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Rahim Khan HA, Gilani JA, Pervez MB, Hashmi S, Hasan S. Penetrating cardiac trauma: A retrospective case series from Karachi. J PAK MED ASSOC 2018; 68:1285-1287. [PMID: 30108408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Penetrating cardiac trauma is a medical emergency that commonly affects young men throughout the world. A retrospective review of the records of all patients presenting with cardiac injury was done from January 2000 to December 2015 at our institute. There were 10 cases of such trauma, all of whom were males, 17 to 48 years of age. The most common mechanism of injury was gunshot wounds followed by stab wounds. The Mean Revised Trauma Score was 7.23±0.855. Only 2 out of the total 10 patients died (20% mortality). The Right Ventricle followed by the Left Ventricle was the most common site of injury. Median Sternotomy was the surgical procedure of choice in managing these patients. Pericardial tamponade and Haemothorax were common intra-operative findings. Patients having penetrating cardiac injury presenting with detectable signs of life on arrival to the hospital can be rescued by early surgical intervention.
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Affiliation(s)
| | | | | | - Shiraz Hashmi
- Section of Cardiothoracic Surgery, Aga Khan University Hospital, Karachi
| | - Sulaiman Hasan
- Section of Cardiothoracic Surgery, Aga Khan University Hospital, Karachi
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Sarfraz M, Rahim Khan HA, Urooba A, Manan Z, Irfan O, Nadeem R, Baqir H, Farooq S, Khan Z, Khan JA, Saleem S. Awareness, use and perceptions about E-cigarettes among adult smokers in Karachi, Pakistan. J PAK MED ASSOC 2018; 68:147-153. [PMID: 29371741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To estimate the prevalence of awareness, current use and intention to use of e-cigarettes among adult smokers. METHODS This cross-sectional survey was carried out at the Aga Khan University Hospital, Karachi, from July to August 2016, and comprised people aged above 18 years who had smoked more than 100 cigarettes in their lifetime. Convenience sampling method was used. A self-administered questionnaire was used to collect data. SPSS 22 was used for data analysis.. RESULTS Of the 387 participants, 359(92.8%) were male. The overall mean age was 32.4±12.6 years. Moreover, 215(55.5%) respondents belonged to the middle socio-economic class. Besides, 249(64.3%) respondents were aware of e-cigarettes while 39(10.1%) used them, and 81(20.9%) wanted to use them. Socio-economic status was the best predictor for awareness about e-cigarettes (p<0.001), while gender (p=0.001), occupation<lt;0.001) and current smoking status (p=0.009) were significantly associated with the use of e-cigarettes. E-cigarettes were perceived as less harmful than tobacco cigarettes by 175(45.3%) respondents, helpful in quitting smoking by 138(35.6%), associated with chronic diseases by 158(40.9%), addictive 142(36.7%), and not safe during pregnancy by 197(50.8%) participants. CONCLUSIONS The percentage of e-cigarette usage was low despite the higher than expected awareness among the subjects.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Sarah Saleem
- Department of Community Health Sciences, Aga Khan University Hospital, Karachi
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Samad MA, Rahim Khan HA, Urooj F, Hyder UA, Khan FW, Fatimi SH, Khan JK. Management Of Penetrating Injury To Thoracic Inlet And Lower Neck With Retained Foreign Body Using Video Assisted Thoracoscopic Surgery. J Ayub Med Coll Abbottabad 2017; 29:486-488. [PMID: 29076689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Penetrating neck and chest injuries are a common form of occupational injuries. We hereby report a unique case in which a metallic rod had penetrated the left chest and neck of a plastic factory worker. The patient was vitally stable when he presented to Emergency Room. Chest X-ray was performed and the patient was rushed to the operating room. VATS (video assisted thoracoscopic surgery) and neck dissection was done for retrieval of the metallic rod. On table, endoscopy was also done to rule out injury to oesophagus. No injury to vital structures was found and the subsequent recovery was uneventful.
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Affiliation(s)
| | | | - Faiza Urooj
- Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan
| | - Usman Ali Hyder
- Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan
| | - Fazal Wahab Khan
- Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan
| | | | - Jamal Kabeer Khan
- Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan
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Khan HAR, Khan FW, Fatimi SH. Giant Ganglioneuroma in a 5-Year Child. J Coll Physicians Surg Pak 2017; 27:S16-S17. [PMID: 28302232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Accepted: 10/27/2016] [Indexed: 06/06/2023]
Abstract
We report a 5-year boy presenting with pain in the lower chest and upper abdomen. On evaluation with computed tomography scan of the chest, he was found to have a large 16 x 14 cm posterior mediastinal mass compressing the inferior vena cava and liver, and shifting the heart to the opposite side. Tumor was approached via right postero-lateral thoracotomy and dissected off from esophagus, heart, inferior vena cava and lungs. The entire tumor was resected without any complications. Postoperative course was unremarkable. Resection of the tumor was successful. The histopathology showed it to be giant ganglioneuroma with no evidence of malignancy.
