Objectives: The purpose of this study was to compare the radiological and clinical results of transpedicular decompression in spinal TB (also known as Pott's spine) patients who had anterior reconstruction using a polyetheretherketone (PEEK) or mesh cage with those who did not. Little study has been conducted on the long-term effects of transpedicular decompression with and without global reconstruction in Pott's spine. PEEK cages for Pott's spine have also not been shown effective. Methods: This Multicenter study was conducted in the department of neurosurgery MMC Mardan between May 2019 and May 2022. Patients who had surgery for Pott's spine and satisfied the inclusion criteria were retrospectively examined using data from hospital records and an imaging database collected. Results: One hundred and fifteen patients were involved in the research, and their mean age was 45.0617.01 years (55 males, 60 females). These individuals showed improvements on the Visual Analog Scale, the Oswestry Disability Index, and the Cobb angle, all statistically significant improvements (p 0.002). The Cobb angle was corrected more in patients who received anterior reconstruction after surgery (p = 0.041), but they also experienced more blood loss (p = 0.03).
The objective of the study: To determine the statistical importance of each predicted factor in terms of prognosis for patients with ruptured MCAAs, we focus on those who have had surgical treatment for their aneurysms. Materials and methods: A total of 104 patients with ruptured MCAAs were examined in this retrospective analysis, which covered the years 2018 through 2020 and was conducted by the Neurosurgical Department at MMC Hosptial Mardan , pakistan . Patient characteristics (age, sex, comorbid conditions), aneurysm location (proximal, bifurcation, or distal), aneurysm dome size (small, large, or giant), aneurysm size at the time of surgery (ultra-early, early, or delayed), and Intracerebral Hemorrhage (ICH) volume are all assessed as potential predictors. Mean, standard deviation, covariance, and correlation were determined for each parameter (through the linear regression model). Results: The World Federation of Neurological Surgeons (WFSN) grading system was used to evaluate each patient's clinical status; a score of 5 indicated excellent quality in 37 (35.3%), while a score of 4 indicated a fair rate in the remaining 28 patients.
Objective: Examining the prevalence of different forms of birth defects and identifying their causes. Study design: Study Design: A cross-sectional study with retrospective analysis for causes. Place and duration of study: Department of Neurosurgery MMC hospital Mardan from 05 Jan 2021 to October 2021. Methods: All gender-neutral newborns seeking well-child care department of Neurosurgery MMC Mardan. Participating subjects were enlisted, and data were input and analyzed using SPSS v 22.0, regardless of whether they had received any prenatal care, or vaccinations, or were born with any observable abnormalities. Results: In our analysis of 497 individuals, 23% exhibited CNS congenital abnormalities. 47 children (9%) had gastrointestinal malformations, 111 had musculoskeletal anomalies, 42 had cardio-vascular anomalies, and 181 had genito-urinary anomalies. Extreme maternal age (less than 74 and more than 42 at conception), consanguinity, preterm deliveries, maternal smoking, and family history of birth abnormalities were similarly distributed across patients with diverse malformations. Genito-urinary abnormalities are the most common, followed by CNS and musculoskeletal anomalies.
Objective: To examine intracranial hypertension patients' spectrum, clinical features, and etiologies. Study Design: A Cross-sectional study. Place and duration of study: In the Department of Neurosurgery MMC Mardan from January 2019 to July 2020. Methodology: We used specific selection criteria to reduce the pool of IH patients from 67 to 32. Statistics and frequency distributions explain patients' demographics, clinical traits, and underlying reasons. Results: According to statistics, females (n = 30; 82%) with ages ranging from 21 to 35 (n = 13; 36%) and obesity (n = 2; 9%) were over represented. The most common clinical sign was headache (n = 18; 69%). On the other hand, idiopathic intracranial pressure had the greatest occurrence (44%). Conclusion: Women between the ages of 21 and 35 who are overweight or pregnant have an increased risk of developing idiopathic intracranial hypertension (IH).
Objective: To evaluate the outcome of endoscopic lumbar discectomy in patients having sciatica due to single level prolapsed disc.Methodology: This descriptive study was conducted in neurosurgery departments of Lady Reading Hospital and Hayatabad Medical Complex Peshawar from June 2017 to December 2019, after approval from the ethics committee. All patients with straight leg raising (SLR) less than 60 degree, failed conservative treatment and with single level prolapsed disc were included while redo cases, cauda equine syndrome and traumatic disc prolapse associated with fractures were excluded. Per operative and post operative complications were documented. Patients were followed up for 3 months. Data was collected and analyzed with SPSS version 20.Results: One hundred and fifteen endoscopic lumbar discectomies were done. There were 75 (65.2%) male and 40 (34.8%) female patients. Age range was 17 to 63 years with mean age of 31.0±2.13 years. L5-S1 was involved in 67 (58.26%) cases, L4-5 in 42 (36.52%) cases and L3-4 in 6 (5.22%) cases. Procedure time ranged from 35 to 125 min with a mean of 62 minutes. Four cases were converted to open discectomies due to technical difficulties. Sciatica pain relief was achieved in 110 (95.65%) cases. Surgical site infection was observed in 2 (1.74%) cases. Conclusion:Endoscopic discectomy has acceptable rate of complications and good post-operative pain relief.
