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Gaffney J, Ramzan A, Dinizulu T, Onamusi DO, Motamedi-Ghahfarokhi G, Mistry H, Price G, Garcez K, Hughes C, Thomson DD, Lee LW, Jain Y, Price JM, McPartlin A. Temporal Incidence and Patterns of Distant Failure for Human Papillomavirus (HPV) Related Oropharyngeal Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e582-e583. [PMID: 37785768 DOI: 10.1016/j.ijrobp.2023.06.2518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) HPV related oropharyngeal cancer (HPV-OPC) enjoys improved treatment outcomes relative to non-HPV related disease but suffers from similar rates of distant metastases (DM) following treatment. Emerging data supports radical intent therapy for oligometastatic relapsed HPV-OPC, suggesting early diagnosis of DM may be beneficial to outcome. We assess temporal patterns in distance relapse to investigate rationalization of post treatment imaging. MATERIALS/METHODS A retrospective single center cohort study was carried out of consecutive HPV-OPC treated with radical intent (chemo)radiotherapy ((CT)RT) between 2011 and 2020. Electronic records were reviewed to identify location and timing of development of DM. Oligometastatic (OM) state was defined as = 5 metastasis in one system. RESULTS A total of 793 HPV-OPC patients were identified with median follow-up 3.15 years (range 0.2-8.9). The median time to recurrence was 15.1 months (range: 2.6-63 months). 87% of DM occurred in the first two years after treatment. Pattern of failure by stage are shown in table 1. Indications for scans performed identifying DM alone were symptoms (66%), follow-up imaging based on previous radiological findings (15%), disease response assessment imaging (15%), and incidental findings (4%). Sites of distant metastasis were lung (64%), thoracic nodes (36.5%), bone (27%), visceral (23%), brain (4%) and skin (2%). The sites of visceral metastasis involvement included liver (92%), Adrenal (18%), kidney (18%), and spleen (9%). Treatment offered to patients with OM alone was best supportive care (46%), palliative chemotherapy (15.4%), palliative RT (23%), immunotherapy (8%), and one patient lost to follow up (8%). SBRT was not available during time period. Median survival following diagnosis was 17.5 months (range 4.4-85.4 months). CONCLUSION Despite no routine imaging beyond initial treatment response assessment, we identify a small minority of HPV OPC patients with OM recurrence that is associated with better outcome and occasional long-term cure from aggressive therapy. The majority (69%) of DM occur in the thorax/upper abdomen of patients in the first two years post treatment. This finding supports the potential utility of regular imaging of thorax/upper abdomen during early follow.
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Affiliation(s)
- J Gaffney
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - A Ramzan
- Department of Radiology, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - T Dinizulu
- Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - D O Onamusi
- The University of Manchester, Manchester, United Kingdom
| | | | - H Mistry
- The University of Manchester, Manchester, United Kingdom
| | - G Price
- The Christie NHS Foundation Trust, Manchester, United Kingdom; The University of Manchester, Manchester, United Kingdom
| | - K Garcez
- Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - C Hughes
- Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - D D Thomson
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - L W Lee
- Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Y Jain
- Department of Radiology, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - J M Price
- Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - A McPartlin
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
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Hazafa A, Iqbal MO, Javaid U, Tareen MBK, Amna D, Ramzan A, Piracha S, Naeem M. Inhibitory effect of polyphenols (phenolic acids, lignans, and stilbenes) on cancer by regulating signal transduction pathways: a review. Clin Transl Oncol 2022; 24:432-445. [PMID: 34609675 DOI: 10.1007/s12094-021-02709-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 09/11/2021] [Indexed: 02/07/2023]
Abstract
Natural products, especially polyphenols (phenolic acids, lignans, and stilbenes) are suggested to be more potent anticancer drugs because of their no or less adverse effects, excess availability, high accuracy, and secure mode of action. In the present review, potential anticancer mechanisms of action of some polyphenols including phenolic acids, lignans, and stilbenes are discussed based on clinical, epidemiological, in vivo, and in vitro studies. The emerging evidence revealed that phenolic acids, lignans, and stilbenes induced apoptosis in the treatment of breast (MCF-7), colon (Caco-2), lung (SKLU-1), prostate (DU-145 and LNCaP), hepatocellular (hepG-2), and cervical (A-431) cancer cells, cell cycle arrest (S/G2/M/G1-phases) in gastric (MKN-45 and MKN-74), colorectal (HCT-116), bladder (T-24 and 5637), oral (H-400), leukemic (HL-60 and MOLT-4) and colon (Caco-2) cancer cells, and inhibit cell proliferation against the prostate (PC-3), liver (LI-90), breast (T47D and MDA-MB-231), colon (HT-29 and Caco-2), cervical (HTB-35), and MIC-1 cancer cells through caspase-3, MAPK, AMPK, Akt, NF-κB, Wnt, CD95, and SIRT1 pathways. Based on accumulated data, we suggested that polyphenols could be considered as a viable therapeutic option in the treatment of cancer cells in the near future.
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Affiliation(s)
- A Hazafa
- Department of Biochemistry, Faculty of Sciences, University of Agriculture, Faisalabad, 38040, Pakistan.
| | - M O Iqbal
- Shandong Provincial Key Laboratory of Glycoscience and Glycoengineering, School of Medicine and Pharmacy, Ocean University of China, Qingdao, 266003, China
| | - U Javaid
- Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, 60800, Pakistan
| | - M B K Tareen
- College of Food Science & Technology, Huazhong Agricultural University, Huazhong, China
| | - D Amna
- Institute of Food Science & Nutrition, Bahauddin Zakariya University, Multan, Pakistan
| | - A Ramzan
- Department of Botany, University of Agriculture Faisalabad, Faisalabad, 38040, Pakistan
| | - S Piracha
- Department of Chemistry, University of Agriculture Faisalabad, Faisalabad, 38040, Pakistan
| | - M Naeem
- College of Life Science, Hebei Normal University, Shijiazhuang, China
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Ansari B, Altafa J, Ramzan A, Ahmed Z, Khalil S, Qamar SUR, Awan SA, Jehangir K, Khalid R, Aziz S, Sultana T, Sultana S, Alsamadany H, Alshamrani R, Awan FS. Molecular Phylogenetics of Physa acuta (Pulmonata: Basommatophora): an Invasive species in Central Punjab Pakistan. BRAZ J BIOL 2021; 83:e246984. [PMID: 34431913 DOI: 10.1590/1519-6984.246984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 02/11/2021] [Indexed: 11/21/2022] Open
Abstract
Physids belong to Class Gastropoda; belong to Phylum Mollusca and being bioindicators, intermediate hosts of parasites and pests hold a key position in the ecosystem. There are three species of Genus Physa i.e. P. fontinalis, Physa acuta and P. gyrina water bodies of Central Punjab and were characterized on the basis of molecular markers High level of genetic diversity was revealed by polymorphic RAPD, however SSR markers were not amplified. The multivariate analysis revealed polymorphism ranging from 9.09 percent to 50 percent among the three Physid species. Total number of 79 loci were observed for the three species under study and 24 loci were observed to be polymorphic. These RAPD fragment(s) can be developed into co dominant markers (SCAR) by cloning and can be further sequenced for the development of the Physa species specific markers to identify the introduced and native species in Pakistan.
