Prostate Cancer: Patient Education For Changing Guidelines, 2018 University of Vermont College of Medicine
Prostate Cancer: Patient Education For Changing Guidelines, Richard Mendez
Family Medicine Block Clerkship, Student Projects
In May 2012 United States Preventative Services Task Force (USPSTF) recommended against prostate cancer screening, Grade D, with no other recommendation for providers. Since prostate cancer continues to be among the most common cancer in the United States among men, patients were exposed to previous guidelines during routine visits and require updated educational materials for primary care visits.
Primary Headache Disorders In The Adult General Population Of Pakistan - A Cross Sectional Nationwide Prevalence Survey., 2017 Headache Research Foundation of Pakistan, Karachi, Pakistan.
Primary Headache Disorders In The Adult General Population Of Pakistan - A Cross Sectional Nationwide Prevalence Survey., A. A. Herekar,, A. Ahmad, , U. L. Uqaili, Bilal Ahmed, J Effendi, S. Z. Alvi, , M. A. Shahab, U. Javed, A. D. Herekar, Rafiq Khanani, T. J. Steiner
Department of Medicine
Background: The large geographical gaps in our knowledge of the prevalence and burden of headache disorders include almost all of Eastern Mediterranean Region (EMR). We report a nationwide population-based study in Pakistan, an EMR country with the sixth largest population in the world, conducted as a project within the Global Campaign against Headache.
Methods: We surveyed six locations from the four provinces of Pakistan: Punjab, Sindh, Khyber Pakhtunkhwa and Baluchistan. We randomly selected and visited rural and urban households in each. One adult member (18–65 years) of each household, also randomly selected, was interviewed by a trained non-medical interviewer ...
Impact Of Natural Blind Spot Location On Perimetry., 2017 Harvard Medical School
Impact Of Natural Blind Spot Location On Perimetry., Mengyu Wang, Lucy Q. Shen, Michael V. Boland, Sarah R. Wellik, Carlos Gustavo De Moraes, Jonathan S. Myers, Peter J. Bex, Tobias Elze
Wills Eye Institute Papers
We study the spatial distribution of natural blind spot location (NBSL) and its impact on perimetry. Pattern deviation (PD) values of 11,449 reliable visual fields (VFs) that are defined as clinically unaffected based on summary indices were extracted from 11,449 glaucoma patients. We modeled NBSL distribution using a two-dimensional non-linear regression approach and correlated NBSL with spherical equivalent (SE). Additionally, we compared PD values of groups with longer and shorter distances than median, and larger and smaller angles than median between NBSL and fixation. Mean and standard deviation of horizontal and vertical NBSL were 14.33° ± 1.37 ...
The Effects Of Continuous Insulin Pump Therapy On Glycemic Control In Pregnant Type 1 Diabetics, 2017 Dominican University of California
The Effects Of Continuous Insulin Pump Therapy On Glycemic Control In Pregnant Type 1 Diabetics, Kimberly Kelsey
Senior Theses and Capstone Projects
Type 1 Diabetics have various ways of managing their diabetes that have been studied for their effectiveness. Pregnancy in the Type 1 Diabetic has been understudied. It is known that Diabetics in general have poorer pregnancy outcomes because of poor glycemic control. This coupled with the fact that the body needs 3-4 times more insulin as pregnancy comes to an end makes managing blood glucose levels challenging for diabetics (Lowdermilk, 2016, p. 689). For the Type 1 Diabetic, there are two main ways to control diabetes: multiple daily injections using at least two type of insulin and continuous subcutaneous insulin ...
Plasma Fibroblast Growth Factor-21 Levels In Patients With Inborn Errors Of Metabolism, 2017 George Washington University
Plasma Fibroblast Growth Factor-21 Levels In Patients With Inborn Errors Of Metabolism, Brian Kirmse, Juan Cabrera-Luque, Omar Ayyub, Kristina Cusmano-Ozog, Kimberly A. Chapman, Marshall L. Summar
Pediatrics Faculty Publications
Fibroblast growth factor-21 (FGF21) levels are elevated in patients with primary mitochondrial disorders but have not been studied in patients with inborn errors of metabolism (IEM) known to have secondary mitochondrial dysfunction. We measured plasma FGF21 by ELISA in patients with and without IEM. FGF21 levels were higher in patients with IEM compared to without IEM (370 pg/dL vs. 0–65 pg/dL). Further study of FGF21 as a biomarker in IEM is warranted.
