Affine-Invariant Outlier Detection and Data Visualization

A wealth of data is generated daily by social media websites that is an essential component of the Big Data Revolution. In many cases, the data is anonymized before being disseminated for research and analysis. This anonymization process distorts the data so that some essential characteristics are lost which may not be captured by methods that are not robust against such transformations. In this paper we propose novel algorithms, for two-dimensional data, for a recently discovered statistical data analysis measure, the Ray Shooting Depth (RSD) that provides an affineinvariant ranking of data points. In addition, we prove some complexity results and illustrate some of the desirable properties of RSD via comparisons with other similar notions. We develop an open-source data visualization tool based on RSD, and show its applications in distribution estimation, outlier detection, and 2D tolerance-region construction

Insular Glioma Esoteric Precinct

Background and Objective:  The complex insular anatomy and its proximity to eloquent areas make this area almost inaccessible for safe surgical resection of Glioma. Aim of our study is to determine outcome assessment after surgical resection. Materials & Methods:  This was a retrospective analysis of 59 patients over a period of 5 years from July 2013 till June 2018. All patients of insular Glioma were included in our study irrespective of age and sex. Degree of surgical resection, Post-operative neurological deficits and complications were assessed. They were followed in the outpatient department at 3, 6 and 12 months. Results:  Total 59 patients were included 38 (64.40%) male and 21 (35.59%) females. 36 (61%) patients had right sided insular Glioma and 23 (38.98%) have left sided. Seizures were main presentation in 46(77.96%) patients. Trans-sylvian route adopted in 34 (57.6%) patients followed by transcortical route. Near total Resection was Possible in 30 (50.84%) patients and partial in 29 (49.15%) patients. Focal neurological deficits the motor weakness & dysphasia were main post-operative complications in 18 (30.5%) patients. Three (5.08%) patients died. In all grade II and grade III Gliomas no increase in size was discovered on MRI Brain at 6 and 12 months. Conclusion:  Maximum safe resection of insular Glioma with acceptable morbidity is possible with improved overall survival and disease free interval

Harmonic scalpel versus electrocautery tonsillectomy: a comparative study in adult patients

OBJECTIVE: To compare harmonic scalpel (HS) tonsillectomy with electrocautery (EC) tonsillectomy in terms of operating time, intra-operative blood loss, post-operative pain and secondary haemorrhage.METHODS: Sixty adult patients subjected to tonsillectomy only, were evaluated in this prospective study. The patients were stratified into 2 groups (30 each) based on the dissecting instrument used (HS vs. EC) at Aga Khan University Hospital Karachi Pakistan from June, 2006 to August, 2008.RESULTS: The mean operative time was less in electrocautery group (EC 3.57 +/- 0.85 minutes Vs HS 4.20 +/- 1.37 minutes;

Autologous Bone Graft vs PEEK Cage in Patients with Cervical Spondylotic Myelopathy

Background:  Cervical spine stenosis is one of the most common degenerative changes of cervical spondylotic myelopathy (CSM) and results in severe dysfunction of the cervical spinal cord. The conventional treatment of such degenerative cervical spine conditions is anterior cervical discectomy and fusion (ACDF). Strut graft remains the gold standard in ACDF with excellent patient recovery but has many shortcomings. Polyetheretherketone (PEEK) cages have recently become popular as a replacement for strut grafts in patients undergoing ACDF. Objective:  This study was carried out to compare the clinical and radiographic outcomes of autologous bone grafts versus PEEK cages in patients undergoing ACDF surgery. Materials and Methods:  It was a randomized controlled trial conducted at the Neurosurgery Department Punjab Institute of Neurosciences for three years. Patients who consented to be a part of this study and fulfilled our predefined inclusion criteria were recruited and randomized into 2 groups. One group underwent ACDF with auto bone graft whereas the other group underwent ACDF with PEEK cage. Results:  A total of 198 subjects were included in this study. The mean age was calculated as 47.60 ± 9.17 years in the PEEK cage group and 46.74 ± 8.87 years in the Autologous bone graft group. Males accounted for 59.6% of the study population.  The fusion rate was found to be higher in the PEEK cage group with a p-value of 0.002. Conclusion:  PEEK cages are superior to strut grafts as they have lesser morbidity after ACDF surgery in patients with CSM. &nbsp

Anatomical variations of nose and para-nasal sinuses; CT scan review

Objective: To determine the frequency of anatomic variations on computed tomography scan of para-nasal sinuses.Methods: The retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised computed tomography scans of 77 patients who had presented between October 2007 and March 2011. All the scans were reviewed using Picture Archiving Communication System computer software. The scans were reviewed for the presence of deviated nasal septum, paradoxical middle turbinate, Haller cell, Onodi cell, and pneumatisation of the middle turbinate and uncinate process.Results: The mean age of the patients was 31±13.15 years. One or more types of anatomical variants were observed in 40 (51.9%) of the patients; the most frequent being the deviated nasal septum 20 (26%) and the Concha bullosa 14 (18.2%).Conclusion: Considering the wide range of variations in the anatomy, each and every para-nasal sinus case should be planned individually and carefully to avoid dreadful complications and maximise patients’ benefit

