Computational biomarkers are a promising area of research for the decision of neurosurgical treatment for brain tumors. These biomarkers can help to predict the biological behavior of tumors, such as their growth rate, invasiveness, and response to treatment. Computational biomarkers can play an important role in the decision-making process for the neurosurgical treatment of brain tumors. These biomarkers provide quantitative and objective measures of tumor characteristics that can help inform the choice of treatment and predict patient outcomes. Some potential computational biomarkers that may be useful in this context include:
{"title":"Computational biomarkers for the decision of neurosurgical treatment for brain tumors","authors":"Saman Shahid, Muhammad Anwar Chaudary","doi":"10.36552/pjns.v26i4.833","DOIUrl":"https://doi.org/10.36552/pjns.v26i4.833","url":null,"abstract":"Computational biomarkers are a promising area of research for the decision of neurosurgical treatment for brain tumors. These biomarkers can help to predict the biological behavior of tumors, such as their growth rate, invasiveness, and response to treatment. Computational biomarkers can play an important role in the decision-making process for the neurosurgical treatment of brain tumors. These biomarkers provide quantitative and objective measures of tumor characteristics that can help inform the choice of treatment and predict patient outcomes. \u0000Some potential computational biomarkers that may be useful in this context include:","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76802349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mukhtiar Rana Zubair Mahmood, Ahmed Lakho, Talha Abbas, Shahzeb Ahmad, Umer Farooq, Muhammad Afraz
Objective: This study explored the effects of octreotide injections in patients with pituitary adenoma pre-operatively. Material and Methods: A quasi-observational study was conducted on 12 patients in the Neurosurgery department of the Punjab Institute of Neurosciences (PINS) with a diagnosis of pituitary adenoma. To determine the size of the tumor, we did an MRI brain with pituitary protocol and after octreotide medication. The mode of diagnosis was clinical status, MRI brain, and biopsy of the tumor. We gave 14 short-acting octreotide injections to all patients before surgery and monitored their clinical and serum IGF levels. After the completion of 14 injections of octreotide, we planned surgery for the complete excision of the tumor. We performed IGF level 2 weeks after surgery. Then, we gave long-acting octreotide injections to all patients after every 28 days. Results: The mean age was 43 years. 67% of patients were male and 33% of patients were female. 92% of patients presented with decreased vision. 17% of patients presented to us with complete loss of vision. In 17% of patients, the vision of the patients improved. Serum IGF levels significantly decreased after short-acting octreotide, surgical excision, and long-acting octreotide therapy. Conclusion: With the use of octreotide therapy clinical status and outcomes of management of pituitary adenoma improve.
{"title":"Outcomes of Management of Pituitary Adenoma by Use of Octreotide Injections Preoperatively","authors":"Mukhtiar Rana Zubair Mahmood, Ahmed Lakho, Talha Abbas, Shahzeb Ahmad, Umer Farooq, Muhammad Afraz","doi":"10.36552/pjns.v26i4.832","DOIUrl":"https://doi.org/10.36552/pjns.v26i4.832","url":null,"abstract":"Objective: This study explored the effects of octreotide injections in patients with pituitary adenoma pre-operatively. \u0000Material and Methods: A quasi-observational study was conducted on 12 patients in the Neurosurgery department of the Punjab Institute of Neurosciences (PINS) with a diagnosis of pituitary adenoma. To determine the size of the tumor, we did an MRI brain with pituitary protocol and after octreotide medication. The mode of diagnosis was clinical status, MRI brain, and biopsy of the tumor. We gave 14 short-acting octreotide injections to all patients before surgery and monitored their clinical and serum IGF levels. After the completion of 14 injections of octreotide, we planned surgery for the complete excision of the tumor. We performed IGF level 2 weeks after surgery. Then, we gave long-acting octreotide injections to all patients after every 28 days. \u0000Results: The mean age was 43 years. 67% of patients were male and 33% of patients were female. 92% of patients presented with decreased vision. 17% of patients presented to us with complete loss of vision. In 17% of patients, the vision of the patients improved. Serum IGF levels significantly decreased after short-acting octreotide, surgical excision, and long-acting octreotide therapy. \u0000Conclusion: With the use of octreotide therapy clinical status and outcomes of management of pituitary adenoma improve.","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87577584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kashif Ali Sultan, Usman Ahmad Kamboh, Ghulam Naseer u Din, Adeel Rauf, Nazeer Ahmad, Mehreen Mehboob, Mehwish Manzoor