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Affiliation(s)
- B Ansari
- Government College University Faisalabad, Department of Zoology, Punjab, Pakistan
| | | | - A Ramzan
- Government College University Faisalabad, Department of Zoology, Punjab, Pakistan
| | - Z Ahmed
- University of Agriculture, Center for Advanced Studies in Agriculture and Food Security - CAS-AFS, Department of Plant Breeding and Genetics, Faisalabad, Pakistan
| | - S Khalil
- The Islamia University of Bahawalpur, Faculty of Agriculture & Environmental Science, Department Forestry Range & Wildlife Management, Bagdad Ul Jadeed Campus, Bahawalpur, Pakistan
| | - S U R Qamar
- Government College University Faisalabad, Department of Zoology, Punjab, Pakistan.,Chulabhorn Graduate Institute, Department of Applied Biological Sciences, Lak Si, Bangkok, Thailand
| | - S A Awan
- University of Agriculture, Department of Computer Science, Faisalabad, Pakistan
| | - K Jehangir
- Government College University Faisalabad, Department of Zoology, Punjab, Pakistan
| | - R Khalid
- Government College University Faisalabad, Department of Zoology, Punjab, Pakistan
| | - S Aziz
- Government College University Faisalabad, Department of Zoology, Punjab, Pakistan
| | - T Sultana
- Government College University Faisalabad, Department of Zoology, Punjab, Pakistan
| | - S Sultana
- Government College University Faisalabad, Department of Zoology, Punjab, Pakistan
| | - H Alsamadany
- King Abdulaziz University, Faculty of Science, Department of Biological Sciences, Jeddah, Saudi Arabia
| | - R Alshamrani
- King Abdulaziz University, Faculty of Science, Department of Biological Sciences, Jeddah, Saudi Arabia
| | - F S Awan
- University of Agriculture, Center of Agricultural Biochemistry and Biotechnology, Faisalabad, Pakistan
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4
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Aziz S, Altaf J, Ramzan A, Ahmed Z, Qamar SUR, Awan SA, Khalil S, Jehangir K, Khalid R, Ansari B, Sultana T, Sultana S, Alsamadany H, Alshamrani R, Awan FS. Characterization of the species of genus Physa on the basis of typological species concept from Central Punjab. BRAZ J BIOL 2021; 83:e246934. [PMID: 34431912 DOI: 10.1590/1519-6984.246934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 02/09/2021] [Indexed: 11/21/2022] Open
Abstract
Physids belong to Class Gastropoda; Phylum Mollusca have important position in food web and act as bio indicators, pests and intermediate host. Being resistant these are called cockroaches of malacology. Physid snails were collected from different water bodies of Faisalabad (Punjab) and were identified up to species using morphological markers. The morphometry of the specimens was carried out with the help of a digital Vernier caliper in millimeters (mm) using linear measurement of shell characters. Linear regression analysis of the AL/SW ratio vs AL and SL/SW ratio vs AL indicated that allometric growth exists only in Physa acuta when compared with P.gyrina and P. fontinalis. This study will lead to assess the status of the Physid species in Central Punjab. The Principal component analysis shows that the Component 1 (Shell Length) and component 2 (Shell Width) are the most prolific components and nearly 80 percent of the identification. The distance between P. acuta and P. fontinalis is 5.4699, P. acuta and P. gyrina is 7.6411, P. fontinalis and P. gyrina is 16.6080 showing that P. acuta resembles with P. fontinalis, and both these specimens donot resemble with P. gyrina. P.acuta is an invasive species and shows bioactivity making it a potent candidate for bioactive substances.
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Affiliation(s)
- S Aziz
- Government College University Faisalabad Department of Zoology, Punjab, Pakistan
| | - J Altaf
- Government College University Faisalabad Department of Zoology, Punjab, Pakistan
| | - A Ramzan
- Government College University Faisalabad Department of Zoology, Punjab, Pakistan
| | - Z Ahmed
- University of Agriculture, Faisalabad, Department of Plant Breeding and Genetics; Center for Advanced Studies in Agriculture and Food Security (CAS-AFS), Faisalabad, Pakistan
| | - S U R Qamar
- Government College University Faisalabad Department of Zoology, Punjab, Pakistan.,Chulabhorn Graduate Institute, Department of Applied Biological Sciences, 54 Kamphaeng Phet 6 Road, Lak Si, Bangkok, Thailand
| | - S A Awan
- University of Agriculture, Faisalabad Department of Computer Science, Faisalabad, Pakistan
| | - S Khalil
- The Islamia University Bahawalpur Department Forestry Range & Wildlife Management, Faculty of Agriculture & Environmental Science, Bagdad Ul Jadeed Campus, Bahawalpur, Pakistan
| | - K Jehangir
- Government College University Faisalabad Department of Zoology, Punjab, Pakistan
| | - R Khalid
- Government College University Faisalabad Department of Zoology, Punjab, Pakistan
| | - B Ansari
- Government College University Faisalabad Department of Zoology, Punjab, Pakistan
| | - T Sultana
- Government College University Faisalabad Department of Zoology, Punjab, Pakistan
| | - S Sultana
- Government College University Faisalabad Department of Zoology, Punjab, Pakistan
| | - H Alsamadany
- King Abdulaziz University, Faculty of Science, Department of Biological Sciences, Jeddah, Saudi Arabia
| | - R Alshamrani
- King Abdulaziz University, Faculty of Science, Department of Biological Sciences, Jeddah, Saudi Arabia
| | - F S Awan
- University of Agriculture, Faisalabad, Centre of Agricultural Biochemistry and Biotechnology, Faisalabad, Pakistan
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Ganai F, Tanki HN, Sherwani A, Altaf K, Chisti N, Ramzan A. Incidence, Clinicopathological Profile and Location - Based Outcome of Intracranial Meningiomas: 10-Year Institutional Study with Review of Literature. Indian Journal of Neurosurgery 2021. [DOI: 10.1055/s-0040-1714436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Abstract
Intracranial meningiomas are the most common extra-axial tumors, representing 15% of all brain tumors. Arising from the arachnoid cells, and common in middle-aged women, 90% meningiomas are benign. We conducted a 10-year study on 183 cases of intracranial meningiomas and observed a lower and decreasing trend; the mean age was 43.3 years but there was also a significant incidence in young females. Parasagittal/falx (29%), sphenoid ridge, convexity meningiomas and middle cranial fossa locations were more common. Histopathologically, meningothelial meningioma was the most common. Benign (WHO I) tumors were found in above 90%, atypical (WHO II) in 5% cases, and malignant (WHO III) in < 4% patients. Most patients underwent Simpsons Grade I excision (35.6%) with dural reconstruction because of late presentations. Posterior fossa meningiomas were mostly benign, while intraventricular ones were mostly malignant with highest postoperation mortality. Mortality in operated patients was 9.8% but was highest in anterior fossa tumors (12.5%).
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Affiliation(s)
- Feroze Ganai
- Department of Neurosurgery and Surgery, Sheri Kashmir Institute of Medical Sciences, Kashmir, Jammu & Kashmir, India
| | - Humam Nisar Tanki
- Department of Neurosurgery and Surgery, Sheri Kashmir Institute of Medical Sciences, Kashmir, Jammu & Kashmir, India
| | - Afaq Sherwani
- Department of Neurosurgery and Surgery, Sheri Kashmir Institute of Medical Sciences, Kashmir, Jammu & Kashmir, India
| | - Kirmani Altaf
- Department of Neurosurgery and Surgery, Sheri Kashmir Institute of Medical Sciences, Kashmir, Jammu & Kashmir, India
| | - Nazish Chisti
- Department of Neurosurgery and Surgery, Sheri Kashmir Institute of Medical Sciences, Kashmir, Jammu & Kashmir, India
| | - Altaf Ramzan
- Department of Neurosurgery and Surgery, Sheri Kashmir Institute of Medical Sciences, Kashmir, Jammu & Kashmir, India
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6
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Hu H, Ramzan A, Wischert R, Jerôme F, Michel C, de Olivera Vigier K, Pera-Titus M. Pivotal role of H 2 in the isomerisation of isosorbide over a Ru/C catalyst. Catal Sci Technol 2021. [DOI: 10.1039/d1cy01709h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
DFT calculations combined with experiments unveil the key role of the H2 coverage on Ru/C catalyst in the isomerization of isosorbide.
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Affiliation(s)
- H. Hu
- Eco-Efficient Products and Processes Laboratory (E2P2L), UMI 3464 CNRS-Solvay, 3966 Jin Du Road, Xin Zhuang Ind. Zone, 201108 Shanghai, China
- IC2MP UMR CNRS_Université de Poitiers 7285, ENSIP 1 rue Marcel Doré, TSA 41195, 86073 Poitiers Cedex 9, France
| | - A. Ramzan
- Univ Lyon, Ecole Normale Supérieure de Lyon, CNRS UMR 5182, Laboratoire de Chimie, F69364 Lyon, France
| | - R. Wischert
- Eco-Efficient Products and Processes Laboratory (E2P2L), UMI 3464 CNRS-Solvay, 3966 Jin Du Road, Xin Zhuang Ind. Zone, 201108 Shanghai, China
| | - F. Jerôme
- IC2MP UMR CNRS_Université de Poitiers 7285, ENSIP 1 rue Marcel Doré, TSA 41195, 86073 Poitiers Cedex 9, France
| | - C. Michel
- Univ Lyon, Ecole Normale Supérieure de Lyon, CNRS UMR 5182, Laboratoire de Chimie, F69364 Lyon, France
| | - K. de Olivera Vigier
- IC2MP UMR CNRS_Université de Poitiers 7285, ENSIP 1 rue Marcel Doré, TSA 41195, 86073 Poitiers Cedex 9, France
| | - M. Pera-Titus
- Eco-Efficient Products and Processes Laboratory (E2P2L), UMI 3464 CNRS-Solvay, 3966 Jin Du Road, Xin Zhuang Ind. Zone, 201108 Shanghai, China
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Bhat I, Malik N, Kareem K, Ramzan A, Sheikh H, Wani A, Singh S, Arif S, Rashid A. Burden of Moderate and Severe Head Injury in Kashmir Valley. Indian Journal of Neurotrauma 2020. [DOI: 10.1055/s-0040-1717217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Abstract
Background Head injury is a major health hazard throughout the world. Overall, the mortality/morbidity has not changed much in the last few decades. In developing nations, the situation is worse.
