Surgical outcome of posterior fossa brain tumors

To determine the surgical outcome of posterior fossa brain tumors. Descriptive case series. Department of Neurosurgery, Jinnah Postgraduate Medical Center Karachi, from April 2012 to October 2012. The data of 66 patients managed during the study period was analyzed. Patients were divided into extra and intra-axial groups. All patients underwent surgery. The outcome was measured as good and poor two months after discharge from the hospital. Out of 66 patients, 41[62%] were males and 25 [38%] females. The mean age of the patients was 31.21 +/- 18.49 year. With respect to age groups, good surgical outcome was observed in 11 to 30 year and 41 to 50 year of age. Good surgical outcome was similar in both the genders. Vestibular schwanoma was the commonest tumor [72.2%] in extraaxial variety of tumors. Good functional outcome [80%] was observed following surgery in extra-axial group of patients. No mortality occurred in extra-axial group while two patients died in intra-axial group. Medulloblastoma [29.26%] and pilocytic astrocytoma [29.26%] were the commonest tumors in intra-axial group. Mortality occurred only in 2 [4.87%], recurrence in 2 [4.87%] and unresolved hydrocephalus in 3 [7.31%] patients. Improvement in morbidity was noticed in 31[75.6%] patients after surgery. Factors associated with good outcome was age > 10 years and type of tumor

Risk factors associated with development of post-meningitic hydrocephalus

To determine the frequency and risk factors associated with the development of post-meningitic hydrocephalus in children suffering from pyogenic meningitis. A descriptive as well as case control study. Children admintted with the diagnosis of pyogenic menigits from December 2010 to July 2011 in the Pediatric unit-2 of Bolan Medical Complex Hospital Quetta. All the children admitted to the Pediatric Unit-2 of Bolan Medical Complex Hospital [BMCH] from December 2009 to July 2011 with the diagnosis of bacterial meningitis. The diagnosis of bacterial meningitis was based on history and examination suggestive of meningitis with at least one of the following items be present, positive CSF culture or positive gram stain [for hemophilus influenza, Streptococus Pneumonae, or Neisseria meningitides], or CSF TLC10/ML and positive blood culture for above mentioned organism or CSF culture and gram stain negative for the organism but CSF WBC100/ML with >50%polymorphonuclear cells. Patients below 2 month of age and patient with Tuberculous meningitis were excluded from the study. The data collected on a specific Performa having different variables such as age, sex, seizure, duration of treatment ect. Then the data was analyzed on Epi info version 6 simple frequencies were calculated for each variable. Chi square analysis was done to see any correlation between the risk factors and post-meningitic hydrocephalus. Odds ratio was calculated for the risk factors. The mean age of study subjects was 7.2 years with 60% males and 40% females. Gram stains were positive in 37.5% of patients, CSF culture was positive in 27.5% of the patients, in 17.5% of the patients hydrocephalus was the main complication of bacterial meningitis and 25% had other type of sequelae including seizures, hearing loss, hemiparesis etc. significant association was found between seizure at admission [p-value<0.040], duration of illness [p-value<0.01%], age and admission [p-value<0.01]. 68.8% patients came for follow up 2.5% patients left against medical advice [LAMA] and 2.5% expired. The association was found between the development of post-meningitic hydrocephalus and variables such as seizure, duration of illness [patients having duration of symptoms like fever, headache, vomiting, cerebrospinal fluid leukocyte count and duration of antibiotic treatment