Objective: To assess the impact of intracranial pressure (ICP) monitored therapy on mortality in patients with severe traumatic brain injury. Materials and Methods: A randomized controlled trial was conducted at the Department of Neurosurgery, Jinnah Hospital Lahore. Forty patients of both genders, aged between 15 to 60 years were randomly selected and divided into two groups (Control & Experimental). Patients injured within 24 hours with a Glasgow Coma Scale (GCS) of 8 or less and showing radiological evidence of raised intracranial pressure were included. Patients with extradural hematoma, penetrating injury, or those requiring any surgery were excluded from the study. Data were analyzed using SPSS version 20. Results: No significant difference was found in mean age and gender among the two groups. The GCS of the control group was 6.2 ± 1.6 while that of the experimental group was 6.7 ± 1.6. The mean of the maximum ICP of the experimental group was 25.31 ± 8.48 mm of Hg. There was a significant difference in the mean duration of ventilation between the two groups. In the control group, 10 (50.0%) patients expired whereas in the experimental group, 8 (40.0%) patients expired. The proportion of mortality was higher in the control group but the difference was not statistically significant between the two groups (P value: 0.525). Conclusion: Intracranial pressure-monitored therapy was effective but statistically showed no significant superiority over unmonitored management.
目的:探讨颅内压监测治疗对重型颅脑损伤患者死亡率的影响。材料和方法:在拉合尔真纳医院神经外科进行了一项随机对照试验。随机选取年龄在15 ~ 60岁的男女患者40例，分为对照组和实验组。在24小时内受伤且格拉斯哥昏迷评分(GCS)为8或更低且影像学证据显示颅内压升高的患者被纳入研究。有硬膜外血肿、穿透性损伤或需要任何手术的患者被排除在研究之外。数据分析采用SPSS version 20。结果:两组患者的平均年龄、性别差异无统计学意义。对照组GCS为6.2±1.6，实验组GCS为6.7±1.6。实验组最大颅内压平均值为25.31±8.48 mm / Hg，两组平均通气时间差异有统计学意义。对照组死亡10例(50.0%)，实验组死亡8例(40.0%)。对照组死亡率较高，但两组间差异无统计学意义(P值:0.525)。结论:颅内压监测治疗有效，但与不监测治疗相比无统计学上的优势。
{"title":"Impact of Intracranial Pressure-Monitored Therapy on Mortality in Patients with Severe Traumatic Brain Injury","authors":"Kashif Ali Sultan, Usman Ahmad Kamboh, Ghulam Naseer u Din, Adeel Rauf, Nazeer Ahmad, Mehreen Mehboob, Mehwish Manzoor","doi":"10.36552/pjns.v26i4.830","DOIUrl":"https://doi.org/10.36552/pjns.v26i4.830","url":null,"abstract":"Objective: To assess the impact of intracranial pressure (ICP) monitored therapy on mortality in patients with severe traumatic brain injury. \u0000Materials and Methods: A randomized controlled trial was conducted at the Department of Neurosurgery, Jinnah Hospital Lahore. Forty patients of both genders, aged between 15 to 60 years were randomly selected and divided into two groups (Control & Experimental). Patients injured within 24 hours with a Glasgow Coma Scale (GCS) of 8 or less and showing radiological evidence of raised intracranial pressure were included. Patients with extradural hematoma, penetrating injury, or those requiring any surgery were excluded from the study. Data were analyzed using SPSS version 20. \u0000Results: No significant difference was found in mean age and gender among the two groups. The GCS of the control group was 6.2 ± 1.6 while that of the experimental group was 6.7 ± 1.6. The mean of the maximum ICP of the experimental group was 25.31 ± 8.48 mm of Hg. There was a significant difference in the mean duration of ventilation between the two groups. In the control group, 10 (50.0%) patients expired whereas in the experimental group, 8 (40.0%) patients expired. The proportion of mortality was higher in the control group but the difference was not statistically significant between the two groups (P value: 0.525). \u0000Conclusion: Intracranial pressure-monitored therapy was effective but statistically showed no significant superiority over unmonitored management. ","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":" February","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91409864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. A. Rehman, Saddam Pervaiz, Inamullah Asghar, M. Jahanzaib, Muhammad Akmal Hussain
