Publications by authors named "Ahsan Khan"

Objectives: To provide information about implementation, resources, practice patterns and prevalent perceptions regarding neuro-oncology tumor boards (NOTBs) in a lower middle income country.

Methods: A nationwide survey was designed to include licensed neurosurgeons involving data on practice, structure, and perceptions of NOTBs with non-probability sampling, a pre-validated proforma, data analysis using SPSS v27, and geospatial mapping using Quantum GIS.

Results: 139 neurosurgeons were surveyed from 63 neurosurgical centers of a lower middle income country.

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Background: Intracranial arteriovenous malformations (AVMs) are extremely rare in the pediatric population, with an estimated prevalence of 0.014-0.028%.

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The Genes & Health study, an initiative focused on British-Pakistani and British-Bangladeshi volunteers, is at the forefront of diversifying genetic research and driving scientific innovation. Here, we explore how this study has propelled scientific advancements and positively impacted communities, emphasizing its collaborative ethos, dedication to societal needs, and accomplishments.

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Objective: To synthesize available evidence on the impact of concomitant focal cartilage lesions and their surgical treatment on clinical outcomes in the setting of anterior cruciate ligament (ACL)-reconstruction at short (6-36 months) and midterm (3-8 years) follow-up.

Design: Original level 1 or 2 studies comparing any patient-reported or objective outcomes in ACL-reconstructed patients (1) with and without concomitant focal cartilage lesion(s) or (2) after any type of cartilage surgical treatment were considered for inclusion. Systematic searches were conducted in MEDLINE via Ovid, Cochrane Library, EMBASE via OvidSP, and Web of Science.

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Damage to bones resulting from trauma and tumors poses a significant challenge to human health. Consequently, current research in bone damage healing centers on developing three-dimensional (3D) scaffolding materials that facilitate and enhance the regeneration of fractured bone tissues. In this context, the careful selection of materials and preparation processes is essential for creating demanding scaffolds for bone tissue engineering.

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Thrombotic thrombocytopenic purpura (TTP) is a thrombotic process characterized by multiorgan failure secondary to microvascular thrombi comprising platelets and von Willebrand factor. HIV is a known risk factor for TTP. However, patients generally have low CD4+ count during initial presentation or subsequent flare-ups.

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Background: Neural stem cells (NSCs) play a crucial role in the progress of ischemic stroke. Research on zebrafish embryonic demonstrates an association between Strawberry Notch 1 (Sbno1) and central nervous system development. However, the regulation and underlying mechanism of Sbno1 in NSCs have not been studied yet.

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Background: Delivering HD-tDCS on individual motor hotspot with optimal electric fields could overcome challenges of stroke heterogeneity, potentially facilitating neural activation and improving motor function for stroke survivors. However, the intervention effect of this personalized HD-tDCS has not been explored on post-stroke motor recovery. In this study, we aim to evaluate whether targeting individual motor hotspot with HD-tDCS followed by EMG-driven robotic hand training could further facilitate the upper extremity motor function for chronic stroke survivors.

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Article Synopsis
  • Chordomas are rare malignant tumors that originate from remnants of the embryonic notochord, primarily found in the vertebral column (55-70%).
  • These tumors are difficult to completely remove surgically due to their tendency to invade local tissues and recur, necessitating additional treatments.
  • Radiotherapy, particularly proton beam therapy (PBT), has shown improved outcomes when used alongside surgery, offering a more precise radiation targeting while minimizing damage to surrounding healthy tissue.
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  • Surgical removal is usually the main way to treat brain tumours, but radiosurgery is a less invasive option that can also be effective.
  • The goal of the study was to understand how radiosurgery can help treat brain tumours, especially in countries that don't have as many medical resources.
  • Even though radiosurgery is becoming more popular in these regions, problems like not having clear guidelines and trained doctors make it harder to use widely.
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Almost any primary or metastatic brain tumour can manifest in intraventricular (IV) locations. These tumours may either originate within the ventricular system or extend into the IV space through growth. Such neoplasms represent a broad spectrum, with supratentorial IV tumours forming a heterogeneous group.

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Metastatic tumours are among the most common types of brain tumours. However, in low- and middle-income countries (LMICs), the numbers are considerably lower. This does not necessarily indicate a decreased incidence but rather points to decreased survival rates or limited access to healthcare.

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This paper presents comprehensive consensus guidelines for the management of intracranial ependymoma, neoplasms arising from ependymal cells in the central nervous system's ventricular system, in low- and middleincome countries (LMICs). Acknowledging the distinct epidemiological patterns of ependymomas, notably their higher incidence in paediatric patients, and variable survival rates, these guidelines emphasize tailored management approaches for different age groups. An expert panel, comprising specialists in neuro-oncology, convened to address gaps in diagnosis and management within LMICs, considering the varying clinical presentation based on tumour size and location.