Methods The study was conducted for a period of 1 year. The data collected include demographic profile, mode, circumstances and timing of the injury, neurological assessment using Glasgow Coma Scale (GCS) scoring, computed tomography (CT) scan findings, type of management, and outcome.
Results Transport-related injuries and falls were the common cause of head injury, with more severe injuries seen in patients without wearing helmets and seat belts. The youth is at high risk of receiving head injuries. The summer season showed a maximum incidence of head injuries. The most common lesions on CT scan were linear fracture of the skull and brain contusion. Mortality rate was 26% and it correlated with the GCS at presentation.
Conclusion Head injury mostly affects young people and males outnumber females. Road traffic accident is the major cause. People not abiding by the traffic rules, such as wearing helmets and seat belts, were at high risk of developing head injury and poor outcome.
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Affiliation(s)
- Irfan Bhat
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Nayil Malik
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Kaiser Kareem
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Altaf Ramzan
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Hilal Sheikh
- Department of Neurology, Shri Maharaja Hari Singh Hospital, Srinagar, Jammu and Kashmir, India
| | - Abrar Wani
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Sarbjit Singh
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Sajad Arif
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Abdual Rashid
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
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Khursheed N, Pahalwan B, Nisar H, Ramzan A, Wani S, Wani A, Singh S, Khawaja R, Hamid A, Arif H, Singh B. The description of urodynamic study for bladder dysfunction in compressive myelo- or radiculo-pathy: A prospective study in an institutional setup. Asian J Neurosurg 2019; 14:828-833. [PMID: 31497109 PMCID: PMC6703038 DOI: 10.4103/ajns.ajns_173_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Purpose: To study the significance of filling cystometry with pressure flow studies and bladder electromyography (EMG) in assessment and management of neurogenic bladder with myelopathies and evaluated neurological recovery in the follow-up period. Methods: The study was a 3-year prospective urodynamic study in 63 patients, with traumatic and nontraumatic myelopathy. Bladder management was advised based on the cystometric findings. Neurological recovery and mode of bladder management were evaluated during follow-up after a minimum of 6 months. Results: Mean age was 44.6 years (range 10–80 years). Thoracolumbar area was most commonly involved. Cystometry revealed overactive detrusor in 46 patients, (17 had detrusor sphincter dyssynergia [DSD], 29 without DSD) and areflexic/underactive detrusor in 9 patients. Postvoid residual (>15% of voided urine) was significant in 27 patients. Neurological recovery was seen in 60.3%, whereas 22.2% showed no improvement (partial improvement in 4.8%) and 12.6% had normal bladder function both initially and at follow-up. Correlation between neurological recovery and bladder management was found to be insignificant (P > 0.05) using spearman's correlation coefficient. Conclusion: Filling cystometry with pressure flow studies and EMG study is valuable for the assessment and management of neurogenic bladder in patients with myelopathy. In neurogenic bladder management and follow-up, pressure flow studies help to prevent complications and upper urinary tract complications.
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Affiliation(s)
- Nayil Khursheed
- Department of Neurosurgery, Sher-i-Institute of Medical Sciences, Srinagar, Jammu and Kashmir
| | - Bilal Pahalwan
- Department of Neurosurgery, Sher-i-Institute of Medical Sciences, Srinagar, Jammu and Kashmir
| | - Humam Nisar
- Department of Neurosurgery, Sher-i-Institute of Medical Sciences, Srinagar, Jammu and Kashmir
| | - Altaf Ramzan
- Department of Neurosurgery, Sher-i-Institute of Medical Sciences, Srinagar, Jammu and Kashmir
| | - Saleem Wani
- Department of Urology, Sher-i-Institute of Medical Sciences, Srinagar, Jammu and Kashmir
| | - Abrar Wani
- Department of Neurosurgery, Sher-i-Institute of Medical Sciences, Srinagar, Jammu and Kashmir
| | - Sarbjit Singh
- Department of Neurosurgery, Sher-i-Institute of Medical Sciences, Srinagar, Jammu and Kashmir
| | - Rouf Khawaja
- Department of Neurosurgery, Sher-i-Institute of Medical Sciences, Srinagar, Jammu and Kashmir
| | - Arif Hamid
- Department of Urology, Sher-i-Institute of Medical Sciences, Srinagar, Jammu and Kashmir
| | - Hussain Arif
- Department of Neurosurgery, Sher-i-Institute of Medical Sciences, Srinagar, Jammu and Kashmir
| | - Baldev Singh
- Department of Urology, Sher-i-Institute of Medical Sciences, Srinagar, Jammu and Kashmir
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Sarmast A, Khursheed N, Ramzan A, Shaheen F, Wani A, Singh S, Ali Z, Dar B. Endoscopic Third Ventriculostomy in Noncommunicating Hydrocephalus: Report on a Short Series of 53 Children. Asian J Neurosurg 2019; 14:35-40. [PMID: 30937005 PMCID: PMC6417306 DOI: 10.4103/ajns.ajns_187_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Introduction: Endoscopoic third ventriculostomy (ETV) is currently considered the best alternative to cerebrospinal fluid (CSF) shunt systems in the treatment of obstructive hydrocephalus. The aim of ETV is to communicate the third ventricle with the interpendicular cistern and create CSF flow which bypasses an obstruction to the circulation of the CSF. Aims and Objectives: The purpose of this study was to elucidate the indications, efficacy, safety and outcome Of ETV pediatric patients of noncommunicating hydrocephalus. Material and Methods: This study is a 3 year prospective study from June 2012 to May 2015. Records were kept for age, gender, etilogical factors, symptoms, signs, previous use of shunt or external ventricular device, imaging findings, and surgical complications (intraoperative and postoperative). Only those patients with age between 6months and 18 years with symptoms of intracranial hypertension and radiographic evidence of noncommunicating hydrocephalus were included in the study. Results: A total of 53 patients were studied, out of these 29 were boys and 24 were girls. The mean age of the patients was 6.6 years. Overall a total of 50 successful ETVs were done in 53 patients. The success rate is estimated to be 94%. There was no mortality. The average postoperative hospital stay was 4 days. The followup ranged from 6 to 16 months (mean, 12 months). Conclusion: ETV in children is a safe, simple and effective treatment and a logical alternative to shunting procedure for patients of noncommunicating hydrocephalus.
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Affiliation(s)
- Arif Sarmast
- Department of Neurosurgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Nayil Khursheed
- Department of Neurosurgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Altaf Ramzan
- Department of Neurosurgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Feroz Shaheen
- Department of Radiodiagnosis, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Abrar Wani
- Department of Neurosurgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Sarbjit Singh
- Department of Neurosurgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Zulfikar Ali
- Department of Neuroanesthesiology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Bashir Dar
- Department of Neuroanesthesiology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
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Shoaib Y, Nayil K, Makhdoomi R, Asma A, Ramzan A, Shaheen F, Wani A. Role of Diffusion and Perfusion Magnetic Resonance Imaging in Predicting the Histopathological Grade of Gliomas - A Prospective Study. Asian J Neurosurg 2019; 14:47-51. [PMID: 30937007 PMCID: PMC6417292 DOI: 10.4103/ajns.ajns_191_16] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Context: Gliomas are the most common brain tumors. In addition to conventional magnetic resonance imaging (MRI) techniques, a variety of new techniques offers more than the anatomic information. The new MRI techniques include perfusion-weighted imaging (PWI) and diffusion-weighted imaging (DWI). Aims: The aim of this study is to assess the sensitivity, specificity, predictive value, and accuracy of diffusion- and perfusion-weighted MRI in the preoperative grading of gliomas. Setting/Design: The study was conducted in the Department of Neurosurgery, Pathology, and Radiodiagnosis, Sher-e-Kashmir Institute of Medical Sciences, Kashmir, India, which is the only tertiary care neurosurgical center in the state. It was a prospective study. Patients and Methods: Thirty-one consecutive patients with gliomas were included in the study. All the patients were evaluated by a standard conventional contrast-enhanced study on Siemens 1.5 Tesla MRI. In addition to the standard MRI, diffusion- and perfusion-weighted MRI were also performed. The histopathological grading of the tumor was done as per the WHO classification of 2007. The sensitivity, specificity, predictive value, and accuracy of diffusion- and perfusion-weighted MRI in determining tumor grade were calculated. Comparison was done between PWI, DWI findings, and WHO histopathological grading. Analysis Method: The statistical analysis was done using the Statistical Package for the Social Sciences, and receiver operating characteristic curves were used to estimate sensitivity, specificity, and accuracy. Results: The overall sensitivity of PWI (with regional cerebral blood volume cutoff of 1.7) in the preoperative assessment of high-grade gliomas was 82.6% and specificity was 75%, the positive predictive value (PPV) was 90.48%, and the negative predictive value (NPV) was 60%. The overall accuracy was 80.65%. In case of DWI, the sensitivity was 69.57% and the specificity was 75%, and the PPV and NPVs were 88.8% and 46.15%, respectively. The overall accuracy was 71%. Conclusion: Our results clearly show higher accuracy of diffusion- and perfusion-weighted MRI in assessment of glioma grade as compared to conventional MRI. This information can prove very useful for the operating neurosurgeon in preoperative assessment and surgical planning. Postoperatively, the neuropathologist can also benefit from such information.
