Introduction: Posterior fossa brain tumor is the most devastating forms of human illness, primarily because of the limited space within the posterior fossa, the potential involvement of vital brain stem nuclei, and the mass effect causes obstructive hydrocephalus. Posterior fossa tumors are more common in children than adults. The Objective of the Study: To find out the satisfactory surgical outcome of posterior fossa brain tumors in children at Civil hospital, Karachi. Materials and Methods and Duration of Study Setting: This prospective observational, case series study was conducted from February 2015 to February 2105 in the Department of neurosurgery, Dow University of Health Sciences, Civil Hospital, Karachi, Karachi. Postoperative patients with the diagnosis of posterior fossa tumor were enrolled in the study. Detailed history, physical examination, anthropometrics, and biochemical measurements were recorded. Magnetic resonance imaging was done to determine the satisfactory surgical outcome. Patients were followed up at the third postoperative month to determine the satisfactory surgical outcome. Results: Seventy-one patients fulfilling the inclusion criteria, the mean ± standard deviation age of the study population was 6.63 ± 3.181 years. 29 (40.8%) were <7 years of age and 42 (59.2%) were of age 7 years and above. 50 (70.4%) were males and 21 (29.6%) were females. 49 (69%) patients presented with vomiting. 34 (47.9%) presented with seizures. (40.8%) had papilledema. (25.4%) presented with hemiparesis. 8 (11.3%) had meningismus. On analysis of the frequency of outcome variables (80.3%) achieved the satisfactory surgical outcome. Conclusions: There has been no major study to determine satisfactory surgical outcome in postoperative patients with posterior fossa brain tumor in our population. The study was to provide local data in our population and compare it to the international data. This may help in proper patient management. Majority of the patients had satisfactory surgical outcome. The absence of papilledema, hemiparesis, and meningismus had more chances of satisfactory surgical outcome.

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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.

Objectives: Our aim was to analyze the postoperative visual status in patientswith suprasellar tumors with preexisting preoperative visual deficit after surgical resection.Study Design: Comparative cross section study. Setting: Civil Hospital Karachi. Period:March 2013 to August 2016. Methods: A total of 107 patients with suprasellar tumors withpreoperative visual deficit who were operated. Either via transsphenoidal (43) or transcranial(64) approaches, were included in this case series. Sixty six patients had pituitary adenomas,24 had craniopharyngiomas, 13 had meningiomas, 3 had chordomas and 1 had epidermoidcyst. Twenty five patients had uniocular visual deficit and 82 had binocular. Visual acuity wasrecorded preoperatively, postoperatively at discharge and at four weeks follow-up. Results:Postoperatively 46% of eyes improved, while 34.4% and 19.6% remained same and deterioratedrespectively. Patients underwent transsphenoidal technique got significant 65% improvement,and those who underwent transcranial had 37.5% improvement (p-valve=0.005). Pituitaryadenomas showed the greatest visual improvement of 65% (p-value=0.000), followed bycraniopharyngiomas (33.5%) and meningiomas (7.6%). In total 52 patients (48.6%) showedimprovement in vision and the visual acuity of remaining 55 (51.4%) did not improve. Conclusion:Patients experience significant benefit in vision after decompressive surgery for suprasellartumors, especially those who have pituitary adenoma and who undergo transsphenoidaltechnique.