Objective: The study compared the efficacy of fusion with non-fusion treatment for recurrent lumbar disc herniation. Materials & Methods: 60 patients including 30 – 65 years of either gender, with recurrent disc herniation and radicular pain from at least six months after primary lumbar disc surgery. Epidural scar tissues were separated and partly resected in patients with RLDH (recurrent lumber disc herniation) undergoing standard revision discectomy (Group A). Posterolateral fusion and trans-pedicular screw fixation were used in Group B. Following the implantation of a subcutaneous suction drain, the closure was performed as usual. The effectiveness was evaluated. The Japanese Orthopedic Association's core was used to measure clinical complaints before and after surgery. Results: Most of the patients (58.33%) were 46 – 65 years old. The mean recurrent time to primary surgery was 11.87 months. 60% of patients reported ? 12 months recurrent time in group B, and 66.6% in group A. Right side was noted in 26.67% of patients of both groups. The mean pre and post-operative JOA scores were 22.34 and 8.54, respectively. The mean recovery rate was 59.32%. This study reported the efficacy of non-fusion treatment versus fusion treatment as 16.67% and 63.33%, respectively. Conclusion: We concluded that the fusion treatment is better than the non-fusion treatment for recurrent lumbar disc herniation.
{"title":"Comparison of the Efficacy of Fusion with Non-Fusion Treatment for Recurrent Lumber Disc Herniation (RLDH)","authors":"M. A. Rehman, Saddam Pervaiz, Inamullah Asghar, M. Jahanzaib, Muhammad Akmal Hussain","doi":"10.36552/pjns.v26i4.812","DOIUrl":"https://doi.org/10.36552/pjns.v26i4.812","url":null,"abstract":"Objective: The study compared the efficacy of fusion with non-fusion treatment for recurrent lumbar disc herniation.\u0000Materials & Methods: 60 patients including 30 – 65 years of either gender, with recurrent disc herniation and radicular pain from at least six months after primary lumbar disc surgery. Epidural scar tissues were separated and partly resected in patients with RLDH (recurrent lumber disc herniation) undergoing standard revision discectomy (Group A). Posterolateral fusion and trans-pedicular screw fixation were used in Group B. Following the implantation of a subcutaneous suction drain, the closure was performed as usual. The effectiveness was evaluated. The Japanese Orthopedic Association's core was used to measure clinical complaints before and after surgery.\u0000Results: Most of the patients (58.33%) were 46 – 65 years old. The mean recurrent time to primary surgery was 11.87 months. 60% of patients reported ? 12 months recurrent time in group B, and 66.6% in group A. Right side was noted in 26.67% of patients of both groups. The mean pre and post-operative JOA scores were 22.34 and 8.54, respectively. The mean recovery rate was 59.32%. This study reported the efficacy of non-fusion treatment versus fusion treatment as 16.67% and 63.33%, respectively.\u0000Conclusion: We concluded that the fusion treatment is better than the non-fusion treatment for recurrent lumbar disc herniation.","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"95 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84352736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rizwan Ahmed Khan, Amjad Ali, M. Fayyaz, Khalid Mahmood
Penetrating injuries of the neck comprise upto 10% of all cases of trauma.We report the case of a 19 years old female who was admitted in Neurosurgery department of Lahore General Hospital with complaints of upper and mid back pain for 3 weeks, numbness of legs, abdomen and chest for 2 weeks and weakness of legs for 10 days. There was no preceeding history of trauma, major surgery or systemic illness. Her neurological examination suggested upper motor neuron signs in both lower limbs. She underwent a series of extensive investigations to rule out the differential diagnosis of myelitis, arteriovenous malformation and caries spine. In parallel to ongoing investigations, she received symptomatic treatment and empirical antituberculous therapy. Her MRI report showed a photon deficient area at the level of T1, which was also seen in chest Xray but was overlooked as artefact. Later on it was found to be a stray bullet which was causing the symptoms.
