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3.
Chin Neurosurg J ; 6: 19, 2020.
Article in English | MEDLINE | ID: mdl-32922948

ABSTRACT

Globally, the discipline of neurosurgery has evolved remarkably fast. Despite being one of the latest medical specialties, which appeared only around hundred years ago, it has witnessed innovations in the aspects of diagnostics methods, macro and micro surgical techniques, and treatment modalities. Unfortunately, this development is not evenly distributed between developed and developing countries. The same is the case with neurosurgical education and training, which developed from only traditional apprentice programs in the past to more structured, competence-based programs with various teaching methods being utilized, in recent times. A similar gap can be observed between developed and developing counties when it comes to neurosurgical education. Fortunately, most of the scholars working in this field do understand the coherent relationship between neurosurgical education and neurosurgical practice. In context to this understanding, a symposium was organized during the World Federation of Neurological Surgeons (WFNS) Special World Congress Beijing 2019. This symposium was the brain child of Prof. Yoko Kato-one of the eminent leaders in neurosurgery and an inspiration for female neurosurgeons. Invited speakers from different continents presented the stages of development of neurosurgical education in their respective countries. This paper summarizes the outcome of these presentations, with particular emphasis on and the challenges faced by developing countries in terms of neurosurgical education and strategies to cope with these challenges.

4.
World Neurosurg ; 131: 385-390, 2019 Nov.
Article in English | MEDLINE | ID: mdl-31658580

ABSTRACT

Traumatic brain injury (TBI) represents a major public health concern worldwide, with no significant change in its epidemiology over the last 30 years. After TBI, the primary injury induces irreversible brain damage, which is untreatable. The subsequent secondary injury plays a critical role in the clinical prognosis because without effective treatment it will provide additional tissue damage. The resulting scenario is the rise in intracranial pressure (ICP) with the development of progressive neurological deficits. Current optimal management is based on a progressive, target-driven approach combining both medical and surgical treatment strategies among which is decompressive hemicraniectomy. With the advent of technology, research in the glymphatic pathways, and advances in microscopic surgery, a novel surgical technique-the cisternostomy-has emerged that holds promise in managing rising ICP in TBI-affected patients. In this article we describe the rationale for cisternostomy, an emerging microneurosurgical approach for the management of moderate to severe TBI.


Subject(s)
Brain Injuries, Traumatic/surgery , Neurosurgical Procedures/methods , Ostomy/methods , Contraindications, Procedure , Decompressive Craniectomy/methods , Drainage/methods , Humans , Intracranial Hypertension/etiology , Intracranial Hypertension/surgery , Medical Illustration , Microsurgery/methods
5.
Cureus ; 10(1): e2064, 2018 Jan 15.
Article in English | MEDLINE | ID: mdl-29552427

ABSTRACT

Orbital roof defects are rare congenital osseous abnormalities that cause protrusion of intracranial contents into the orbit, resulting in a condition known as the orbital meningoencephalocele, a rare cause of pulsatile proptosis. We present a case of a 25-year-old lady, presented to us with complaints of left frontal headache, left eye protrusion and double vision from the left eye for the past three months. Her higher mental functions were intact. Local examination revealed non-axial pulsatile proptosis and an outward depression of the left eyeball along with diplopia. Extraocular movements and pupillary light response were normal with no bruit or orbital tenderness. Computed tomography (CT) scan of the brain and orbit with contrast showed deficient bone on the left orbital roof and floor with left frontal gliotic brain compressing the eyeball. Magnetic resonance imaging (MRI) of the brain and orbit with contrast showed an asymmetrical deformity of the skull and left cerebral hemisphere which was bulging towards the left orbit. We planned a two-staged surgical reconstruction. The orbital roof was first reconstructed using a titanium mesh. Within two weeks of surgery her pulsatile proptosis, diplopia, and headache had considerably improved and the proptosis had resolved with no visible pulsations. She is scheduled for second stage surgery after three months for reconstruction of the orbital floor.

6.
J Infect Dev Ctries ; 10(10): 1124-1128, 2016 Oct 31.
Article in English | MEDLINE | ID: mdl-27801376

ABSTRACT

INTRODUCTION: According to the World Health Organization, the estimated number of malaria cases in Pakistan is about 1.5 million. Hematological variables like platelets, total leukocyte count (TLC), and hemoglobin (Hb) need to be evaluated to diagnose malaria in suspects. This study aimed to investigate the association between blood group and susceptibility to malaria and effects on platelets, TLC, and Hb. METHODOLOGY: This was a case-control study with a sample size of 446, of which 224 were malarial cases and 222 were controls. A designated questionnaire was developed to know age, gender, malarial strain, Hb, TLC, platelets, and blood group. RESULTS: Of 224 malarial cases, 213 were P. vivax, and 11 were P. falciparum. There were 58 patients with blood group A, 72 with group B, 69 were O and 23 were AB. There was no significant difference in the blood group of controls compared to malarial patients (p > 0.05). Mean Hb level was 11.5mg/dL in malaria patients and 12.5mg/dL in controls. There was significant difference (p<0.01) in the mean platelet count in malarial (11,7000/µL) and control (24,5000/µL) patients. All blood groups showed similar falls in Hb and platelet levels, showing no significant difference among blood groups (p = 0.79 and p = 0.52, respectively). TLC was not significant between malarial and control groups (p = 0.072). Males were two times susceptible to malaria. CONCLUSIONS: There was no significant association between the type of blood group and susceptibility to malaria or developing anemia or thrombocytopenia.


Subject(s)
Anemia/epidemiology , Blood Group Antigens , Disease Susceptibility , Malaria/complications , Malaria/epidemiology , Thrombocytopenia/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Case-Control Studies , Child , Child, Preschool , Female , Hemoglobins/analysis , Humans , Infant , Infant, Newborn , Leukocyte Count , Male , Middle Aged , Pakistan/epidemiology , Platelet Count , Young Adult
7.
Asian Cardiovasc Thorac Ann ; 23(3): 320-2, 2015 Mar.
Article in English | MEDLINE | ID: mdl-24887895

ABSTRACT

Hydatid cysts of the cardiac interventricular septum are rare and present a diagnostic and therapeutic challenge. We report the case of a 48-year-old woman who was successfully treated with cyst excision and capitonnage.


Subject(s)
Echinococcosis/diagnosis , Echinococcosis/surgery , Heart Diseases/pathology , Heart Diseases/surgery , Ventricular Septum/pathology , Cardiac Surgical Procedures/methods , Cardiopulmonary Bypass/methods , Echinococcosis/diagnostic imaging , Echinococcosis/pathology , Echocardiography , Female , Heart Diseases/diagnostic imaging , Humans , Middle Aged , Tomography, X-Ray Computed , Treatment Outcome , Ventricular Septum/diagnostic imaging , Ventricular Septum/surgery
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