Medicine and Health Sciences Commons^™

Clinical Study On The Use Of Nozovent In A Tertiary Care Setting, M Sohail Awan, M Mubarik Ali, Manzoor Ahmed, Asim Iqbal, M Javed Aslam

Section of Otolaryngology, Head & Neck Surgery

Objective: To assess the effectiveness of the Nozovent device in Pakistani subjects at Aga Khan University Hospital, Karachi and Sir Ganga Ram Hospital, Lahore from 15 January 2001 to 15 January 2002.Methods: Sixty males and 40 females were selected by non probability purposive sampling, from OPD of ENT Department, complaining of nasal obstruction due to various reasons, e.g. vasomotor rhinitis, allergic rhinitis, congestion during pregnancy and menstruation, common cold, traumatic nose and nasal valve problem.Results: All patients benefited subjectively but the degree of relief varied in individuals.CONCLUSION: The Nozovent provides a unique method to relieve nasal obstruction with no side …

Diagnostic Value Of Fine Needle Aspiration Cytology In Parotid Tumors, Muhammad Sohail Awan, Zafar Ahmad

Section of Otolaryngology, Head & Neck Surgery

Objective: To evaluate the usefulness and accuracy of fine needle aspiration cytology in the diagnosis of parotid gland tumors.Methods: We reviewed files of all patients who underwent parotidectomy for various parotid pathologies at Aga Khan University Hospital. Study design included a comparison between results of preoperative FNAC with final histopathological diagnosis. Galen & Ganbino method was used to calculate sensitivity and specificity of FNAC.Results: Among 50 patients reviewed, there was one false positive and 3 false negative results reported on FNAC. This gives a sensitivity of FNAC for reporting malignancy to be 74% and specificity to rule out malignancy 97%. …

Surgical Palliation For Unresectable Pancreatic Carcinoma, Dildar Hussain, Muhammad Rizwan Khan, Rizwan Azami

Department of Surgery

Objectives: To review the results of surgical palliation for unresectable pancreatic carcinoma, and to analyze the morbidity and mortality associated with the surgical procedure. The reasons for readmission after discharge from the hospital were also analyzed.Methods: A retrospective study from 1995 to 2001 was done on 30 patients with pancreatic cancer operated with palliative intent, or those explored with curative intent but histopathology revealed positive resection margins or lymph node metastasis.Results: Twenty-five (83.25%) patients were above 50 years of age. There were 16 (53.28%) male, and 14 (46.62%) females, 8 (26.64%) had diabetes mellitus, 2 (6.66%) chronic pancreatitis and 4 …

Preventing Neural Tube Defects By Folic Acid Fortification Of Flour, Rashid Jooma

Section of Neurosurgery

No abstract provided.

Demystifying Health Care, Khabir Ahmed

Department of Surgery

No abstract provided.

Blinding Trachoma : A Disease Of Poverty, Khabir Ahmed, Pashtoon M. Kasi, Ahmed I Gilani, Naveed Janjua

Department of Surgery

No abstract provided.

Is Extended Volume External Beam Radiation Therapy Covering The Anastomotic Site Beneficial In Post-Esophagectomy High Risk Patients?, Edward Yu, Rashid Dar, George Rodrigues, Larry Stitt, Gregory Videtic, Pauline Truong, Anna Tomiak, Robert Ash, Ed Brecevic, Richard Inculet, Richard Malthaner, Mark Vincent, Ian Craig, Walter Kocha, Michael Lefcoe

Edward Yu

Background and purpose: To assess the impact of extended volume radiation therapy (RT) with anastomotic coverage on local control in high risk post-operative esophageal cancer patients. Patients and methods: This is a retrospective study of high risk (T(3), T(4), nodes positive, with or without margin involvement) post-operative esophageal cancer patients treated at London Regional Cancer Centre from 1989 to 1999. After esophagectomy, all patients received adjuvant combined modality therapy consisting of four cycles of fluorouracil-based chemotherapy, and loco-regional RT with or without coverage of the anastomotic site. RT dose ranged from 45 to 60 Gy at 1.8-2.0 Gy/fraction with treatment …

Cystic Breast Lymphangioma, S N. Waqar, H Khan, S F. Mekan, N Kayani, A J. Raja

Department of Biological & Biomedical Sciences

No abstract provided.

