3,874 results match your criteria: "The Aga Khan University.[Affiliation]"

Background: Liver transplantation (LT) for nonresectable colorectal liver metastasis (NRCRLM) has become accepted for select patients meeting strict inclusion criteria. Advancements in patient selection and understanding of cancer biology may expand benefits to patients with colorectal liver metastasis (CRLM). In this meta-analysis, we sought to assess survival outcomes, recurrence patterns, and quality of life (QoL) after LT for CRLM.

View Article and Find Full Text PDF

Objectives: Neurological disorders represent a significant global health challenge, necessitating the exploration of novel therapeutic agents. Apigenin, a natural flavonoid abundantly found in various plants, has garnered attention for its potential neuroprotective properties. In this study, we employed molecular docking simulations to investigate the interaction between apigenin and key molecular targets associated with neurological disorders.

View Article and Find Full Text PDF

Background: Hydroxychloroquine (HCQ) has proved ineffective in treating patients hospitalised with Coronavirus Disease 2019 (COVID-19), but uncertainty remains over its safety and efficacy in chemoprevention. Previous chemoprevention randomised controlled trials (RCTs) did not individually show benefit of HCQ against COVID-19 and, although meta-analysis did suggest clinical benefit, guidelines recommend against its use.

Methods And Findings: Healthy adult participants from the healthcare setting, and later from the community, were enrolled in 26 centres in 11 countries to a double-blind, placebo-controlled, randomised trial of COVID-19 chemoprevention.

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

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.

View Article and Find Full Text PDF

Primary lymphoma of the central nervous system (PCNSL) is a rare and aggressive form of extranodal non-Hodgkin lymphoma primarily involving the brain, spinal cord, cerebrospinal fluid, and eyes. The role of surgical intervention in PCNSL is currently limited to biopsy and decompression of critical structures if needed - extended resection is debated. Chemotherapy is the mainstay of treatment.

View Article and Find Full Text PDF

The understanding of brainstem gliomas and diffuse midline gliomas has significantly increased in the last decade. However, the management paradigm remains a dilemma. The critical location is the foremost factor dictating the outcome.

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
  • * These tumors often cause obstructive hydrocephalus and symptoms such as headaches, nausea, and impaired gait due to mass effect.
  • * Diagnosis primarily relies on imaging, while biopsy is required for histologic confirmation, except for germinomas, which can be identified through specific tumor markers; treatments vary from surgery for benign tumors to additional chemotherapy and radiotherapy for malignant ones.
View Article and Find Full Text PDF
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.
View Article and Find Full Text PDF

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.

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

High-grade glioma (HGG), a formidable and often incurable disease, presents an even greater challenge in low- and middle-income countries (LMICs) where resources and medical expertise are scarce. This scarcity not only exacerbates the suffering of patients but also contributes to poorer clinical outcomes. Particularly in LMICs, the underrepresentation of the population in clinical trials and the additional hurdles posed by financial constraints underscore an urgent need for contextspecific management strategies.

View Article and Find Full Text PDF

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.

View Article and Find Full Text PDF

Guidelines for low- and middle-income countries (LMICs) are needed in complex, multidisciplinary areas such as oncology, requiring mobilising considerable resources and specialists for coordinated care. Neuro-oncology guidelines have been primarily established in countries where technological advancements and robust care pathways facilitate broad resource utilisation. In contrast, LMICs require complex and region-specific interventions to provide equitable care.

View Article and Find Full Text PDF

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.

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

Brain tumour diagnosis involves assessing various radiological and histopathological parameters. Imaging modalities are an excellent resource for disease monitoring. However, manual inspection of imaging is laborious, and performance varies depending on expertise.

View Article and Find Full Text PDF

Approaches to brain tumour diagnosis and detecting recurrence after treatment are costly and significantly invasive. Developing peripheral-sample liquid biopsy tools is the key to enhancing our ability to prognosticate brain tumour subtypes and molecular heterogeneity. The present scoping review was designed to discuss current updates in liquid biopsy tools for diagnosis and guiding clinical management of brain tumours; we evaluated the literature within the context of low-and-middle-income country challenges.

View Article and Find Full Text PDF

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.

View Article and Find Full Text PDF

Over the past few decades, the global healthcare community has achieved remarkable success in controlling many communicable diseases across various regions. However, non-communicable diseases now constitute a significant portion of disease morbidity and mortality, particularly in low- and middle-income countries (LMICs). Among these, cancer, in particular, is witnessing a notable increase in incidence in many LMICs.

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