Surgical outcome of benign intracranial hypertension in terms of improvement in vision

To know about surgical outcome of benign intracranial hypertension in terms of improvement of vision.METHODOLOGY ; This Prospective observational study was conducted at of 22 patients operated in neurosurgery unit lady reading hospital Peshawar from Jan 2011 to Jun2014. Written consent was obtained from all the patients or their relatives All patients of either age and sex with Diagnosed cases of BIH were included in the study, Patients with depressed conscious level, malignant hypertension, space occupying lesion in brain on MRI and those Patients unfit or unwilling for surgery were excluded from the study. Patients particulars like age ,gender , and post operative outcome was documented on predesigned proforma . All the results were analyzed by spss version 16 and represented in the form o graphs/charts and tables. RESULTS;- Total 22 patients of BIH were studied which were all females (100%) having age range of 18 to 58 years with mean of 38 ± 5 years SD. Headache was present in all (100%) patients followed by visual deterioration having 20(90.90%) cases. CSF manometery showed opening pressure from 28cm of H2O to 50 cm of H2O, with mean of 39. 19. Post operatively headache improved in 16(72%) patients, Papilledema in 18(81.81%) caseswhile 4(18%) patients did not improved. In 2(9.09%) cases there was and CSF leak was in 1(4.54%) case.CONCLUSION; BIH has good surgical outcome in terms of improvement in vision, if managed before advanced stage of Papilledem

Fixed Point Theorems for Multivalued Mappings Involving -Function

We obtain some fixed point theorems with error estimates for multivalued mappings satisfying a new --contractive type condition. Our theorems generalize many existing fixed point theorems, including some fixed point theorems proved for --contractive type conditions

Two new species of genus Leucoagaricus (Agaricaceae, Agaricales) from Pakistan

The genus of basidiomycetous fungi, Leucoagaricus, occurs worldwide, from subtropical to boreal latitudes. Several collections of Leucoagaricus were made during mycological field trips conducted in different forests of Margalla, Pakistan. An integrative framework combining morphological and phylogenetic data was employed for their study. As a result, the two species La. margallensis and La. glareicolor are here described as new to science. Detailed macro- and micro-morphological descriptions, and a molecular phylogenetic reconstruction based on nrITS and LSU sequence data are provided and used to discriminate the new species from morphologically and phylogenetically close taxa. Whereas, our phylogenetic tree inference gave unequivocal support for the inclusion of these two species within the section Leucoagaricus

The Effect of Epidural Steroids on Postoperative Pain and Hospital Stay in Patients Having a Single-Level Lumbar Discectomy

OBJECTIVES To determine the effect of Epidural steroids on postoperative pain and hospital stay in patients having a single-level lumbar discectomy. METHODOLOGY A quasi-experimental study was conducted at the Neurosurgery department, Qazi Hussain Ahmad Medical Complex, Nowshera.  Sixty patients with a mean age of 40.3±9.21 years were enrolled. The enrolled patients were divided into two groups: Group A patients were given intraoperative epidural methylprednisolone 80 mg, while Group B patients were given only normal saline. Pre- and post-operative pain was assessed after 6 hours, 12 hours and at the discharge time from the hospital. The duration of hospital stay was also noted. RESULTSOut of 60 patients, 55.0% were male, and 45.0% were female, with an overall mean age of 40.3±9.21 years. The VAS score in Group A was 0.82±0.26 compared to 2.30±0.71 in group B (P <0.000). And at first follow-up, the VAS score was 0.13±0.05 and 1.25±0.33 in groups A and B, respectively.   The length of hospital stay was 1.39±0.44 and 1.98±2.50 in groups A and B, respectively. CONCLUSION Intra-operative epidural steroid is beneficial in reducing post-operative pain and hospital stay

Symptom Outcome of Walant Technique for Carpal Tunnel Release – A Prospective Study in the Tertiary Care Hospital, Nowshera

OBJECTIVES The study aims to determine the outcome of the WALANT technique for Carpal Tunnel Release CTR.METHODOLOGY A descriptive study was done in the Neurosurgery department at Qazi Hussain Ahmad Medical Complex, Nowshera, from 15th September 2020 to 15th March 2021. A total of 29 consecutive patients of carpal tunnel syndrome (CTS) were undergoing carpal tunnel release (CTR) under wide awake local anaesthesia no tourniquet (WALANT) technique, using a mixture of lidocaine and epinephrine for local anaesthesia, and the outcome was assessed for patient satisfaction by Boston Carpal Tunnel Questionnaire (BCTQ) (symptom severity scales (SSS)) at pre-operatively and six weeks postoperatively.RESULTSWide awake CTR was done in 29 patients; 86.2% were female and 13.8% male. The mean age was 47.3 years. The average time of return to daily activity was three weeks. No complications were noted, like wound infection and dehiscence. BCTQ symptom (BCTQ-S) score significantly improved at six weeks postoperatively. 86% significantly reduced the symptom severity score (SSS). Mean SSS improved from preoperative 3.2 points to 1.7 points postoperatively. There was a significant decrease in distal latencies (p <0.01).   CONCLUSIONWide awake surgery is an excellent technique with favourable outcomes and good satisfaction rates for CTR. The study shows that clinical symptoms resolve rapidly after CTR. Without the need for monitored anaesthesia, the cost could decrease dramatically

Impact of Bronchoscopic Lavage and Aggressive Chest Physiotherapy on Clinical Pulmonary Infection Score of Patients of Severe Traumatic Brain Injury

Introduction:  Traumatic brain injury patients present in the emergency room with a variable conscious status depending upon the severity of the injury. The process of aspiration starts from the scene of trauma as the patients with Traumatic brain injury and chest trauma have higher rates of aspiration pneumonia. Materials and Methods:  We conducted a prospective study to assess the impact of bronchoscopy lavage and aggressive chest physiotherapy on the Critical Pulmonary Infection Score of Patients with Severe Traumatic Brain Injury in the Neurocritical Care Unit. Patients with severe traumatic brain injury who met the inclusion criteria were enrolled in the study. Patients of both genders, ages ranging from 05 – 70 years were included in the study. Results:  48 patients who met the inclusion criteria were enrolled in the study. 8 patients expired before 7 days and were excluded from the study. 88% were male and 12 % were females. Out of 40 patients, 30 were ventilated and 10 were managed without ventilation. Brain contusion was the most common CT scan finding. Out of 40 patients, 18 underwent surgical intervention, with decompressive hemicraniectomy being the most commonly performed procedure. Out of 40 patients, 32 patients underwent bronchoscopy. 8 patients out of 32 had more than two sessions of bronchoscopy. Conclusion:  As Critical Pulmonary Infection Score is an important indicator for pneumonia in the neurocritical care unit, the importance of standardized chest care with the help of bronchoscopic lavage and chest physiotherapy in keeping the Critical Pulmonary Infection Score on the lower side can prevent patients from developing life-threatening pneumonia

Fungal systematics and evolution : FUSE 7

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