Insecurity And Lack Of Funds Hamper Progress On Afghan Health Service, Khabir Ahmed

Department of Surgery

Ambitious Afghan Government plans to provide basic health-care services to 25 million
Afghan people who have one of the lowest health standards in the world are being
hampered by a lack of funds and mounting insecurity, government and humanitarian officials
said. Abdullah Sherzai, Deputy Minister of Public Health, told the Bulletin that his ministry
was still waiting for almost half the funds needed for this year's budget alone. Donors, like
USAID and The World Bank, have approved the Afghan Government plan.

Living Donor Liver Transplantation: Surgical Techniques And Innovations, Vivian C. Mcalister

Vivian C. McAlister

A colleague and I attended a talk about a set of liver transplant experiments in mice, which the speaker had designed to undermine a commonly held immunological belief. My companion (who should have known better) afterward asked me rhetorically, "What's next? Heart transplantation in a tadpole?"

When does the awe-inspiring give way to the commonplace? Technically wonderful surgery is considered ordinary not because it is commonly done but because the holder of this opinion has no image of the technique.

Not long ago, resectional hepatic surgery was followed by the development of orthotopic liver transplantation. Although both techniques have matured …

Spenderblut Vom Rind

Vivian C. McAlister

Chance-Type Flexion-Distraction Fracture Of Lumbar Spine, Arshad A. Siddiqui, Ahmad Ali Shah

Section of Neurosurgery

A case of a twenty years old male who had been hit by a van at the lower back, presented two weeks later with complete paraplegia and double incontinence is presented. Radiological imaging revealed shearing of spine with fracture line slicing through the second lumbar (L2) vertebra going across all the three vertebral columns with complete retrolisthesis of upper fragment. He was managed conservatively with immobilization and rehabilitation.

Diagnostic Surgical Pathology: The Importance Of Second Opinion In A Developing Country, Z. Ahmed, N. Yaqoob, S. Muzaffar, N. Kayani, Shahid Pervez, S. H. Hasan

Department of Pathology and Laboratory Medicine

Objective: To review the cases sent to the section of histopathology, Aga Khan Universty (AKU) for second opinion and see whether there are significant differences in the original outside diagnosis and the subsequent diagnosis submitted by us.

Methods: A retrospective study of all consecutive cases for second opinion in the form of paraffin blocks from 1st Novemver 2001 to 31st July 2002. The primary submitted diagnosis in each case was compared with the subsequent AKU diagnosis.

Results: The study included a total of 381 cases. However, in 45 cases (11.81%), initial histopathological diagnosis was not provided. Out of the remaining …

Passing The Boards: Can Usmle And Orthopaedic In-Training Examination Scores Predict Passage Of The Abos Part-I Examination?, Gregg R Klein, Matthew S Austin, Susan Randolph, Peter F Sharkey, Alan S Hilibrand

Department of Orthopaedic Surgery Faculty Papers

No abstract provided.

Complete Surgical Excision Of Intramedullary Schwannoma At The Craniovertebral Junction In Neurofibromatosis Type-2, A A. Siddiqui, A A. Shah

Section of Neurosurgery

Intramedullary spinal schwannomas are extremely rare. We describe a case of a 13-year-old female who was found to have an intramedullary schwannoma at craniovertebral junction along with incidental bilateral acoustic neuromas, which was excised completely. To our knowledge, this is the first report of a case of intramedullary schwannoma in association with NF-2 located at the craniovertebral junction. The literature has been reviewed with emphasis on radiological imaging, histopathological diagnosis and technique to achieve complete microsurgical excision.

Esophageal Foreign Body In Neonates, Tasneem Fatima, M A M Khan, N Uddin

Section of Paediatric Surgery

No abstract provided.

Paraduodenal Hernia: A Case Report, A Munir, S M. Saleem, S Hussain

Section of Paediatric Surgery

No abstract provided.

An Audit Of Head Trauma Care And Mortality, Arshad A. Siddiqui, Hasnain Zafar, S H. Bashir

Section of Neurosurgery

Objective: To analyze the factors contributing to deaths from head trauma by using standardized assessment parameters and to provide a peer-review of head injury deaths with focus on identifying deficiencies and analyzing contributory factors.
Design: Descriptive study.
Place and duration of study: The study was carried out at the Emergency, Aga Khan University Hospital during January 1998 to December 1999.
Subjects and method: One hundred and three patients above the age of 15 years presenting alive to the Aga Khan University Hospital (AKUH) emergency with head injury were included in this study. Identified deaths data was reviewed by the Hospital …

Successful Use Of Angiographic Embolization To Control Hemorrhage From Blunt Pelvic Trauma In A Pediatric Patient, Z A. Qasim, R Masood, M A. Mateen

Section of Paediatric Surgery

No abstract provided.

