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Sohail Z, Shaikh H, Iqbal N, Masood H, Parkash O. Aetiology, presentation and outcomes of patients presenting with acute pancreatitis in a tertiary care hospital. J PAK MED ASSOC 2024; 74:563-565. [PMID: 38591298 DOI: 10.47391/jpma.9279] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
Acute pancreatitis (AP) is a multi-causal disease with a high rate of hospita lisation. Only a few cl inical stud ies have i nvestig ated the aetiologic al backgroun d, sever it y, and outcome of AP in Pakistan. Hence, this study was carried out to determine the aforementioned factors and correlate them w ith outcomes in a tert iary care set ting. This was a cros s -sec tional, retrospective study conducted at the Department of Gast roe nterolo gy, Aga Khan University Hospita l, Karachi, from Januar y 1, 2022, to December 31, 2022. Data was analysed using statis tical s oftware SPSS version 25. Vomiting was th e predominant presenting complaint and was seen in 139 (78.5%) patients. Gallstones were the predominant cause in 68 (37%) patients, followed by idiop athic panc reatitis in 22 (12%) p atients. Thirteen (7.1 % ) pat ients expire d. Patients with syst emi c complications were lik ely to suffer fro m severe disease (p=0.0 2), whereas those with lo cal complications were at an increa sed ris k of mor tal it y (p=0.04). Due to lac k of diagnostic facilities, the aetiology of a large number of AP cases remains unknown.
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Affiliation(s)
- Zahabia Sohail
- Department of Gastroenterology, Aga Khan University Hospital, Karachi, Pakistan
| | | | - Nimra Iqbal
- 4th Year MBBS Student, Aga Khan University, Karachi, Pakistan
| | - Hassan Masood
- 3rd Year MBBS Student, Aga Khan University, Karachi, Pakistan
| | - Om Parkash
- Department of Gastroenterology, Aga Khan University Hospital, Karachi, Pakistan
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Sain A, Metry A, Manzoor N, Wattage K, Elkilany A, Halasa M, Chia J, Arif S, Hussain F, Aisabokhale O, Sohail Z. THE ROLE OF DISTAL LOCKING IN INTRAMEDULLARY NAILS FOR HIP FRACTURE FIXATION: A REVIEW OF CURRENT LITERATURE. Georgian Med News 2024:149-150. [PMID: 38609132] [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] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
Traditionally, it was believed that both proximal and distal locking are essential for achieving stability during intra-medullary fixation for extra-capsular hip fractures. However, recent literature has presented varying perspectives on the necessity of distal locking. Distal locking plays a significant role in managing hip fractures with uncertainties regarding longitudinal and rotational stability. This includes cases of comminuted intertrochanteric fractures with subtrochanteric extension, reverse oblique and high oblique fractures, broad medullary canals, comminution of the lateral wall, diaphyseal fractures, and large posteromedial fragments extending below the level of the lesser trochanter. In stable pertrochanteric fractures, with the lag screw passing through the lateral cortex of the distal fragment, may not require a distal locking screw. Distal locking has been associated with potential complications, including irritation of the fascia lata, prolonged operation time, increased radiation exposure, greater blood loss, implant loosening, secondary femoral stress fractures, and damage to the femoral artery. Thus, although distal locking is of doubtful significance in stable pertrochanteric fractures it is essential in unstable fracture patterns.
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Affiliation(s)
- A Sain
- Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, United Kingdom
| | - A Metry
- Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, United Kingdom
| | - N Manzoor
- Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, United Kingdom
| | - K Wattage
- Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, United Kingdom
| | - A Elkilany
- Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, United Kingdom
| | - M Halasa
- Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, United Kingdom
| | - J Chia
- Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, United Kingdom
| | - S Arif
- Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, United Kingdom
| | - F Hussain
- Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, United Kingdom
| | - O Aisabokhale
- Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, United Kingdom
| | - Z Sohail
- Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, United Kingdom
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Sain A, Arif S, Manyar H, Manzoor N, Wattage K, Halasa M, Metry A, Chia J, Prendergast E, Elkilany A, Aisabokhale O, Hussain F, Sohail Z. CURRENT CONCEPTS IN THE MANAGEMENT OF BOXER'S FRACTURE. Georgian Med News 2024:122-124. [PMID: 38609127] [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] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
Fractures of the metacarpal particularly the 5th metacarpal is quite common among all hand fractures and has a high incidence in male adult population. Proper management of these fractures plays a key role in rehabilitation and early return to work thus reducing the economic burden. Treatment of these injuries depends on the type of injury: whether it is a closed/open fracture, degree of angulation at the fracture site and also mal-rotation and shortening of the finger. Non-operative management is suitable for fractures which are closed, non-displaced and without angulation or rotation. Open fractures, fractures with angulation and/or mal-rotation and fractures with neuro-vascular injury are more suitable for operative management. The acceptable angulation for conservative management for most studies is 70 degrees. Buddy strapping with a Futura splint provides good functional results. In fractures requiring operative intervention, K-wire fixation is a minimally invasive method of fixation, which in most cases has good functional results. Plate and screw fixation, however, is preferred for cases with significant comminution or multiple metacarpal fractures.