{"title":"Metallic Foreign Body in the Neck – a Rare Incidence","authors":"Rizwan Ahmed Khan, Amjad Ali, M. Fayyaz, Khalid Mahmood","doi":"10.36552/pjns.v26i4.774","DOIUrl":"https://doi.org/10.36552/pjns.v26i4.774","url":null,"abstract":"Penetrating injuries of the neck comprise upto 10% of all cases of trauma.We report the case of a 19 years old female who was admitted in Neurosurgery department of Lahore General Hospital with complaints of upper and mid back pain for 3 weeks, numbness of legs, abdomen and chest for 2 weeks and weakness of legs for 10 days. There was no preceeding history of trauma, major surgery or systemic illness. Her neurological examination suggested upper motor neuron signs in both lower limbs. She underwent a series of extensive investigations to rule out the differential diagnosis of myelitis, arteriovenous malformation and caries spine. In parallel to ongoing investigations, she received symptomatic treatment and empirical antituberculous therapy. Her MRI report showed a photon deficient area at the level of T1, which was also seen in chest Xray but was overlooked as artefact. Later on it was found to be a stray bullet which was causing the symptoms.","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"109 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80614711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Adnan Khalid, Usman Nazir, Naeem Raza, Sheraz Aslam, Muhammad Naveed Majeed, Muhammad Anwar
Objective: Complete surgical removal of intracranial meningiomas is curative but with significant blood loss. Tranexamic acid has been proven beneficial in reducing blood loss following major surgical procedures. Therefore, the purpose of the study was to evaluate how well tranexamic acid worked to stop blood loss in patients having an intracranial meningioma removed. Objective: This study compares the effects of tranexamic acid and placebo on intraoperative blood loss, transfusion needs, and the frequency of surgical sites with good hemostatic quality in patients having an intracranial meningioma removed. Materials & Methods: This clinical trial was carried out in the Department of Neurosurgery, unit II PGMI/ PINS, Lahore over 1 year. Two equal groups of 30 individuals each were formed from a total of 60 patients having an intracranial meningioma diagnosis. Group 1 was given TXA, whereas Group 2 was given a placebo (normal saline). Patients were assessed for intraoperative blood loss, transfusion needs, and a clean surgical area in terms of hemostasis. Results: Mean blood loss in the TXA group was 803.0 ± 106.53mL while that in the placebo group was 1159.5 ± 101.79 mL which was statistically significant (p = 0.000). TXA also significantly reduced transfusion requirements (p = 0.000) and was associated with better hemostasis of the surgical field (p = 0.000). Conclusion: This study concluded that TXA can reduce intraoperative blood loss and decrease the transfusion requirements in the postoperative period significantly as compared to placebo in patients experiencing surgical intracranial meningioma excision.
