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Search Results: 1 - 10 of 52996 matches for " Syed Y Iftikhar "
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A review on gastric diverticulum
Farhan Rashid, Ahmed Aber, Syed Y Iftikhar
World Journal of Emergency Surgery , 2012, DOI: 10.1186/1749-7922-7-1
Abstract: Gastric diverticulum (GD) is an outpouching of the gastric wall. GDs are rare and they are commonly detected incidentally during routine diagnostic testing. Prevalence ranges from 0.04% in contrast study radiographs and 0.01% - 0. 11% at oesophagogastrodeudenum (OGD) [1,2]. The incidence of gastric diverticulum is equally distributed between males and females and typically may present in the fifth and sixth decades. However it is worth mentioning that it may present in patients as young as 9 years old [3].The lack of exact pathogonomic symptoms and the vague long history of presenting complaints that can range from dyspepsia to major upper gastrointestinal (GI) bleed make this condition a diagnostic challenge.We conducted a literature search using the "Pubmed" search engine. The following terms "gastric diverticulum" and "Stomach diverticulum" were used to identify the appropriate papers.In this review, our emphasis is to highlight on the presentation, the pathophysiology, investigations and different management options for this condition.Symptoms of GD vary and can imitate those of other common disorders. It is important to note that most GD are asymptomatic but may present with a vague sensation of fullness or discomfort in the upper abdomen. Presenting complaint might also be the result of a major complication of GD. This includes acute upper gastrointestinal bleed or perforation [1,2] (Table 1).GD in general is a rare condition; It is found in 0.02% (6/29 900) of autopsy studies and in 0.04% (165/380 000) of upper gastrointestional studies [1,3,4]. Meeroff et al reported a prevalence of 0.1-2.6% in an autopsy series [4].Seventy-five percent of true gastric diverticula were located in the posterior wall of the fundus of the stomach, 2 cm below the oesophagastric junction and 3 cm from the lesser curve. False diverticula were either traction or pulsion and associated with inflammation, other diseases, or both. Diverticula were usually less than 4 cm in size (range
Accidental finding of a toothpick in the porta hepatis during laparoscopic cholecystectomy: a case report
Waleed Al-Khyatt, Farhan Rashid, Syed Y Iftikhar
Journal of Medical Case Reports , 2011, DOI: 10.1186/1752-1947-5-421
Abstract: In the current report, we describe the case of a 37-year-old Caucasian woman with an incidental finding of a toothpick in the porta hepatis during laparoscopic cholecystectomy for symptomatic gall stones.Toothpick ingestion is not an uncommon event and can predispose patients to serious complications. In this particular case, the toothpick was only discovered at the time of unrelated surgery. Therefore, it was important during surgery to exclude any related or missed injury to the adjacent structures by this sharp object.Unintentional ingestion of a toothpick is not an uncommon event. Often the ingested toothpicks spontaneously pass through the gut without sequelae [1]. However, serious complications can happen when these sharp objects migrate through the gastrointestinal wall [2]. Patients with ingested toothpicks in the gastrointestinal tract typically have no recollection of the event. Symptoms related to toothpick ingestion are often variable and non-specific [3,4]. In the current report, we describe the case of a 37-year-old Caucasian woman with an incidental finding of a toothpick in the porta hepatis during laparoscopic cholecystectomy for symptomatic gall stones.A 37-year-old Caucasian woman presented to our facility with recurrent attacks of upper abdominal pain over a six-month period. Otherwise, she was fit and well with no significant medical history. The results of general and abdominal examinations were normal. Results from her initial blood tests showed deranged liver function of the obstructive type. An abdominal ultrasound scan revealed a thickened gall bladder wall containing multiple gall stones. A magnetic resonance cholangiopancreatography (MRCP) study showed multiple gall stones; however, there was no choledocholithiasis. Our patient underwent elective laparoscopic cholecystectomy and on-table cholangiogram (OTC) for symptomatic gall stones. The procedure was performed with a standard Veress needle using the pneumoperitoneum technique, with fou
Atypical right diaphragmatic hernia (hernia of Morgagni), spigelian hernia and epigastric hernia in a patient with Williams syndrome: a case report
Farhan Rashid, Ramakrishna Chaparala, Javed Ahmed, Syed Y Iftikhar
