Framed Stereotactic Brain Biopsy Outcome – Single Center Study

stereotactic biopsy. The study was conducted at the Neurospinal & Cancer Care Institute Karachi. Material and Methods:  After the approval from the ethical hospital committee, the study was conducted on 34 patients, in which 9 (26.4%) were females, and 25 (73.5%) were males. 34 consecutive patients with biopsy inclusion deep seated lesion, mid line pathology, eloquent area and operated surgery, previous radiation treatment were excluded, and after that, the biopsy report based surgery or radiotherapy treatment was decided. Result:  The biopsy underwent histopathological diagnosis proving Astrocytoma in 7 (20.5%) patients out of which four were in the Eloquent area, tuberculosis diagnosed in 5 (14.7%) patient, Oligodendroglioma diagnosed in 3 (8.8%) patients, metastasis in 5 (14.7%), Abscess in 4 (11.7%) patient which was aspirated to maximum and sent for culture, Malignant tumor (grade 3 & 4) 5 (14.7%), Lymphoma in 2 (5.8%) patient both were given radiation therapy Tumor necrosis 1 (2.9%) case,  and No tissue obtained in 2 (5.8%) which was repeated later. No major complication or side effects were observed in the patient. Conclusion:  Stereotactic Framed biopsy is safe and accurate and can be used in deep seated lesions with high success rate, minimal complication and decrease surgical morbidity for patients, and it is comparable to updated methods. &nbsp

Craniosynostosis: Clinical Presentation and Outcome of Surgical Treatment

Objective:  Craniosynostosis presents sclerosis cranial sutures, ossification and fusion involving the vault of the base, sutures involved can be one or more sutures. This study aimed to determine the surgical outcome of craniosynostosis. Material and Method:  The prospective study was conducted at the neuro spinal and cancer care institute, Karachi. Patients presented with sagittal, metopic, unicoronal, lambdoid, bicoronal craniosynostosis were included in the study, while patients with coagulopathy, previously operated cases were excluded from the study. Results:  We had 26 children in our study, age range about 1–3 years. Patients were cleaved into groups depending on their age. Most of the children 15 (57.6%) were in 1–2 years age group and 11 (42.3%) were in 2-3 years of age. Boys were 18 (69.2%) and girls were 8(30.7%). Coronal 11 (42.3%) was the most common suture involved, followed by sagittal 9 (34.6%). Lambdoid suture 3 (11.5%), metopic 2 (7.6%) and 3 (11.5%) case presented with raised intracranial pressure with multiple sutures closed involved. Strip craniectomy was done in all cases. We did bicoronal flap and Scalp flap turned into a supraorbital region while in metopic suture Fronto-orbital advancement and remodeling approach were used. No major complication was observed. Conclusion:  Cases which are managed early age have given good acceptable results in follow up, proper surgical expertise, perioperative management of temperature, blood loss, relieving the restriction of sutures and normalizing raised intracranial pressure can decrease the morbidity and mortality

Cervical Spine Discectomy, Osteo-facetectomy by Noble Art of Cloward Procedure and Its Modification- A Single Centre study

Objectives: To analyze the surgical outcome of cervical spine osteo-facetectomy discectomy, and modified Cloward procedure.Materials and Methods: A prospective study was conducted at the Neurospinal & cancer care institute, Karachi. The duration of study was from 1st June 2017 to 25th November 2019. Patients having prolapsed intervertebral cervical discs included in the study, while those with trauma, cervical radiation, previous cervical surgery andmultiple level involvement were excluded. Pre and post-surgical data was collected. Titanium Hashmi cage was used in all operated patients at single level instrumentation.Results: A total of 113 patients satisfied the inclusion criteria and were considered in the study. Among them, 77 patients were male and 36 were female. The age range from 26 to 65 with a base age of 53 years ± 2.5. C5 – C6 was the commonest level for fusion C6 – C7, C3 – C4 and C4 – C5 were less common. For the outcome of theprocedure Odom’s criteria, was followed the results showed excellent improvement in 88 (77.87%), Good results in 18 (15.9%), fair in 5 (4.42%) and 2 patient had Poor (1.76%) results. Fusion was seen in 86 patients, superficial infection in two cases.Conclusion: Patients with single-level degenerative disc and treated with modified titanium Hashmi cage provided a good fusion with the relief of upper limb pain without donor site morbidity at anterior iliac spine

