Frequency of Infected Healthcare Workers and Factors Leading to Infection in Emergency Neurosurgical Trauma during COVID-19 Pandemic

Objective:  The aim of this study was to know the frequency of COVID-19 infection in healthcare workers and to identify the risk factors leading to infection in emergency neurosurgical trauma during COVID-19 pandemic. Material and Methods:  This descriptive cross-sectional study was conducted in the Department of Neurosurgery, Ayub Teaching Hospital. A total of 99 healthcare workers with an age range from 22 – 55 years attending or carry emergency procedures with both male and female gender were included in the study. Age, gender, sign and symptoms, safety measures and COVID PCR reports were recorded. Results:  12 (12.1%) out of 99 healthcare workers got an infection with COVID-19. 83.3% of the infected healthcare workers were male while 16.6% were females. A maximum of the healthcare workers infected with COVID-19 was in the age range 31 – 40 (50%). Most of them were Doctors (66.6%) followed by nursing staff (25%). Low-grade fever and cough were the most common symptoms. The most important factors which affect the transmission of infection to healthcare workers were improper use of personal protective equipment (PPE), masks, gloves by healthcare professionals, and inability to maintain social distancing with the patients. Conclusion:  To protect healthcare workers from getting infections, proper personal protective equipment should be used. Early recognition of the infected patient and prompt isolation should be done to prevent or minimize the chain of transmission

Risk Factors and the Incidence of Diabetes Insipidus after Pituitary Surgery

Background:  To improve patient care, determining the post-surgery risk factors for diabetes insipidus are extremely significant. We demonstrated the pre-operative factors and postoperative incidence of diabetes insipidus in pituitary surgery. Materials and Methods:  Patients of both genders with ages between 18-65 years having pituitary adenoma amenable to surgery were included. The sample size mainly constitutes macroadenomas and giant adenomas i.e., greater than 1 cm and equal to or greater than 4 cm, respectively. The Hosmer-Lemeshow test was used to measure model fit. The receiver operator characteristic curve was used to evaluate the model and variables such as preoperative serum sodium and urine specific gravity. Results:  Only 210 of 279 patients met the selection criteria. Most of the patients have lesions greater than 1cm, as a result of which a greater number of patients had undergone transcranial approach. Out of these patients, 27% have developed diabetes insipidus. The mean age was 53 years in the non-DI group, whereas, 47 years was the mean age in the patients with DI. 25% of females and 31% of males developed diabetes insipidus. 75% of females and 64% of males did not develop DI. The highest percentage (61%) of patients who developed DI came from giant adenomas.  Conclusion:  Giant adenomas, aggressively primarily treated adenomas, and those lesions that were approached transcranially, showed an increased risk of diabetes insipidus and those who have undergone redo surgery have reduced incidence of diabetes insipidus

EGFR-1 Expression in Meningioma: Insights into Gender Distribution and Grade

Objective:  Meningioma is the most common primary brain. Histopathological grading (from I to III) is essential for prognostication and therapeutic decisions. EGFR-1 overexpression has been implicated in tumor progression and poor outcomes in various cancers. However, its role in meningioma pathophysiology and gender disparities remains unclear. This study aimed to determine the expression of EGFR-1 in grade I and grade II meningioma and explore associations with clinicopathological parameters. Materials & Methods:  This cross-sectional study was conducted at Ayub Teaching Hospital in collaboration with the Neurosurgery Department, Histopathology Laboratory of Ayub Medical College, and Health Diagnostic Laboratory. Non-probability consecutive sampling technique was used to include meningioma patients aged 23-54 years after obtaining ethical approval. Data was collected from medical records, and histopathological examination and immunohistochemical analysis were performed on meningioma tissue samples. Statistical analysis was conducted using SPSS Version 25, and associations between clinicopathological parameters and EGFR-1 expression were evaluated using appropriate tests. Results:  We included 39 meningioma patients, with a female predominance of 22 (56.4%). The majority had grade I tumors (89.7%). EGFR-1 expression was observed as severe 30 (76.9%), moderate 7 (17.9%), and mild 2 (5.1%). No significant association was found between gender and meningioma grade or EGFR-1 expression. However, a significant association was observed between meningioma grade and EGFR-1 expression in grade I tumors (p = 0.049), but not in grade II tumors (p = 0.248). Conclusions:  A significant correlation between meningioma grade and EGFR-1 expression in Grade I meningioma suggests that EGFR expression could serve as a prognostic biomarker