{"title":"A Comparison of the Use of Tranexamic Acid versus Placebo in Patients Undergoing Excision of Intracranial Meningioma","authors":"Adnan Khalid, Usman Nazir, Naeem Raza, Sheraz Aslam, Muhammad Naveed Majeed, Muhammad Anwar","doi":"10.36552/pjns.v26i4.822","DOIUrl":"https://doi.org/10.36552/pjns.v26i4.822","url":null,"abstract":"Objective: Complete surgical removal of intracranial meningiomas is curative but with significant blood loss. Tranexamic acid has been proven beneficial in reducing blood loss following major surgical procedures. Therefore, the purpose of the study was to evaluate how well tranexamic acid worked to stop blood loss in patients having an intracranial meningioma removed. \u0000Objective: This study compares the effects of tranexamic acid and placebo on intraoperative blood loss, transfusion needs, and the frequency of surgical sites with good hemostatic quality in patients having an intracranial meningioma removed. \u0000Materials & Methods: This clinical trial was carried out in the Department of Neurosurgery, unit II PGMI/ PINS, Lahore over 1 year. Two equal groups of 30 individuals each were formed from a total of 60 patients having an intracranial meningioma diagnosis. Group 1 was given TXA, whereas Group 2 was given a placebo (normal saline). Patients were assessed for intraoperative blood loss, transfusion needs, and a clean surgical area in terms of hemostasis. \u0000Results: Mean blood loss in the TXA group was 803.0 ± 106.53mL while that in the placebo group was 1159.5 ± 101.79 mL which was statistically significant (p = 0.000). TXA also significantly reduced transfusion requirements (p = 0.000) and was associated with better hemostasis of the surgical field (p = 0.000). \u0000Conclusion: This study concluded that TXA can reduce intraoperative blood loss and decrease the transfusion requirements in the postoperative period significantly as compared to placebo in patients experiencing surgical intracranial meningioma excision.","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"161 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86446961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Usman Haqqani, Bilal Khan, Ali Shahjehan, Sajjad ullah, Shafaat Hussain
Objective: To identify and highlight the challenges faced in initial traumatic brain injury management in a developing country Materials and Methods: The study includes 294 TBI-related admissions. We included all admitted Patients with Traumatic brain injury via. A and E (accident & emergency) departments and all patients of either age or gender. We included information related to the area of the initial trauma, whether the patient was referred from another setup after initial management, whether CT brain was performed at an initial health care facility, time since trauma to our hospital/ER presentation, duration of stay in our hospital, whether ICU was provided or not, and whether the patient was managed conservatively or required surgery at our hospital. Results: Out of the total patients received male to female ratio was 9 to 1 and the age group most involved was 15 to 45 years old.72% of patients were referred from local healthcare setups. 24% of patients underwent surgery. 64% were received from other districts. CT was performed by 41% before presenting. 61% of patients reached the hospital within 3 hours of injury. 51% stayed in the hospital for 1 – 3 days. 17% were shifted to ICU, Ventilator support was only given to 9.5% of patients. In 25% of patients, Steroids were given, and 5 redo surgeries were performed in the same hospital setting. Conclusion: This Short report provides a snapshot of the difficulties and weaknesses of the health system in the region.
