20 research outputs found
Frequency of Functional Outcome Among Patients with Spinal Tumor Visiting Tertiary Care Hospital
No full textObjective: To determine the frequency of functional outcomes among patients with spinal tumors.
Materials and Methods: This study was conducted at the neurological surgery department, Liaquat University of Medical and Health Sciences, Jamshoro and it was a descriptive study. A total of 145 patients presenting with spinal cord tumors were admitted through the outpatient department (OPD) and subsequently underwent surgical procedures. The diagnosis was primarily based on MRI findings, and the Frankel scale was used to assess neurological progress.
Results: The current study included 145 patients in total, with 65.5% of them being male. The majority (75.2%) were older than 60, whereas the mean age was 65.65±6.43 years. In contrast to the 15.9% of tumors in the cervical spine, 73.8% in the thoracic spine, and 10.3% in the lumbar spine, there were 13.8% intramedullary and 86.2% extramedullary tumors. Eight percent of patients required dorsal stabilization, 9.7% had surgical issues, 11.7% had medical difficulties, 66.2% required perioperative corticosteroid administration, and 11% required neuromonitoring. Upon admission, 11.7% had radiating pain, 34.5% had back discomfort, 82.1% had sensory deficiency, and 71% had bowel/bladder dysfunction. The mean McCormick score was 3.17±0.67 and 2.56±0.92 on admission and discharge, respectively whereas the mean KPS was 49.42±11.78 and 49.42±11.78 receptively. There were 40% of patients with unfavorable and 60% with favorable outcomes.
Conclusion: Early diagnosis with minimal symptoms leads to better outcomes, whereas delayed presentation and significant neurological deficits are associated with poorer prognosis
Paroxysmal nocturnal hemoglobinuria presenting as cerebral venous sinus thrombosis: a case report
No full textParoxysmal Nocturnal Hemoglobinuria (PNH) is a rare type of acquired hemolytic anemia that is frequently associated with thrombophilia. It may rarely present with cerebral venous sinus thrombosis, which manifests clinically with signs of raised intracranial pressure and requires lifelong anticoagulation therapy. One such rare presentation was seen in a 28 years old male who had history of recurrent episodes of passing red colored urine and this time presented with severe headache. He was diagnosed to have cerebral venous sinus thrombosis and on further workup was found to be suffering from PNH
Micropropagation of Arugula Plant (Eruca sativa Mill.)
No full textTissue culture, an essential technique in modern plant biology, offers promising avenues for the mass production of elite plant varieties for desirable traits. This study compared the effects of 0.1 mg L-1 NAA- 0.25 mg L-1 BAP plant growth regulator combination using Cotyledon leaves (0.4 cm²) of three Eruca cultivars Estht 195, Estht 198, and Estht 201 of arugula (Eruca sativa Mill.) cultured for four and six weeks. Significant differences were noted among them for callus induction percentage, shoot induction percentage, and plant height (cm). Notably, var. Estht 201 indicated consistently improved performance, with a callus formation percentage of 61.83 % in 4 weeks and 74.05 % in 6 weeks. Similarly, Var. Estht 201 exhibited higher shoot induction (Week 4 67.45 %, Week 6:69.9 %), and plant height (Week 4:7.50 cm, Week 6:9.6 cm), throughout the experiment. These findings contributed to a deeper understanding of arugula micropropagation Dynamics. At the same time, this study has once again shown how important tissue culture micropropagation protocols are in terms of improving yield and quality as well as breeding studies.
