Publications by authors named "Shakir Muhammad"

Objective: To compare correction of kyphotic deformity (KD) and implant failure (IF) in percutaneous short-segment pedicle screws fixation (SSPF) with index level versus long-segment pedicle screws fixation (LSPF) without index level for traumatic thoracolumbar (TL) fractures.

Methods: This prospective study comprised 56 patients who met the study's inclusion criteria from the Department of Neurosurgery at the Punjab Institute of Neurosciences in Lahore, Pakistan presented between June 2022 and May 2023. We separated them into two groups: Group-A and Group-B, each with 28 patients.

View Article and Find Full Text PDF

 Neurosurgery receives several applicants every year, but the decreasing size of the neurosurgery workforce in Pakistan despite evidence of initial student interest is perplexing. Therefore, it is vital to evaluate the perspective of medical students and recent graduates to get a holistic view of perceptions toward neurosurgery.  A nationwide cross-sectional study was conducted on a sample of medical students and recent graduates from different medical colleges.

View Article and Find Full Text PDF

Background: Appropriate surgical infrastructure is important for improving patient outcomes. However, low- and middle-income countries (LMICs) often struggle to provide adequate brain tumor surgery due to fractured infrastructure. This study aims to identify and evaluate barriers to surgical care infrastructure for brain tumors in LMICs.

View Article and Find Full Text PDF

Objective: To evaluate the role of endovascular thrombectomy (EVT) in patients presenting with acute ischemic stroke (AIS) due to large vessel occlusion in the very late window (>24 hours).

Methods: A systematic review was conducted according to PRISMA guidelines using PubMed, CINAHL, Scopus, and Google Scholar databases till 2024. Quality assessment was performed using the Newcastle-Ottawa Scale (NOS).

View Article and Find Full Text PDF

Objective: To compare outcomes of middle meningeal artery embolization (MMAE) alone versus combined with conventional surgery in the management of chronic subdural hematoma (cSDH).

Methods: A systematic literature search was performed on PubMed, Google Scholar, Scopus, and CINAHL, followed by a meta-analysis comparing recurrence rates, surgical rescue, mortality, in-hospital complications, and length of hospital stay was conducted. Mean differences and risk ratios were pooled using a random effects model, with subgroup analysis performed using Cochrane RevMan 5.

View Article and Find Full Text PDF
Article Synopsis
  • 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.
View Article and Find Full Text PDF

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.

View Article and Find Full Text PDF
Article Synopsis
  • The posterior fossa is a small area in the brain that, when affected by tumors or lesions, can lead to severe neurological issues due to pressure on vital structures and fluid buildup (hydrocephalus).
  • Urgent surgical intervention is typically necessary, and neuro-oncologists play a crucial role in helping patients and families navigate treatment options and understand long-term outcomes.
  • Advances in molecular classifications and high-dose radiation therapy have the potential to enhance survival rates and quality of life, with different tumors commonly affecting children (like ependymomas and medulloblastomas) versus adults (who often have metastatic disease).
View Article and Find Full Text PDF

Intra-cranial meningiomas represent the most common type of extra-axial brain tumour in adults. Characteristically slow-growing and often asymptomatic, these tumours may only require observation in some cases. However, lesions that cause a significant mass effect necessitate intervention, primarily through surgical means.

View Article and Find Full Text PDF

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.

View Article and Find Full Text PDF
Article Synopsis
  • 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.
View Article and Find Full Text PDF

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.

View Article and Find Full Text PDF

Objective: The aim of this study is to assess the feasibility and implementation of a novel approach for intraoperative brain smears within the operating room, which is augmented with deep learning technology.

Materials And Methods: This study is designed as an observational to evaluate the feasibility and implementation of using an innovative approach to intraoperative brain smears within the operating room, augmented with deep learning technology. The study will be conducted at Aga Khan University Hospital in Karachi, Pakistan, from May 2024 to July 2026, with an estimated sample size of 258.

View Article and Find Full Text PDF

Background: Conservative treatments for minimally symptomatic chronic subdural hematoma (cSDH) are debated, with surgery as the primary option.

Objective: To assess failure rates of a conservative approach for management of cSDH.