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Affiliation(s)
- Yawar Shoaib
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Khursheed Nayil
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Rumana Makhdoomi
- Department of Pathology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Abraq Asma
- Department of Anesthesiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Altaf Ramzan
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Feroze Shaheen
- Department of Radiodiagnosis, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Abrar Wani
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
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Mubeen B, Makhdoomi R, Nayil K, Rafiq D, Kirmani A, Salim O, Mustafa F, Aimen A, Khursheed S, Bashir S, Shafi S, Ramzan A. Clinicopathological Characteristics of Meningiomas: Experience from a Tertiary Care Hospital in the Kashmir Valley. Asian J Neurosurg 2019; 14:41-46. [PMID: 30937006 PMCID: PMC6417349 DOI: 10.4103/ajns.ajns_228_16] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: Meningiomas comprise 15%–20% of all primary intracranial tumors. They are generally benign tumors, and most patients are cured after surgery and remain free of recurrence. However, some tumors behave in an aggressive manner, and patients develop local recurrence or metastasis. Overall prognosis is good. Patients and Methods: This is an 11-year retrospective study conducted in the Departments of Pathology and Neurosurgery at Sheri-I-Kashmir Institute of Medical Sciences, Kashmir, India. Besides the demographic profile, the parameters analyzed were location of tumor on imaging, histopathological subtype, and grade of tumor according to the 2007 WHO classification and recurrence at follow-up. Results: A total of 254 patients were included in our study, of which 205 (80.7%) were brain meningiomas and 49 (19.3%) were spinal, with an overall female: male ratio of 2:1. Female: male ratio was more in spinal meningiomas, 15.3:1. Most of our patients were in the 4–6th decade of life with a mean age of 48 years (range: 5–73 years). Meningothelial meningioma was the most common histological type. Of ten patients who showed recurrence, seven cases showed only recurrence, but no progression to higher grade and three cases showed recurrence with progression by one WHO-grade. We also noticed that recurrence was higher in Simpson Grades II and III. Conclusion: Meningiomas are common in females and most of the meningiomas do well after surgery. The recurrence rate was 3.93% in our study and Simpson grade of tumor excision and histopathological grade contribute significantly to the recurrence of the tumor.
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Affiliation(s)
- Basharat Mubeen
- Department of Pathology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Rumana Makhdoomi
- Department of Pathology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Khursheed Nayil
- Department of Neurosurgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Danish Rafiq
- Department of Pathology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Altaf Kirmani
- Department of Neurosurgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Othman Salim
- Department of Pathology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Farhat Mustafa
- Department of Pathology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Aifa Aimen
- Department of Pathology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Sumat Khursheed
- Department of Pathology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Shazia Bashir
- Department of Pathology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Saba Shafi
- Department of Pathology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Altaf Ramzan
- Department of Neurosurgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
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Kareem K, Nayil K, Ali Z, Dar B, Ramzan A. Postelectrocution Massive Brain Infarcts. IJNT 2018. [DOI: 10.1055/s-0037-1612646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
AbstractAcute brain infarct is an uncommon complication of electrical injury, and only a few cases have been reported. A young man sustained a high-voltage electrical injury followed by a fall from height. Imaging revealed right hemibrain infarct. He was operated for that, but did not make much progress. Electric shock injury with the high-voltage current even for short period of contact may cause massive infarction of brain, and prognosis remains dismal.
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Affiliation(s)
- Kaiser Kareem
- Department of Neurosurgery, Sheri-Kashmir-Institute of Medical Sciences, Kashmir, Jammu and Kashmir, India
| | - Khursheed Nayil
- Department of Neurosurgery, Sheri-Kashmir-Institute of Medical Sciences, Kashmir, Jammu and Kashmir, India
| | - Zulfikar Ali
- Department of Anesthesiology, Sheri-Kashmir-Institute of Medical Sciences, Kashmir, Jammu and Kashmir, India
| | - Bashir Dar
- Department of Anesthesiology, Sheri-Kashmir-Institute of Medical Sciences, Kashmir, Jammu and Kashmir, India
| | - Altaf Ramzan
- Department of Neurosurgery, Sheri-Kashmir-Institute of Medical Sciences, Kashmir, Jammu and Kashmir, India
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13
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Affiliation(s)
- Uday Raswan
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India
| | - Nayil Khursheed
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India
| | - Rumana Makhdoomi
- Department of Pathology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India
| | - Altaf Ramzan
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India
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Wani A, Ramzan A, Khan A, Malik N, Pervez K. Pituitary Adenoma Presenting As Trigeminal Neuralgia. IJNS 2017. [DOI: 10.1055/s-0036-1596043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
AbstractCompression of trigeminal nerve in cavernous sinus leading to trigeminal neuralgia is one of the rare presentations of pituitary tumor. We report a patient whose presenting complaint was trigeminal neuralgia in V1, V2 distribution and he had pituitary macroadenoma invading ipsilateral cavernous sinus. After surgery, the neuralgia disappeared completely.
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Affiliation(s)
- Abrar Wani
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Jammu & Kashmir, India
| | - Altaf Ramzan
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Jammu & Kashmir, India
| | - Abdul Khan
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Jammu & Kashmir, India
| | - Nayil Malik
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Jammu & Kashmir, India
| | - Khalid Pervez
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Jammu & Kashmir, India
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15
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Khursheed N, Dar S, Ramzan A, Fomda B, Humam N, Abrar W, Singh S, Sajad A, Mahek M, Yawar S. Spinal epidural abscess: Report on 27 cases. Surg Neurol Int 2017; 8:240. [PMID: 29026676 PMCID: PMC5629861 DOI: 10.4103/sni.sni_105_17] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 07/26/2017] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Spinal epidural abscess, although an uncommon disease, often correlates with a high morbidity owing to significant delay in diagnosis. METHODS In a prospective 5-year study, the clinical and magnetic resonance (MR) findings, treatment protocols, microbiology, and neurological outcomes were analyzed for 27 patients with spinal epidural abscess. RESULTS Patients were typically middle-aged with underlying diabetes and presented with lumbar abscesses. Those undergoing surgical intervention >36 h after the onset of symptoms had poor neurological outcomes. CONCLUSION Early recognition and timely evacuation of spinal abscesses minimized neurological morbidity and potential mortality.
