Clinical outcome and complication of anterior cranial Fossa meningiomas in tertiary care Hospital Peshawar

Objectives:  We examined the surgical outcome and complications of anterior cranial Fossa meningiomas. Materials and Methods:  A prospective study was conducted at the Department of Neurosurgery Prime Teaching Hospital, Peshawar, KPK, Pakistan from June 2019 to June 2021. A total of 31 patients were selected through non-probability consecutive sampling. After clinical examination and radiological findings, the patients were diagnosed with anterior cranial Fossa meningiomas. Microsurgical Trans cranial approaches did. Clinical outcomes and complications were documented. Tumor anterior cranial fossa meningiomas. A low Karnofsky performance scale index was used to analyze the functional impairment of the patients. Results:  9 (29.03%) were male and 22 (70.96%) patients were female. The mean age of presentation was 42 ± 5 years. Headache 25 (80.6%) and Visual loss were the main presenting symptoms 24 (77.5%), and Tuberculum sellae meningioma patients 08 (25.08%). The most common approach was Bifrontal craniotomy for OGM in 9 patients and two small OGM were operated on utilizing frontolateral craniotomy. The rest of the cases were operated through Pterional craniotomy. Tuberculamsalle meningiomas surgery results in a visual improvement in 6 patients (75%), Complete tumor resection was achieved in 22 (70.9%) patients and subtotal resection is achieved in 6 (19.3%) patients. In a few patients 03 (9.67%) only safe debulking and biopsy were taken. Postoperative hemorrhage was in 4 (12.9%) patients. Conclusion:  Transcranial approach for microsurgical resection of anterior cranial fossa meningiomas is an effective and feasible approach in terms of visual outcome and extent of resection. Keywords:  Anterior cranial Fossa Meningioma, Bifrontal Craniotomy, Front-lateral craniotomy

Poetic Craft in Syed Masood Hassan Shahab Dehlvi's Jang Nama

Poetry after battles and wars between generations created masterpieces. These masterpieces remain constant in the history and memory of nations. 1965 Pak-India war inherited epic poetry to Urdu Literature. Shahab Dehlvi's epic poem "Jang Nama" is a work of art. He has narrated the story of the seventeen days of the Pak-India war. There are some art and craft problems in the poems of this war. Shahab Dehlvi has used his artistic skills beautifully to make "Jang Naama" a memorable poem. Particularly, the use of artistic innovations of poetry made this poem a great piece of Urdu epic poetry. Some technical terms of Urdu poetry such as Talmeeh, Irsaad, Trafuq, Maraatun nazeer, exaggeration, iham are crafted in this poem

Unsteady axisymmetric flow and heat transfer over time-dependent radially stretching sheet

AbstractThis article address the boundary layer flow and heat transfer of unsteady and incompressible viscous fluid over an unsteady stretching permeable surface. First of all modeled nonlinear partial differential equations are transformed to a system of ordinary differential equations by using similarity transformations. Analytic solution of the reduced problem is constructed by using homotopy analysis method (HAM). To validate the constructed series solution a numerical counterpart is developed using shooting algorithm based on Runge-Kutta method. Both schemes are in an excellent agreement. The effects of the pertinent parameters on the velocity and energy profile are shown graphically and examined in detail

Prescribing pattern in outpatient department of neurosurgery in a tertiary care hospital of North India

Background: The neurosurgical disorders are amongst the leading cause of global mortality and morbidity. Though surgical intervention is thought to be the main management protocol in the neurosurgical setup but drugs are being equally used especially in the outpatient setting. The present study was carried out in view of the sparse data available on prescribing pattern in neurosurgery.Methods: The present study was conducted by the department of pharmacology in outpatient department of neurosurgery in a tertiary care centre to look into the prescription pattern among these patients.Results: In 268 patients analyzed, mean age was 43.02±15.93 years and 52.23% were females. Majority of our participants (44%) were found to be of young to middle age group (21-40 years). The diagnosis among the study population was spread over large number of diseases. Lumbar Disc Prolapse (LDP) was found to be the leading cause of neurosurgical morbidity, amounting to 32%. As far as the prescription of various drugs in the outpatient of neurosurgery is concerned, Analgesics were the most common drugs prescribed constituting about 48% of the total drugs prescribed followed by GABA analogues and multivitamins which equally formed 41% of the total prescribed drugs.Conclusions: Although the prescription pattern studies among the outpatient neurosurgery patients are very scant, the analysis of prescription studies will be helpful to encourage the rational drug prescribing pattern

Audit of endoscopic third ventriculostomy in the treatment of obstructive hydrocephalus

To analyze various aspects of endoscopic third ventriculostomy in the treatment of obstructive hydrocephalus. Material and Methods: This descriptive study was conducted in the Department of Neurosurgery Lady Reading Hospital Peshawar from September 2010 to April 2011. All patients who underwent endoscopic third ventriculostomy were included in the study. Data was analyzed on SPSS version sixteen. Results: Total of 59 patients were included in the study. Thirty two patients were male and 27 were female. Most of the patients presented with headache, vomiting and loss of consciousness. The procedure was successful in 69 percent of cases. Common operative complication was minor hemorrhage while postoperatively three patients died because of the fits. Conclusion: Endoscopic third ventriculostomy can be used as an alternative to other diversion procedure. It is safe, less invasive and has got an acceptable success rate

Outcome of Anterior Cervical Discectomy with PEEK Cage Fixation for Single Level Cervical Disc Disease

