patients were collected through a manually designed questionnaire. Computed tomography, digital subtraction angiography and magnetic resonance imaging were used to make the diagnosis. Data was incorporated and analyzed by SPSS version 26. Results: A total of 34 patients were included in the study of which 16(47%) were males and 18(53%) were females with first follow up after 6-month up to two year clinical and radiological follow-up. The mean age of the patients was 42.5±13.5 with a minimum age of 20 years and maximum age of 65 years. The KPS scale was 2.09±0.45 and the volume of the tumor was 33.8±22.5 cm3 . The improvement was shown in 27 patients of which 14 were males and 13 were females showing insignificance post radiation change. Of all 34 patients, the outcome was recorded as 3(9%) for excellent, 22(64%) for good, 6(17%) for fair and 3(9%) were poor results. Conclusions: Gamma Knife radiosurgery is a safe and effective primary therapy and salvage therapy for residual and recurrent cases of glomus jugulare and tympanicum tumors. [ABSTRACT FROM AUTHOR]
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