Objective: To determine the differences in post-operative pain experienced by patients undergoing emergency versus elective craniotomies. Study Design: Cross-sectional study. Setting: General Hospital, Karachi. Period: January 2017 to December 2019. Material & Methods: We included all the patients who underwent craniotomy at our institute and we measured their pain assessment levels. Further we excluded patients whose data was missing any variable of interest or whose measurements could not be taken at the time they were admitted to the hospital. All the data was analyzed using SPSS statistical software. Results: We included 152 patients in our study population. The mean age of the patients in our study group was 50 years of age and there were 81 males and 71 females included in our study. The combined pain scores for patients undergoing elective and emergency procedures was found to be 5.5 (Standard deviation= 2.6 for day one, 4.8 (Standard deviation= 2.6) for day two and 4.5 (Standard deviation=2.9) for day three post-operation respectively. When analysis was done to compare the differences in the VAS score for patients of the two categories we found no significant difference between the groups for day one having a p value of 0.485, for day two there was no significant difference as well having a p value of 0.957. Conclusion: We did not find any statistical difference in the two groups under study. The postoperative pain experience was similar in patients who underwent elective as compared to emergency craniotomies.

Objectives: The aim of our study is to compare the Canadian Head CT rule to New Orleans Criteria, to find a more efficient guideline in predicting the important CT findings in mild Traumatic Brain Injury (TBI) cases. Study Design: Observational study. Setting: Tertiary Health Care Facility in Karachi, Pakistan. Period: 6 months from June 2017 to December 2017. Material & Methods: We divided a sample of 150 mild TBI patients into two groups of Glasgow coma scale (GCS) scores of 13-14 and GCS score of 15. Then using a separate scoring system for both the CCHR and NOC, we evaluated their accuracy and efficiency in predicting mild TBI through a total of 7 major clinical items. Specificity and sensitivity were calculated to compare both the scoring systems and results were compared through univariate and multivariate analysis. A p value of less than 0.05 was considered to be statistically significant. Results: We analyzed the relation between clinical items and important CT findings and found that the CCHR, through multivariate analysis, was more closely associated with important CT findings. We also found that the factors of age, and the Glasgow comma scale score were also strong indicators of important CT findings regardless of which guideline was used. Conclusion: In our study, we found CCHR to be a stronger predictor of important CT findings than the NOC. We found that CCHR performed significantly higher than the NOC.