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Affiliation(s)
- Nayil Khursheed
- Department of Neurosurgery, Sheri-Kashmir-Institute of Medical Sciences, Kashmir, India
| | - Sultan Dar
- Department of Neurosurgery, Sheri-Kashmir-Institute of Medical Sciences, Kashmir, India
| | - Altaf Ramzan
- Department of Neurosurgery, Sheri-Kashmir-Institute of Medical Sciences, Kashmir, India
| | - Bashir Fomda
- Department of Microbiology, Sheri-Kashmir-Institute of Medical Sciences, Kashmir, India
| | - Nisar Humam
- Department of Neurosurgery, Sheri-Kashmir-Institute of Medical Sciences, Kashmir, India
| | - Wani Abrar
- Department of Neurosurgery, Sheri-Kashmir-Institute of Medical Sciences, Kashmir, India
| | - Sarbjit Singh
- Department of Neurosurgery, Sheri-Kashmir-Institute of Medical Sciences, Kashmir, India
| | - Arif Sajad
- Department of Neurosurgery, Sheri-Kashmir-Institute of Medical Sciences, Kashmir, India
| | - Masood Mahek
- Department of Neurosurgery, Sheri-Kashmir-Institute of Medical Sciences, Kashmir, India
| | - Shoaib Yawar
- Department of Neurosurgery, Sheri-Kashmir-Institute of Medical Sciences, Kashmir, India
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Ramzan A, Nizami F, Malik N, Kumar A, Khan A, Wani A. Ventriculoperitoneal shunt blockage by hydatid cyst. IJNS 2017. [DOI: 10.4103/2277-9167.110207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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17
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Sarmast A, Nayil-M K, Makhdoomi R, Butto A, Ramzan A. Metastatic Ameloblastoma to Brain: A Rare Entity. Gulf J Oncolog 2016; 1:69-71. [PMID: 28191811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2016] [Indexed: 06/06/2023]
Abstract
Ameloblastoma is a rare odontogenic tumor of the jaw. It is a benign neoplasm but local recurrence is common. Metastasis from this tumor is all the more rare. The commonest site for metastasis is lung. Brain is a very uncommon site of involvement. Overall prognosis is good. We hereby discuss ameloblastoma of lower jaw in a young adult which had metastasized to brain. Patient was operated for the metastatic lesion of brain and is doing well on follow-up.
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Affiliation(s)
- Arif Sarmast
- Dept. of Neurosurgery, Sheri-Kashmir Institute of Medical Sciences, Kashmir, India
| | - Khursheed Nayil-M
- Dept. of Neurosurgery, Sheri-Kashmir Institute of Medical Sciences, Kashmir, India
| | - Rumana Makhdoomi
- Dept. of Pathology, Sheri-Kashmir Institute of Medical Sciences, Kashmir, India
| | - Azhar Butto
- Dept. of Surgical Oncology, Sheri-Kashmir Institute of Medical Sciences, Kashmir, India
| | - Altaf Ramzan
- Dept. of Neurosurgery, Sheri-Kashmir Institute of Medical Sciences, Kashmir, India
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Tanki H, Ramzan A, Arif S, Chhiber S. Anterior Spinal Artery Infarct Secondary to “Rotatory Atlantoaxial Subluxation” in a Pediatric Patient: A Case Report and Review of the Literature. IJNT 2016. [DOI: 10.1055/s-0036-1586737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Humam Tanki
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu & Kashmir, India
| | - Altaf Ramzan
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu & Kashmir, India
| | - Sajad Arif
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu & Kashmir, India
| | - Sarbjit Chhiber
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu & Kashmir, India
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Arif S, Laharwal M, Ramzan A, Raswan U. Attempted Suicide with Needle Penetration through Cranial Defect: A Rare Case Report. IJNT 2016. [DOI: 10.1055/s-0036-1586217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Sajad Arif
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Masood Laharwal
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Altaf Ramzan
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Uday Raswan
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
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20
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Sultan M, Khursheed N, Makhdoomi R, Ramzan A. Compressive Myelopathy due to Osteochondroma of the Atlas and Review of the Literature. Pediatr Neurosurg 2016; 51:99-102. [PMID: 26734949 DOI: 10.1159/000442473] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 11/12/2015] [Indexed: 12/30/2022]
Abstract
We report a case of vertebral osteochondroma arising from the posterior C1 arch that presented with features of compressive myelopathy. Osteochondromas are usually found in extremities and are rarely seen in the spine. They are most commonly found in posterior elements in the spine, and intraspinal extension is uncommon. The most common presentation is incidental finding during routine imaging followed by palpation of painless swelling. Compressive myelopathy as a presentation of vertebral osteochondroma in a child is a rare entity. Surgical excision is the treatment of choice. Spinal osteochondromas should also be kept in mind as a cause of spinal cord or nerve root compression in children.
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Affiliation(s)
- Muhammad Sultan
- Department of Neurosurgery, Sheri-Kashmir Institute of Medical Sciences, Kashmir, India
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Jain A, Haneef M, Tanki H, Ramzan A, Shaheen F, Wani A, Khursheed N. Skull Vault Morphology in Subdural Hematomas: A Geometrical Analysis. IJNT 2015. [DOI: 10.1055/s-0035-1570092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Ashish Jain
- Department of Neurosurgery, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Muhammad Haneef
- Department of Mechanical Engineering, National Institute of Technology, Srinagar, Jammu and Kashmir, India
| | - Humam Tanki
- Department of Neurosurgery, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Altaf Ramzan
- Department of Neurosurgery, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Feroze Shaheen
- Department of Radiology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Abra Wani
- Department of Neurosurgery, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Nayil Khursheed
- Department of Neurosurgery, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
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Sarmast A, Ramzan A, Dar B, Khursheed N. Dorso-Lumbar Burst Fractures Secondary to a Peculiar Tipper Truck Injury: A Report on Two Cases. IJNT 2015. [DOI: 10.1055/s-0035-1570093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Arif Sarmast
- Department of Neurosurgery, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Altaf Ramzan
- Department of Neurosurgery, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Bashir Dar
- Department of Anesthesiology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Nayil Khursheed
- Department of Neurosurgery, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
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Tanki H, Khan A, Ganie M, Ramzan A, Tanki F, Wani A, Khursheed N. Long-Term Outcomes of Paraplegics in a Resource-Limited Society: Are We Doing Enough? IJNT 2015. [DOI: 10.1055/s-0035-1569469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Humam Tanki
- Department of Neurosurgery, Sheri-Kashmir Institute of Medical Sciences, Jammu and Kashmir, India
| | - Abdul Khan
- Department of Neurosurgery, Sheri-Kashmir Institute of Medical Sciences, Jammu and Kashmir, India
| | - Majid Ganie
- Department of Psychiatry, Sheri-Kashmir Institute of Medical Sciences, Jammu and Kashmir, India
| | - Altaf Ramzan
- Department of Neurosurgery, Sheri-Kashmir Institute of Medical Sciences, Jammu and Kashmir, India
| | - Farah Tanki
- Department of Clinical Psychology, University of Kashmir, Srinagar, Jammu and Kashmir, India
| | - Abrar Wani
- Department of Neurosurgery, Sheri-Kashmir Institute of Medical Sciences, Jammu and Kashmir, India
| | - Nayil Khursheed
- Department of Neurosurgery, Sheri-Kashmir Institute of Medical Sciences, Jammu and Kashmir, India
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Babu M, Kirmani A, Ramzan A, Bhat A, Alam S, Ahmad A, Baba K, Wani A. Giant cell tumor of axis: A rare entity. J Pediatr Neurol 2015. [DOI: 10.1055/s-0035-1557399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Makhan Babu
- Department of Neurosurgery, Sheri Kashmir Institute of Medical Sciences, Srinagar, Kasgmir, India
| | - Altaf Kirmani
- Department of Neurosurgery, Sheri Kashmir Institute of Medical Sciences, Srinagar, Kasgmir, India
| | - Altaf Ramzan
- Department of Neurosurgery, Sheri Kashmir Institute of Medical Sciences, Srinagar, Kasgmir, India
| | - Abdul Bhat
- Department of Neurosurgery, Sheri Kashmir Institute of Medical Sciences, Srinagar, Kasgmir, India
| | - Syed Alam
- Department of Neurosurgery, Sheri Kashmir Institute of Medical Sciences, Srinagar, Kasgmir, India
| | - Altaf Ahmad
- Department of Neurosurgery, Sheri Kashmir Institute of Medical Sciences, Srinagar, Kasgmir, India
| | - Khalil Baba
- Department of Pathology, Sheri Kashmir Institute of Medical Sciences, Srinagar India
| | - Abrar Wani
- Department of Neurosurgery, Sheri Kashmir Institute of Medical Sciences, Srinagar, Kasgmir, India
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Raswan U, Jan B, Ramzan A, Nayil K. Occipital Condylar Fracture with Isolated Unilateral Hypoglossal Nerve Injury: A Case Report. IJNT 2015. [DOI: 10.1055/s-0035-1555002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Uday Raswan
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Kashmir, India
| | - Basharat Jan
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Kashmir, India
| | - Altaf Ramzan
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Kashmir, India
| | - Khursheed Nayil
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Kashmir, India
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Abstract
Brain tumors are not rare in children. The common brain tumors in children are medulloblastomas and craniopharyngiomas. Intraparenchymal meningiomas are very rare. We report a case of intraparenchymal meningioma in a child who was operated with a preoperative impression of a primitive neuroectodermal tumor.
