ABSTRACT
To compare the signs and symptoms of Medulloblastomas and Desmoblastic Medulloblastomas. Retrospective study. This study was conducted at King Khalid University Hospital, Rayadh, Saudi Arabia from 1[st] January 2001 till 31[st] December 2010. Total of 37 patients were included in the study. After taking written consent from all the patients or their relatives, this study was conducted. Permission was also taken from the ethical committee of the hospital. 37 patients were included in the study. Percentage of important symptoms of intracranial tumors like headache, reduced vision and hydrocephalus was comparatively higher in medulloblastomas as compare to desmoblastic medulloblastomas. None of the desmoblastic variety had metastasis on presentation, hence all of them completely excised. Unfortunately, we were able to excise only 82.14% of medulloblastomes. 14.28% were partially excised while in 3.57% of cases, surgeon was only able to take biopsy. Desmoblastic variety of medulloblastoma had better prognosis as compare to Classical Medullblastoma
ABSTRACT
Chronic subdural hematoma having diversity of clinical features, poor index of suspicion and non availability of CT scan is still diagnosed very late in AJK. The objective of study was to find out the clinical status at the time of admission and outcome of surgery in these patients managed in our hospital. Descriptive study. This study was conducted at the DHQ Hospital Mirpur AJK from March 2006 to April 2010. A total number of 47 patients with chronic subdural hematoma of all age groups were operated at DHQ hospital Mirpur in this period. Clinical presentation of the patients at the time of admission was recorded. Patients were followed for a period of 2-3 months after surgery. Forty seven patients were studied. Among them 40[85%] were male and 7[15%] were female. The age range was 2 months to 100 years with average age 52.5 years. Thirty one [66%] had positive history of head trauma whereas 16 patients [34%] did not remember any injury. Thirty one [66%] had headache, 35[74.5%] had hemiparesis, 19[40.4%] had behavioral changes and urinary incontinence. Six patients [12.8%] were having GCS 3 with reactive pupils. One [2.1%] patient came with decreased vision. CT scan showed unilateral hematoma in 37 [78.7%] and bilateral in 10 [21.3%] patients. Twenty five [53%] patients had hematoma on left side, 12[25.5%] had hematoma on right side and 10[21.3%] had bilateral hematoma. Thirty four [72.3%] had good recovery. Four [8.5%] could not survive. Chronic subdural hematoma due to diversity of symptoms, poor index of suspicion, and non availability of CT scan is still diagnosed very late in AJK. Elderly patients with diversity of confusing neurological symptoms need to be kept under high index of suspicion for diagnosis of chronic subdural hematoma. Drainage of Chronic hematoma with two burr holes and placements of subdural drain offered excellent
Subject(s)
Humans , Male , Female , Hematoma, Subdural, Chronic/diagnosis , Tomography, X-Ray Computed , Neurologic Manifestations , Craniocerebral TraumaABSTRACT
General anesthesia is most frequently used for lumbar disc surgery despite the evidence that spinal anesthesia is as safe and may offer some additional advantages. The purpose of this study was to compare the intraoperative parameters and postoperative outcome after spinal and general anesthesia in demographically well matched patients undergoing elective lumbar Decompressive surgery. Prospective randomized controlled study. This study was carried out DHQ Hospital Mirpur AJK from January 2007 and May 2010. In this randomized controlled study we analyzed the outcome obtained in 44 patients in whom either spinal or general anesthesia was induced for lumber disc surgery. The variables recorded were anesthesia related class, surgical diagnosis, disc levels operated and pre, peri and postoperative measurements of variables like BP, and heart rate. All aspects of surgery, recovery, post anesthesia care and pain management were same irrespective of anesthetic type The narcotic and antiemetic requirement and length of stay in the hospital and incidence of urinary retention were also recorded in the post operative course. Demographically both groups were well matched. Anesthesia time was longer in patients receiving GA with increased heart rate and MABP perioperatively. There was more nausea and greater requirements for antiemetic and analgesics in patients receiving. GA [p value<0.05]. Perioperative heart rate and MABP was on normal side and there was no urinary retention in patients who received spinal anesthesia. Spinal anesthesia was a safe and effective as GA for patients undergoing lumbar Decompressive surgery. Spinal anesthesia had added advantages of short anesthesia duration, decreased antiemetic and analgesic requirements. GA general anesthesia, HR heart rate, I/V intravenous, MAP mean arterial pressure, PACU post anesthesia care unit, RCT randomized controlled trial, SA spinal anesthesia