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Article Synopsis
  • Craniopharyngiomas are non-cancerous tumors linked to the pituitary gland, causing challenges due to their location near vital brain structures like the hypothalamus and optic nerves.
  • Surgical removal is the main treatment, but complications like recurrence and visual problems are more common in low- and middle-income countries (LMICs) due to factors like late diagnosis and lack of resources.
  • The manuscript offers management guidelines for LMICs, suggesting a mix of surgery and chemoradiation for better patient outcomes, ideally overseen by a specialized neuro-oncology team.
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The management of medulloblastoma, a pediatric brain tumor, has evolved significantly with the advent of genomic subgrouping, yet morbidity and mortality remain high in LMICs like Pakistan due to inadequate multidisciplinary care infrastructure. This paper aims to establish evidence-based guidelines tailored to the constraints of such countries. An expert panel comprising neuro-oncologists, neurosurgeons, radiologists, radiation oncologists, neuropathologists, and pediatricians collaborated to develop these guidelines, considering the specific challenges of pediatric brain tumor care in Pakistan.

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  • Vestibular Schwannoma (VS), also known as acoustic neuroma, is the most common tumor in the cerebellopontine angle (CPA), with most management guidelines coming from high-income countries (HICs).
  • These HIC guidelines are often not suitable for low- and middle-income countries (LMICs) like Pakistan, where healthcare challenges like workforce shortages, poor infrastructure, and limited resources complicate their application.
  • The article aims to provide tailored recommendations for the screening, diagnosis, and management of VS specifically for LMICs, addressing the unique circumstances and constraints these regions face.
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Low-grade gliomas (LGG) are brain tumors of glial cells origin. They are grade 1 and grade 2 tumors according to the WHO classification. Diagnosis of LGG is made through imaging, histopathological analysis, and use of molecular markers.

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The incidence and prevalence of brain tumours have steadily increased within low- and middle-income countries, similar to patterns seen in high-income countries. In addition to the epidemiological landscape of brain tumours in Pakistan, it is important to consider the economics of brain tumour diagnosis and management to inform policy on neuro-oncological healthcare service delivery. The challenges associated with conducting economic evaluations in LMICs include the ability to receive funding for country-specific estimates, dearth of existing data and methodological development, and the need for investment in economic evaluations of health.

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Low- and middle-income countries (LMICs) have historically been under-represented in clinical trials, leading to a disparity in evidence-based recommendations for the management of neurooncological conditions. To address this knowledge gap, we conducted a scoping review to assess the current literature on clinical trials in neuro-oncology from LMICs. The eligibility criteria for inclusion in this review included clinical trials registered and conducted with human subjects, with available English language text or translation, and focussed on neuro-oncological cases.

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Paediatric neuro-oncology in low- and middle-income countries (LMICs) accounts for a significant proportion of cancer-related mortalities in this age group. The current dearth of structured paediatric neurosurgery training programmes in LMICs requires multidisciplinary coordination; neurosurgeons play certain key roles, as discussed in this article, in ensuring safe and effective care for paediatric neuro-oncology patients. This document intends to elaborate through illustrative cases of the technical and structural nuances required by neurosurgeons in LMICs to provide appropriate surgical care.

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Article Synopsis
  • The objective of the project was to create the first brain tumor surgery lab in a low-resource setting, aimed at training future neurosurgeons and residents.* -
  • A workshop utilized affordable noncadaveric models and mixed-fidelity teaching methods, featuring well-equipped dissection stations for hands-on training in brain surgery techniques.* -
  • The results showed that using 3D-printed and animal brain models effectively trained participants in complex surgical approaches, demonstrating that cost-effective simulation can enhance neurosurgical skills in a safe environment.*
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The act of recalling memories can paradoxically lead to the forgetting of other associated memories, a phenomenon known as retrieval-induced forgetting (RIF). Inhibitory control mechanisms, primarily mediated by the prefrontal cortex, are thought to contribute to RIF. In this study, we examined whether stimulating the medial prefrontal cortex (mPFC) with transcranial direct current stimulation modulates RIF and investigated the associated electrophysiological correlates.

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  • Many COVID-19 survivors from the early pandemic showed signs of cardiac injury, prompting investigations into long-term heart effects using cardiac imaging techniques like CMR and TTE.
  • A study involving 40 COVID-19 survivors and 12 matched controls conducted TTE and CMR at an average of 308 days post-infection, revealing no significant differences in heart structure, function, or tissue abnormalities between the groups.
  • The findings suggest that there is no lasting damage or inflammation to the heart in these survivors, despite previous reports of cardiac issues during acute COVID-19.
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