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Affiliation(s)
- Khursheed Nayil
- Department of Neurosurgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, Jammu and Kashmir, India
| | - Rumana Makhdoomi
- Department of Neurosurgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, Jammu and Kashmir, India
| | - Rayees Malik
- Department of Neurosurgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, Jammu and Kashmir, India
| | - Altaf Ramzan
- Department of Neurosurgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, Jammu and Kashmir, India
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Ramzan A, Meneses T, Lin Y, Fauceglia P. Discrepant cervical cytology and colposcopic directed biopsies: Clinical predictive factors. Gynecol Oncol 2014. [DOI: 10.1016/j.ygyno.2014.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Makhdoomi R, Ramzan A, Khursheed N, Bhat S, Baba K, Mohsin R, Basharat M, Yameen B, Ahmad R, Iqbal L, Maqbool M, Ajaz H, Farhat M. Clinicopathological characteristics of chordoma: an institutional experience and a review of the literature. Turk Neurosurg 2014; 23:700-6. [PMID: 24310451 DOI: 10.5137/1019-5149.jtn.5941-12.3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
AIM To study the clinicopathologic characteristics of chordomas from a single institution. MATERIAL AND METHODS This study is a retrospective analysis of 18 cases of chordomas diagnosed over a period of 5-years at Sher-i-Kashmir Institute of Medical Sciences, Srinagar, from 2006 to 2010. RESULTS The overall mean age of the patients was 46.72 years. Males outnumbered females. Sacrum was the commonest site involved. Histopathologically, the majority of cases were conventional chordoma with four cases of chondroid variety. There was a single case of dedifferentiated chordoma that presented with bone metastasis. Most patients did well after surgery and radiotherapy. One patient had a local recurrence and one patient with dedifferentiated variant died on follow-up. CONCLUSION Though locally aggressive, chordomas are effectively treated with resection and postoperative radiotherapy.
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Khursheed N, Ramzan A, Shoaib Y, Bashir I, Wani A, Shafiq A. Is hypothyroidism and hypogonadism an issue after aneurysmal subarachnoid hemorrhage-an institutional experience? Int J Endocrinol Metab 2013; 11:179-83. [PMID: 24348590 PMCID: PMC3860112 DOI: 10.5812/ijem.8241] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Revised: 04/18/2013] [Accepted: 04/24/2013] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The incidence of hypopituitarism in aneurysmal subarachnoid hemorrhage ranges from 0% to 45%. Also the screening for hypopituitarism in survivors of aneurysmal SAH is not a routine. This has led to a controversy in the management of such patients. OBJECTIVES The aim of the study was to evaluate the endocrine profile of our patients who had presented with aneurysmal SAH. PATIENTS AND METHODS This was a prospective study conducted over a period of three years in patients of aneurysmal subarachnoid hemorrhage. The serum samples for levels of free T4, free T3, TSH, prolactin, FSH, LH and testosterone were analyzed at the time of admission and at a follow-up period between 9-12 months. Patients with known endocrine abnormalities, liver or kidney disease and patients with hemodynamic abnormalities were excluded from the study. Abnormalities in levels were noted and a comparative analysis of the hormone levels between the 2-time periods was done. A total of 73 patients were enrolled in the study. RESULTS Serum prolactin was raised in 17.80% (13/73) and FSH, LH and testosterone levels were reduced in 12.32% (9/73) of patients in the acute phase at admission. After 9 months follow-up, serum prolactin normalized in all except one patient and in all the males, testosterone level increased significantly. Two patients (3%) developed central hypothyroidism on follow-up. CONCLUSIONS Chronic hypothyroidism and hypogonadism is not an issue in aneurysmal SAH patients.
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Affiliation(s)
- Nayil Khursheed
- Department of Neurosurgery, Sheri-Kashmir Institute of Medical Sciences, Kashmir, India
- Corresponding author: Nayil Khursheed, Department of Neurosurgery, Sheri-Kashmir Institute of Medical Sciences, Kashmir, India. Tel: +194-9999465, Fax: +194-2426958, E-mail:
| | - Altaf Ramzan
- Department of Neurosurgery, Sheri-Kashmir Institute of Medical Sciences, Kashmir, India
| | - Yawar Shoaib
- Department of Neurosurgery, Sheri-Kashmir Institute of Medical Sciences, Kashmir, India
| | - Iftikhar Bashir
- Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Kashmir, India
| | - Abrar Wani
- Department of Neurosurgery, Sheri-Kashmir Institute of Medical Sciences, Kashmir, India
| | - Alam Shafiq
- Department of Neurosurgery, Sheri-Kashmir Institute of Medical Sciences, Kashmir, India
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Ramzan A, Nayil K, Asimi R, Wani A, Makhdoomi R, Jain A. Childhood tubercular meningitis: an institutional experience and analysis of predictors of outcome. Pediatr Neurol 2013; 48:30-5. [PMID: 23290017 DOI: 10.1016/j.pediatrneurol.2012.09.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Accepted: 09/04/2012] [Indexed: 10/27/2022]
Abstract
Tubercular meningitis constitutes an important cause of morbidity and mortality in developing countries, and various factors determine its outcome. We studied demographic and clinical profiles of childhood tubercular meningitis, and identified predictors of outcome. This prospective study was performed in 65 children aged ≤ 18 years, hospitalized with a diagnosis of tubercular meningitis. Boys outnumbered girls. Most patients presented with a poor clinical grade. Headache and vomiting comprised common features. Cerebrospinal fluid was characterized by predominant lymphocytosis. Many patients were diagnosed for Mycobacterium tuberculosis via polymerase chain reaction. Hydrocephalus comprises a common finding via computed tomography. Low Glasgow Coma Scores, seizures, basal exudates, and infarcts predict outcomes. Children with headaches, fevers, and altered sensorium should be investigated promptly for tubercular meningitis. Timely intervention may lead to early diagnoses and reductions in morbidity and mortality.
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Affiliation(s)
- Altaf Ramzan
- Department of Neurosurgery, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India
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Bhat AR, Wani MA, Kirmani AR, Alam S, Raina T, Arif S, Ramzan A, Lahawal MA. Missile injuries of spine and spinal cord in civilian Kashmir – Analysis and outcome evaluated by new Modified SKIMS-Functional Scales. The Indian Journal of Neurotrauma 2012. [DOI: 10.1016/j.ijnt.2012.11.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Nayil K, Laharwal M, Dhar A, Wani A, Ramzan A, Arif S. Vertex epidural hematoma with bilateral abducent nerve palsy: case report and literature review. Turk Neurosurg 2012; 22:257-60. [PMID: 22437306 DOI: 10.5137/1019-5149.jtn.3372-10.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Epidural hematomas which are located at the vertex are rarely seen and form a small percentage of total epidural hematomas. Tearing in the superior sagittal sinus is the usual cause of an epidural hematoma located in the vertex. The clinical features of this entity are non-specific; hence, localization of the lesion is difficult. We report an adult who was hit by a motorcycle and was initially discharged from the hospital as a case of concussional head injury. He returned back with raised intracranial pressure symptoms, so a CT scan was done but was misinterpreted, and he reported one week later with bilateral abducent nerve palsy. Magnetic resonance imaging confirmed vertex EDH for which he was operated.These hematomas are seen rarely and can be interpreted as an artifact. Its recognition is important because it has an excellent prognosis. We concluded that all head injury patients should get high axial cuts on the CT scan, and any degree of suspicion should prompt a neurosurgeon to investigate further with coronal CT scan or MRI.
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Affiliation(s)
- Khursheed Nayil
- Sher-i-Kashmir Institute of Medical Sciences, Department of Neurosurgery, Kashmir, India.
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Kumar A, Ramzan A, Malik N, Naseer S, Wani A. Spontaneous acute subdural hematoma in a patient with multiple myeloma. IJNS 2012. [DOI: 10.4103/2277-9167.102287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Abstract
Acute spontaneous subdural hematoma in a patient of multiple myeloma receiving chemotherapy is an unknown event, needing an urgent neurosurgical management. We report this patient who presented with progressive neurological deterioration and a low platelet count. She was successfully managed by craniotomy and evacuation of subdural hematoma with intraoperative transfusion of platelets. The acute spontaneous subdural hematoma in her was probably related to the bleeding diathesis due to thrombocytopenia associated with chemotherapy.