{"title":"Emerging Challenges in the Management of Initial Traumatic Brain Injury: A Prospective Study from a Developing Country","authors":"Usman Haqqani, Bilal Khan, Ali Shahjehan, Sajjad ullah, Shafaat Hussain","doi":"10.36552/pjns.v26i4.816","DOIUrl":"https://doi.org/10.36552/pjns.v26i4.816","url":null,"abstract":"Objective: To identify and highlight the challenges faced in initial traumatic brain injury management in a developing country \u0000Materials and Methods: The study includes 294 TBI-related admissions. We included all admitted Patients with Traumatic brain injury via. A and E (accident & emergency) departments and all patients of either age or gender. We included information related to the area of the initial trauma, whether the patient was referred from another setup after initial management, whether CT brain was performed at an initial health care facility, time since trauma to our hospital/ER presentation, duration of stay in our hospital, whether ICU was provided or not, and whether the patient was managed conservatively or required surgery at our hospital. \u0000Results: Out of the total patients received male to female ratio was 9 to 1 and the age group most involved was 15 to 45 years old.72% of patients were referred from local healthcare setups. 24% of patients underwent surgery. 64% were received from other districts. CT was performed by 41% before presenting. 61% of patients reached the hospital within 3 hours of injury. 51% stayed in the hospital for 1 – 3 days. 17% were shifted to ICU, Ventilator support was only given to 9.5% of patients. In 25% of patients, Steroids were given, and 5 redo surgeries were performed in the same hospital setting. \u0000Conclusion: This Short report provides a snapshot of the difficulties and weaknesses of the health system in the region.","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86747208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Waqas Noor Chughtai, Manqoosh-ur-Rehman, Muhammad Adeel Razzaque, Azhar Rashid, Tanveer Ahmad, Amjad Maqsood
Objective: To assess the relationship between hypovitaminosis D and chronic low back pain in South Punjab. Materials and Methods: Retrospective research was done from January 2021 to June 2022. 173 chronic nonspecific low back pain patients presenting in outpatient clinics were included in our study. Two groups were made of all patients, one was vitamin-D level deficient, and the other was a vitamin-D normal group. The blood level of 30 ng/ml of vitamin D was taken as normal. Chronic Low back pain status was analyzed by VAS score. All the demographic data of patients were recorded. The relationship between vitamin D and VAS score was assessed by the spearman coefficient and p <0.05 was taken as significant. Results: The majority of patients had a mean age of 36.45 ± 21 years, were female preponderance, married, and vegetarians with a mean sun exposure time of about 2 hours. In group 1, the vitamin D level was 13.41 ± 3.8 and in group 2 vitamin D was 38.71 ± 5.8 with p value< 0.0001. Spearman rho coefficient was used to assess the relationship between vitamin D and pain score. The result was a negative correlation between these 2 variables (r=-0.572) and p <0.0001. Conclusion This research work showed the significant probability of association between vitamin D level and patients having nonspecific chronic low back pain. There was a negative association between vitamin D level and VAS score of patients having chronic low back pain.
目的:探讨南旁遮普地区维生素D缺乏症与慢性腰痛的关系。材料与方法:回顾性研究时间为2021年1月至2022年6月。173例在门诊就诊的慢性非特异性腰痛患者纳入了我们的研究。所有患者分为两组，一组为维生素d缺乏组，另一组为维生素d正常组。血中维生素D 30 ng/ml为正常水平。采用VAS评分法分析慢性腰痛状态。记录所有患者的人口统计资料。采用spearman系数评价维生素D与VAS评分的关系，以p <0.05为显著性。结果:患者平均年龄36.45±21岁，女性居多，已婚，素食者居多，平均日晒时间约2小时。1组维生素D水平为13.41±3.8,2组维生素D水平为38.71±5.8,p值< 0.0001。采用Spearman系数评价维生素D与疼痛评分的关系。结果这两个变量之间呈负相关(r=-0.572)， p <0.0001。结论维生素D水平与非特异性慢性腰痛有显著相关性。慢性腰痛患者的维生素D水平与VAS评分呈负相关。
{"title":"Assessment of the Association between Hypovitaminosis D and Chronic Low Back Pain in South Punjab","authors":"Waqas Noor Chughtai, Manqoosh-ur-Rehman, Muhammad Adeel Razzaque, Azhar Rashid, Tanveer Ahmad, Amjad Maqsood","doi":"10.36552/pjns.v26i4.815","DOIUrl":"https://doi.org/10.36552/pjns.v26i4.815","url":null,"abstract":"Objective: To assess the relationship between hypovitaminosis D and chronic low back pain in South Punjab.\u0000Materials and Methods: Retrospective research was done from January 2021 to June 2022. 173 chronic nonspecific low back pain patients presenting in outpatient clinics were included in our study. Two groups were made of all patients, one was vitamin-D level deficient, and the other was a vitamin-D normal group. The blood level of 30 ng/ml of vitamin D was taken as normal. Chronic Low back pain status was analyzed by VAS score. All the demographic data of patients were recorded. The relationship between vitamin D and VAS score was assessed by the spearman coefficient and p <0.05 was taken as significant.