Background: Dengue is the most prevalent mosquito-born viral illness in theworld. Clinically dengue ranges from asymptomatic, non-febrile illness, classic dengue todengue hemorrhagic fever/dengue shock syndrome. Objective: Subjects & Methods: Thisstudy was included 79 patients conducted at Nawaz Sharif Social Sevurity Hospital, Lahoreduring the epidemic of dengue in Lahore from September 2011 to Dec 2011. Results: Twenty outof 79 patients suspected of dengue fever were dengue IgM positive. Male to female ratio was1.19: 1. Our study included 79 patients suspected of having dengue fever. Fever was the mostcommon symptom in these patients. Conclusions: Early identification of dengue with risk ofdeveloping hemorrhage is an important clinical objective. The morbidity and mortality can bereduced by appropriate and judicious treatment of dengue patients.

Objective To study the Pattern and Practice of Paediatric neurosurgical procedures during one year among patients presenting to Children Hospital, Faisalabad. Materials and Methods Retrospective case series of 778 consecutive cases done in Paediatric Neurosurgery Department, Children Hospital, Faisalabad over the period of one year (October 2019- November 2020). Patients of age less than 15 years, any gender, admitted in Paeds Neurosurgery ward for management were included and studied for their demographic data hospital stay, procedure done and outcome. Results A total of 778 patients who required some neurosurgical intervention were admitted, 725 underwent various types of procedures and remaining were treated conservatively. 320 (44.14%) were male and 405 (55.86%) were female. Age range was 20 days to 13 years. The most common diagnosis was hydrocephalous, and then was Meningomyelocele (MMC). First three common procedures performed included monitoring of Cerebrospinal fluid (CSF) in 36% cases, Placement of shunt (21%), and placement of external ventricular drain (EVD) in 13% cases of cerebrospinal fluid ( CNS) infections in patients of hydrocephalous. Conclusion Pattern of presentation of paediatric neurosurgical cases take in almost all types of diseases like neural tube defects, hydrocephalous, cranial trauma, tumors, cysts and infections but surgical procedures in routine practice in Faisalabad district cover mainly hydrocephalous and its complications. Endoscopic or advanced procedures are not commonly practiced due to multiple factors but existing constrains do not prevent best management of paediatric neurosurgery patients.   Key Words: Paediatric neurosurgery, Neurosurgical procedures, Children hospital, Faisalabad

Objective:  The aim of this survey was to observe the impacts of COVID-19 pandemic on neurosurgery practices during this pandemic, assess various types of adaptations taken by them, protective measures during patient examination and effects on their health, family and socioeconomic life. Material & Methods:  A Questionnaire comprising 32 questions was circulated among practicing Neurosurgeons of Pakistan by social media, e-mails for 8 weeks (January-February 2021) and their responses were analyzed. Results:  108 participants were involved from all over Pakistan. 32% respondents stated reduction in clinical practice to a level of less than 25%. While, 10% reported complete closure of outpatient services during pandemic. There were varied responses on the use of protective measures and most used N95 mask only (31%). Pandemic also affected the research work, finances and leisure time activities. Conclusion:  Our study showed that neurosurgical practice was influenced by COVID-19 pandemic in many aspects in Pakistan. Proper method of protective measures and COVID testing of patients were lacking among them. Neurosurgeons should follow standard guidelines according to institutional directives in local neurosurgical practices so as to avoid being influenced by such crisis.c

Objective:  Brain abscess is a focus of pus in the brain due to infection somewhere else in the body. It is common in males than females and the average age in children ranges from 4 to 7 years. It develops by skull trauma or contiguous or hematogenous spread of infection. The study aimed to identify the pattern of microbiological involvement in the etiology of pediatric brain abscesses and the outcome so as to enable us to ensure definitive treatment with the appropriate and specific antimicrobial regimen. Materials and Methods:  A prospective study was conducted in 80 pediatric patients of brain abscess admitted to the Pediatric Neurosurgery Department, Children Hospital, Lahore, Pakistan. Results:  The median age was 5.2 years with a predominance of males (60%). The most common presentation was fever (72.5%) and then fits (35%). Congenital heart disease was the commonest factor in 32% of cases. Streptococcus was a commonly isolated pathogen in 17% cases out of 70% of culture positive cases. Recovery was seen in 70% of cases and the mortality was 7.5%. Conclusion:  Congenital heart disease is the most common causative factor in pediatric brain abscesses and most of the abscesses were found culture negative. There is a pressing need to carry out multicenter studies over a large sample size over extended study duration in developing countries to help establish guidelines in treating pediatric brain abscesses.