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Nayil K, Ramzan A, Sajad A, Zahoor S, Wani A, Nizami F, Laharwal M, Kirmani A, Bhat R. Subdural hematomas: an analysis of 1181 Kashmiri patients. World Neurosurg 2012; 77:103-10. [PMID: 22405391 DOI: 10.1016/j.wneu.2011.06.012] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2011] [Revised: 04/11/2011] [Accepted: 06/02/2011] [Indexed: 11/18/2022]
Abstract
BACKGROUND We endeavored to analyze patients of subacute and chronic subdural hematomas studied in a 4-year period at the Sher-i-Kashmir Institute of Medical Sciences, Kashmir, India. METHODS The study was a retrospective analysis of 1181 patients of subdural hematomas. Demographic characteristics, clinico-radiologic features, operative modalities, and outcome were studied. Acute subdural hematomas were excluded from the study. RESULTS The mean age was 60.4 ± 12.4 and males outnumbered females. Chronic subdural collections were more common than subacute subdural hematomas and left side predominated. Two burr holes with closed-system drainage was used in most patients. Incidence of postoperative seizures is very low. Overall recurrence rates were low; however, multilocular hematomas had the highest incidence of recurrence. Morbidity and mortality were 7.53% and 2.96%, respectively. Preoperative neurologic grade correlated with outcome. CONCLUSIONS Subdural hematomas are common in elderly males. Preoperative neurologic grade dictates the outcome. Multilocular hematomas have a higher chance of recurrence. Craniotomy should be reserved for recurrent hematomas, and there may be a scope of craniotomy for multilocular chronic subdural hematomas at the outset. Antiepileptic prophylaxis is not routinely recommended.
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MESH Headings
- Aged
- Anticoagulants/therapeutic use
- Craniocerebral Trauma/complications
- Craniotomy
- Disease Susceptibility
- Female
- Follow-Up Studies
- Functional Laterality/physiology
- Hematoma, Subdural/diagnostic imaging
- Hematoma, Subdural/epidemiology
- Hematoma, Subdural/surgery
- Hematoma, Subdural, Chronic/diagnostic imaging
- Hematoma, Subdural, Chronic/epidemiology
- Hematoma, Subdural, Chronic/surgery
- Humans
- India/epidemiology
- Male
- Middle Aged
- Nervous System Diseases/etiology
- Neurosurgical Procedures
- Postoperative Care
- Postoperative Complications/epidemiology
- Postoperative Complications/therapy
- Recurrence
- Retrospective Studies
- Tomography, X-Ray Computed
- Treatment Outcome
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Affiliation(s)
- Khursheed Nayil
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Kashmir, India.
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Nayil K, Ramzan A, Makhdoomi R, Wani A, Zargar J, Shaheen F. Incidental traumatic pseudoaneurysm of the middle meningeal artery: case report and literature review. Turk Neurosurg 2012; 22:239-41. [PMID: 22437301 DOI: 10.5137/1019-5149.jtn.3165-10.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Traumatic pseudoaneurysm of the middle meningeal artery is rare and is associated with high mortality. Skull fracture is usually an associated feature of this entity. An elderly male was brought to our hospital in a stage of coma. The details of ictus were not known. The Glasgow coma scale score was 9/15. Examination revealed a pseudo-aneurysm arising from the posterior branch of the left middle meningeal artery which was excised. The case is presented for its rarity and its characteristic radiology. Traumatic pseudoaneurysm of middle meningeal artery is rare. It is important to recognize this treatable entity.
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Rumana M, Khursheed N, Ramzan A. Congenital occipital encephalocele with Dabska tumor: report of an unusual case. Pediatr Neurosurg 2012; 48:48-50. [PMID: 22831960 DOI: 10.1159/000339555] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Accepted: 05/07/2012] [Indexed: 11/19/2022]
Abstract
Encephaloceles arise from developmental defects in neural tube formation. These lesions contain brain and meninges which herniate through a defect in the skull. These may present as isolated malformations or rarely be associated with brain tumors. We hereby discuss a case of an unusual association of an occipital encephalocele with papillary intralymphatic angioendothelioma or Dabska tumor arising from the sac itself. The patient underwent resection of the herniated brain tissue with repair and closure of the dural defect. Histopathological examination revealed evidence of Dabska tumor from the sac. This is the first case report of the association of an occipital encephalocele with a rare vascular tumor, i.e. papillary intralymphatic angioendothelioma.
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Affiliation(s)
- M Rumana
- Department of Pathology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
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Nayil K, Makhdoomi R, Ramzan A, Malik R, Alam S, Wani A, Chhiber S. Primary sacral lymphoma: a case report and review of the literature. Turk Neurosurg 2011; 21:659-62. [PMID: 22194134 DOI: 10.5137/1019-5149.jtn.3001-10.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AIM Primary sacral lymphoma is rare. It usually presents in elderly males as low back ache and radiculopathy. CASE REPORT We hereby report a case of primary sacral lymphoma in a 53-year-old male who presented with low back pain. Imaging showed a sacral lesion which on histopathology proved to be a non-Hodgkin's lymphoma of B cell lineage. MATERIAL AND METHODS The case is presented for its rarity and for the reason that it mimicked a primary bone tumor. Its recognition is important because it has an excellent prognosis. CONCLUSION Primary sacral epidural lymphoma should be considered in the differential diagnosis of a sacral mass.
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Nayil K, Wani M, Ramzan A, Shaheen F, Lone I, Wani A. Lhermitte - Duclos disease with syrinx: case report and literature review. Turk Neurosurg 2011; 21:651-4. [PMID: 22194132 DOI: 10.5137/1019-5149.jtn.2989-10.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Lhermitte-Duclos disease is typified by a hamartomatous lesion of the cerebellum. It is usually seen in females. The usual presentation is of raised intracranial pressure along with cerebellar signs. CASE REPORT We report an 18-year-old female patient who presented to us with history of headache and gait ataxia and was observed to have Lhermitte-Duclos disease with cervical cord syrinx on imaging. DISCUSSION To our knowledge this is the fifth case of Lhermitte-Duclos disease with syringomyelia in the pediatric age group. The treatment of this condition is decompression of the lesion. Malignant transformation never occurs and the prognosis is excellent.
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Wani NA, Kousar TL, Gojwari T, Robbani I, Singh M, Ramzan A, Khan Q, Kirmani A, Wani A. Computed tomography findings in cerebral hydatid disease. Turk Neurosurg 2011; 21:347-51. [PMID: 21845570 DOI: 10.5137/1019-5149.jtn.3922-10.0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIM To describe imaging findings of cerebral hydatid cysts on computed tomography of brain. MATERIAL AND METHODS We retrospectively reviewed CT scans of brain in 5 patients with pathologically confirmed hydatid cysts in cerebral hemispheres. The patients were scanned either on a spiral (single slice) CT or on multidetector-row CT before and after intravenous injection of iodinated contrast material. RESULTS All the patients were children aged 8 to 13 years with 3 boys and 2 girls. Features of raised intracranial tension were present in all the cases at presentation. CT findings of a large intracerebral cystic lesion with significant mass effect and without any calcification or enhancement were common in all 5 cases. Perilesional edema was present in 1 case. Cerebral hydatid was seen as either a homogenous fluid attenuation unilocular cyst (3 cases) or a unilocular cyst with few peripheral daughter cysts (1 case) or cyst filled by multiple daughter cysts inside (1 case). All the cases were operated and cyst was removed completely after craniotomy. CONCLUSION Accurate preoperative diagnosis of cerebral hydatid by CT followed by surgery with care to avoid cyst rupture can result in favorable outcome.
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Affiliation(s)
- Nisar A Wani
- Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Department of Radiology, Srinagar, J&K, India.
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Abstract
OBJECT The aim of this study was to analyze the correlation of hypodensity in extradural hematomas on CT with the clinical profile in pediatric patients. This is the only study available in this age group. METHODS This was a prospective study conducted over a period of 3 years in which all children 18 years old or younger with a diagnosis of cranial extradural hematoma were included. The patients were allocated to 2 groups: those with mixed-density clots (17 cases) and those with classically hyperdense clots (52 cases). A comparative analysis between the 2 groups was conducted. RESULTS Patients with mixed-density clots presented earlier to the hospital, had poor Glasgow Coma Scale scores at admission, exhibited large clot volumes, had a high incidence of active bleeding at surgery, and had increased morbidity and mortality as compared with the patients with hyperdense extradural hematomas. CONCLUSIONS Early recognition and rapid evacuation of the mixed-density clot with restoration of hemostasis may result in a decline in morbidity and death in children with this entity.
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Affiliation(s)
- Khursheed Nayil
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India.