\u0000Results: The majority of patients had a mean age of 36.45 ± 21 years, were female preponderance, married, and vegetarians with a mean sun exposure time of about 2 hours. In group 1, the vitamin D level was 13.41 ± 3.8 and in group 2 vitamin D was 38.71 ± 5.8 with p value< 0.0001. Spearman rho coefficient was used to assess the relationship between vitamin D and pain score. The result was a negative correlation between these 2 variables (r=-0.572) and p <0.0001.\u0000Conclusion This research work showed the significant probability of association between vitamin D level and patients having nonspecific chronic low back pain. There was a negative association between vitamin D level and VAS score of patients having chronic low back pain.\u0000 ","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75124399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Niaz Ahmed Khan, Muhammad Assad Javed, Nafees Ahmed, Muhammad Anees Awan, Faisal Sultan, Daniyal Ahmed
Objectives: The study aimed to compare the surgical outcome of two different procedures for lumbar spinal stenosis. It helped us in the decision-making to go for less invasive procedures, as compared to conventional laminectomy in lumbar spinal stenosis patient patients. Materials and Methods: An interventional randomized controlled trial was conducted in the department of neurosurgery, Shaheed Zulfiqar Ali Bhutto Medical University, PIMS Islamabad. A total of 158 adult patients aged between 35 to 55 years with an established diagnosis of lumbar stenosis and claudication distance of fewer than 100 meters were enrolled. Patients were randomly included into two equal groups via the computerized method. In Group A laminectomy was done and in Group Blaminoforaminotomy was adopted. The outcome was measured in terms of claudication distance at 4 weeks after the procedure, and compared in both groups. Results: The mean age of the patients was 44.92 ± 6.28 years. Poor outcome was significantly lower in the Laminoforaminotomy group as compared to the Laminectomy group, at 4 weeks after the procedure. The frequency of claudication distance > 500m (good) at 4 weeks was found to be 62 (78.5%) in the Laminectomy group and it was found in 74 (93.7%) patients in the Laminoforaminotomy group (p = 0.022). Conclusions: The study concluded that the laminoforaminotomy is superior to laminectomy, in terms of claudication distance at four weeks after the procedure.
目的:本研究旨在比较两种不同手术方法治疗腰椎管狭窄的手术结果。与传统的椎板切除术相比，它帮助我们选择微创手术治疗腰椎管狭窄症。材料与方法:一项介入性随机对照试验在Shaheed Zulfiqar Ali Bhutto医科大学伊斯兰堡PIMS神经外科进行。共入组158例年龄在35 - 55岁之间，明确诊断为腰椎管狭窄且跛行距离小于100米的成年患者。采用计算机化方法将患者随机分为两组。A组行椎板切除术，A组行椎间孔切开术。在手术后4周测量跛行距离，并比较两组的结果。结果:患者平均年龄44.92±6.28岁。手术后4周，椎板间孔切开术组的不良预后明显低于椎板切除术组。椎板切除术组4周跛行距离> 500m(良好)的发生率为62例(78.5%)，椎板间孔切开术组为74例(93.7%)(p = 0.022)。结论:本研究认为椎板间孔切开术在术后四周的跛行距离方面优于椎板切除术。
{"title":"The Outcome of Laminectomy versus Laminoforaminotomy in Terms of Claudication Distance in Lumbar Spinal Stenosis","authors":"Niaz Ahmed Khan, Muhammad Assad Javed, Nafees Ahmed, Muhammad Anees Awan, Faisal Sultan, Daniyal Ahmed","doi":"10.36552/pjns.v26i4.817","DOIUrl":"https://doi.org/10.36552/pjns.v26i4.817","url":null,"abstract":"Objectives: The study aimed to compare the surgical outcome of two different procedures for lumbar spinal stenosis. It helped us in the decision-making to go for less invasive procedures, as compared to conventional laminectomy in lumbar spinal stenosis patient patients. \u0000Materials and Methods: An interventional randomized controlled trial was conducted in the department of neurosurgery, Shaheed Zulfiqar Ali Bhutto Medical University, PIMS Islamabad. A total of 158 adult patients aged between 35 to 55 years with an established diagnosis of lumbar stenosis and claudication distance of fewer than 100 meters were enrolled. Patients were randomly included into two equal groups via the computerized method. In Group A laminectomy was done and in Group Blaminoforaminotomy was adopted. The outcome was measured in terms of claudication distance at 4 weeks after the procedure, and compared in both groups. \u0000Results: The mean age of the patients was 44.92 ± 6.28 years. Poor outcome was significantly lower in the Laminoforaminotomy group as compared to the Laminectomy group, at 4 weeks after the procedure. The frequency of claudication distance > 500m (good) at 4 weeks was found to be 62 (78.5%) in the Laminectomy group and it was found in 74 (93.7%) patients in the Laminoforaminotomy group (p = 0.022). \u0000Conclusions: The study concluded that the laminoforaminotomy is superior to laminectomy, in terms of claudication distance at four weeks after the procedure.","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"127 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76076482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ehtisham Ahmed khan Afridi, Gohar Ali, Mohammad Wasim, Aqsa Shahzadi, Sidra Asghar
