Quality of Life in Children Treated for Craniopharyngiomas.

Craniopharyngiomas are common but complex paediatric brain lesions that present interesting management challenges. Quality of life is an important consideration while choosing management options. In this review, we have discussed the existing literature on various aspects of quality of life in patients treated for craniopharyngioma, assessed by variety of measurement tools.

Non O1, non O139 Vibrio cholerae bacteraemia in an infant; case report and literature review.

Non 01, Non O139 Vibrio cholerae bacteraemia is a rare but potentially fatal occurrence. There have been very few incidents of this infection from around the world. The treatment regimen of antibiotics also varies in literature. We present a case of bacteraemia caused by Non O1, Non O139 Vibrio cholerae along with associated risk factors, disease manifestations, laboratory diagnosis and treatment regimen. This serves to add additional information regarding symptoms and signs of this infection along with management of patient. Knowledge regarding this topic shall be highly useful to professionals if further cases are detected. In the discussion section, a review of literature of previous cases is also presented.

30-Day Readmission Rate and its Causes in General Surgical Patients.

OBJECTIVE: To find out the 30-day readmission rate for different surgical procedures and determine the causes for readmissions. STUDY DESIGN: An audit report. PLACE AND DURATION OF STUDY: Department of Surgery, The Aga Khan University Hospital, Karachi, in the calendar year 2014. METHODOLOGY: Records were retrospectively reviewed for 30-day readmission rate and their cause in general surgical patients who underwent a general surgical procedure at The Aga Khan University Hospital, Karachi, in the year 2014. RESULTS: Out of 217 (6.4%) readmissions in 3,387 patients, more than 50% unplanned readmissions were avoidable. The highest readmission rate was after placement of feeding tubes (28.5%). CONCLUSION: More than half of the readmissions could have been prevented by proper patient/attendant education, good communication and provision of nursing services to these patients beyond the hospital.

Association of Vitamin D with outcome after intra cytoplasmic sperm injection.

OBJECTIVE: To observe effects of vitamin D levels on pregnancy outcome after intra cytoplasmic sperm injection (ICSI). METHOD: It was a cross-sectional study conducted in Australian Concept Infertility Medical Center from July 2011 to August 2014. Estimation of 25-hydroxy cholecalciferol (25-OHD) of consented females (252) was done before treatment protocol for ICSI. Results of ß hCG performed 14 days after embryo transfer categorized groups; Pregnant with ß hCG more than 25 IU/mL and rest included in non-pregnant group. Both groups were compared by independent sample t-test and Pearson's Chi Square test. Binary Logistic Regression Analysis was used to estimate odds ratio of pregnancy outcome with its predictors including Vitamin D. RESULTS: The mean value of 25-OHD, number of oocytes, fertilized oocytes and endometrial thickness was significantly higher in pregnant women. A significant positive association of 25-OHD with clinical pregnancy and thickness of endometrium was observed. After adjustment with female age and BMI, positive association of vitamin D with endometrial thickness was observed. CONCLUSION: Deficiency of 25-OHD in females hinders the accomplishment of optimal endometrial thickness required for implantation of embryo after ICSI. The improvement in vitamin D status can thus improve success results in assisted reproductive clinics.

Fertilization rate and its determinants in intracytoplasmic sperm injection.

OBJECTIVE: To identify predictors of fertilization rate in patients of unexplained infertility after intracytoplasmic sperm injection (ICSI). METHODS: Retrospective analysis of females (282) enrolled in quasi experimental design for ICSI at "Islamabad Clinic Serving Infertile Couples" was carried out from July 2013 till June 2014. Females with unexplained infertility were included, whereas well defined male and female causes of infertility were excluded. Fertilization rate (FR) was calculated as percentage transformation of micro injected oocytes into two pronuclei. Categorical variable of FR defined on the basis of 50% FR grouped females; Group I with FR ≤50% and Group II with FR >50%. The groups were compared in terms of demographic variables, base line hormones and oocyte parameters. Univariate logistic regression was executed to obtain odds ratio with 95% confidence interval to quantify the association of predictors like age, duration of infertility, oocytes parameters, hormones; Estradiol, progesterone, follicle stimulating hormone (FSH), luteinizing hormone, prolactin and cytokines interleukin-Iß (IL-Iß) with the FR. RESULTS: In our study out of 282 females, 19 (6.73%) were in group I and 263 (93.26%) comprised of Group II. Females with high FR(group II) had low Progesterone and FSH (p=0.04, p=0.02) respectively. Mature oocytes (OR: 0.35; 95% CI 1 - 2.56) and IL-Iß in follicular phase (OR: 1.04; 95% CI: 0.000- 1.20) were significant positive predictors of FR while peak progesterone and FSH had significant negative effect on it. CONCLUSION: Fertilization of oocytes in females of unexplained infertility depended on maturity of oocytes and optimal amounts of ILI- ß released by developing follicles in the follicular phase of stimulation cycles of ICSI.