Objective:To assess the risks and benefits of surgical treatment (Open Craniotomy) of Intra-cerebral hematoma (ICH).Methods:Twenty seven patients of ICH who underwent surgical treatment at Neurosurgical department of Sheikh Zayed Hospital, Rahim Yar Khan, from 1st January 2015 to 31st December 2015 were included in this study. The primary outcome measured was death and improvement in GCS Status among survivor’s at three months.Results:Mean age of the patients was 58.4±10.7 and majority of patients (48.1%) were in the age range of 60-70 years. There were22.2% patients with ICH volume of >50 ml. Six (6) patients had 8 GCS with 50ml volume, who later died in ICU. Three of the patients who expired developed post-operative pneumothorax. These patients also acquired RTI resulting in deterioration of GCS. The rest of the expired patients showed deterioration in their GCS associated with oedma on brain CT scan. One patient died as a result of re-bleed. Twenty one (21) patients were discharged from hospital, two of these patients were lost in second follow up. Rest of the patients showed a gradual improvement in GCS touching 15/15 by 2nd follow up visit.Conclusion:Surgical prognosis of ICH depends on the patients GCS received and size of hemorrhage at the time of presentation. Urgent surgical evacuation in patients with rapid deterioration carries good outcome, hence should be considered.

Objectives: Acute Traumatic Subdural Hematoma (ASDH) is one of the most dangerous and challenging neurosurgical problems faced by neurosurgeons. Road traffic accidents (RTAs) and falls are the most common causes of ASDH. This study focused to evaluate the incidence, mode, and severity of the injury, treatment options, and determine outcomes in patients with ASDH. Material & Methods:  Thirty patients with ASDH were studied over a period of three years. Detailed history, general and neurological examination including GCS were noted, CT scans were done and patients managed according to said protocol. Results:  Twenty-three (76.66%) were male and Seven (23.33%) were female. The common mode of injury were road traffic accidents (66.66%) and falls (26.66%). Out of 30 patients, 53.33% had GCS 3-5. Overall, the mortality rate was 60%. 23.33% of patients survived with severe disability and 10% of patients showed moderate disability and good recovery. The mortality rate was higher in patients above 50 years of age. Conclusion:  Acute traumatic subdural hematoma is still very fatal and has a high mortality. Early CT scanning emergency, surgery and good postoperative ICU care can play a role in improving the outcome in patients with ASDH.

Objectives:  This study aimed to evaluate incidence, mode, and severity of injury, treatment options and to determine the outcome in pediatric age group patients with head injury. Patients & Methods:  120 pediatric patients with a head injury, with ages up to 15 years or less, were included. Detailed history, general and neurological examination including GCS were noted. The CT scans were conducted and the patients managed as per said protocol. Various surgical procedures were performed including craniotomies and evacuation of hematoma, the elevation of depressed fractures and repair of the dura, decompression craniotomies, and evacuation of Subdural collections and contusions. Results:  60.1% of patients were boys and 39.16% were girls. In the majority (63%) of the children, the ‘fall’ was reported. The majority of children (68.3%) in our study had a mild head injury with GCS 13 – 15. 35.83% patients had normal CT scans, and 23.33% had isolated skull fractures. 68.75% patients were with a severe head injury and had a poor outcome. A poor outcome was noted in patients having brain edema, subdural hematoma, and brain contusions. Conclusion:  Head injury in the pediatric age group still continues to be a significant cause of mortality and morbidity. The outcome is directly being related to the severity of injury i.e., GCS. Falls and RTAs are the most common causes and preventive measures in different forms need to be addressed.

Objective: To know the epidemiology of female homicidal deaths in Sahiwal. Study Design: Descriptive Retrospective study. Setting: Department of Forensic Medicine, Sahiwal Medical College and DHQ Teaching Hospital Sahiwal. Period: 1stJanuary 2016 to 31st December 2018. Material & Methods: This study includes 73 cases of female homicide from a total of 314 autopsies conducted at DHQ Teaching Hospital,Sahiwal. These cases were examined regarding their age, marital status, residential background, cause of death, alleged offender and apparent motive of Killing. Result: The study revealed that commonly involved age group was 20-29 years (45.2%), 45 (61.6%) females were married and 64 (87.7%) female victims belonged to rural area. Firearms were the causative agent in 31 (42. 5%) cases. In 19 (59.5%) cases the alleged offender was husband. Honor killing, financial/property disputes were the main reason for homicides. Conclusion: The violence against women in Sahiwal is higher in rural areas and more commonly affecting the married women of child bearing age.