Although a relatively simple procedure, cranioplasties have been associated with high complication rates. Keeping this in perspective, we aimed to determine the factors immediate and long-term complications of at our institution.A retrospective review patient records was carried out for patients having undergone reconstructive institution during last 10 years (2001-2010). All case notes, records, investigations were reviewed data recorded predesigned questionnaire. Complications along...

Abstract Background and study aims Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) using a 15-mm lumen apposing metal stent (LAMS) has emerged as viable alternative to surgical gastrojejunostomy for management of gastric outlet obstruction (GOO). However, given the size anastomosis created with LAMS, long-term luminal patency clinical outcomes may be suboptimal. The aim this was evaluate technical feasibility, efficacy, safety EUS-GE large-diameter (20 mm) LAMS (LLAMS). Patients...

Surgical excision of the primary tumor with safe margins remains mainstay treatment for oral cavity squamous cell carcinoma (OSCC). The standard care assessment intraoperative is frozen section histopathology. Unfortunately facility not available at most centers in limited resource countries. Toluidine blue, a metachromatic dye, has been well described clinical identification malignant and premalignant lesion cavity. Considering this we decided to explore use toluidine blue staining,...

Literature on the safety of endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients is divided. Based this we decided to examine ERCP nonagenarian patients.A total 1,389 patients, with a mean age 63.94±19.62 years, underwent during study period. There were 74 aged 90 years or older 92.07±1.8. Logistic regression showed that had significantly increased odds in-patient mortality (adjusted ratio [AOR]=9.6; 95% confidence interval [CI]=4, 23; p≤0.001). Charlson Comorbidity...

Changing environmental conditions have increased the transmission period for both dengue and malaria. Annual incidence of malaria in 2006 alone was 247 million cases leading to nearly 881 000 deaths; whereas another 50 100 infections, associated with an overall mortality 2.5%, are expected each year. In Pakistan, like many developing nations endemic malaria, empirical clinical diagnosis is usually made, due a lack resources availability diagnostic facilities. Since diseases same population...

External ventricular drains (EVD) are commonly utilized for temporary diversion of cerebrospinal fluid (CSF). Many neurosurgeons prefer long-tunneled EVDs in their routine practice. However, it is still unclear whether this extended tunneling helps reducing CSF infection. Keeping mind, we decided to compare infection rates versus short-tunneled the setting a developing country.A prospective study 60 patients was conducted. Consenting who underwent (Group A) or B) between January 2008 and...

Given the improved survival of patients requiring decompressive craniectomies, frequency subsequent cranioplasties are on rise. The most feared complication autologous cranioplasty is infection and one method for reducing rate infection, to store bone flaps at subnormal temperatures. However, date there no defined temperature flap storage ranges from - 18 83°C have been described in literature. Considering our limited resources it has practice center 26°C. In this study, we retrospectively...

Hypoplasia of the internal carotid artery is a rare congenital anomaly, with only 24 cases bilateral hypoplasia reported to date. Here, we present case 48-year-old woman hypoplasia. She had collateral circulation through vertebrobasilar system; however given high pressure flow she developed aneurysmal formations in posterior communicating artery. To best our knowledge, seven have been associated intracranial formations. A Sindhi from Karachi, Pakistan, presented emergency room sudden onset...

Endoscopic transpapillary gallbladder drainage (ETPGBD) is gaining popularity for the management of acute cholecystitis (AC) in high-risk patients. However, stents placed during procedure are not immune to obstruction. Here we describe a novel technique stenting with two and evaluate its technical feasibility, safety, efficacy AC.A retrospective analysis all patients undergoing ETPGBD using dual AC at our institution between November 1, 2017 August 31, 2020 was conducted. We abstracted...

Introduction: Cranial reconstruction after decompressive craniectomy (DC) has been shown to be associated with a relatively high complication rate (16.4%-34%) compared standard neurosurgical procedures (2%-5%). Most studies that have previously attempted formulate multivariate model for identifying factors predictive of postoperative complications cranioplasty either were unsuccessful or yielded conflicting results. Therefore, fuzzy logic-based inference system (FIS), which proven useful...

Percutaneous endoscopic gastrostomy (PEG) is a relatively safe procedure; however, no study has evaluated the safety of PEG tube placement in patients over age 100 years.We conducted retrospective review patient records for who underwent placement. Thirty aged years and older were identified random sample 275 was selected comparison.The mean 80.6±16.2 years. No procedure-related deaths or major complications identified; overall inpatient mortality rate 7.6%. Minor noted 4% (n=12) patients....

Background . Developing countries, home to 80% of epilepsy patients, do not have comprehensive surgery programs. Considering these needs we set up first center in Pakistan. Methods Seventeen teleconferences focused on setting an at the Aga Khan University (AKU), Karachi, Pakistan were arranged with experts from Alberta Hospital, Alberta, Canada and West Virginia, USA over a two-year period. Subsequently, visited proposed provide hands training. During this period several interactive teaching...

Aggressive fibromatosis is a benign tumor, thought to arise from deep musculoaponeurotic structures, rarely found in the head or neck. However, when it does occur and neck region, tends be more aggressive associated with significant morbidity, which may attributed vital vascular, neurological anatomical structures close proximity.We report case of 39-year-old Pakistani man who presented two-month history lump on right side his The mass was excised histopathological analysis revealed...

Studies have shown that nearly 3% of closed head injuries result in basal ganglia hemorrhages and this may be a more frequent occurrence pediatric patients. Various mechanisms based on shearing forces been implicated the injury; however, underlying mechanism leading to increased incidence patients has not well described. Angiographic data suggest putamenal perforators children are severely stretched at acute angles compared those adults, which contributing factor incidence.We discuss series...

Primary central nervous system lymphoma (PCNSL) is an uncommon form of non-Hodgkin affecting the brain, spinal cord, and leptomeninges. Carcinomatous meningitis (CM) cord compression in PCNSL are very rare usually present advanced stages disease. The average survival time a CM patient about 4 to 6 weeks, which may be extended months with treatment. Here we case by multiple 6-year-old girl, who has survived 2 years 9 posttreatment no recurrence. To best our knowledge this first reporting...

Currently, there are no uniform guidelines regarding the appropriate amount of blood products ordered prior to spine surgery. Here, we audited our own institution's practices along with preoperative variables that contributed perioperative transfusion requirements for elective spinal arthrodesis.This study utilized a single institution retrospective chart review patients undergoing fusion over 2 year period. The cross matched transfused (C/T) ratio was compare different patient groups....