Fifty patients were randomly selected who presented with symptoms of hemorrhoids at out patient of surgical-I Jinnah Hospital, Lahore between Jan 01-June 02. Eligibility criteria were laid down and half of our study population was subjected to open haemorrhoidectomy and half to close. Post operatively all the study participants were evaluated for the healing time and stenosis. The results showed that hemorrhage less. healing time rapid with rare incidence of anal stenosis in closed as compared to open haemorrhoidectomy. The results were statistically significant when Fisher`s exact probability was applied. Based on results it was concluded that closed haemorrhoidectomy is a far superior procedure than open.

BACKGROUND: The posterolateral or transpedicular approach has been used extensively for themanagement of spinal TB. This approach is a viable and importantly a safe surgical option for ventraldecompression in thoracic spine TB when followed by anti tuberculosis treatment for 18 months andimmobilization in an alkathene shell for 3 months.OBJECTIVE: To determine clinical outcome of thoracotomy, anterior spinal decompression andfixation with screws and rods for dorsal spine TB.MATERIAL AND METHODES: This observational prospective study was conducted inNeurosurgery Department Lady Reading Hospital Peshawar from Mar 2013 to March 2014. All patientsadmitted with dorsal spine tuberculosis and undergone thoracotomy, anterior spinal decompression andfixation with screws & rods were included in the study while those having unstable dorsal spine due tothe metabolic, neoplastic, traumatic pathologies & stable dorsal spine tuberculosis cases were excluded.Patients’ age, sex, addresses, level of dorsal spine tuberculosis, pre operative signs & symptoms, per &post op complications and post op variations in clinical status were recorded on a designed proforma.Minimum 6 months follow up was done. Data was analyzed by SPSS version 17 and expressed in theform of tables and charts.RESULTS: Total 24 patients were included in this study in which males and females were equal innumber. The age range was from 15 to 50 years and mean age was 31.5 ±3.8 years. Backward & hillyareas patients 15(62.5%) were on the top. D7,8,9 levels had highest frequency of involvement 45.83%(11) . Lower limbs weakness was present in all cases (100%) followed by back ache in 23 (95.8 %)while power >3/5,3/5 were noted in 22(75.4 %) followed by gibus formation in 29.3 % cases. Postoperative improvement in pain and power was 100%, 62.5 % while complications occurred in 4 (16.7%) cases having no mortalityCONCLUSIONS: Incidence of dorsal spine tuberculosis is more in backward hilly areas of KPKeffecting lower part of dorsal spine and great improvement in power of lower limbs & pain occurs afterthoracotomy, decompression, bone grafting with cage placement and fixation with screws and rods withacceptable mortality and morbidityKEY WORDS: Dorsal spine tuberculosis, Thoracotomy, Anterior spinal decompression & stabilizationwith screws and rods, clinical outcome.

Background: Rapid motorization bought a boon along with the curse of road traffic accidents toll. Injuries and deaths due to road traffic accidents (RTA) are one of the major public health problems across the globe especially in developing countries due to lack of comprehensive legislative measures. It will have immeasurable impact on the families affected by RTAs.Methods: A hospital based, cross sectional study with victims of road traffic accidents admitted in S.V.R.R. Government General Hospital, Tirupathi, as study subjects was done during June 2013 to May 2014 for one year where 820 victims of road traffic accidents were interviewed after taking prior consent using a predesigned questionnaire.Results: External injury was seen in almost all cases (97.9%) and 61.5% suffered grievous injury. Laceration, fractures and abrasion are the most common types of injuries found. Regarding anatomical sites, head injury is the commonest (68.8%). Majority of the victims suffered grievous injury during 6AM to 12 PM (66.2%). The proportion of grievous injury was most commonly found in victims who were hit by Unknown vehicle (84.6%).Conclusions: Road side medical assistance by their timely action can prevent the toll of RTA fatalities and disabilities. Studies on injuries help in developing improved personal protective gear and safety measures inside the vehicles through novel engineering technology.

Objective: The present study examined the epidemiology, clinical features, and outcome of pediatric traumatic brain injuries (TBI) in tertiary care hospitals in Khyber Pakhtunkhwa (KPK) . Duration and Place of the Study: Duration of study was From February 2020 to February 2022.It was conducted in Neurosurgery Department, Khyber teaching hospital MTI, and Hayatabad medical complex Peshawar. Material and Methods: A total of Six hundred and forty-three pediatric patients, ages 01 to 11years, who had suffered traumatic brain injury were included in the study. All children were first seen at an emergency room, where they had a series of diagnostic tests and a physical examination. All necessary radiological studies were carried out under the watchful eye of the senior consultant neurosurgeon. In addition to demographic information, the pattern, treatment, and outcome of children with head injury were also recorded. Results: Among the 643 kids examined, 411 (or 65%) were boys, and 232 (or 35%) were girls. At presentation, the average age was 4.062 years. Among the children surveyed, 525 (82%) lived in an urban setting, while the remaining 117 (18%) lived in a rural region. Three hundred and seventy-eight (60%) of the children suffered a head injury secondary to fall, whereas just 207 (33%) had been involved in automobile accidents. 58% (374) had mild head injury and 185 29% had moderate head injuries, 84 (13%) had severe head injury. 12% (74) of patients underwent craniotomy for extra-dural hematoma. 46 (7.1%) of the children had depressed skull fracture which was surgically treated. 23 (3.5%) patient had acute sub-dural hematoma for which craniotomy was done. Rest of the 27(4.1%) children had traumatic sub-arachnoid hemorrhage and intracerebral bleed which were treated. Out of the total 76(11.6%) children did not recover and died, most of them presented with severe head injuries Conclusion: Most common cause for head injury in our setup was fall from height which was followed by motor vehicle accidents. Over half of the children presented mild to moderate head injuries. Over half were treated conservatively with good outcome. We had mortality of 11.6% with most having severe head injuries. Keywords: Mortality, Brain Injury, fall, Car Accidents, depressed skull fracture, extra-dural hematoma, acute sub-dural hematoma.

Objective:  To assess the outcome of anterior cervical discectomy and fusion (ACDF) with PEEK cage. Material and Methods:  This prospective study was conducted in the Departments of Neurosurgery Prime Teaching Hospital and Irfan General Hospital Peshawar. Patients undergoing one level ACDF with PEEK cage fixation were enrolled in the study. Patients who needed multiple level ACDF or corpectomy with plating and redo cases were excluded from the study. A proforma, which included age, gender, address, level of prolapsed disc, sign and symptoms, pain score, MRI findings were filled. All patients were assessed on day of discharge and on follow-up visit after one month. Data was analyzed with SPSS version 22. Results:  Total 95 patients were included out of which 58 (61%) were male and 37 (39%) were female. Range of patients` Age was from 27 years to 64 years with 50.4 years mean age. Most patients (65%) had C6 radiculopathy. 58 patients (61%) had right sided radicular pain. 5 patients (5.26%) had radiculomyelopathy. C5 – C6 was the most common level operated (68 patients). Excellent results were achieved in 75 patients (79%) while satisfactory results in the rest of patients using Odom’s criteria. Bony fusion occurred in 92% of patients at 6 months. Conclusion:  ACDF with PEEK cage fixation is a safe and beneficial procedure in one level cervical prolapse disc disease