Vitamin D Deficiency in Patients with Diabetic Peripheral Neuropathy
No full textObjective: To determine the frequency of vitamin D deficiency in patients presenting with diabetic peripheral neuropathyPatients and Methods: This cross sectional study was carried out in Department of Medicine and Neurology Indus Medical College, Tando Muhammad khan. from March 2017 to August 2017. Total 74 cases of Diabetes Mellitus presenting with peripheral diabetic neuropathy were selected for the study. Evolution of degree of Neuropathy was based on TCSS score as: {no neuropathy: ≤5, severe: ≥12, moderate: 9-11 and mild: 6-8}. Vitamin D level was categorized as (deficiency (0-20 ng/ml), insufficiency (21-30 ng/ml) sufficiency (>30 ng/ml), excess (>50 ng/ml) and toxicity (>100 ng/ml). All the data was entered in SPSS.Results: Total 74 patients with diabetic neuropathy were studied. Vast majority of patients 36(48.6%) were found in age group 51-60 years, Majority were males 45(60.8%). Most of the cases 35(47.3%) were with 1-3 years duration of neuropathy. Majority of patients 42(56.8%) were found with Mild peripheral neuropathy. Vitamin-D deficiency was present in 2(43.2%) cases and insufficiency was observed in 27(36.5%) cases. No significant association was found between vitamin D deficiency and severity of neuropathy.Conclusion: Vitamin D deficiency was found (43.2%) in patients of diabetic peripheral neuropathy. Vitamin screening and intake of supplement is necessary, will help to decrease the complication of peripheral neuropathy in Diabetic cases. Key words: Diabetes, Peripheral neuropathy, Vitamin
Success Rate of Endoscopic Third Ventriculostomy (ETV) in Non-Communicating Hydrocephalus in Pediatric Age Group
No full textObjective: To evaluate success rate of the endoscopic third Ventriculostomy (ETV) in non-communicating type of hydrocephalus in pediatric age group.
Material and Methods: This study was carried in the department of neurosurgery at Liaquat university hospital, Jamshoro in which an endoscopic third Ventriculostomy procedure was performed in patients (n = 55) with non-communicating hydrocephalus from October 2016 to April 2017. Post-operative follow-up was done on the 15th day post-operative to assess clinical and radiological improvement.
Results: 55 patients were included in this study, 26 (47.27%) males and 29 (52.73%) females. The mean age was 3.96 years. The most common etiology was aqueductal stenosis 28 (50.90%) patients followed by posterior fossa tumors in 18 (32.72%) patients. The operative technique was successful in 41 (74.55%) patients. Out of 41 successful patients, 34 (82.92%) patients had clinical as well as radiological improvement whereas 7 (17.07%) patients had clinical improvement only.
Conclusion: The success rate of ETV was 74.55% in the non-communicating hydrocephalus in the pediatric age group in our study. Endoscopic third Ventriculostomy is an effective treatment for non-Communicating hydrocephalus in pediatric age groups by diversion of CSF intracranially. This procedure provides shunt freedom and can be used alternative to shunts in pediatric age groups with non-communicating hydrocephalus
Magnetic Resonance Imaging Findings in Delayed Milestones Associated with Additional Clinical Features in Pediatric Patients
No full textBackground: Rare, but the delay in the process of achieving milestones has a devastating effect,with a vast number of etiologies associated with it. This study aimed to identify the brain MRIfindings in patients showing additional clinical features with developmental delay and thedevelopment of a correlation between clinical findings and MRI findings.Methods: This cross-sectional study included 22 patients with developmental delay at LiaquatUniversity of Medical and Health Sciences, Hyderabad, from August 2022 to August 2024, usingnon-probability consecutive sampling. Clinical histories, examinations, and brain MRIs using a1.5 Tesla scanner were conducted. Data were analyzed in SPSS v26. Descriptive statistics, Chi-square or Fisher’s exact test were applied, and a p-value <0.05 was considered statisticallysignificant for associations between clinical features and MRI findings.Results: The study included 22 patients, evenly distributed between genders (11 males and 11females). The majority, 10 (45.5%), were aged 2–5 years. The most common clinicalmanifestations were epilepsy (14, 63.6%, p = 0.01), gait disturbance (13, 59.1%, p = 0.03), grossdevelopmental delay (9, 40.9%, p = 0.04), visual and auditory disturbances (7, 31.8%, p = 0.02),motor disturbances (7, 31.8%, p = 0.05), neurological deficits (7, 31.8%, p = 0.04), and speechdeformities (6, 27.3%, p = 0.03). Some cases also had associated radiological abnormalities. A p-value < 0.05 was considered statistically significant.Conclusion: Patients of delayed milestones that are exposing additional clinical features arelikely to have some kind of abnormalities on MRI scan despite of their etiological variables
Frequency and Clinical Presentation of Spina Bifida at Liaquat University Hospital
No full textObjective: The study was conducted to observe the clinical presentation and variation of Spina Bifida in the study population.