Dynamics of A Polluted Tidal Estuary, Gizri Creek During South West Monsoon

Abstract: A 25 hours study was conducted in a polluted Estuary, Gizri Creek in order to investigate how current speed, salinity and water temperature stratification behaves under the influence of a polluted freshwater source. Vertically lunar hourly profiles of salinity, water temperature and current speed were obtained and the results indicate that the estuary is forced by semi-diurnal tides. The profiles of current intensity indicates that the flood currents slightly higher than the ebb ones, with maximum values of about 33.45 and 31.51 cms-1, respectively. The major flooding velocity was enhanced by the strong tidal currents. The lunar hourly variations of salinity and water temperature reveal that during the ebb, the vertical stratification increases, decreasing during the flood period. The salinity ranges between 28 and 41 ppt (parts per thousand) and the water temperature between 30.2 and 33.7 ºC. At surface and near the bed the salinity and water temperature increases during the flood periods, decreasing during the ebb. From the 25 hours observation of water column stratification or salinity vertical structure on the basi

Multimodality Treatment of Craniopharyngioma: Aspiration of Cystic Contents and Placement of Ommaya Reservoir Stereotactically Followed by Gamma Knife Radiosurgery – Single Center Study of 81 Cases

Objective:  The objective of this present study was to assess the accuracy, result, and safety measures of stereotactic biopsy. The study was conducted at the Neurospinal & Cancer Care Institute Karachi. Material and Methods:  After the approval from the ethical hospital committee, the study was conducted on 34 patients, in which 9 (26.4%) were females, and 25 (73.5%) were males. 34 consecutive patients with biopsy inclusion deep seated lesion, mid line pathology, eloquent area and operated surgery, previous radiation treatment were excluded, and after that, the biopsy report based surgery or radiotherapy treatment was decided. Result:  The biopsy underwent histopathological diagnosis proving Astrocytoma in 7 (20.5%) patients out of which four were in the Eloquent area, tuberculosis diagnosed in 5 (14.7%) patient, Oligodendroglioma diagnosed in 3 (8.8%) patients, metastasis in 5 (14.7%), Abscess in 4 (11.7%) patient which was aspirated to maximum and sent for culture, Malignant tumor (grade 3 & 4) 5 (14.7%), Lymphoma in 2 (5.8%) patient both were given radiation therapy Tumor necrosis 1 (2.9%) case,  and No tissue obtained in 2 (5.8%) which was repeated later. No major complication or side effects were observed in the patient. Conclusion:  Stereotactic Framed biopsy is safe and accurate and can be used in deep seated lesions with high success rate, minimal complication and decrease surgical morbidity for patients, and it is comparable to updated method

A comparative analysis on expansion of Pakistan fisheries trade: World & China

1643-1650China Pakistan Economic Corridor (CPEC) is a major pillar of Belt and Road initiative project of Chinese Government. China has investing billions of US$s in Pakistan to forestall the major energy crises, bilateral trade and mutual development. This research article describes the comparative analysis of fisheries products exported from Pakistan to china and rest of the world. An in-depth analysis is done on cooperation position and coming possibilities in export by fisheries product between Pak-China. On this basis, we will explore into how the “Belt and Road Initiative” will promote further expansion of China-Pakistan Economic Trade Cooperation and propose specific measures for China-Pakistan to expand economic and trade cooperation. China is the one of the biggest export markets of fisheries products from Pakistan. China has imported and exported 39599 thousand tons of fisheries products and this figure is expected increase in future. The annual growth in value from 2014 to 2018 exports of fish & fishery products from Pakistan to the China registered high growth in fresh or chilled (0302) fish products which increased by 20 %, 18 % growth is observed in dried or salted (0305), 17 % growth in live fish (0301) and 13 % in frozen fish (0303) products. While, the annual growth in export value from 2014 to 2018 to the World have registered an increase at 14 % in fish fleets (0304), 12 % in Molluscs (0307), 11 % in frozen fish (0303) and 10 % in dried or salted (0305) fish products

Resource evaluation, stock, growth and mortality of the Bombay duck (Harpodon nehereus Hamilton, 1822) fishery in the coastal waters of Pakistan

