Open Access. Powered by Scholars. Published by Universities.®

Surgery Commons™

Open Access. Powered by Scholars. Published by Universities.®

Department of Surgery Docs

Articles 241 - 266 of 266

Full-Text Articles in Surgery

Management Outcome Of Residual Common Bile Duct Stones At Aga Khan University Hospital, Muhammad Rizwan Khan, Sameera Naureen, Dildar Hussain, Rizwan Azami Jan 2005

Management Outcome Of Residual Common Bile Duct Stones At Aga Khan University Hospital, Muhammad Rizwan Khan, Sameera Naureen, Dildar Hussain, Rizwan Azami

Department of Surgery Docs

Background: The frequency of residual common bile duct (CBD) stones in patients with previous cholecystectomy ranges from 2-10%, and a minimally invasive approach is generally recommended for these patients. This study reviews the experience in the management of residual CBD stones at the Aga Khan University Hospital.Methods: All adult patients diagnosed to have residual CBD stones, from 1993 to 2001, were identified and analyzed in terms of the treatment modality utilized and its associated complications. The role of endoscopic sphincterotomy was particularly analyzed in our set-up.Results: The study population consisted of 66 patients. The mean age was 52 (range:18-84 years) …

Go to article

Surgical Palliation For Unresectable Pancreatic Carcinoma, Dildar Hussain, Muhammad Rizwan Khan, Rizwan Azami Dec 2004

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

Department of Surgery Docs

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 …

Go to article

Demystifying Health Care, Khabir Ahmed Nov 2004

Demystifying Health Care, Khabir Ahmed

Department of Surgery Docs

No abstract provided.

Go to article

Blinding Trachoma : A Disease Of Poverty, Khabir Ahmed, Pashtoon M. Kasi, Ahmed I Gilani, Naveed Janjua Nov 2004

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

Department of Surgery Docs

No abstract provided.

Go to article

Insecurity And Lack Of Funds Hamper Progress On Afghan Health Service, Khabir Ahmed Sep 2004

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

Department of Surgery Docs

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.

Go to article

Continuous Quality Assessment; Development Of A Simple Computer Based Model For Audit, N K. Waheed, F S. Awan, A Ahad, A Rahman, K M. Pal Sep 2001

Continuous Quality Assessment; Development Of A Simple Computer Based Model For Audit, N K. Waheed, F S. Awan, A Ahad, A Rahman, K M. Pal

Department of Surgery Docs

Objective: Accurate assessment of quality of care is a fundamental first step in the process of quality improvement. The vast amount of data generated in a hospital mandates some form of computerization for management of information. We describe a locally developed simple computer based program to access relevant information from a hospital patient management network. The objective was to reduce the amount of manual work involved for busy clinicians attempting to audit quality of care.Methods: A single surgical procedure, Laparoscopic Cholecystectomy was chosen. Quality indicators were identified by literature review as conversion rate from laparoscopic to open cholecystectomy and length …

Go to article

Thymic Hyperplasia: A Cause Of Respiratory Distress, F K. Tareen, S Hussain, F Moazam Aug 2001

Thymic Hyperplasia: A Cause Of Respiratory Distress, F K. Tareen, S Hussain, F Moazam

Department of Surgery Docs

No abstract provided.

Go to article

An Audit Of Blood Cross-Match Ordering Practices At The Aga Khan University Hospital: First Step Towards A Maximum Surgical Blood Ordering Schedule, T Chawla, G N. Kakepoto, M A. Khan Jul 2001

An Audit Of Blood Cross-Match Ordering Practices At The Aga Khan University Hospital: First Step Towards A Maximum Surgical Blood Ordering Schedule, T Chawla, G N. Kakepoto, M A. Khan

Department of Surgery Docs

Objective: In the absence of an explicit maximum blood order policy, ordering for blood transfusion is frequently based on subjective anticipation of blood loss instead of evidence based estimates of average requirement in a particular procedure. This study was done to assess current practice and the feasibility of a prospective randomized work to develop practice guidelines.METHOD: We audited transfusion data for elective surgical procedures in our hospital during the last 2 years. Cross-matched to transfused ratio (C/T ratio) and Transfusion Index (Ti) for each of the elective surgical procedures was performed during the study period. C/T ratio is used as …