Materials & Methods: This retrospective study analyzed the prevalence and clinical presentation of Spina Bifida among surgical patients, in which 172 cases admitted via OPD were included. Data collected covered demographics and clinical details, including age, gender, cousin marriage, region, type of Spina Bifida (meningocele or meningomyelocele), hydrocephalus association, and defect width were diagnosed by MRI lumber spine and CT scan brain which was done in all patients.
Results: Over three years, a total of 1,756 elective surgeries were performed, with 172 cases identified as Spina Bifida, representing approximately 9.8% of the total surgeries conducted. Sub-classification of Spina Bifida cases delineated 166 (96%) cases as Spina Aperta and 6 (4%). Predominantly featured myelomeningocele (MMCs), comprising approximately 81% of the aperta cases. Further stratification of MMCs based on size revealed varying proportions, with approximately 64 (37%) less than 3*3cm, 76 (44%) between 3*3cm and 5*5cm, and 32 (19%) exceeding 5*5cm, indicating a spectrum of severity within this subset of cases. Anatomical distribution delineated the majority of Spina Bifida cases (approximately 95.9%) located in the lumbar region, with fewer occurrences observed in the dorsal (2.9%) and cervical (1.2%) regions.
Conclusion: These findings underscore the multifaceted nature of Spina Bifida, encompassing diverse clinical presentations, anatomical variations, and associated anomalies, necessitating a comprehensive and multidisciplinary approach to management tailored to the individualized needs of patients
Outcome Difference between Traumatic and Spontaneous Chronic subdural hematoma
No full textObjective: To evaluate the effect of traumatic or spontaneous etiology on outcome of CSDH patients
Material and methods: It is retrospect case control study and was conducted in Liaquat University hospital. The duration of study was 1st Jan 2023 to 1stJan 2024. The patient that was included in study was divide into two groups either spontaneous or old history of trauma less than 3 months. The Pre-operative and post-operative GCS were noted. The post-operative (on discharge) GOSE were noted.
Results: Total numbers of 32 patients with 16 in single group were included, the mean age was 60, out of which 65.6% were males. . After surgery, the mean GCS in spontaneous group was 9.62 and 12.81 in traumatic group (p-0.020). The post-operative GOSE in spontaneous group was mostly Grade I (Dead, 56.2%) and Grade VIII (upper good recovery, 62.5%) in traumatic group. The effect on GOES either spontaneous or traumatic is non-significant that p- 0.051, but the spontaneous CSDH has more chances of being dead as compare to traumatic CSDH and vice versa with Odd ratio of 1.2.
Conclusion: The spontaneous etiology holds grave outcomes as compare to traumatic etiology. Both etiologies do improve the immediate Post-operative GCS but the GOES grading worsens with spontaneous etiology.
Functional Outcome of Chronic Subdural Hemorrhage on Glasgow Comatose Outcome Scale Extended
No full textObjectives: Chronic Subdural hemorrhage is one of the most common neurosurgical disorders, mainly affecting the older population. The main objective is to assess the functional outcome of patients with Chronic Subdural hematoma on GCOSE.
Materials and Methods: This is a prospective cross-sectional study conducted at Liaquat University Hospital Hyderabad with a duration of January to December 2023. Patients presented with CSDH and different management was performed at the time of discharge or death GCOSE scale was recorded on a predesigned questionnaire.
Results: A total of 63 patients were included in the study, the mean age was 58.26, of which 69.8% were males, the most common presentation was One-sided weakness 58.9%, followed by the altered level of consciousness 57.3%. The mean pre and postoperative GCS was 10.98 and 11.87 respectively. Most of the patients had unilateral collection 89% with a few having bilateral CSDH 11%. The outcome GCOSE was such that 50% of the patients were found in grade VIII i.e. upper good recovery, all the patients that underwent through and through drainage had the best outcome with a p-value of 0.001, however, 22% of the patients were found in grade I (dead).
Conclusion: The functional outcome of Chronic subdural hematoma is best delineated with GCOSE as compared to the modified ranking scale and GOS.
Keywords: CSDH, functional outcome, GCS, GCOSE, head trauma, Glasgow outcome scale, Glasgow outcome scale extended, modified ranking scale
