Medicine and Health Sciences Commons^™

Exploring The Uncommon: A Case Report On Localized Peritonitis Caused By Ingested Toothpick, Narmeen Asif, Salva Shariq, Abdul Rehman Alvi

Department of Surgery

Introduction: Bowel perforation is a serious emergency. Occasionally, sharp objects like toothpicks can get stuck in narrow parts of the small intestine, potentially resulting in impaction, obstruction, or perforation.
Presentation of case: A 20-year-old male arrived at our hospital's emergency department with sudden, severe abdominal pain persisting for 24 h. On examination, his abdomen showed tenderness, and bowel sounds were reduced. Contrast-enhanced computed tomography (CECT) indicated possible small intestine inflammation due to a foreign object and a diagnostic laparoscopy revealed a hyperemic terminal ileum.
Discussion: This case involves ileal perforation from an unnoticed toothpick ingestion. Detecting foreign object perforations is …

Immunohistochemical Detection And Prognostic Significance Of P53, Epidermal Growth Factor Receptor, Murine Double Minute 2, And Isocitrate Dehydrogenase 1 In Glioblastoma Multiforme Patients Of Pakistan, Syed Muhammad Adnan Ali, Muhammad Shahzad Shamim, Syed Ather Enam, Zubair Ahmad, Yumna Adnan, Hasnain Ahmed Farooqui

Department of Surgery

Introduction: Glioblastoma multiforme (GBM) is one of the deadliest cranial tumors occurring in adults. Various biomarkers have been tested for their significance in diagnosis, prognosis, and treatment of GBM. Some well-studied markers in GBM are Isocitrate dehydrogenase 1 (IDH1), Murine double minute 2 (MDM2), Epidermal Growth Factor Receptor (EGFR), and p53. The aim of this study was to investigate the protein expression of these markers in GBM patients of Pakistan.
Methods: A total of 102 surgically resected formalin-fixed paraffin-embedded specimens from patients diagnosed and treated at Aga Khan University Hospital were included in this study. Immunohistochemistry (IHC) for IDH1, MDM2, …

Case Report: Axilla Fibroadenoma - An Atypical Presentation, Safna Naozer Virji, Lubna Mushtaque Vohra, Syeda Sakina Abidi, Romana Idress

Department of Surgery

No abstract provided.

Identifying The 'Vulnerable Plaque' In Asymptomatic Carotid Artery Disease Patients, Zia Ur Rehman

Department of Surgery

No abstract provided.

High Cd44 Immunoexpression Correlates With Poor Overall Survival: Assessing The Role Of Cancer Stem Cell Markers In Oral Squamous Cell Carcinoma Patients From The High-Risk Population Of Pakistan, Yumna Mirza, Syed Adnan Ali, Hasnain Ahmed Farooqui, Hammad A. Kayani, Romana Idress, Mohammad Sohail Awan

Department of Surgery

Oral squamous cell carcinoma (OSCC) is a top-ranked cancer in the Pakistani population, and patient survival has remained unchanged at ∼50% for several decades. Recent advances have claimed that a subset of tumour cells, called cancer stem cells (CSCs), are responsible for tumour progression, treatment resistance, and metastasis, which leads to a poor prognosis. This study investigated the impact of CSC markers expression on overall survival (OS) and disease-free survival (DFS) of OSCC patients. Materials and Methods. Immunohistochemistry was used to evaluate CD44, CD133, L1CAM, and SOX2 expression in a well-characterized cohort of 100 Pakistani patients with primary treatment …

Understanding Deep Learning - Challenges And Prospects, Niha Adnan, Fahad Umer

Department of Surgery

The developments in Artificial Intelligence have been on the rise since its advent. The advancements in this field have been the innovative research area across a wide range of industries, making its incorporation in dentistry inevitable. Artificial Intelligence techniques are making serious progress in the diagnostic and treatment planning aspects of dental clinical practice. This will ultimately help in the elimination of subjectivity and human error that are often part of radiographic interpretations, and will improve the overall efficiency of the process. The various types of Artificial Intelligence algorithms that exist today make the understanding of their application quite complex. …

Concordance Between Clinical And Pathological Response Assessment After Neo-Adjuvant Chemotherapy In Patients With Invasive Lobular Carcinoma, Aisha Shaikh, Muhammad Usman Tariq, Shaista Khan, Romana Idress, Lubna Mushtaque Vohra, Saira Fatima Shaikh, Hira Waheed

