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Biomedical subjects

Irfan Ahmed

Publications and source records attributed to Irfan Ahmed.

12 recordsLinked to original sources
PubMed2006

Abdominal organ motion measured using 4D CT.

PURPOSE: To measure respiration-induced abdominal organ motion using four-dimensional computed tomography (4D CT) scanning and to examine the organ paths. METHODS AND MATERIALS: During 4D CT scanning, consecutive CT images are acquired of the patient at each couch position. Simultaneously, the patient's respiratory pattern is recorded using an external marker block taped to the patient's abdomen. This pattern is used to retrospectively organize the CT images into multiple three-dimensional images, each representing one breathing phase. These images are analyzed to measure organ motion between each phase. The displacement from end expiration is compared to a displacement limit that represents acceptable dosimetric results (5 mm). RESULTS: The organs measured in 13 patients were the liver, spleen, and left and right kidneys. Their average superior to inferior absolute displacements were 1.3 cm for the liver, 1.3 cm for the spleen, 1.1 cm for the left kidney, and 1.3 cm for the right kidney. Although the organ paths varied among patients, 5 mm of superior to inferior displacement from end expiration resulted in less than 5 mm of displacement in the other directions for 41 of 43 organs measured. CONCLUSIONS: Four-dimensional CT scanning can accurately measure abdominal organ motion throughout respiration. This information may result in greater organ sparing and planning target volume coverage.

Abdomen↗
PubMed2006

The SLAPPA (significance of lower abdominal/periumbilical piercing as a predictor of acute appendicitis) audit.

BACKGROUND: Anecdotal observations among medical staff suggest that young women with periumbilical piercing presenting with right iliac fossa pain are more likely to have pelvic inflammatory disease than acute appendicitis because of an unconventional lifestyle. This audit was performed to test the validity of this prejudice. METHODS: The clinical data of all female patients aged 16-45 years admitted to a teaching hospital with suspected acute appendicitis were collected prospectively over six months. Patients who had undergone previous appendicectomy or gynaecological surgery, those with known Crohn's disease, or those on antibiotics at the time of admission were excluded. RESULTS: 107 patients with a median age of 29.7 years (range 15-45 years) were studied. Thirty-two patients had periumbilical piercing (Group A) and 75 patients did not (Group B). Fifty-nine out of 107 (55.14%) were operated upon. Ten (31.2%) patients in Group A had histologically confirmed acute appendicitis compared with 25 (33.3%) in Group B. Other diagnoses in Group A included non-specific abdominal pain (n = 13, 40.6%), urinary tract infection (4, 12.5%), pelvic inflammatory disease (4, 12.5%) and ovarian cyst (1, 3.1%). Corresponding figures for patients in Group B were 30 (40.0%), 8 (10.7%), 7 (9.3%) and 4 (5.3%) respectively. None of the differences between the two groups were statistically significant. CONCLUSIONS: There was no difference in the frequency of a final diagnosis of acute appendicitis or pelvic inflammatory disease in female patients with and without periumbilical piercing. Health care professionals should not allow their clinical judgment to be prejudiced by the presence of body piercing.

Abdominal Pain↗
PubMed2005

Bedside diagnosis of spontaneous bacterial peritonitis using reagent strips.

OBJECTIVE: To determine the efficacy of reagent strip for bedside diagnosis of spontaneous bacterial peritonitis (SBP). DESIGN: Cross-sectional analytical study. PLACE AND DURATION OF STUDY: Shaikh Zayed Postgraduate Medical Institute from November 2003 to August 2004. PATIENTS AND METHODS: Patients with cirrhosis and ascites underwent diagnostic paracentesis. Fluid was checked for leukocyte esterase released by PMN by using Combur 10 urine strip and graded for color change from 0-3. Fluid was also analyzed by cytology for PMN count. Results of both methods were compared to determine sensitivity, specificity and accuracy of strip for diagnosis of SBP. RESULTS: Of 214 paracentesis performed, SBP was diagnosed in 38 patients whereas 176 were negative for infection. Strip test was 97.7% sensitive and 89.4% specific with positive predictive value of 90%, negative predictive value of 97.7% and accuracy of 96.2%, when reagent strip grade 3 was considered as positive for diagnosis. CONCLUSION: Reagent strip is a quick bedside test, highly sensitive and specific for the diagnosis of SBP, based on polymorphonuclear count in ascitic fluid, to initiate early treatment, thus improving patient's outcome.

Adult↗
PubMed2005

Down syndrome: clinical and cytogenetic analysis.

