Microsurgical Resection of Intracranial Dermoid and Epidermoid Tumors

Objective: To Ascertain the outcome of microsurgical resection of intracranial dermoid and epidermoid tumors.Materials and Methods: This prospective study was carried out in Neurosurgical Department, Lady Reading Hospital (LRH) Peshawar and followed for 3 years after microsurgical resection. All the patients with suspected intracranial Dermoid and epidermoid tumors (IDETs) on imaging study pre-operatively and later confirmedpostoperatively (after histopathology) were enrolled. Patients having recurrent tumor, opting for nonsurgical management and those deem unfit for surgery were not included in the study.Results: 27 patients were included in the study with 12 (44.4%) males and 15 (56.6%) female. Age of the patients rangefrom 11 to 58 years.Mean age was 38.6 years. Epidermoid tumors were 19 (70.3%) in number and dermoid 8 (29.7%) in number. The most common presentation was increased intracranial pressure (ICP) and cranialnerve deficit. The lesion was located in infratentorial location in 15 (56.6%) patients, 12(44.4%) were supratentorialy located. Gross total removal (GTR) was performed in 21 (77.8%) patients, while in six patients (22.2%) subtotal removal (STR) was attempted. 1 (3.7%) patient died while 2 (7.4%) patients had permanent morbidity post operatively, all other patients (89%) improved. Recurrence occurred in 9.5% of GTR patients while in STR patients, 33.3% patients were noted with increase in residual tumor on neuroimaging.Conclusion: Microsurgical resection with GTR is possible for most IDET and gives good results with minimalcomplications

Gendering cross-border networks in the Greater Mekong Subregion: drawing invisible routes to Thailand

"This article discusses human trafficking within the Greater Mekong Subregion (GMS) in relation to the strengthened inter-state economic and infrastructural co-operation and connectivity, taking the life history of sex workers in Thailand into account. Over the last decades, Thailand became known as a hub of entertainment sectors. Traffickers often use socio-economic integration in the GMS to their advantage. A large number of trafficked women ends up in the Thai entertainment industry doing sex work in confined conditions similar to slavery. Poor women are often lured by false promises of well-paid jobs abroad and pay exorbitant fees to agents for such an opportunity. Intermediaries introduce family members to agents who promise to make arrangements for the relevant documentation and transportation across borders. Traffickers use their own marked routes to transport their prey which are more invisible than generally could be imagined." (author's abstract)"Der vorliegende Beitrag betrachtet den Menschenhandel in der Greater Mekong Subregion (GMS) unter Berücksichtigung der Stärkung zwischenstaatlicher wirtschaftlicher und infrastruktureller Kooperation und Vernetzung. Dabei nimmt er Lebensgeschichten Prostituierter in Thailand genauer unter die Lupe. Im Laufe der Jahre wurde Thailand als Drehscheibe des Unterhaltungssektors berühmt. Es ist jedoch weitgehend unbekannt, dass eine Großzahl der Opfer des Menschenhandels in der Sexarbeit und in der Sklaverei ähnlichen Arbeitsverhältnissen landet. Menschenhändler nützen die sozioökonomische Integration in der GMS zu ihrem Vorteil. Diese Studie zeigt, dass von Armut betroffene Frauen in der Regel durch falsche Versprechungen gut bezahlter Arbeitsplätze ins Ausland gelockt werden und für solche Gelegenheiten exorbitante Gebühren an ihre Agenten bezahlen. Vermittler bringen Familienmitglieder und Agenten zusammen, welche die entsprechenden Unterlagen vorbereiten um den Transport über den Grenzübertritt möglich zu machen. Menschenhändler nutzen eigene markierte Routen, um ihre Beute zu transportieren - Wege die unsichtbarer sind, als man sich allgemein vorstellt." (Autorenreferat

IMPACT OF SCHOOL CLOSURE DUE TO COVID-19 ON DISABLED STUDENT'S WELLBEING IN LAHORE

Abstract COVID-19 can have a significant impact on pupils in general. Fiscal and physical health concerns, fast change, and increasing isolation all affect students and everyone. Students with health/disabilities face more risks in a variety of respects than non-disabled students. The present research was conducted to find out Impact of School Closure Due to COVID-19 on Disabled Students’ Psychological Wellbeing in Lahore. Quantitative research method was used as a method of inquiry. The target population was the disabled students enrolled in high level special education schools of Lahore. Participants was selected through the simple random sampling method. The available population size for this study is 873, comprising both male and female students. Out of this, 267 students were targeted sample. Data was collected through the adopted questionnaires. Already validated questionnaire of “WELL-BEING QUESTIONNAIRE FOR PISA” was used for the survey. The social survey through the questionnaire was used in the examination of the existing study. Quantitative data analysis was done through the SPSS. Linear regression analysis used to test the hypothesis. Questionnaire’s reliability was tested by the Cronbach’s alpha test that proved data excellence. There was significant and positive relationship between our independent variable “school closure” and dependent variable “well-being

National Security: An Exception of Freedom of Speech

The real autonomy would not be possible if people were not capable to express their thoughts, compose their opinions, or linked with those who might discuss their feelings and thoughts. It is also an essential right in a free society to be liberally allowed to participate in the welfare of society. The equilibrium should be maintained by imposing realistic restrictions which may be levied under the law when the right to Freedom of Speech comes in clash with rights of other individuals which can help the democratic state to preserve the basic right of Freedom of Speech at an admissible level. The basic purpose of this article is to explore the scope and extent of “protection of national security” an exception of Freedom of Speech in the light of national and international instruments

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 Surgical Treatment for Lumber Disc Herniation Causing Painful Incomplete Foot-Drop

Objective:  To determine the outcome of surgical treatment for lumder disc herniation causing the painful incomplete foot drop. Material and Methods:  This retrospective observational study was conducted at the Department of Neurosurgery Lady Reading Hospital, Peshawar. Both Male and female patients with lumbar disc disease causing unilateral incomplete painful foot drop were included in our study. Patients with complete or painless foot drop, bilateral foot-drop, Multiple level disc prolapse, cauda equina syndrome or sciatic neuropathy due to injection injury were excluded. Patients were followed was post-operatively in terms of power in foot dorsiflexion, medical research council (MRC) grade and pain relief  on a Visual Analogue Scale (VAS) after 1 month and then after 6 months. Results: Total number of patients included were 43. Age was ranging from 18 years to 54 years and mean age was 33 years. Before surgery,  power of MRC grade 3 or less, but greater than 1 in dorsiflexion was noted in all patients. The pain was scaled using VAS. Post peratively, at 1 month follow up, the foot-drop improved to MRC grade 4 or 5 along with pain relief of ≥ 2 points on VAS in 81. 4% (n = 35) patients and at 6 month follow-up, the figure rose to 93% (n = 40). Conclusion:  Lumbar disc disease can cause a debilitating foot-drop and pain. Improving or restoring a neurology early surgical intervention has proven benefits

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