Go to article

Diagnostic Issues In Abdominal Tuberculosis, M R. Khan, I R. Khan, K M. Pal Apr 2001

Diagnostic Issues In Abdominal Tuberculosis, M R. Khan, I R. Khan, K M. Pal

Department of Surgery Docs

Objective: To analyze the modes of presentation and diagnostic issues in the management of abdominal tuberculosis at a tertiary care hospital in a developing country, where most of the established diagnostic modalities are available.SETTING: The Aga Khan University Hospital, Karachi.Methods: This study is a retrospective review of medical records of all inpatients, diagnosed to have abdominal tuberculosis, from January 1991 to December 1997. The data was collected and particularly analyzed for spectrum of presentation and role of various diagnostic modalities. Of special interest was the sub-group of patients, who after all investigations did not have a firm diagnosis. Following a …

Go to article

Human Subject Research, Ethics And The Developing World, F Moazam Nov 2000

Human Subject Research, Ethics And The Developing World, F Moazam

Department of Surgery Docs

No abstract provided.

Go to article

Non-Small Cell Lung Cancer: Disease Spectrum And Management In A Tertiary Care Hospital, M R. Khan, S B. Hasan, S A. Sami Oct 2000

Non-Small Cell Lung Cancer: Disease Spectrum And Management In A Tertiary Care Hospital, M R. Khan, S B. Hasan, S A. Sami

Department of Surgery Docs

Objectives: To review the spectrum of presentation and the surgical management of Non Small Cell Lung Cancer (NSCLC) and the role of various diagnostic modalities in predicting the post-operative stage and the correlation of the post-operative stage with the chances of recurrence.SETTINGS: The Aga Khan University Hospital, Karachi--a tertiary care referral center in Paksitan.Methods: This is a retrospective study of medical records of all the patients who were managed at the Aga Khan University Hospital (AKUH) between 1988 and 1998. The patients with a diagnosis of lung cancer were identified using the ICD-9-CM coding system and the data was analyzed …

Go to article

Pilomatrixoma And Pilomatrix Carcinoma Deceptively Similar But Distinct Entities, T S. Khan, A Khan Jun 2000

Pilomatrixoma And Pilomatrix Carcinoma Deceptively Similar But Distinct Entities, T S. Khan, A Khan

Department of Surgery Docs

No abstract provided.

Go to article

Diagnosis And Management Of The Neonatal Cloaca, A Samad, S Hussain, M Arshad, F Moazam Feb 2000

Diagnosis And Management Of The Neonatal Cloaca, A Samad, S Hussain, M Arshad, F Moazam

Department of Surgery Docs

No abstract provided.

Go to article

The Use Of Intra Aortic Baloon Pump In Patients Undergoing Coronary Artery Bypass Grafting At The Aga Khan University Hospital, Karachi, Aamir M. Jafarey, Muneer Amanullah, Sajid A. Khan, Sulaiman B. Hasan Jan 2000

The Use Of Intra Aortic Baloon Pump In Patients Undergoing Coronary Artery Bypass Grafting At The Aga Khan University Hospital, Karachi, Aamir M. Jafarey, Muneer Amanullah, Sajid A. Khan, Sulaiman B. Hasan

Department of Surgery Docs

Objective: To review the experience in the use of Intra Aortic Balloon Pump (IABP) in patietits undergoing Coronary Artery Bypass Grafting (CABG) at a tertiary care hospital with a new Open Heart surgery program. Design: Retrospective study. Setting: The Aga Khan University Hospital, Karachi.
Patients: Medical records of all patients undergoing CABG between November 1994 and July 1997 were reviewed and those in whom IABP device was used, were included in this study.
Results: A total of 15 patients had IABP suppOrt during the study period. Four surgeries were done urgently while two were emergencies. There were three mortalities. Ejection …

Go to article

Preoperative Work Up: Are The Requirements Different In A Developing Country?, K M. Pal, I A. Khan, B Safdar Nov 1998

Preoperative Work Up: Are The Requirements Different In A Developing Country?, K M. Pal, I A. Khan, B Safdar