Journal of Medical Case Reports , 2009, DOI: 10.1186/1752-1947-3-7
Abstract: This 49-year-old woman with Williams syndrome, cognitive impairment and aortic stenosis presented to physicians with right-sided chest pain. She had previously undergone repair of her right spigelian and epigastric hernia. Her abdominal examination was unremarkable. Chest X-ray suggested right-sided diaphragmatic hernia and pleural effusion for which she received treatment. The computed tomography scan showed a diaphragmatic hernia with some collapse/consolidation of the adjacent lung. Furthermore, the patient had aortic stenosis and was high risk for anaesthesia (ASA grade 3). She underwent successful laparoscopic repair of her congenital diaphragmatic hernia leading to a quick and uneventful postoperative recovery.These multiple hernias suggest that patients with Williams syndrome may have some connective tissue disorder which makes them prone to develop hernias especially associated with those parts of the body which may have intracavity pressure variations like the abdomen. Diaphragmatic hernia may be the cause of chest pain in these patients. A computed tomography scan helps in early diagnosis, and laparoscopic repair helps in prevention of further complications, and leads to quick recovery especially in patients with learning disabilities. In the presence of significant comorbidities, a less invasive operative procedure with quick recovery becomes advisable.Congenital diaphragmatic abnormalities occur in 1/2000 to 1/4000 births [1]. The most common defect is congenital diaphragmatic hernia. Morgagni's hernia is a rare cause of diaphragmatic hernia. It is usually described as an anterior diaphragmatic defect occurring on the right side and located in the anterior mediastinum because of the retrosternal location of the foramen of Morgagni [2]. These hernias are usually diagnosed incidentally when the patient has reached adulthood, or when they become symptomatic due to intestinal involvement (occlusive symptoms) or when they present with respiratory distress [3]
A review on delayed presentation of diaphragmatic rupture
Farhan Rashid, Mallicka M Chakrabarty, Rajeev Singh, Syed Y Iftikhar
World Journal of Emergency Surgery , 2009, DOI: 10.1186/1749-7922-4-32
Abstract: A Pubmed search was conducted using the terms "delayed presentation of post traumatic diaphragmatic rupture" and "delayed diaphragmatic rupture". Although quite a few articles were cited, the details of presentation, investigations and treatment discussed in each of these were not identical, accounting for the variation in the data presented below.Late presentation of diaphragmatic rupture is often a result of herniation of abdominal contents into the thorax[1]. Sudden increase in the intra abdominal pressure may cause a diaphragmatic tear and visceral herniation[2]. The incidence of diaphragmatic ruptures after thoraco-abdominal traumas is 0.8–5% [3] and up to 30% diaphragmatic hernias present late[4]. Diaphragmatic, lumbar and extra-thoracic hernias are well described complications of blunt trauma [5]. Incorrect interpretation of the x ray or only intermittent hernial symptoms are frequent reasons for incorrect diagnosis[6].Diaphragmatic rupture with abdominal organ herniation was first described by Sennertus in 1541[7,8]. Diaphragmatic injury is a recognised consequence of high velocity blunt and penetrating trauma to the abdomen and chest rather than from a trivial fall[8]. These patients usually have multi system injuries because of the large force required to rupture the diaphragm[9].Blunt trauma to the abdomen increases the transdiaphragmatic pressure gradient between the abdominal compartment and the thorax[10]. This causes shearing of a stretched membrane and avulsion of the diaphragm from its points of attachments due to sudden increase in intra abdominal pressure, transmitted through the viscera[11]. Delay in presentation of a diaphragmatic hernia could be explained by various different hypotheses. Delayed rupture of a devitalised diaphragmatic muscle may occur several days after the initial injury [8]. This is best exemplified in the case report of bilateral diaphragmatic rupture [12], where the left diaphragmatic rupture was identified 24 hours after th
Probing the link between oestrogen receptors and oesophageal cancer
Farhan Rashid, Raheela N Khan, Syed Y Iftikhar
World Journal of Surgical Oncology , 2010, DOI: 10.1186/1477-7819-8-9