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Abstract
Intracranial dermoid tumors constitute a rare entity. Their association with Klippel-Feil anomaly is all the more rare. These lesions, if associated with dermal sinuses, receive attention when a patient presents with features of central nervous system infection. We describe a 5-year-old girl who presented with purulent discharge from an occipital dermal sinus with an infected posterior fossa dermoid associated with cerebellar abscesses and characteristic Klippel-Feil anomaly.
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Affiliation(s)
- Altaf Ramzan
- Department of Neurosurgery, Sheri-Kashmir Institute of Medical Sciences, Kashmir, India
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Ramzan A, Malik KN, Makhdoomi R, Wani A, Jain A. Giant craniocervical schwannoma in a teenage girl. Childs Nerv Syst 2011; 27:1503-6. [PMID: 21744138 DOI: 10.1007/s00381-011-1510-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Accepted: 06/09/2011] [Indexed: 11/30/2022]
Affiliation(s)
- Altaf Ramzan
- Department of Neurosurgery, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
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Nayil K, Singh S, Makhdoomi R, Ramzan A, Wani A. Sellar-suprasellar tuberculomas in children: 2 cases and literature review. Pediatr Neurol 2011; 44:463-6. [PMID: 21555059 DOI: 10.1016/j.pediatrneurol.2011.01.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Revised: 11/16/2010] [Accepted: 01/24/2011] [Indexed: 11/26/2022]
Abstract
Sellar and suprasellar tuberculomas are rare. Patients with these lesions usually experience headache, vomiting, and hypofunction of pituitary gland; imaging reveals an enhancing sellar-suprasellar mass. We report 2 rare cases of sellar-suprasellar tuberculomas in children aged 8 and 6 years. One child presented with features of headache and vomiting, and the other presented with posterior pituitary dysfunction. In both cases, imaging revealed sellar-suprasellar masses. Both cases were multidrug-resistant tuberculomas. We discuss sellar-suprasellar tuberculomas, a rare form of neurotuberculosis in the background of an overall increase in multidrug-resistant tuberculosis, especially in children.
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Affiliation(s)
- Khursheed Nayil
- Department of Neurosurgery, Sheri-Kashmir-Institute of Medical Sciences, Kashmir.
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Khursheed N, Rumana M, Ramzan A, Furqan N, Abrar W, Salma B. Frontal intraparenchymal schwannoma. J Clin Neurosci 2011; 18:411-3. [DOI: 10.1016/j.jocn.2010.05.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2010] [Revised: 04/28/2010] [Accepted: 05/04/2010] [Indexed: 11/29/2022]
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Rogers GJ, Tolhurst G, Ramzan A, Habib AM, Parker HE, Gribble FM, Reimann F. Electrical activity-triggered glucagon-like peptide-1 secretion from primary murine L-cells. J Physiol 2011; 589:1081-93. [PMID: 21224236 PMCID: PMC3060588 DOI: 10.1113/jphysiol.2010.198069] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2010] [Accepted: 12/31/2010] [Indexed: 01/21/2023] Open
Abstract
Glucagon like peptide 1 (GLP-1) based therapies are now widely used for the treatment of type 2 diabetes. Developing our understanding of intestinal GLP-1 release may facilitate the development of new therapeutics aimed at targeting the GLP-1 producing L-cells. This study was undertaken to characterise the electrical activity of primary L-cells and the importance of voltage gated sodium and calcium channels for GLP-1 secretion. Primary murine L-cells were identified and purified using transgenic mice expressing a fluorescent protein driven by the proglucagon promoter. Fluorescent L-cells were identified within primary colonic cultures for patch clamp recordings. GLP-1 secretion was measured from primary colonic cultures. L-cells purified by flow cytometry were used to measure gene expression by microarray and quantitative RT-PCR. Electrical activity in L-cells was due to large voltage gated sodium currents, inhibition of which by tetrodotoxin reduced both basal and glutamine-stimulated GLP-1 secretion. Voltage gated calcium channels were predominantly of the L-type, Q-type and T-type, by expression analysis, consistent with the finding that GLP-1 release was blocked both by nifedipine and ω-conotoxin MVIIC. We observed large voltage-dependent potassium currents, but only a small chromanol sensitive current that might be attributable to KCNQ1. GLP-1 release from primary L-cells is linked to electrical activity and activation of L-type and Q-type calcium currents. The concept of an electrically excitable L-cell provides a basis for understanding how GLP-1 release may be modulated by nutrient, hormonal and pharmaceutical stimuli.
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Affiliation(s)
- G J Rogers
- Cambridge Institute for Medical Research, Wellcome Trust/MRC Building, Addenbrooke's Hospital, Box 139, Hills Road, Cambridge CB2 0XY, UK
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Makhdoomi R, Nayil K, Rayees A, Kirmani A, Ramzan A, Khalil MB, Dhar A, Besina S, Chanda N, Lone AR, Qadiri S, Maqbool M. Primary CNS lymphoma in immunocompetent: a review of literature and our experience from Kashmir. Turk Neurosurg 2011; 21:39-47. [PMID: 21294090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
AIM To study the clinicopathological aspects of primary CNS lymphoma in immunocompetent patients. MATERIAL AND METHODS Sixteen patients with primary CNS lymphoma were analyzed for their clinico-pathological characteristics and followed-up for the treatment and subsequent management in Neurosurgery, and Medical and Radiation Oncology. RESULTS The fronto-parietal region was the commonest location of CNS lymphoma; four cases of cerebellar lymphoma were seen. Our patients were relatively young with a mean age of 48 years and an age range of 35-60 years. Females outnumbered males with a ratio of 2.7:1. The commonest presentation was focal neurological-deficits and features of raised intracranial pressure. All the patients histologically had diffuse large B-cell lymphoma. Radiologically, most presented as disc-enhancing lesions. Two patients had multiple lesions. Most of the patients (10) died within a mean of 4.4 months (range 2 weeks-16 months). CONCLUSION Primary CNS lymphoma is seen in immunocompetent patients as well. Relapse is common after treatment and the overall prognosis is unfavorable.
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Affiliation(s)
- N Khursheed
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India.
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Nayil K, Makhdoomi R, Ramzan A, Zahoor S, Rasool M, Wani A, Dhar A, Mubeen B, Singh S, Bhat R, Kirmani A. Childhood tumors of the brain: demographic pattern over a ten-year period in the Kashmir Valley. Pediatr Neurosurg 2011; 47:31-7. [PMID: 21546761 DOI: 10.1159/000327143] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2010] [Accepted: 03/08/2011] [Indexed: 11/19/2022]
Abstract
Brain tumors in children represent the second most frequent tumors in this age group after hematologic malignancies. We highlight the demographic pattern after retrospective analysis of brain tumors in children from geographically and ethnically distinct Kashmir Valley managed in our center between 2000 and 2009. We had a total of 248 pediatric patients with brain tumors. The parameters analyzed were age, gender, location of tumors and histopathological subtypes as well as WHO grade of tumor. We also did a comparison between the frequencies of common varieties of tumor in the first and second 5-year periods. We found that 111 tumors (44.75%) were supratentorial, and 137 (55.25%) were infratentorial. The male-to-female ratio was 1.4:1. The proportions of low-grade and high-grade tumors were 60 and 40%, respectively. The most common tumor in our series was astrocytoma. The most common tumors in the supratentorial and infratentorial compartments were craniopharyngioma and medulloblastoma, respectively. Our experience reflects a different demographic profile of pediatric brain tumors as compared with other regions of the world.
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Affiliation(s)
- Khursheed Nayil
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India.
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Khursheed N, Rumana M, Ramzan A, Zahoor S, Nisar S, Sarbjit C, Abrar W, Basharat M, Mohsin R, Kirmani A, Bhat R. Pediatric epidural tumors of the spine--experience of a decade from the Kashmir Valley. Pediatr Neurosurg 2011; 47:22-30. [PMID: 21613777 DOI: 10.1159/000327142] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2010] [Accepted: 03/07/2011] [Indexed: 11/19/2022]
Abstract
We present our experience after analyzing retrospectively the clinicopathological characteristics, surgical approaches, immediate and long-term postoperative complications and survival outcome of pediatric spinal epidural tumors treated over a period of 10 years from 2000 to 2009 in a tertiary-care hospital. Our study included benign and malignant tumors. The majority of our patients were boys (14:8). The duration of symptoms was longer in benign lesions. Non-Hodgkin's lymphoma was the commonest malignant tumor and aneurysmal bone cyst was the commonest benign tumor. The mean duration of follow-up was 19 months (range 3-48 months). Most of the patients improved in their neurological grade after surgery; however, the degree of excision had no bearing on the length of survival for malignant lesions.
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Affiliation(s)
- N Khursheed
- Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India.
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