Management of Postoperative Pseudomeningocele following Posterior Cranial Fossa Surgery

Objective: Pseudomeningoceles are common complications after posterior fossa surgery. Management guide-lines are lacking, and radically different suggested treatments varying from observation to immediate surgical intervention are encountered in literature. The purpose of our study was to detail our experience in the manage-ment of pseudomeningocele following posterior fossa surgery.Methods: A retrospective, single-center study was conducted on 137 patients who underwent elective posterior fossa surgery for a variety of diseases. Patients with post operative pseudomeningocele formation were initially treated with conservative measures including bed rest, head elevation, pressure dressing and CSF lumbar drain-age. Surgical re-exploration and repair of the dural rent was done in case the pseudomeningocele didn’t settle with these conservative measures. In patients having gross hydrocephalus on post-operative CT scan a VP (ventriculo-peritoneal) shunt was done in case the conservative measures failed.Results: There were 8 (5.8%) cases of pseudomeningocele formation after posterior fossa surgery. The pseudomeningocele didn’t settle with conservative measures in any case. Surgical re-exploration and repair of the dural rent lead to the settlement of pseudomeingocele in four cases. VP shunting for gross hydrocephalus on post operative CT lead to the settlement of the pseudomeningocele in the other four cases. Conclusion: Although it has been stated in literature that most cases of pseudomeningocele settle with conser-vative treatment with only a few requiring surgical intervention, our findings were different with conservative measures failing to resolve the pseudomeningocele in all the cases. We believe that it would be beneficial to take an aggressive attitude toward this condition and to consider the possibility of early surgical intervention more seriously

Level of Stress Among Health Care Workers in COVID-19 Dedicated Setup

Objective: To determine the co-relation between perceived social support and stress among nursing staff working in a COVID-19 dedicated hospital setup. Study Design: Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Mental Health (AFIMH), Rawalpindi from 30 Aug 2020 to 02 March 2021. Materials and Methods: We consecutively sampled 128 subjects. All participants were requested to complete a brief demographic sheet, Urdu version of the Depression, Anxiety and Stress Scale 21 (DASS-21) to assess the level of severity of stress among nursing staff and the Urdu version of the Multidimensional Scale of Perceived Social Support (MSPSS). Data analysis was done using SPSS version 23.0. Results: The mean duration of stay of nursing staff in ward was 4.86 ± 2.28 weeks. Sixty-two (48.44%) nurses had duration of 2 to 4 weeks while 66 (51.56%) nurses had duration of more than 4 weeks of stay in the ward. The mean total stress score was 6.86 ± 5.80. The mean multidimensional scale of perceived social support (MSPSS) score was 47.29 ± 22.53. There was significant negative correlation between MSPSS score and stress score (r= -0.396, p-value < 0.05). Conclusion: Results of this study highlighted that a significant negative co-relation is present between perceived social support and stress among nursing staff working in a COVID-19 dedicated hospital setup

Neurological disorder burden in Faisalabad, Punjab-Pakistan:data from the major tertiary carecenters of the city

The burden of neurological disorders (NDs) in developing countries is 4-5%, compared to 10-11% in developed countries. This burden is rising in developing countries due to prolonged life expectancy, improved health facilities, easy access to diagnostic facilities, and a trend in urbanization. There is inadequate data about the epidemiology of major NDs in Pakistan and most available information are hospital-based estimations or physicians’ collected data

Frequency and predisposing factors of pharyngocutaneous fistula after total laryngectomy

AbstractObjectiveThe objective of our study was to determine the frequency and predisposing factors of pharyngocutaneous fistula in postlaryngectomy patients.Materials and methodsCharts of those patients who were treated with total laryngectomy for laryngeal carcinoma in our department from 2000 to 2008 were reviewed. Total 77 patients were included in the study. The variables studied for the development of pharyngocutaneous fistula (PCF) after total laryngectomy were: age and gender, diabetes mellitus, post-operative hemoglobin, ischemic heart disease, chronic obstructive pulmonary disease, tumor characteristics including tumor site, stage, differentiation and extension into pyriform sinus, pre-operative radiotherapy, pre-operative chemotherapy, pre-operative tracheostomy and positive surgical margins.ResultsUnivariate analysis showed diabetes, pre-operative radiotherapy, pre-operative chemotherapy and pre-operative tracheostomy to be significantly associated with the formation of PCF. However, multivariate regression revealed that the only pre-operative radiotherapy was highly associated with the formation of PCF (OR=132.923, P=0.001).ConclusionsWe found 28.6% incidence of pharyngocutaneous fistula mainly because of the number of patients undergoing radiotherapy and chemotherapy as primary treatment for laryngeal cancers is increasing with current approach of organ preservation protocol