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Affiliation(s)
- A Sain
- Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, United Kingdom
| | - S Arif
- Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, United Kingdom
| | - H Manyar
- Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, United Kingdom
| | - N Manzoor
- Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, United Kingdom
| | - K Wattage
- Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, United Kingdom
| | - M Halasa
- Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, United Kingdom
| | - A Metry
- Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, United Kingdom
| | - J Chia
- Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, United Kingdom
| | - E Prendergast
- Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, United Kingdom
| | - A Elkilany
- Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, United Kingdom
| | - O Aisabokhale
- Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, United Kingdom
| | - F Hussain
- Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, United Kingdom
| | - Z Sohail
- Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, United Kingdom
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Sohail Z, Samar MR, Qureshi NJ, Arshad S, Zaki A. A Curious Case of Primary Gastric Mucosal Melanoma. Korean J Gastroenterol 2024; 83:33-36. [PMID: 38268167 DOI: 10.4166/kjg.2023.136] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/14/2023] [Accepted: 12/29/2023] [Indexed: 01/26/2024]
Abstract
Malignant melanoma is a neoplasm of melanin-producing cells predominantly of cutaneous origin, which uncommonly develops within gut mucosa. We present the case of a 58-year-old woman with complaints of abdominal pain, loss of appetite and weight. Esophagogastroduodenoscopy revealed a gastric mass and systemic imaging demonstrated widespread nodal and bilateral adrenal gland involvement. Histopathology of the gastric mass confirmed primary malignant mucosal melanoma of the stomach. The patient received three cycles of Nivolumab but did not respond, and thus, was then offered best supportive care. Although infrequent, mucosal melanoma can arise from the gastrointestinal tract, and in contrast to the cutaneous form, advanced disease usually has a dismal prognosis and responds poorly to immune checkpoint inhibitors. Primary gastric melanoma is an aggressive disease that is diagnosed by exclusion after the differential diagnosis of metastasis from a cutaneous or unknown primary site has been conducted. If available, patients with treatment-naïve mucosal melanoma should be considered for enrollment in clinical trials.
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Affiliation(s)
- Zahabia Sohail
- Department of Gastroenterology, The Aga Khan University Hospital, Karachi, Pakistan
| | - Mirza Rameez Samar
- Department of Medical Oncology, The Aga Khan University Hospital, Karachi, Pakistan
| | | | - Sidra Arshad
- Department of Pathology, The Aga Khan University Hospital, Karachi, Pakistan
| | - Adeeba Zaki
- Department of Medical Oncology, The Aga Khan University Hospital, Karachi, Pakistan
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Karim MM, Khalid AB, Sohail Z, Yasrab M. Recurrence of portosystemic encephalopathy in cirrhotic patients and its risk factors. Pak J Med Sci 2024; 40:140-144. [PMID: 38196479 PMCID: PMC10772413 DOI: 10.12669/pjms.40.1.8025] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 08/25/2023] [Accepted: 09/18/2023] [Indexed: 01/11/2024] Open
Abstract
Objectives Recurrent episodes of Portal Systemic Encephalopathy (PSE), poses a significant burden of illness on the patients and healthcare system. The objective of this study was to assess the recurrence of PSE in cirrhotic patients after index episode of PSE and to identify various risk factors associated with it. Methods A retrospective, single-centre study was conducted at Aga Khan University Hospital over a span of one year. Patients who were admitted first time with PSE and admitted within three months of index PSE were enrolled in the study. Variables assessed were demographic data, associated comorbid conditions, aetiology of cirrhosis, Child-Turcotte-Pugh (CTP) score, Model of End-Stage Liver Disease (MELD) score, PSE grade, laboratory tests, ascites with spontaneous bacterial peritonitis (SBP), variceal bleeding. Statistical analysis was done and variables of those who developed recurrence were compared with those who did not. Results Fifty one patients were recruited. Thirty three (64.7%) were readmitted with PSE. On comparative analysis of both groups; infection, Meld score, low albumin, and raised total bilirubin showed significant P-value (<0.05). Conclusion Identification of risk factors during assessment can reduce the recurrence of PSE. We would recommend to validate result of our study on a large scale prospectively.
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Affiliation(s)
| | - Abdullah Bin Khalid
- Abdullah Bin Khalid, Lecturer, Department of Medicine, Lecturer, Dow University of Health Science, Karachi, Pakistan, Aga Khan University Hospital, Karachi, Pakistan
| | - Zahabia Sohail
- Zahabia Sohail, Resident, Post Graduate Medical Education, Aga Khan University Hospital, Karachi, Pakistan
| | - Mohammad Yasrab
- Mohammad Yasrab, Student, Undergraduate Medical Education, Aga Khan University, Karachi, Pakistan
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Shahid Y, Sohail Z, Urrehman A, Uddin Z. Microscopic Colitis in a Young Male: Unveiling the Rarity. Cureus 2024; 16:e51638. [PMID: 38313985 PMCID: PMC10837784 DOI: 10.7759/cureus.51638] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2024] [Indexed: 02/06/2024] Open
Abstract
In recent decades, microscopic colitis (MC) has become increasingly recognized as a common contributor to diarrhea and lower gastrointestinal symptoms, particularly among the older demographic. The condition is distinguished by persistent diarrhea with loose watery stools, and endoscopic examination is typically normal with characteristic histopathologic findings. MC is rarely seen under 30 years of age and is less common in males. Our case highlights an exceedingly uncommon clinical setting as it involves a young male who was diagnosed with collagenous colitis. The diagnosis of MC can easily be missed by physicians during initial evaluation. Specifically in irritable bowel syndrome patients with diarrhea predominant symptoms, a colonoscopy should be performed and biopsies should be taken from the entire colon to rule out MC.