Abstract: We performed a comprehensive literature search and analysed the results regarding ER expression in oesophageal tumours with special emphasis on expression of different oestrogen receptors and the role of sex hormones in oesophageal cancer. This article also focuses on the significance of the two main ER subtypes and mechanisms underlying the presumed male predominance of this disease.We postulate that differential oestrogen receptor status may be considered a biomarker of poor clinical outcome based on tissue dedifferentiation or advanced stage of the disease. Further, if we can establish the importance of oestrogen and its receptors in the context of oesophageal cancer, then this may lead to a new future direction in the management of this malignancy.Human oesophageal carcinoma is the eighth most common type of malignancy in the world [1], with approximately half a million people diagnosed annually worldwide [2]. Over the last three decades, the incidence of oesophageal cancer in many parts of the world has risen significantly [3-7]. The prevalence of the two main histological subtypes of oesophageal cancer, adenocarcinoma (AC) and squamous cell carcinoma (SCC) varies depending upon geographical location [8]. The AC is common in Europe and Australia [9] followed by the USA [8,9], while SCC predominates in Asian countries especially in the far East[10]. The incidence of oesophageal AC in the western world has risen rapidly over several years [11-13] whilst that of SCC has decreased[8], although increasing trends have been observed in Denmark and the Netherlands among men [14]. Carcinogens including dioxins, nitrosamines and polycyclic aliphatic hydrocarbons present in tobacco, processed meats and fried foods along with alcohol consumption and gastrooesophageal reflux disease and others have all been identified as risk factors for oesophageal cancer[15] although contribution of aetiological factors varies amongst histological subtypes of the disease. Figures 1 and 2
Alterations in Antioxidant Vitamins in Bronchial Asthma and Its Correlation with Spirometry  [PDF]
Syed Hafeezul Hassan, Iftikhar Ahmad, Rubina Ghani, Muhammed Sarwar
Pharmacology & Pharmacy (PP) , 2013, DOI: 10.4236/pp.2013.42019
Abstract: Bronchial asthma may result in oxidant/antioxidant imbalance. Antioxidant vitamins E and C concentrations were estimated in plasma of asthmatics that were also simultaneously subjected to spirometry and matched with healthy controls showing significant changes in both the vitamin concentrations. Vitamin C showed strong correlation whereas vitamin E was not correlated with spirometry.
A pre-operative elevated neutrophil: lymphocyte ratio does not predict survival from oesophageal cancer resection
Farhan Rashid, Naseem Waraich, Imran Bhatti, Shopan Saha, Raheela N Khan, Javed Ahmed, Paul C Leeder, Mike Larvin, Syed Y Iftikhar
World Journal of Surgical Oncology , 2010, DOI: 10.1186/1477-7819-8-1
Abstract: Patients who underwent resection for oesophageal carcinoma from June 1997 to September 2007 were identified from a local cancer database. Data on demographics, conventional prognostic markers, laboratory analyses including blood count results, and histopathology were collected and analysed.A total of 294 patients were identified with a median age at diagnosis of 65.2 (IQR 59-72) years. The median pre-operative time of blood sample collection was three days (IQR 1-8). The median neutrophil count was 64.2 × 10-9/litre, median lymphocyte count 23.9 × 10-9/litre, whilst the NLR was 2.69 (IQR 1.95-4.02). NLR did not prove to be a significant predictor of number of involved lymph nodes (Cox regression, p = 0.754), disease recurrence (p = 0.288) or death (Cox regression, p = 0.374). Furthermore, survival time was not significantly different between patients with high (≥ 3.5) or low (< 3.5) NLR (p = 0.49).Preoperative NLR does not appear to offer useful predictive ability for outcome, disease-free and overall survival following oesophageal cancer resection.Human oesophageal carcinoma is considered one of the most aggressive malignancies and is associated with a poor prognosis [1]. Despite recent advancement in surgical and oncological treatment the five year survival remains very poor [2-4]. Oesophagectomy for oesophageal cancer is a major operative intervention which carries a high risk of complications. Hence any means of predicting patients with an inherently poor prognosis or high risk from surgery would be valuable in making treatment recommendations.Generally agreed prognostic factors for most gastrointestinal cancers include tumour size, marginal resection line involvement, lymph node metastases and tumour differentiation [5]. During the last fifteen years there has been debate about the interaction between cancer and host inflammatory responses, in particular whether cancer may alter regulation leading to further DNA damage, promotion of angiogenesis, inhibition of
Spectrum of Diseases, Disease Related Mortality and Overall Financial Burden of Hospitalized Patients in Medical Wards of Tertiary Care Public Hospital  [PDF]