Confirmation That Mat1a P.Ala259val Mutation Causes Autosomal Dominant Hypermethioninemia, 2017 George Washington University
Confirmation That Mat1a P.Ala259val Mutation Causes Autosomal Dominant Hypermethioninemia, M J. Muriello, S Viall, T Bottiglieri, K Cusmano-Ozog, C R. Ferreira
Pediatrics Faculty Publications
Methionine adenosyltransferase (MAT) I/III deficiency is an inborn error of metabolism caused by mutations in MAT1A, encoding the catalytic subunit of MAT responsible for the synthesis of S-adenosylmethionine, and is characterized by persistent hypermethioninemia. While historically considered a recessive disorder, a milder autosomal dominant form of MAT I/III deficiency occurs, though only the most common mutation p.Arg264His has ample evidence to prove dominant inheritance. We report a case of hypermethioninemia caused by the p.Ala259Val substitution and provide evidence of autosomal dominant inheritance by showing both maternal inheritance of the mutation and concomitant hypermethioninemia. The p.Ala259Val ...
Good Knowledge About Hypertension Is Linked To Better Control Of Hypertension; A Multicentre Cross Sectional Study In Karachi, Pakistan., Aysha Almas, Saniya Siraj Godil, Saima Lalani, Zahra Aziz Samani, Aamir Hameed
Department of Medicine
BackGround: According to the National Health survey only 3% of the population has controlled hypertension. This study was designed to elucidate the knowledge about hypertension in hypertensive patients at three tertiary care centers in Karachi. Secondly we sought to compare the knowledge of those with uncontrolled hypertension and controlled hypertension.
Methods: It was a cross-sectional study conducted at The Aga Khan University hospital (AKUH), Ziauddin Hospital (ZH) and Civil hospital, Karachi (CHK. All diagnosed Hypertensive patients (both inpatients and outpatients) coming to a tertiary care hospital in Pakistan aged > 18 years were included. Patients were categorized into 2 groups: controlled ...
Successful Surgical Embolectomy In Acute Massive Bilateral Pulmonary Embolism, 2017 Aga Khan University
Successful Surgical Embolectomy In Acute Massive Bilateral Pulmonary Embolism, Taimur Saleem, Saulat Hasnain Fatimi, Umair Khalid
Acute massive pulmonary embolism is a life-threatening emergency that must be promptly diagnosed and managed. A 52-year-old man presented with progressively increasing dyspnoea for three days. He had a previous history of chronic obstructive pulmonary disease and was currently a heavy smoker. Examination revealed bilateral wheezing. Chest x-ray and electrocardiography showed non-specific changes. The patient was initially treated as a case of chronic obstructive pulmonary disease exacerbation secondary to pneumonia. However, despite optimum medical management, his oxygen saturation deteriorated. Emergent computed tomography scan of chest showed bilateral massive pulmonary emboli. As the patient's haemodynamic status rapidly deteriorated, cardiothoracic surgery ...
Right Ventricular Perforation: A Rare Complication Of Pulmonary Artery Catheterization, 2017 Aga Khan University
Right Ventricular Perforation: A Rare Complication Of Pulmonary Artery Catheterization, Khalid Ahsan, Mohammad Hamid, Saulat H. Fatimi, Ijaz Hidayat
A 70 years old male underwent Coronary Artery Bypass and Graft (CABG) surgery. After induction, a Pulmonary Artery Catheter (PAC) was inserted via right IJV with some difficulty in achieving PA tracing. During distal RCA anastomosis, surgeon noticed PAC tip coming out of Right Ventricular (RV) surface. Resistance was felt on trying to pull PAC, so it was left there. Cardiac surgeon then opened the Right Atrium (RA) and pulled out the catheter. Multiple attempts during insertion of PA catheter should always raise the suspicion of PAC tip slipping back into the RV. It should be closely monitored during surgery ...
Successful Tricuspid Valvectomy In A Septic Patient With Tricuspid Valve Endocarditis, 2017 Aga Khan University
Successful Tricuspid Valvectomy In A Septic Patient With Tricuspid Valve Endocarditis, Taimur Asif Ali, Saulat Hasnain Fatimi, Syed Saad Naeem, Wasiq Faraz Rawasia
Abstract Endocarditis is characterized by vegetations, which is a mass of platelets, ﬁbrin, micro-colonies of micro-organisms, and inﬂammatory cells, in the endocardium. Over the past three decades, the incidence of right-sided endocarditis has risen dramatically in Pakistan. We report a 36-year woman with a history of repeated intravenous analgesic injections for low back pain, presenting with high grade fever, sepsis and a white cell count of 44,000 with 90% neutrophils. Echocardiography showed large mobile vegetations on TricuspidValve (TV). Tricuspid Valve Endocarditis (TVE) is generally responsive to medical treatment; however, about 25% of TVE patients require surgical intervention. Long-term survival ...