Department of Surgery Docs

In developing countries there is a tendency to advocate routine testing in asymptomatic healthy patients to identify undocumented significant medical conditions. A retrospective review of pre- operative laboratory investigations undertaken in patients attending the General Surgical department was performed. Three hundred and twenty patients case notes were reviewed, patients were selected on the basis of common general surgical procedures. Two hundred and sixteen patients (67.5%) did not have any associated medical illness on history and physical examination. Analysis of laboratory results showed that 42/216 (19.4%) had low hemoglobin. An abnormal chest X-ray was the next common abnormality 11/103 (10.6%). Mild …

Go to article

Appendicitis: A Continuing Challenge, K M. Pal, A Khan Jul 1998

Appendicitis: A Continuing Challenge, K M. Pal, A Khan

Department of Surgery Docs

Acute appendicitis is a common surgical emergency in urban setting, of a developing country. The computerised hospital patient database at Aga Khan University Hospital, Karachi, was utilised to obtain records of all adults with a histologically proven diagnosis of acute appendicitis. A review of patients treated over a 18 month period was undertaken. One hundred and three appendicectomies were performed for acute appendicitis during this period. The diagnosis was clinical in all cases. Investigations like leucocyte count and lower abdominal ultrasound scan were used to improve diagnostic accuracy without a clear advantage. A number of routine investigations like, haemoglobin estimation …

Go to article

Hydatidosis: Experience With Hepatic And Pulmonary Hydatid Disease, T Pishori, R Azami, S M. Ali Jul 1998

Hydatidosis: Experience With Hepatic And Pulmonary Hydatid Disease, T Pishori, R Azami, S M. Ali

Department of Surgery Docs

From 1989-1992, 35 cases comprising of 20 hepatic and 15 pulmonary hydatid cysts were seen. Four patients with pulmonary hydatid disease had previous or concomitant hepatic hydatidosis compared to no concomitant pulmonary hydatid disease in the hepatic group. Hepatic hydatid disease had a greater tendency to be right sides, infected and calcified. Anaphylactic reactions occurred in 3 of 20 patients with hepatic hydatid disease against none in 15 patients with pulmonary disease. Management consisted of evacuation, drainage and obliteration of the residual cavity by capittonage in the lung and omentoplasty in the liver. Two patients, one hepatic and one with …

Go to article

Open Fractures Caused By High Velocity Missiles: The Outcome Of Treatment Of 39 Fractures Followed For 1-3 Years, M A. Khan, R Hussain, S H. Khan, M Umar Nov 1997

Open Fractures Caused By High Velocity Missiles: The Outcome Of Treatment Of 39 Fractures Followed For 1-3 Years, M A. Khan, R Hussain, S H. Khan, M Umar

Department of Surgery Docs

Between 1993 and 1995, thirty-three patients having 39 fractures caused by missiles fired from a high velocity rifle were reviewed retrospectively between 1 and 3 years after injury and the outcome of treatment assessed. Majority (33 out of 39) were Grade III. Union was achieved in 35 out of 39 fractures, there was deep infection and delayed union in one case each. Non-union occurred in three fractures. The fractures were stabilized using different techniques, but highest complication rate was seen with the use of the static external fixator. This was related to the severe nature of the injury as well …

Go to article

Needle Localization Of Non-Palpable Breast Lesions, S Khan, N Mitha, F Kazi, M Siddiqui Jul 1996

Needle Localization Of Non-Palpable Breast Lesions, S Khan, N Mitha, F Kazi, M Siddiqui

Department of Surgery Docs

Screening mammography identifies suspicious, non palpable mammary lesions. Mammographic needle localization (MNL) is currently being used to facilitate excision biopsy of these lesions. Thirty-two patients underwent biopsies of the breast after MNL for non-palpable lesions. Mammographic indications for biopsy consisted of microcalcifications (48%), mass or abnormal density (21%) or mass+abnormal density (24%). The carcinoma was identified in four cases (12%). Two of these were in situ, one was microinvasive and one was frankly invasive. Three were treated with a modified radical mastectomy. One of these non palpable lesion demonstrated nodal metastasis but none showed distant metastasis. All radiologically detected abnormalities …

Go to article

Penile Fracture, M A. Khan, M N. Sulaiman Jun 1996

Penile Fracture, M A. Khan, M N. Sulaiman

Department of Surgery Docs

No abstract provided.