Objective:  To assess the outcome of anterior cervical discectomy and fusion (ACDF) with PEEK cage. Material and Methods:  This prospective study was conducted in the Departments of Neurosurgery Prime Teaching Hospital and Irfan General Hospital Peshawar. Patients undergoing one level ACDF with PEEK cage fixation were enrolled in the study. Patients who needed multiple level ACDF or corpectomy with plating and redo cases were excluded from the study. A proforma, which included age, gender, address, level of prolapsed disc, sign and symptoms, pain score, MRI findings were filled. All patients were assessed on day of discharge and on follow-up visit after one month. Data was analyzed with SPSS version 22. Results:  Total 95 patients were included out of which 58 (61%) were male and 37 (39%) were female. Range of patients` Age was from 27 years to 64 years with 50.4 years mean age. Most patients (65%) had C6 radiculopathy. 58 patients (61%) had right sided radicular pain. 5 patients (5.26%) had radiculomyelopathy. C5 – C6 was the most common level operated (68 patients). Excellent results were achieved in 75 patients (79%) while satisfactory results in the rest of patients using Odom’s criteria. Bony fusion occurred in 92% of patients at 6 months. Conclusion:  ACDF with PEEK cage fixation is a safe and beneficial procedure in one level cervical prolapse disc diseas

Outcome of Endoscopic Third Ventriculostomy: An Experience of 80 Treated Patients

Objective: To examine the outcome of Endoscopic Third Ventriculostomy in 80 consecutive patients operated in Irfan General Hospital and Prime Teaching Hospital Peshawar.Materials and Methods: Prospective observational study was conducted in the neurosurgery department of Prime Teaching Hospital and Irfan General Hospital Peshawar. 80 patients (48 male and 32 female) were followed for 3 months. The inclusion criteria all patients with Third ventricular hydrocephalus were included in this study and the exclusion criteria unwilling patients and those who opted for VP shunting rather than ETV. Data was analyzed using SPSS version 22.Results: ETV was performed in 80 patients. With highest success rate inAqueductal stenosis and posterior fossa tumors 88% and 87% respectively. ETV had a lowest success score of 50% in patients with Hydrocephalus TBM. Common post-operative complications were seizures and CSF leakage.Conclusion: ETV is less invasive and effective treatment for non-communicating hydrocephalus.ETV is most effective in treating aqueductal stenosis and posterior fossa tumors. The overall success rate of ETV is 74%. Based on these findings, it is recommended that ETV should be attempted as first line treatment for patients with triventricular hydrocephalus due to various pathologies

COVID-19 Advertorials Accentuating Fright and Xenophobia in Ecosystem: An Eco-linguistic Approach to SFL

This present study explores manipulation of language of COVID-19 advertorials to achieve specific goal of fear and xenophobia among people through ecolinguistic study of five advertorials published on COVID-19 on five global websites. To the best of author’s knowledge, no research has been conducted on advertorials of different websites in this COVID-19 language context. The purpose of this research is to investigate and apply M.A.K. Halliday’s  3 semantic meta-functions proposed in Systemic Functional Linguistics (henceforth SFL) on corona advertorials from ecolinguistic perspective. Collection of 5 corona advertorials was gathered as data from 5 different websites. Only one corona advertorial from each website was built. Ecolinguistic analysis of Halliday’s 3 meta-function was adopted as analytical framework to analyse elements of fear and xenophobia in the language of COVID-19 advertorials. Present research employed qualitative, descriptive method containing observation. Results revealed that 3 meta-functions of ecolinguistic SFL can be used in shedding light on use of language in these advertorials to sustain and invigorate a global narrative of fright and xenophobia. Findings showed that language of COVID-19 advertorials accentuates elements of fright and xenophobia in ecosystem. Results of current study will deliver a guideline of didactic inferences for future researchers in the field

Frequency of Cauda Equina Syndrome in Patients with Lumbar Disc Herniation

Introduction: Herniation of the lumbar inter-vertebral disc can cause severe compression of the cauda equina. A precise understanding of this syndrome is important because any delay in diagnosis and treatment may result in poor outcome. Objective: The objective of this study is to determine the frequency of Cauda Equina Syndrome in patients with lumber disc herniation. Materials and Methods: This cross sectional descriptive study was conducted at Department of Neurosurgery, Postgraduate Medical Institute Lady Reading Hospital, Peshawar. A total of 127 patients of cauda equina syndrome were taken through convenience (non-probability) sampling, in a period of six months (from November, 2010 to May 2011). Patients of both genders presented with unilateral or bilateral foot drop, ankle areflexia, saddle anesthesia and urinary incontinence due to lumber disc herniation were included while patients with spinal tumors, lumbar Spinal stenosis and recurrent disc herniation were excluded. The data was analyzed using the statistical program SPSS version 10. Results: Out of 127 patients majority of the patients were male i.e. 65.35% (n = 83) 44.65% were female. Most of the patients were between 31 – 40 years of age followed by 20 – 30 years, 29.92% (n = 38). Frequency of cauda equina syndrome in patients with lumbar disc herniation was found in 11.02% (n = 14). Conclusion: The relationship between Cauda Equina Syndrome was found with lumbar disc herniation and the frequency was found in accordance to other studies. Cauda Equina Syndrome is most common in the patients between 31 – 40 years of age, followed by 20 – 30 years of age. Gender distribution of the patients showed that majority of the patients were male. Frequency of cauda equina syndrome in patients with lumbar disc herniation was 11%