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Affiliation(s)
| | - Fazal Wahab Khan
- Department of Surgery, The Aga Khan University Hospital, Karachi
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Khan SA, Khan MF, Bakhshi SK, Irfan O, Khan HAR, Abbas A, Awan S, Bari ME. Quality of Life in Individuals Surgically Treated for Congenital Hydrocephalus During Infancy: A Single-Institution Experience. World Neurosurg 2017; 101:247-253. [PMID: 28179172 DOI: 10.1016/j.wneu.2017.01.107] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 01/22/2017] [Accepted: 01/26/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Congenital hydrocephalus (CH) is a frequently encountered birth anomaly that can hinder long-term neurologic maturity and social well-being of affected children. This study was undertaken to assess quality of life (QOL) 10-15 years after surgical treatment for primary CH during infancy at a tertiary care hospital in a developing country. METHODS This retrospective cohort study included individuals who presented to Aga Khan University Hospital, Karachi, Pakistan, between 1995 and 2005 at <1 year old and underwent surgery for primary CH. The Hydrocephalus Outcome Questionnaire was used to assess outcomes with respect to QOL. RESULTS Of 118 patients, 90 patients participated in the study. Mean age at first admission was 6.2 months. Mean length of follow-up was 5.4 years. Of these, 28 patients had died after surgery. Shunt infection (P = 0.012) and delayed milestones (P = 0.003) were found to be statistically significant factors affecting mortality in the patients who died. The mean overall health score was 0.67 ± 0.30. Age <6 months at the time of first surgery was a poor predictor of overall health on the Hydrocephalus Outcome Questionnaire (P = 0.039). CONCLUSIONS In our analysis, we assessed the QOL associated with CH. We hope that these results will provide insight for future prospective work with the ultimate goal of improving long-term QOL in children with CH.
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Affiliation(s)
- Saad Akhtar Khan
- Department of Neurosurgery, Memon Medical Institute Hospital, Karachi, Pakistan; Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Muhammad Faheem Khan
- Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Saqib Kamran Bakhshi
- Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Omar Irfan
- Medical College, Aga Khan University Hospital, Karachi, Pakistan
| | | | - Asad Abbas
- Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Safia Awan
- Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Muhammad Ehsan Bari
- Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
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Yakoob J, Fatima SS, Abbas Z, Mustafa SF, Khan HAR, Raghib MF, Awan S, Ahmad Z. Distribution of gastric carcinoma in an area with a high prevalence of Helicobacter pylori. Turk J Gastroenterol 2017; 28:98-103. [PMID: 28119270 DOI: 10.5152/tjg.2017.17607] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND/AIMS South Asia is an enigma for gastric cancer (GC) because it is a low risk region with a high prevalence of Helicobacter pylori (H. pylori) infections. We evaluated the trend of GC clinical presentation and risk factors in patients with dyspeptic symptoms. MATERIALS AND METHODS The medical records of patients, coded by the international classification of diseases (ICD-10-CM, 2015, Diagnosis Code C16.9) for malignancies of stomach diagnosed by esophagogastroduodenoscopy (EGD) and histopathology, were studied. RESULTS 394 GC cases with a mean age of 54±15 years, range of 18 to 88, were analyzed. 256 (65%) were male. Distal non-cardiac and cardiac tumors were 302 (77%) and 92 (23%) cases, respectively. The WHO classification of GC defined 222 (56%) cases as intestinal type adenocarcinoma, 68 (17%) cases as signet ring cell carcinoma (SRC), 62 (16%) cases as diffuse type and 42 (11%) cases as B cell non-Hodgkin lymphoma. The co-morbid conditions associated with GC were H. pylori infection (positive in 246 (62%) cases), diabetes mellitus type 2 (in 90 (23%) cases), and cigarette smoking (in 94 (24%) cases). Of the male patients, 88 (34%) (p<0.001) were smokers. Body mass index was abnormal in all age groups and in both sexes. Cardiac regions for GC were more common in the 46- to 60-year old age range and in males. Diffuse GC was seen in all age groups but there were significantly more common in the 18- to 45-year old age range. Gastric non-Hodgkin's lymphoma was seen at an early age of 18-45 years in 14(12%) and a later of 61-88 years in 20 (15%). CONCLUSION Intestinal type GC is common at all ages but SRC and diffuse GC are more common in patients less than 50 years old. SRC and diffuse GC were not specific to the elderly in our study population.