1222-1228Bombay duck, Harpadon nehereus (Hamilton, 1822), harvested mainly by dol nets, has been a prolific fishery in the northern Arabian Sea. Monthly length composition data for H. nehereus, landed at the Karachi Fish Harbor (KFH) from July 2014 to June 2015 was used to determine growth, mortality and stock evaluation. Total  2252 specimen with an average of 19.171 ± 2.659 cm TL (14 to 28 cm total length), an average of 45.254 ± 23.113 g of 9 to 174 g (total body weight) analyzed. The data used in FiSAT-II applying ELEFAN-I package for estimating population dynamics. The estimated the growth parameters of von Bertalanffy L∞ = 29.40 cm, K = 0.610 year-1 and t0 = -0.359 year-1 with a phi φ’ = 2.722. The length-weight relationship was W = 0.001L3.477 (R2 = 0.918) and b > 3 is described as positive allometric growth. Total mortality was calculated at Z = 1.800 year-1, natural mortality estimated at M = 1.276 year-1 at 27 °C in addition, fishing mortality rate was 0.524 year-1 is not much higher than the safe level (Fopt = 0.638 year-1) and a little below edge (Flimit = 0.850 year-1) biological reference points. Due to mortality and exploitation rate (E = 0.291 < 0.50), the population stock and reserves were underutilized

Growth Pattern and Morphological Variation of Labeo calbasu Found in Indus River, Sindh-Pakistan

The present work reports the length–weight relationships (LWR) and condition factor relationships for Labeo calbasu collected from Upstream (Matyari) Kotri barrage at, River Indus, Pakistan, because stock assessment helps the fisheries managers to conserve the commercially important fish. Morphological characters of fish as well as Length-weight relationship are an important tool for fishery management. The results of LWR (W= aLb), for L calbasu.  Representing negative allometric growth pattern. LWRs and condition factor relationships were found significantly correlated. A total of 200 and 190 specimens from upstream and downstream were collected, respectively. The assessed values of length-weight correlation and condition factor were calculated as Kn=39.663 (LeCren), and K=11.915 (Fulton) for upstream and Kn=44.066 and K=13.872 for downstream. Length-weight was found with a strong correlation of n= 2.892, a=0.0235 with r2=0.934 for upstream population then the downstream population.  The results of this work would be beneficial for sustainable management as well as fishery managers. 

Juvenile Batten disease (CLN3): Detailed Ocular Phenotype, Novel Observations, Delayed Diagnosis, Masquerades, and Prospects for Therapy

PURPOSE To characterize the retinal phenotype of juvenile neuronal ceroid lipofuscinosis (JNCL), highlight delayed and mistaken diagnosis, and propose an algorithm for early identification. DESIGN Retrospective case series. SUBJECTS Eight children (5 females) with JNCL. METHODS Review of clinical notes, retinal imaging including fundus autofluorescence (FAF) and optical coherence tomography (OCT), electroretinography (ERG), and both microscopy and molecular genetic testing. MAIN OUTCOME MEASUREMENTS Demographic data, signs and symptoms, visual acuity, FAF and OCT findings, ERG phenotype, and microscopy/molecular genetics. RESULTS Subjects presented with rapid bilateral vision loss over one to eighteen months, with mean visual acuity deteriorating from 0.44 LogMAR (range: 0.20 - 1.78 LogMAR) at baseline, to 1.34 LogMAR (0.30 LogMAR - light perception) at last follow-up. Age of onset ranged from 3 to 7 years (mean 5.3 years). The age at diagnosis of JNCL ranged from 7 to 10 years (mean 8.3 years). Six children displayed eccentric fixation, and six had cognitive or neurological signs at time of diagnosis (75%). Seven patients had bilateral bull’s-eye maculopathy at presentation. Coats-like exudative vasculopathy, not previously reported in JNCL, was observed in one patient. OCT imaging revealed near complete loss of outer retinal layers, and marked atrophy of the nerve fibre and ganglion cell layers, at the central macula. An ‘electronegative’ ERG was present in four patients (50%), but with additional a-wave reduction; there was an undetectable ERG in the remaining four. Blood film microscopy revealed vacuolated lymphocytes and electron microscopy showed lysosomal (fingerprint) inclusions, in all eight patients. CONCLUSIONS In a young child with bilateral rapidly progressive vision loss and macular disturbance, blood film microscopy to detect vacuolated lymphocytes is a rapid, readily accessible, and sensitive screening test for JNCL. Early suspicion of JNCL can be aided by detailed directed history and high-resolution retinal imaging, with subsequent targeted microscopy/genetic testing. Early diagnosis is critical to ensure appropriate management, counselling, support and social care for children and their families. Furthermore, although potential therapies for this group of disorders are in early phase clinical trial, realistic expectations are that successful intervention will be most effective when initiated at the earliest stage of disease

Effect of Different Levels of Phosphorus and Method of Application on the Growth and Yield of Wheat

S. Noonari et al. 30