Morphometric localisation of pterion for lateral neurosurgical planning and approach.

OBJECTIVE: To localise pterion, as a safe landmark, on dry skulls, for performing various neurosurgical procedures. To analyse the variation in the type and location of pterion among Pakistani male population. METHODS: This cross sectional study was conducted form August 2018 to May 2019 on 50 dry skulls obtained from The anatomy departments of different medical colleges of Rawalpindi and Islamabad. Shape of the pterion was noted and different measurements of the pterion from the two reference points, frontozygomatic suture and superior border of zygomatic arch, were recorded. Mean differences between the right and left sides were compared using SPSS version 23. RESULTS: The pattern of pterion suture was sphenoparietal in 47 skulls, 2 skulls had epipteric type and 1 skull had a stellate type of pterion. The mean distance of pterion, on the right side, from posterolateral aspect of frontozygomatic suture was 2.490±0.596cm, 1.485±0.497cm, 2.922±0.697cm measured as horizontal, vertical and direct respectively. The mean horizontal, vertical and direct frontozygomatic measurements on the left side were 2.265±0.574cm, 1.395±0.548cm, 2.717±0.665cm respectively. The mean frontozygomatic horizontal and direct measurements were significantly greater on the right side as compared to the left side (p value 0.001). The mean distance from superior border of zygomatic arch to the centre of pterion on the right and left sides were 3.744±0.444cm and 3.644±9.473 respectively. CONCLUSIONS: The findings of the study provided important information regarding the probability of type and location of pterion in Pakistani males for lateral skull neurosurgical planning, especially when CT scan facility is not available.

Haematological outcomes in progression of malaria: A cohort study from district Dera Ismail Khan, Pakistan.

Malaria is the second highest reported disease from public health sector which affects about 4 million people each year in Pakistan. The study sought to evaluate the haematological changes in malarial patients in order to find any relation of these changes with malarial pathogenesis. This cross sectional descriptive study was designed at the pathology department of Gomal Medical College, Dera Ismail Khan during March 2015 to February 2017. Blood samples were collected from 400 malaria microscopy positive in EDTA tubes for the analysis of haematological parameters like Total leucocyte count, Haemoglobin, Platelets, Mean Cell Volume, Mean Cell Haemoglobin and Mean Cell Haemoglobin Concentration. Out of the 400 cases of malaria, 366 (91.5%) were Plasmodium vivax, 24 (6.0%) were Plasmodium falciparum and 10 (2.5%) were co-infection of Plasmodium vivax and Plasmodium falciparum infection. Anaemia was seen in 148 (37%) of cases; thrombocytopenia was 316(79%) and 60 (15%) cases had leucopenia. This study shows that malarial patients exhibited important changes in haematological parameters like thrombocytopenia; anaemia and leucopenia are significant predictors of malaria infection. When used in combination with other clinical and microscopy methods, these parameters could improve the diagnosis and treatment of malaria.