Objective: The study compared the postoperative back pain VAS score in bilateral interlaminar and classic laminectomy techniques in patients with lumbar canal stenosis. Material and Methods: This randomized controlled experiment was carried out at Ayub Teaching Hospital's Neurosurgery Department. 30 patients were in the bilateral interlaminar (BIL) group (A) and 30 were in the traditional laminectomy group (B). The bilateral interlaminar decompression technique was carried out utilizing the operating microscope. Both groups employed facet joint undercutting to reduce the 61-facet joint excision. All patients had postoperative CT scans to assess how well the decompression went. Postoperative VAS score was stratified to age, gender, duration of complaints, and duration of the procedure. Results: In group A, the mean age of patients was 51.10 years while in group B, the mean age was 54.500 years. There was a male dominance of male patients in both groups. The baseline mean VAS score was 7.9 in group A and group B both. The duration of the procedure was 71.2 minutes in group A, and 104.7 minutes in group B. Mean postoperative VAS score was 5.4 in group A and 3.3 in group B. There existed a significant difference in mean postoperative VAS scores between groups concerning gender, the duration of complaints, and procedures. Conclusion: In patients with lumbar canal stenosis, bilateral interlaminar allows for safe and adequate spinal canal decompression. Keywords: Lumbar canal stenosis (LCS), Bilateral Interlaminar (BIL), Classic Laminectomy, Visual Analog Scale (VAS).
{"title":"Lumbar Canal Stenosis Decompression Using Bilateral Interlaminar Versus Classic Laminectomy Technique","authors":"Ehtisham Ahmed khan Afridi, Gohar Ali, Mohammad Wasim, Aqsa Shahzadi, Sidra Asghar","doi":"10.36552/pjns.v26i4.800","DOIUrl":"https://doi.org/10.36552/pjns.v26i4.800","url":null,"abstract":"Objective: The study compared the postoperative back pain VAS score in bilateral interlaminar and classic laminectomy techniques in patients with lumbar canal stenosis. \u0000Material and Methods: This randomized controlled experiment was carried out at Ayub Teaching Hospital's Neurosurgery Department. 30 patients were in the bilateral interlaminar (BIL) group (A) and 30 were in the traditional laminectomy group (B). The bilateral interlaminar decompression technique was carried out utilizing the operating microscope. Both groups employed facet joint undercutting to reduce the 61-facet joint excision. All patients had postoperative CT scans to assess how well the decompression went. Postoperative VAS score was stratified to age, gender, duration of complaints, and duration of the procedure. \u0000Results: In group A, the mean age of patients was 51.10 years while in group B, the mean age was 54.500 years. There was a male dominance of male patients in both groups. The baseline mean VAS score was 7.9 in group A and group B both. The duration of the procedure was 71.2 minutes in group A, and 104.7 minutes in group B. Mean postoperative VAS score was 5.4 in group A and 3.3 in group B. There existed a significant difference in mean postoperative VAS scores between groups concerning gender, the duration of complaints, and procedures. \u0000Conclusion: In patients with lumbar canal stenosis, bilateral interlaminar allows for safe and adequate spinal canal decompression. \u0000Keywords: Lumbar canal stenosis (LCS), Bilateral Interlaminar (BIL), Classic Laminectomy, Visual Analog Scale (VAS).","PeriodicalId":19963,"journal":{"name":"Pakistan Journal Of Neurological Surgery","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88370653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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