Objective: The study's goal is to find out how often individuals with myelomeningocele and TCS repair have leakage of cerebrospinal fluid. Study Design: Cross-sectional Place and Duration: Women medical college Abbottabad and Children hospital and the institute of child health, Multan, during from the period July, 2021 to Dec, 2021. Methods: There were 55 participants of both sexes in this research. Those being treated ranged in age from 5 to 20 years old. After obtaining written permission, we collected demographic data on each patient, including their age, gender, and BMI measurements. There were patients who had TCS repair as well as those who had undergone myelomeningocele repair procedures. It was determined how often cerebrospinal fluid leaks occurred in patients. SPSS 22.0 was used to analyze all of the data. Results: Among 55 cases, majority were males 32 (58.2%) and 23 (41.8%) were females. Included patients had mean age 9.5±6.14 years. Frequency of CSF leak was found among 18 (32.7%) patients. The mean duration of CSF leaks was 13.11±10.34 days. In 18 patients of CSF leaks, Frequency of MMC repair was 11, TCS release was found in 3 patients and meningocele repair in 4 patients. With the use of tincture benzoyl-enhanced primary wound healing in three patients with CSF leaks during surgery, the HCP postoperative signs were resolved. HCP was found in two further patients after their sutures mended with benzoyl tinctures, and they were placed in the shunt. Conclusion: In this research, we found that CSF leaks are more common in patients having myelomeningocele and TCS repair. Skin-healing tincture benzoyl will help these people. Keywords: Cerebrospinal fluid leak (CSF), Tether cord syndrome (TCS), Myelomeningocele (MMC)

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Objective: The aim of this study is to determine the frequency of complication among patients after endoscopic third ventriculostomy in obstructive hydrocephalus. Study Design: Descriptive study Place and Duration: Conducted at the department of Neurosurgery, Bacha Khan Medical College Mardan/ Medical Complex Mardan and Frontier Medical and Dental College, Abbottabad for duration of 06 months from April 2021 to September 2021. Methods: There were one hundred and fifteen patients of both genders with ages 1-40 years were presented. Included patients had obstructive hydrocephalus. Detailed demographics, including age, sex, and BMI, were obtained from all patients with signed permission. Patients underwent CT scan and brain MRI. Endoscopic third ventriculostomy was performed among all the cases after indication of symptoms. Post-treatment effectiveness and complication were assessed after follow up within duration of 2-weeks. SPSS 25.0 version was used to analyze all data. Results: Mean age of the patients was 6.2 ±3.25 years. Among 115 cases, 70 (60.9%) were males and 45 (29.1%) were female patients. Aqueductal stenosis was the most common disease found in 77 (67%) cases followed by posterior fossa tumours 20 (17.4%), VP shunt blocked in 17 (14.8%) and CSF ascites in 3 (2.6%) cases. We found complications in 24 (20.9%) cases CSF leak was the most common found in 12 (10.4%) cases, meningitis in 4 (3.5%), seizures and bleeding in 3 (2.6%). Mortality found in 2 (1.7%) cases. Conclusion: We concluded in this study that the endoscopic third ventriculostomy is an effective and safe method for the patients of obstructive hydrocephalus in terms of minimum complication with lower rate of mortality. Keywords: Endoscopic Third Ventriculostomy, Obstructive Hydrocephalus, Mortality, Complications