Successful Management Of A Stab Wound To The Left Ventricle, 2017 Ziauddin University
Successful Management Of A Stab Wound To The Left Ventricle, Jaleed Ahmad Gillani, Hamza Ar Khan, Omar Irfan, Saulat H. Fatimi
A 24 year old male presented to the emergency room with a 2 hour history of knife stab wound. He was haemodynamically stable with good bilateral air entry. However on X-ray an enlarged cardiac silhouette was seen. The patient suddenly became hypotensive and on suspicion of cardiac tamponade a catheter was introduced in pericardial space, but the measure was unsuccessful and he was rushed to the Operating Room. During the surgery a 2 cm long laceration was identified in the mid-left ventricular (LV) wall less than 1mm away from the Left Anterior Descending (LAD) Artery. The Left Anterior Descending Vein ...
Tracheal Reconstruction For Comlex Acute Tracheal Stenosis, 2017 Aga Khan University
Tracheal Reconstruction For Comlex Acute Tracheal Stenosis, Saulat H. Fatimi, M.Qasim Raza, Alina Ghani, Nilay Shah, Awais Ashfaq
Tracheal stenosis refers to a reduction in the size of the tracheal lumen and can be due to a myriad of reasons, but the most common remains trauma. In iatrogenic situations, internal trauma is the most likely culprit, resulting from prolonged intubation. Our case reviews a patient who developed severe tracheal stenosis (90% reduction in lumen size) within a month of a threeday- long intubation, and presented to the emergency room with dyspnea, orthopnea, and stridor. Tracheal reconstruction with resection of the stenosed segment and end-to-end anastomosis was done. The patient returned a month later with re-stenosis, and underwent tracheal ...
Successful Resection Of Lymphangioma Of The Neck And Mediastinum Presenting As Stridor In A 12 Year Old Child, 2017 Jinnah Sindh Medical University
Successful Resection Of Lymphangioma Of The Neck And Mediastinum Presenting As Stridor In A 12 Year Old Child, Babar Irfan, Maha Tahir, Omar Irfan, Hamza Abdur Rahim Khan, Saulat H. Fatimi
Lymphangiomas are congenital malformations of lymphatic tissue. This benign condition is generally found in the neck region and is discovered by 2 years of age. Here we report the case of a 12 year old child who presented with a cervical and mediastinal cystic hygroma that had progressed to such a space occupying nature as to cause the shifting of the trachea. The entire mass was successfully resected with a lower neck incision. Our case suggests the necessity of considering cystic lymphangioma in the differential diagnosis of lateral neck masses and use of adequate imaging to substantiate the preoperative diagnosis.
Primary Melanotic Schwannoma With Typical Histology, 2017 Aga Khan University
Primary Melanotic Schwannoma With Typical Histology, Usman B. Mahmood, Fazal Wahab Khan, Benish Fatima, Muhammad Usman Tariq, Saulat Hasnain Fatimi
Abstract We present a case of a 17-year male with a soft tissue density spreading from the neural foramina (T3) of the spinal cord and involving the right upper thoracic cavity. We managed the patient through surgical intervention and resected the complete tumor. Gross definition and microscopic findings of the resected tissue revealed the definitive diagnosis of melanotic schwannoma. The histological characteristics in this case were very specific and harbour an important diagnostic clue for this rare disease. Malignant melanoma was ruled out on the basis of histological findings. The patient recovered completely and was healthy on one-year follow-up.
Near Complete Aortic Transection And Its Successful Repair Using A Novel Cardiopulmonary Bypass Technique, 2017 Dow University of Health Sciences, Karachi,
Near Complete Aortic Transection And Its Successful Repair Using A Novel Cardiopulmonary Bypass Technique, Dania Aijaz Shah, Adil Aijaz Shah, Syed Jawad Shah, Muhammad Naseer Khan, Saulat H. Fatimi
Abstract The case of a 38-year old female, victim of a road traffic accident who presented with a near complete aortic transection is presented. An emergent repair employing cardiopulmonary bypass was attempted in the operating room. Anticipating a high-risk of compromise to cerebral perfusion from air micro-emboli, the bypass was attempted with an innovative approach involving the successful cannulation of the pulmonary artery and descending aorta. The patient survived and was found to be doing well on subsequent post-operative visits.
