Antiviral, embryo toxic and cytotoxic activities of Astragalus membranaceus root extracts

Antiviral activity of Astragalus membranaceus aqueous and methanol root extracts was determined against Avian influenza H9 virus. Toxicity profile of extracts was evaluated using chicken embryos and BHK-21 cell line. Different concentrations [400, 200, 100, 50, 25. 12.5, 6.25 and 3.12µg/mL] of both aqueous and methanol extracts were mixed with standard virus inoculum [4HAunits] and incubated for 30minutes at 37oC prior to inject the chicken embryos. Chorioallantoic fluid harvested 72 hours post inoculation and evaluated for virus growth using hemagglutination assay. Same concentrations of both extracts without virus were injected in chicken embryos to evaluate embryo toxic activity as well. The cytotoxic activity of aqueous and methanol extracts was determined by MTT colorimetric assay using BHK-21 cells. Three concentrations [400, 200 and 100µg/mL] of aqueous and five concentrations [400, 200, 100, 50 and 25µg/mL] of methanol extract showed antiviral activity. None of the tested concentrations of aqueous and methanol A. membranaceus root extracts caused chicken embryo mortality. Cell survival percentage of aqueous extract was higher than 50 at all of the tested concentrations except 400µg/mL. Two concentrations [400 and 200µg/mL] of methanol extract showed cytotoxicity. It was concluded that aqueous and methanol roots extracts of A. membranaceus have antiviral activity and concentrations which were safe may be used for treatment of Avian influenza H9 virus infections

Posterior Fossa Decompression with Duraplasty in Chiari-1 Malformations

Objective: To evaluate the symptomatic outcome after PFD [Posterior Fossa Decompression] with duraplasty in Chiari-1 malformations. Study Design: Case series. Place and Duration of Study: Department of Neurosurgery, JPMC, Karachi, from July 2008 to September 2012. Methodology: This included 21 patients of Chiari 1 malformations admitted in department through OPD with clinical features of headache, neck pain, numbness, neurological deficit, and syringomyelia. Diagnosis was confirmed by MRI. PFD followed by C1 laminectomy with duraplasty was done in all cases and symptomatic outcome was assessed in follow-up clinic. Results: Among 21 patients, 13 were females and 8 were males. Age ranged from 18 to 40 years. All the patients had neck pain and numbness in h and s. Only 3 patients had weakness of all four limbs and 12 with weakness of h and s. Symptoms evolved over a mean of 12 months. Syringomyelia was present in all cases. All patients underwent posterior fossa decompression with duraplasty with an additional C1 laminectomy and in 2 cases C2 laminectomy was done. Syringo-subarachnoid shunt was placed in one patient and ventriculo-peritoneal shunt was placed in 2 patients. Pain was relieved in all cases. Weakness was improved in all cases and numbness was improved in 19 cases. Syringomyelia was improved in all cases. Postoperative complications included CSF leak in 2 patients and wound infection in one patient. However, there was no mortality. Conclusion: Posterior fossa decompression with duraplasty is the best treatment option for Chiari-1 malformations because of symptomatic improvement and less chances of complications. Key Words: Chiari-1 malformation. Posterior fossa decompression. Duraplasty.

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

Anterior decompression and fixation with webb-morley procedure in dorsolumbar spinal injury

To evaluate the neurological outcome of anterior decompression and fixation with Webb-Morley procedure in dorsolumbar spinal injuries. A case series study. The Neurosurgery Department, Jinnah Postgraduate Medical Centre, Karachi, from May 2008 to July 2010. Patients with post-traumatic unstable dorsolumbar spine having compression of the spinal cord with bony fragments of the fractured vertebra were included in the study. Patients below the age of 15 years and patients with bed sores and unfit for anaesthesia were excluded. Plain X-rays and magnetic resonance imaging [MRI] were done. All patients were treated for dorsolumbar fractures by anterior decompression and fixation with Webb-Morley procedure. All patients were assessed clinically by the Frankel's grading before and after surgery. Among 60 patients, 41 were males and 19 were females. Mean age was 37.2 +/- 4 years. Major cause of trauma was road traffic accident. The commonest level of the fracture was at the dorsolumbar junction i.e. 71.66% [n = 43]. About 19 [31.66%] patients improved to the Frankel's grade-E, while 41.66% [n = 25] improved to grade-D after surgery. There was no postoperative mortality. According to the current study, anterior decompression and fixation with Webb-Morley procedure is an effective and safe approach. Those patients who had complete motor deficit showed no improvement in power but those who had partial motor deficit, had excellent improvement