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Byline: A. Wani, M. Laherwal, A. Ramzan, N. Malik, I. Lone, F. Nizami Sir, Malignant peripheral nerve sheath tumors (MPNSTs) are rare soft tissue sarcomas of ectomesenchymal origin, comprising 5% [...]

The article presents a case study of a 56-year-old male diagnosed with malignant peripheral nerve sheath tumors (MPNSTs). Topics discussed include the medical record of the patient, the diagnosis of his MPNSTs, his physical examinations through magnetic resonance imaging, his treatment, and an overview of the disease.

Background: Geographically Kashmir valley is isolated from the rest of the country. It has a different climate with people having different social and dietary habits. Gastric cancer, esophageal, and skin (Kangri) cancer have a higher prevalence but there is little data available on the cancers of brain. Objectives & Methodology: Aim was to study brain tumors prospectively and retrospectively, to analyse brain tumors geographically and to analyse the age and sex ratio of brain tumors in Kashmir valley. In this Retrospective and Prospective study, retrospectively (initial seven years) all patients were analyzed for their clinical symptoms, age, sex, residence, histopathologic characteristics of tumors. Prospectively (later three years) after getting the radiological diagnosis pathological diagnosis was arrived by procedures like open, stereotactic, and endoscopic procedures. All patients were then analysed for age, sex, residence, signs and symptoms and histopathological characteristics. Follow up was done for gliomas. Mortality and morbidity was analysed for gliomas in these 3 years. Patients who lost the follow up were considered dead. Out of 1730 patients included in our study, there were 1031 males and 699 females. The most common age group was between 41-50 years. Results: The most common tumor was gliomas followed by meningiomas. Gliomas were most common in men and meningiomas in females. Out of all the histological grades in gliomas, the glioblastoma multiforme (GBM) was the most common, and frontal lobe was the commonest anatomical site involved. The most common symptom in our study was headache followed by vomiting. [ABSTRACT FROM AUTHOR]

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., (Copyright © 2012 Elsevier Inc. All rights reserved.)

HIV infection has attained extraordinary attention among surgeons and other health care workers as a potential source of occupational infection. Disease is usually blood-borne and transmissible, and due to the nature of surgical work, surgical community has become involved and is developing sterile surgical barriers, and improved surgical techniques and procedures.

Objective: To determine the significance of the Diagnosis to Delivery Interval (DDI) on perinatal outcome and maternal complications in patients with umbilical cord prolapse., Methods: This was a case series of 44 patients identified with "Umbilical cord prolapse" during a 10-year period at the Aga Khan University Hospital. Data was retrieved for gestational age, foetal presentation, DDI, incision to delivery time, delivery method, apgar score, birth weight and outcome, and maternal complications. The influence of DDI on perinatal mortality, apgar scores at 5 minutes, neonatal intensive care unit (NICU) admission and maternal complications resulting from mode of delivery with cord prolapse was assessed., Results: The hospital based incidence of cord prolapse was 1.4 per 1000 deliveries. The mean DDI was 18 minutes, with 64% of women delivering within this time. Of the 13 (29%) neonates transferred to NICU with < 7 apgar score at 5 minutes, 10/13 (76%) delivered within the mean DDI. There were 4 perinatal deaths, of which 2 were term pregnancies with birth asphyxia, whereas 2 were < or = 28 weeks. There was no statistically significant impact of DDI on 5-minute apgar scores, perinatal mortality, NICU admissions and maternal complications in patients with cord prolapse, Conclusions: DDI may not be the only critical determinant of neonatal outcome. Most neonates with poor apgar scores had DDI within the average time. Artificial rupture of membranes should be performed cautiously with preexisting CTG trace abnormalities. In-utero resuscitative measures may help reduce further cord compression and improve outcome.

Objective: To evaluate the effects of soluble fiber rich bread on lowering blood glucose, blood pressure and blood lipid levels., Design: An interventional study., Place and Duration of Study: The study was undertaken at Medical Unit III, Jinnah Postgraduate Medical Centre, Karachi. Duration of the project was one year (1997-1998)., Subjects and Methods: Twenty stable diabetics of both genders were included in this study. They were provided with this bread (test diet) to replace their usual breakfast bread and chapati for lunch and dinner. The intakes of other foods as well as medications were unchanged. Anthropometric measurements, fasting and 2 hours postprandial blood sugar, fasting serum cholesterol and triglyceride levels were recorded before and after 4 weeks of intervention. Blood sugar and blood pressure were checked every week. Quality of life was assessed subjectively with the help of questionnaire, which were asked before and after the end of the intervention., Results: Glycemic control, both fasting and postprandial, improved significantly during intervention. Satisfactory reduction of blood pressure as well as serum cholesterol and triglyceride level was also observed in these cases. The medicines reduced significantly and quality of life improved in all subjects. None of these subjects complained any gastrointestinal discomfort during their consumption of this bread for 4 weeks., Conclusion: The use of soluble fiber rich bread helps to control blood sugar, the hyperlipidemia, and blood pressure which are elevated in poorly controlled diabetics. Thus, integrated improvement will improve the quality of life, reduce the cost of drugs as well as help to avoid harmful effect of drugs.

Sixtynine patients (31 males and 38 females) above the age of 12 years undergoing surgery under general anaesthesia were selected for this study. Thirty percent males and 29% females were depleted, 55% and 37% males and females, respectively, were normal and 13% and 34% males and females, respectively, were obese as indicated by Body-mass index (BMI). Measurement of midarm-muscle-circumference (MAMC) indicated mild to moderate protein deficiency in 32% of the patients while triceps skinfold thickness (T.S.T) indicates mild to severe calorie deficiency in 68% males and 50% females. Dietary intake both pre and post operatively was unsatisfactory. Pre-operatively 26% of the females had Hb level below normal (less than 11 G%). Only 3-5% of the patients had protein and albumin level below normal (less than 3.5 G%). Post-operatively all the anthropometric measurements as well as serum protein and albumin levels decreased and BUN increased significantly indicating body catabolism. Post operative hospital stay was significantly more in undernourished patients.