Iftikhar Haider Naqvi, Khalid Mahmood, Abu Talib, Syed Muhammad Kashif, Ali Sajjad
Open Journal of Epidemiology (OJEpi) , 2017, DOI: 10.4236/ojepi.2017.74028
Abstract: Background: Detailed assessment of pattern of diseases and trend of mortalities tends to aid in formulating pivotal aspects of in-hospital policies, standards of care and so consequently promoting efficient work system. This also reserves limited resources keeping within the limit of financial grasp. The study aims to reimburse the colossal paucity of data covering epidemiological burden of diseases, impact on mortality as well as financial burden in socioeconomically challenged public health system. Methods: This was a retrospective cross-sectional hospital based study conducted in department of Medicine, Civil Hospital Karachi, from February 2016 to July 2016 using questionnaire based data collection system. Results: Eight thousand and fifty three (8053) cases with almost equal gender proportion were analyzed. Chronic liver disease (CLD) was the most rampant disease, followed by cerebrovascular accident (CVA), tuberculosis and diabetes. Overall 51% cases were attributed to infectious diseases. Overall the average percentage mortality was found to be 20% of all cases. Mean duration of stay was 7.56 ± 7 days. Estimated average total in-hospital expenditure per patient on each visit or stay was 159.15 ± 41.2 $USD (16670.96 ± 4315.7 PKR). Average total diagnostic and medications costs per visit or stay were 89.74 ± 31.2 $USD (9400.26 ± 3268.2 PKR) and 48.68 ± 18.0 $USD (5099.23 ± 1885.5 PKR) respectively. Conclusion: Chronic liver disease, cerebrovascular accident and diabetes were most frequent reasons of hospital admission and mortality. Recognition of most common and fatal diseases with their expenditure is going to lead to formulation of targeted policies both of which would be effective and efficient.
Syed Iftikhar Hussain Jafri,Amjad Ali Arain
Academic Research International , 2012,
Abstract: In secondary schools in Pakistan, the pupils are provided with the concepts of physics at higher level and opportunities to do laboratory work and experiments. The survey of journals and periodicals of inter and intra country repute, revealed that from the pre and postimplementation of the new syllabus in Physics operative from the early seventies, no research realization of objectives was conducted although its need was felt. This study is intended to find out scientifically the coverage of objectives by Boards’ examination question papers in the first three aspects of cognitive development in the subject of Physics at Secondary Level in Sindh. A random sample of 280 school teachers working as examiners in the Board of Intermediate and Secondary Education (BISE) Hyderabad and of Secondary Education (BSE) Karachi was selected. The tool for determining the weightage of objectives was developed.This included an investigation of five years Physics question papers from (1997 to 2001) to classify the concepts of knowledge, understanding and application. The data were collectedthrough tool. It was found that there was imbalance in proportion of knowledge, understanding and application; it reflected inappropriateness and unsuitability of the weightage of the objectives covered by the paper setters. On the basis of the study findings,the question papers of both the Boards’ were found to be invalid and incapacitated to cover the objectives of physics at secondary level. As a result of this study, various suggestions were put forth to streamline the process for the coverage of objectives.
Elements of an Effective Repair Program for Cavitation Damages in Hydraulic Turbines
Iftikhar Ahmad,Syed Asif Ali,Barkatullah
Information Technology Journal , 2007,
Abstract: In this study, various repair methods have been discussed with reference to the cavitation damages in hydraulic turbines. The study is focused on the fact that timely and proper repair of the cavitation damages results in the better performance and increased efficiency of the equipment. On the other hand, if left un-repaired or improperly repaired, theses damages cause further deterioration of the equipment. The aim of the study is to provide an overview of the various traditional and modern techniques to the power plant maintenance crew. Various repair methods have been discussed with their merits and demerits. Outlay of an effective repair program that can be integrated with on-line monitoring system is presented. A software approach to integrate repair program with an on-line vibration monitoring system is also proposed. The study is expected to provide better understanding of cavitation repair methodologies based on the plant operating conditions and various turbine construction materials.
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