Aim And Objectives: AML is the most common acute leukemia affecting adults, its incidence increases with increasing age; the study aims to find out the clinical and haematological parameters of adult AML patients and the frequency of AML FAB subtype among these patients. Methods: This descriptive, cross sectional study was conducted in IRNUM; KTH and HMC tertiary care hospitals of Peshawar, 30 diagnosed AML patients of age ≥ 50 years were included in the study. The demographic details were recorded in a questionnaire, previous clinical record was obtained and the hematological findings at the diagnosis were recorded. Data was recorded in Microsoft Excel® (version 2013) data sheet, for further analysis the data was imported into Statistical Package for Social Sciences® (SPSS) version 22. Results: Overall 30 diagnosed denovo AML patients of age ≥50 years of age, included 19 male (63.3%) and 11 females (36.7%) patients were included in the study. The mean age of our study patients was 57.83 ± 5.26 years whereas the median was 59.5 years. The most common AML-FAB subtype found among study patients was AML-M2 found in 12 (40%) of patients followed by AML M4 9(30%), AML M1 6(20%) and AML M5 3(10%) in respective order. The mean hemoglobin level among the study patients was 72.10 g/L. Anaemia severity was significantly higher in AML-M2 subtype (z-score 2.0). The AML-subtypes have statistically similar pattern of WBC count (Fischer Exact P-value 0.681). Among the presenting clinical features in the study group fever, anaemia, bone pain and weakness is the most frequent presenting features in all the AML FAB subtypes. However gingivitis and hepatomegaly is the most common presenting feature in AML-M5 in the study group. Conclusion: AML M2 was the most frequent AML FAB subtype found in study patients with the male predominance M: F is (1.7:1). Anaemia, fever, weakness and bone pain was the most frequent presenting feature among the study group. Weight loss is most common ......
Objective: To assess post operative neurosensory deficit following craniomaxillofacial reconstruction using bicoronal flap. Subject and Methods: In altogether, 44 individuals between the ages of 18 and 60 were included in the research. All patients reported with primary complain of craniomaxillofacial trauma. Bicoronal flap was utilized in all patients. All patients were clinically examined for neurosensory deficits (supraorbital , supratrochlear region , zygomaticotempral and auriculotempral nerve). At least three intervals of one month, three months, and six months have been used to follow up on every case. Results: In 1st month evaluation, 14 patients were seen with neurosensory deficit with supraorbital nerve and 2 patients with supratrochlear nerve, while none of the patients were seen with disturbances in auriculotemporal and zygomaticotemporal nerve. At 6 month interval only 3 patients were remained with paresthesia of supraorbital nerve Conclusion: Using a bicoronal flap during craniomaxillofacial surgery is recommended, it provides excellent access and has reduced complications Keywords: Bicoronal Flap, Craniomaxillofacial Reconstruction, Neurosensory Deficit
Objective: To know the surgical outcome of endoscopic third ventriculostomy(ETV) in non communicating hydrocephalous. Design: Cross sectional descriptive study.st Setting: Neurosurgery department of Hayatabad Medical Complex, Peshawar. Period: 1 March2010 to 1st march 2011. Materials and methods: A total of 41 patients with non-communicatinghydrocephalous, irrespective of gender discrimination were included in this study. Patientsbelow two years of age and hydrocephalus with infected CSF or hemorrhage were excluded.Hydrocephalous was diagnosed on CT scan brain. The information regarding patientdemographical details, causes of hydrocephalus and complications of procedure wasdocumented in patient’s Performa. The data was analyzed by SPSS version 16. Frequency andpercentage was calculated for categorical variables. Mean ± SD was calculated for age. Resultswere presented as tables. Results: A total of 41 patients with non-communicatinghydrocephalous were included in the study. Out of 41 patients, there were 26(63.41%) males and15(36.58%) females. The mean age was 21 years. Etiologically tuberculous meningitis was thecommonest cause of non communicating hydrocephalous. Post-operatively CSF leakage waspresent in 4(9.75%) patients, pseudomeningocele in 2(4.87%) patients, transient memory loss in2(4.87%) patients and pneumocephalous in 1(2.43%) patient. Conclusions: The complicationsof endoscopic third ventriculostomy are transient. Those patients who meet the criteria,endoscopic third ventriculostomy offers the possibility of freedom from shunt dependency.
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