Methods: We searched PubMed, SCOPUS, Web of Science, and ClinicalTrials.

View Article and Find Full Text PDF

Patients with cerebral palsy (CP) are particularly vulnerable to respiratory infections, yet comparative outcomes between COVID-19 and influenza in this population remain underexplored. Using the National Inpatient Sample from 2020-2021, we performed a retrospective analysis of hospital data for adults with CP diagnosed with either COVID-19 or influenza. The study aimed to compare the outcomes of these infections to provide insights into their impact on this vulnerable population.

View Article and Find Full Text PDF
Article Synopsis
  • Spontaneous pneumothorax (PTX) is more common in COVID-19 patients, leading to worse health outcomes compared to those without PTX.
  • In-hospital costs and lengths of stay were significantly higher for COVID-19 patients with PTX, with mortality rates showing a notable increase.
  • Demographic factors like being Hispanic, male, or obese were associated with a higher risk of developing PTX in COVID-19 patients.
View Article and Find Full Text PDF

Background: Adjuvant therapy is an important tool in the arsenal of brain tumor management and can improve patients' outcomes significantly but low- and middle-income countries (LMICs) often face challenges in provision. Therefore, our study aims to highlight barriers and strategies to adjuvant therapy of brain tumors in low-resource settings.

Method: A comprehensive search of literature was conducted using PubMed, CINAHL, Google Scholar, and Scopus, from inception to October 20, 2022.

View Article and Find Full Text PDF

Objective: While early diagnosis of brain tumors is essential for improving prognoses, several challenges prevent early diagnosis of these illnesses in low- and middle-income countries (LMICs). The objective of this systematic review is to identify and evaluate the barriers and challenges to early detection of brain tumors in LMICs, as well as to propose potential solutions.

Methods: A thorough search of the literature was carried out with the aid of multiple databases, including Google Scholar, CINAHL, PubMed, and Scopus.

View Article and Find Full Text PDF

Background: Low- and middle-income countries (LMICs) often struggle to provide adequate neurosurgical care due to poor governance and institutional efforts, making access to care difficult. Therefore, our review of literature aims to identify gaps in government, national, and institutional efforts to combat barriers to neurosurgical care of brain tumors in LMICs, to inform future policy and action planning.

Methods: A comprehensive literature search was conducted using PubMed, Scopus, Google Scholar, and CINAHL without language restrictions from inception to October 20, 2022.

View Article and Find Full Text PDF
Article Synopsis
  • Health care in low- and middle-income countries (LMICs) struggles with inadequate data management and national cancer registries, hindering the understanding and treatment of brain tumors.
  • A literature review identified 23 studies revealing significant challenges such as poor hospital records (43%), absence of a national brain tumor registry (67%), and low research output (33%).
  • Strategies to improve data management include enhancing recording systems (45%), establishing a population-based brain tumor registry (64%), and creating local treatment guidelines (9%), requiring government and public health support for effective implementation.
View Article and Find Full Text PDF
Article Synopsis
  • Pediatric brain tumors (PBTs) face delayed diagnoses in low- and middle-income countries (LMICs) due to vague symptoms and socioeconomic factors, impacting survival rates.
  • A systematic review revealed that nonspecific symptoms and family financial issues are primary contributors to diagnostic delays, with patients experiencing an average prediagnostic interval of about 230 days.
  • The findings highlight the urgent need for targeted policies to improve awareness and healthcare access in LMICs, addressing multifaceted barriers to timely diagnosis.
View Article and Find Full Text PDF

Background: Ultra-low-field magnetic resonance imaging (ULF-MRI) has emerged as an alternative with several portable clinical applications. This review aims to comprehensively explore its applications, potential limitations, technological advancements, and expert recommendations.

Methods: A review of the literature was conducted across medical databases to identify relevant studies.

View Article and Find Full Text PDF

 Pakistan has a significant proportion of medical graduates who intend to leave the country for better opportunities abroad, leading to a brain drain. However, the push and pull factors within neurosurgery remain unexplored, emphasizing the need for evaluation to enact policy changes.  We conducted a nationwide survey across 22 College of Physicians and Surgeons of Pakistan accredited neurosurgery training centers in all provinces of Pakistan.

View Article and Find Full Text PDF