Peer Review Audit Of Trauma Deaths In A Developing Country, Aa Jat, Mr Khan, Hasnain Zafar, Aj Raja, Q Hoda, R Rehmani, Rh Lakdawala, S. Bashir

Section of General Surgery

OBJECTIVES: Peer review of trauma deaths can be used to evaluate the efficacy of trauma systems. The objective of this study was to estimate teh proportion of preventable trauma deaths and the factors contributing to poor outcome using peer review in a tertiary care hospital in a developing country.
METHODS: All trauma deaths during a 2-year period (1 January 1998 to 30 December 1998) were identified and registered in a computerized trauma registry, and the probability of survival was calculated for all patients. Summary data, including registry information and details of prehospital, emergency room, and definitive care, were provided to …

An Experience With Free Scapular Flap For Reconstruction Of Lower Extremity Defects At Aga Khan University Hospital Karachi, Pervaiz Mehmood Hashmi

Section of Orthopaedic Surgery

Background: Reconstruction of large composite tissue defects with exposed vital structures and weight bearing surfaces are extremely difficult for reconstructive surgeons. Coverage of such difficult defects can be achieved with free tissue transfer provided microsurgical expertise is available. This study was carried out to determine the outcome of free scapular flaps performed for lower extremity defects.
Methods: Clinical records of the patients were reviewed and important variables included demographic data, etiology of soft tissue defects, site and size of defect, complications and percentage of wound coverage by flap. Patient satisfaction and objective assessment of flap coverage and motion of involved …

Extradural Granulocytic Sarcoma Causing Acute Paraparesis, Arshad A. Siddiqui, Naim-Ur Rehman

Section of Neurosurgery

A case of 9 years old female presenting with rapidly progressive paraparesis during remission phase of acute myeloblastic leukemia is reported. Radiological imaging revealed an extradural mass in the upper dorsal spine producing significant cord compression. The patient showed a dramatic neurological recovery after spinal cord decompression and subsequently treated with appropriate chemotherapy and local radiotherapy.

Neonatal Extra-Renal Wilm's Tumour, S Hussain, S Nizami, F Tareen

Section of Paediatric Surgery

No abstract provided.

Boerhaave's Syndrome: A Diagnostic Dilemma In The Emergency Room, Ab Zubairi, I Khalid, Saulat H. Fatimi, J Hussain, N Salahuddin

Department of Medicine

Boerhaave's syndrome is a potential lethal condition which presents not only a diagnostic but also a therapeutic challenge. Errors in diagnosis are usually caused by unawareness of its varied and atypical presentations. All clinicians need to be aware of this lethal disease, its frequent unusual presentations and the importance of early diagnosis.

Living-Donor Liver Transplantation: Surgical Techniques And Innovations By Tanaka, Koichi Inomata, Yukihiro Kaihara, Santoshi, Vivian C. Mcalister

Vivian C. McAlister

Living-donor liver transplantation combines the techniques of hepatic resection and transplantation. The principal difference between living donation of liver and resection is the absolute requirement in the former to maintain the integrity of the liver on each side of the dividing line. To do this, the surgeon must retain the vascular supply and drainage of both sides throughout the dissection, up to the moment of graft removal. In this book, Tanaka and colleagues take us through the surgery in a manner that is at once detailed and exciting, through the generous use of magnificent electronic photography.

Surgical Limits: The Life Of Gordon Murray By Shelly Mckellar, Vivian C. Mcalister

Vivian C. McAlister

Gordon Murray ranks as Canada’s greatest surgical pioneer, to whom history has been most unkind. Shelley McKellar has written a surgical biography that goes a long way toward explaining how this came about, and gives us a good opportunity to reassess Murray’s extraordinary career.

Fall Prevention Programs For The Elderly: A Bayesian Secondary Meta-Analysis, Joseph F. Lucke

Joseph Lucke

A secondary meta-analysis of programs to reduce falls in the elderly is undertaken to demonstrate a Bayesian analysis. The Bayesian statistical tradition is carefully distinguished from the standard Neyman-Pearson-Wald (NPW) statistical tradition. In the 12 studies, the logit effect size is used to compare treatment groups using a prevention program to control groups without a program. To contrast the Bayesian analysis, independent-effects and fixed-effect meta-analyses are first conducted in the NPW tradition. This is followed by Bayesian independent-effects and fixed-effect meta-analyses that numerically replicate the NPW results but have conceptually different interpretations. The final analyses comprise Bayesian random-effects and predictive …