Go to article

The Extranasal Glioma - A Cause Of Neonatal Respiratory Distress, Muneer Amanullah, F Attar Z Mar 1996

The Extranasal Glioma - A Cause Of Neonatal Respiratory Distress, Muneer Amanullah, F Attar Z

Department of Surgery Docs

Normal brain tissue in an abnonnal configuration, occurring at a site away from the cranial cavity, is temied an Extranasal Glioma. Since its first description in 1852 by Reid2, only 140 patients with this entity have been reported. Heterotopic brain tissue when present in a confined area may cause obstmction, pressure and pain. Its occurrence in the nasopharyngeal region is relatively rare and only 19 cases have been reported so far2, the majority presenting with respiratory distress in the early neonatal period. The objective of this report is to create an awareness amongst the physicians of …

Go to article

Intestinal Obstruction In Adults At The Aga Khan University Hospital, S Q. Hasnain, M Ahmed Jun 1994

Intestinal Obstruction In Adults At The Aga Khan University Hospital, S Q. Hasnain, M Ahmed

Department of Surgery Docs

During the period January, 1987 to June, 1991, 208 adults with mechanical bowel obstruction were managed at The Aga Khan University Hospital (AKUH). Post-operative adhesions accounted for 34% of the cases and were the most frequent cause of intestinal obstruction. External hemia (16%), malignancy (13.5%) and tuberculous stricture (10%) were the next most frequent causes. The predominance of adhesive intestinal obstruction at AKUH shows a trend towards a Western disease pattern. Socioeconomic status was a significant determinant of the cause of obstruction. The proportion of self paying to welfare patients was significantly lower in tuberculous obstruction as compared with adhesive …

Go to article

A Simple Technique Of Umbilical Port Closure In Laparoscopic Cholecystectomy, A Khan, M N. Siddiqui, M Ahmed Nov 1993

A Simple Technique Of Umbilical Port Closure In Laparoscopic Cholecystectomy, A Khan, M N. Siddiqui, M Ahmed

Department of Surgery Docs

No abstract provided.

Go to article

Retained Stones In The Common Bile Duct: Results Of Management, Kamran Hamid, R Azami, W Jaffery, T Hameed May 1993

Retained Stones In The Common Bile Duct: Results Of Management, Kamran Hamid, R Azami, W Jaffery, T Hameed

Department of Surgery Docs

Seventeen patients underwent treatment for retained common bile duct stones. In 7 patients the stones were removed via a T-tube tract using steerable catheters while 5 patients underwent ERCP and sphincterotomy and 5 underwent surgical re-exploration. Considering morbidity, mortality, success rate and patients' stay in the hospital, non-operative modalities should be the treatment of choice for retained common bile duct stones.

Go to article

An Unusual Presentation Of Ischiorectal Abscess, K Hameed, R Maniar Mar 1992

An Unusual Presentation Of Ischiorectal Abscess, K Hameed, R Maniar

Department of Surgery Docs

No abstract provided.

Go to article

Nutritional Parameters Predicting Postoperative Infections, Jamsheer Talati, M. Shameem, Mohammad Khurshid Jan 1988

Nutritional Parameters Predicting Postoperative Infections, Jamsheer Talati, M. Shameem, Mohammad Khurshid

Department of Surgery Docs

Thirteen nutritional parameters viz body mass index (BMI), mid arm circumference (MAC), mid calf circumference (MCC), triceps skin fold thickness (TST), abdominal skin fold thickness (ASFT), abdominal girth at umbilicus (AG U), haemoglobin (Hb), total leucocytes count (WBC), absolute lymphocyte count (ALC), serum proteins (Prot.), serum albumin (AIb), serum total iron binding capacity (TIBC) and serum iron (Fe) were estimated in 52 (36 male and 16 female) consecutive patients admitted to a surgical service at the Abbasi Shaheed Hospital, Karachi. Nine males and one female developed surgical infections whilst the wounds of 27 males and 15 females healed by primary …

Go to article

First Prev