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Affiliation(s)
- Yumna Shahid
- Gastroenterology, Aga Khan University Hospital, Karachi, PAK
| | - Zahabia Sohail
- Gastroenterology, Aga Khan University Hospital, Karachi, PAK
| | | | - Zeeshan Uddin
- Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, PAK
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Parkash O, Sohail Z, Khalid N. Endoscopic stent placement for the management of gastro-pleural and gastro-cutaneous fistula post laparoscopic sleeve gastrectomy: a case report. J Med Case Rep 2023; 17:461. [PMID: 37926809 PMCID: PMC10626742 DOI: 10.1186/s13256-023-04200-9] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 10/02/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND Gastro-pleural and gastro-cutaneous fistulae formation are rare yet life-threatening complications post-bariatric surgery. To our knowledge so far only limited cases of gastro-pleural and gastro-cutaneous fistulae post gastric sleeve surgery have been reported in the literature with their corresponding management. Therefore, we are reporting a case of placement of an endoscopic stent in the management of gastro-cutaneous fistula post laparoscopic sleeve gastrectomy. CASE PRESENTATION A 42 years old Pakistani, female morbidly obese patient, underwent laparoscopic sleeve gastrectomy. Within a week after the procedure, the patient presented with dyspnea. Workup showed a gastric leak for which percutaneous drain placement was done. Later, gastro-pleural and gastro-cutaneous fistulae were formed for which endoscopic fistula closure was done using a metallic stent. CONCLUSION Endoscopic stent placement is an emerging field and it is considered safe and effective for the management of complications related to bariatric surgery.
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Affiliation(s)
- Om Parkash
- The Aga Khan University Hospital, Karachi, Pakistan
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Raees A, Sohail Z, Parkash O. An Uncommon Gastrointestinal Manifestation of Systemic Lupus Erythematosus: Lupus Enteritis. J Coll Physicians Surg Pak 2023; 33:42-44. [PMID: 37710935 DOI: 10.29271/jcpspcr.2023.42] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 05/28/2023] [Indexed: 09/16/2023]
Abstract
Systemic Lupus Erythematosus (SLE) is a chronic inflammatory disorder with heterogeneous presentation and clinical course. We present a case of a young female with an atypical presentation of SLE. A young woman with no known prior comorbidities presented with a history of chronic diarrhoea, vomiting, and weight loss, followed by generalized weakness. An extensive workup was done and she was diagnosed with lupus enteritis based on history, laboratory investigations, and imaging findings. She was given pulse therapy to which she responded very well. The case describes the importance of high clinical suspicion and timely intervention as well as adds to the evidence on a rare clinical entity of lupus enteritis. Key Words: Systemic lupus erythematosus, Lupus enteritis, Autoimmune disorder, Chronic diarrhoea.
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Affiliation(s)
- Aimun Raees
- Department of Medicine, The Aga Khan University Hospital, Karachi, Pakistan
| | - Zahabia Sohail
- Department of Medicine, The Aga Khan University Hospital, Karachi, Pakistan
| | - Om Parkash
- Department of Medicine, The Aga Khan University Hospital, Karachi, Pakistan
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Tahir A, Sohail Z, Nasim B, Parmar NV. Widespread cutaneous small vessel vasculitis secondary to COVID-19 infection. Int J Dermatol 2020; 59:1278-1279. [PMID: 32880974 PMCID: PMC7461325 DOI: 10.1111/ijd.15106] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/09/2020] [Accepted: 07/14/2020] [Indexed: 12/30/2022]
Affiliation(s)
- A Tahir
- Department of Internal Medicine, Rashid Hospital, Dubai Health Authority, Dubai, UAE
| | - Z Sohail
- Department of Emergency Medicine, Rashid Hospital, Dubai Health Authority, Dubai, UAE
| | - B Nasim
- Department of Internal Medicine, Rashid Hospital, Dubai Health Authority, Dubai, UAE
| | - N V Parmar
- Dermatology Centre, Dubai Health Authority, Dubai, UAE
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Zaffar A, Tauqir RA, Sohail Z, Malik S. Parapharyngeal tumor presenting as acute airway obstruction. J PAK MED ASSOC 2001; 51:264-5. [PMID: 11558221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- A Zaffar
- Department of ENT Head and Neck Surgery, Karachi Medical and Dental College, Abbasi Shaheed Hospital, Karachi
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