How Vats Has Changed The Management Of Spontaneous Pneumothorax In The 21st Century, 2017 Aga Khan University
How Vats Has Changed The Management Of Spontaneous Pneumothorax In The 21st Century, Saulat H. Fatimi, Hashim Muhammad Hanif, Sana Mansoor, Marium Muzaffar
Objective: To determine the outcome of patients having undergone Video Assisted Thoracoscopic Surgery (VATS) for spontaneous pneumothrox in terms of hospital stay, complications and recurrence. Methods: The netrospective study included the review of 39 cases who had presented with spontaneous pneumothorax at the Aga Khan University Hospital, Karachi, Pakistan, between January 2001 to November 2008 and had undergone video assisted thoracoscopic surgery (VATS). Results: The duration of hospital stay (had a range of 3 to 9 days), and the length of chest tube in place (a range of 2 to 8 days), 2 (5.1%) patients developed recurrence after VATS ...
Hydatid Cyst Disease Of The Thorax, 2017 Aga Khan University
Hydatid Cyst Disease Of The Thorax, Saulat H. Fatimi, Naima Waqar Butt, Taimur Saleem, Mohammad Asim Beg
Hydatid disease is a frequently encountered entity in endemic areas and constitutes a serious health problem. The lung is the second most commonly affected organ after the liver. In three of four cases of pulmonary hydatid cyst, the cyst is solitary. The early phase after primary infection is always asymptomatic. Primary symptoms in patients with pulmonary cystic echinococcosis include cough, fever, and chest pain. The clinical and radiological manifestations for the hydatid cyst in the lung depend on the integrity of the cyst. Bronchial fistulization is an important event in the evolution of the cyst. In cases of dubious orientation ...
Giant Synovial Cell Sarcoma Of The Thorax In A 46-Year-Old Man: A Case Report., 2017 Aga Khan University
Giant Synovial Cell Sarcoma Of The Thorax In A 46-Year-Old Man: A Case Report., Saulat Hasnain Fatimi, Taimur Saleem
Background:Although synovial cell sarcoma is a common tumor of the extremities, its occurrence in the thorax has been less frequently documented. Case Presentation: A 46-year-old Pakistani man presented with a 2 month history of progressively increasing cough and left lower chest pain. Initial evaluation was done using a chest x-ray, the Patient was found to have a large mass involving the lower portion of the left chest. A computed tomography scan was performed next which showed a large mass involving the left chest wall with invasion into the pericardium and left hemidiaphragm. En bloc surgical resection of the tumor ...
Incidental Finding Of A Giant Aortic Root Aneurysm And Its Repair, 2017 Aga Khan University
Incidental Finding Of A Giant Aortic Root Aneurysm And Its Repair, Saulat H. Fatimi, Roheena Zainab Panni, Awais Ashfaq
The prevalence of aortic aneurysms is 3-4% in individuals more than 65 years. Age and haemodynamic factors play an important role in the development of aortic aneurysms. Most patients with aortic aneurysms are asymptomatic at the time of discovery. Thoracic aneurysms are usually found incidentally after chest radiographs or other imaging studies. The most common complications of thoracic aortic aneurysms are acute rupture or dissection. Some patients present with tender or painful nonruptured aneurysms. Patients are thought to be at increased risk for rupture and should undergo surgical repair on an emergent basis We document a case of a 66-year-old ...
Giant Pulmonary Bulla With Mediastinal Shift In A 12 1/2 Year Old Girl, 2017 Aga Khan University
Giant Pulmonary Bulla With Mediastinal Shift In A 12 1/2 Year Old Girl, Saulat H. Fatimi, Asif Jafferani, Awais Ashfaq
Pulmonary bulla in children represent interesting entities. Mostly congenital bronchopulmonary foregut malformations and acquired cysts like pneumatocoeles have also been described. We present a case of a 12 1/2 years old girl with acute onset respiratory distress symptoms harbouring a huge pulmonary cyst exhibiting mass effects, resulting in mediastinal deviation. Following initial workup, cyst excision was carried out which revealed presence of fungal hyphae that was susceptible to Fluconazole therapy post operatively. The case points out how a pulmonary cyst can present in older children with symptoms of respiratory distress and mass effects.