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Affiliation(s)
- Javed Yakoob
- Departments of Medicine, Aga Khan University, Karachi, Pakistan.
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Zahid I, Rahim Khan HA, Irfan O, Fatima B, Tahir M, Tariq M, Khan FW, Fatimi S. Retrograde bullet migration from inferior vena cava into right common iliac vein following gunshot: A case report. J PAK MED ASSOC 2016; 66:1673-1675. [PMID: 28179710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Bullet embolization cases are rare and even rarer are its retrograde migration in the veins. We report the case of a 14 year old male with a gunshot wound to the left side of his chest. CT scan revealed bilateral haemothorax and foreign body in the right common iliac vein. The patient was immediately taken to the operating theatre and median sternotomy performed. Bullet entry tear was found in the inferior vena cava however, the bullet was found lodged in the right common iliac vein and slipped down against the flow of blood. The bullet was left in situ and after the necessary repair the chest was closed and the patient shifted to the CICU and discharged after 4 days in stable condition. Patient was followed after 1 week and reassured and advised for one year follow-up.
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Affiliation(s)
- Ibrahim Zahid
- Dow University of Health Sciences, Aga Khan Hospital, Karachi, Pakistan
| | | | - Omar Irfan
- Medical College, Aga Khan University, Karachi, Pakistan
| | - Benish Fatima
- Medical College, Liaquat National Hospital, Aga Khan Hospital, Karachi, Pakistan
| | - Maha Tahir
- Medical College, Dow International, Aga Khan Hospital, Karachi, Pakistan
| | - Muhammad Tariq
- Department of Cardiothoracic Surgery, Aga Khan Hospital, Karachi, Pakistan
| | - Fazal Wahab Khan
- Department of Cardiothoracic Surgery, Aga Khan Hospital, Karachi, Pakistan
| | - Saulat Fatimi
- Department of Cardiothoracic Surgery, Aga Khan Hospital, Karachi, Pakistan
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Khan HAR, Batool S, Khan FW, Fatimi SH. Successful Treatment of Giant Left Subclavian Artery Pseudoaneurysm Abutting the Arch of the Aorta and Descending Aorta. Heart Views 2016; 17:106-108. [PMID: 27867459 PMCID: PMC5105221 DOI: 10.4103/1995-705x.192560] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
A 28-year-old woman presented with 3-month history of fever of unknown origin and progressively increasing cough. She was diagnosed with pulmonary tuberculosis on bronchial lavage cultures. A chest X-ray performed on follow-up showed a new opacity in the left apical area of the chest. Computed tomography scan of chest showed a large 10 cm pseudoaneurysm of the left subclavian artery 1 cm from its take off from the arch of the aorta. The pseudoaneurysm was approached through a left posterolateral thoracotomy and opened following a proximal and distal control. A 3 cm longitudinal defect was identified in the subclavian artery within its intrathoracic portion. This was debrided and repaired with an autologous pericardial patch. The patient had an uneventful recovery and remained well on follow-up.
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Affiliation(s)
| | | | - Fazal Wahab Khan
- Department of Surgery, Division of Cardiothoracic Surgery, Aga Khan University, Karachi, Pakistan
| | - Saulat Hasnain Fatimi
- Department of Surgery, Division of Cardiothoracic Surgery, Aga Khan University, Karachi, Pakistan
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Khan MH, Kashif R, Rahim Khan HA, Fatimi SH. Myxoid Liposarcoma Originating In The Anterior Mediastinum. J Ayub Med Coll Abbottabad 2016; 28:818-820. [PMID: 28828769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Myxoid liposarcomas of the head and neck are mostly metastatic in nature, with the primary lesion usually in lower extremities or retroperitoneum. Primary mediastinal liposarcomas are even rarer. Although there have been previous cases reporting their incidence, there is no evidence of any case comprising of both the neck and the mediastinal region yet. We here present a case of a 43 year old male with a primary liposarcoma of the myxoid subtype originating in the anterior mediastinum. This is the first time such a case has presented in literature. The patient presented with a right sided neck swelling associated with pain and shortness of breath upon lying down. CT neck revealed an enhancing mass extending from right cervical region to axilla and encasing the subclavian artery and involving a portion of the right lung. The patient underwent wide local excision of the mass along with chemoradiotherapy to prevent recurrence.
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Affiliation(s)
| | - Ramsha Kashif
- Department of Cardiothoracic Surgery, Aga Khan University, Karachi, Pakistan
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Zain S, Mustafa SF, Khan HAR, Raghib MF, Fatima SS. Association Between Migraine and Diabetes in Pregnancy. Avicenna J Med Biochem 2016. [DOI: 10.17795/ajmb-33474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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