Department of Surgery

Background: Neo-adjuvant chemotherapy (NAC) is frequently administered in breast carcinoma patients. The clinical response to NAC guides further treatment. The pathological response is not only an independent prognostic factor, but it also guides further treatment and prognosis.
Objectives: The aim of our study was to find the degree of concordance between clinical and pathological response assessments after NAC in Invasive lobular Carcinoma (ILC) cases by using World Health Organization (WHO) criteria and different pathological systems, respectively. We also tried to identify any useful parameter of clinical assessment that could better correlate with pathologic assessment and provide a better estimation of …

Percutaneous Venoplasty For Central Venous Stenosis: Effect On Patient's Symptoms And Patency Of Arteriovenous Accesses, Zia Ur Rehman, Abdul Hakeem Memon, Raza Sayani, Nida Zahid

Department of Surgery

Objective: To determine symptomatic relief and patency rate of arteriovenous (AV) fistulae and grafts after venoplasty in patients with central venous stenosis (CVS) on hemodialysis.
Study Design: Case series.
Place and Duration of Study: The Aga Khan University Hospital, Karachi, from January 2012 to December 2017.
Methodology: The data of patients who had one session of successful venoplasty for CVS were reviewed. The outcomes measured were symptomatic recovery and improvement in the patency of AV accesses. Symptomatic recovery was termed 'complete', when there was complete symptomatic relief after venoplasty; and 'partial' when the procedure was technically successful, but symptoms were …

Significantly Low Effective Dose From 18fdg Pet/Ct Scans Using Dose Reducing Strategies: "Lesser Is Better", Maseeh Uz Zaman, Nosheen Fatima, Unaiza Zaman, Rabia Tahseen

Department of Surgery

Abstract

BACKGROUND:

Fluorodeoxyglucose (18FDG) PET/CT imaging has become an important component of the management paradigm in oncology. However, the significant imparted radiation exposure is a matter of growing concern especially in younger populations who have better odds of survival. The aim of this study was to estimate the effective dose received by patients having whole body 18FFDG PET/CT scanning as per recent dose reducing guidelines at a tertiary care hospital.

MATERIALS AND METHODS:

This prospective study covered 63 patients with different cancers who were referred for PET/CT study for various indications. Patients were prepared as per departmental protocol and 18FDG …

Outcome And Cost Effectiveness Of Autobiographically Guided Surgical Clip Placement For Tumor Localization In Patients Undergoing Neo-Adjuvant Chemotherapy For Breast Cancer., Imrana Masroor, Sana Zeeshan, Shaista Afzal Saeed, Saira Naz, Madeeha Ali, Khabir Ahmad, Shaista Khan

Department of Surgery

Abstract

BACKGROUND:

To determine the outcome and cost saving by placing ultrasound guided surgical clips for tumor localization in patientsundergoing neo-adjuvant chemotherapy for breast cancer.

MATERIALS AND METHODS:

This retrospective cross sectional analytical study was conducted at the Department of Diagnostic Radiology, Aga Khan University Hospital, Karachi, Pakistan from January to December 2014. A sample of 25 women fulfilling our selection criteria was taken. All patients came to our department for ultrasound guided core biopsy of suspicious breast lesions and clip placement in the index lesion prior to neo-adjuvant chemotherapy. All the selected patients had biopsy proven breast cancer.

RESULTS: …

Temporal Trends In Results Of 9170 Myocardial Perfusion Imaging Studies (2004 To 2013)., Nosheen Fatima

Department of Surgery

Abstract

BACKGROUND:

To assess the frequency of normal and abnormal myocardial perfusion imaging (MPI) in a consecutive cohort of patients from Pakistan over a period of 8.5 years.

MATERIAL AND METHODS:

We assessed 9170 patients who had undergone stress-rest MPI between January 2004 and June 2013. Patients were assessed for change in demographics, risk factors, and frequency of abnormal and normal MPI.

RESULTS:

Overall mean age and male predominance of studied cohort was ≈ 55 years and ≈ 55:45 (M:F), respectively, with no appreciable decline or rise. Marked decline in exercise as mode of stress (from 71% to 35%, p …

Abdominal Tuberculosis With Massive Jejunal Haemorrhage, Abdul Rehman Alvi, Tanveer Ui Haq, Amyn Pardhan

Department of Surgery

ABSTRACT Jejunum is a rare site of involvement in intestinal tuberculosis (TB) and massive lower gastrointestinal haemorrhage is an even rare reported condition. The authors report a 15-year-old female student, who presented with fever, anaemia, hypoalbunemia and developed massive lower gastrointestinal haemorrhage during hospital stay. The diagnosis of abdominal TB was established on tissue biopsy; tissue culture was positive for Mycobacterium TB. Optimal outcome was achieved with aggressive resuscitation, repeated mesenteric angio-embolization and anti-tuberculosis chemotherapy