OBJECTIVE: To describe the clinical features and cytogenetic analysis of patients with Down syndrome (DS). DESIGN: An observational study. PLACE AND DURATION OF STUDY: The Departments of Paediatrics and Internal Medicine of Military Hospital, Rawalpindi (MH, RWP) from January 1998 to December 2001. PATIENTS AND METHODS: Two hundred and ninety-five children <18 years of age clinically diagnosed as DS were included. The clinical presentation features, associated anomalies and maternal characteristics were noted. RESULTS: Out of 295, 170 boys and 125 girls had chromosomal findings consistent with the diagnosis of DS. The mean presentation age was 16.2 months while 49 (16.6%) children presented in the neonatal period and 124 (42%) in infancy. Mongoloid slant, epicanthal folds, hypertelorism, simian crease, flat nasal bridge, and microcephaly were observed in >60% of cases. Congenital heart disease was documented in 103 (34.9%) cases and ventricular septal defect was the commonest cardiac anomaly. The cytogenetic analysis revealed that 282 (95.6%) had trisomy 21, 11(3.7%) had translocation, and only 2(0.7%) were mosaic. The mean maternal age was 29.8 years. One hundred and sixty (56.7%) cases with trisomy 21 had maternal age> 35 years, whereas 9/11(81.8%) cases of translocation had maternal age < 35 years. CONCLUSION: The cytogenetic pattern of DS was similar to previously described series. Inadequate antenatal screening and scarce neonatal examination results in late presentation of DS. Majority of cases can be diagnosed on the clinical features of DS.

Down Syndrome↗
PubMed2005

Genitourinary manifestations of Klippel-Trenaunay syndrome: report of two cases managed with systemic alpha-interferon.

We present our experience of two cases with genitourinary manifestations of Klippel-Trenaunay syndrome. A MEDLINE search for the period 2001-2004 was done using the keywords "Klippel-Trenaunay syndrome", "vascular malformation" and "genitourinary". Only three cases with genitourinary manifestations of this syndrome were reported during this period. Genitourinary problems are rare in Klippel-Trenaunay syndrome; however, their management may be a challenge for the urologist. In one of our patients who failed to respond to endoscopic laser coagulation and partial cystectomy we used systemic alpha-interferon, with a good short-term response.

Angiogenesis Inhibitors↗
PubMed2005

Childhood visceral leishmaniasis in Muzaffarabad, Azad Jammu and Kashmir: frequency and response to treatment in 61 cases.

OBJECTIVE: To study the epidemiology and status of resistance to antimonial compounds of paediatric hospital population with visceral leishmaniasis in Muzaffarabad, Azad Jammu and Kashmir, Pakistan. METHODS: Children admitted between January to December 1999 in Azad Kashmir Combined Military Hospital Muzaffarabad and diagnosed as Visceral Leishmaniasis by demonstration of Leishmania parasites in bone marrow aspirate were included in the study. Patients received meglumine antimoniate for 21 days. The demographic information and time taken for resolution of fever after initiation of treatment were recorded. RESULTS: During study period out of 3520 paediatric admissions, 61 patients had visceral leishmaniasis. The frequency of disease was 1.73%. Median age of the patients was 18 months. Eighty two percent cases reported during non-winter seasons. Fifty nine (96.7%) patients responded to treatment with antimonial compounds. Median time taken for resolution of fever was 5.7 days. Two of the patients died during the study period. CONCLUSION: Childhood visceral leishmaniasis is common in Muzaffarabad and there is no resistance to antimonial compounds.

Antiprotozoal Agents↗
PubMed2004

Recent advances in the management of abdominal compartment syndrome.

Abdominal compartment syndrome is a systemic syndrome involving derangement in cardiovascular hemodynamics, respiratory and renal function as a result of sustained increase in intra-abdominal pressure. This results in multi-organ failure requiring prompt action and treatment. Presentation can be acute, chronic and acute on chronic. Initial diagnosis is clinical, confirmed by measurement of urinary bladder pressure. Treatment is abdominal decompression by laparostomy and delayed abdominal closure. Awareness among the surgeons has increased because laparoscopy has resulted in determination of intra-abdominal pressure as a readily measurable quantity. They have been able to appreciate the benefit of abdominal decompression by performing repeated planned laparotomies for trauma.

Abdomen↗
PubMed2003

Ectopic intestinal varices as a rare cause of lower gastrointestinal haemorrhage.

Ectopic intestinal varices are rarely responsible for lower gastrointestinal (GI) haemorrhage. A case of 55 years old male with recurrent melena is being presented, who was found to have scattered varices on small as well as large intestine. Selective review of literature regarding presentation, diagnosis and management of these cases is also part of presentation.

Antihypertensive Agents↗
PubMed2002

The aesthetic post and core: unifying radicular form and structure.

Use of a post system for the rehabilitation of endodontically treated teeth requires traditional planning for the function of the restoration as well as a structural and aesthetic strategy for novel technologies in ceramic and composite dentistry. Contemporary material options have greatly expanded the clinician's ability to rehabilitate the coronoradicular complex. Transilluminating posts, bondable fabrics, and high-technology ceramics create exciting possibilities in post and core design. The use of bondable materials allows the practitioner to unify the structure and morphology of root systems to provide creative solutions to challenges heretofore unmet.

Biomechanical Phenomena↗
PubMedDate not supplied

Clinicopathological features of childhood visceral leishmaniasis in Azad Jammu & Kashmir Pakistan.

BACKGROUND: In Pakistan visceral leishmaniasis (VL) is endemic in Azad Jammu & Kashmir. Northern Areas and Northwest Frontier Province; the areas which lack adequate diagnostic facilities. This study describes the clinical and laboratory features in 61 cases of childhood VL. METHODS: All the children below 12 years of age who were managed as indoor cases from 1st Jan 1999 to 31st Dec 1999 were included in this study. The diagnosis of VL was established by demonstration of leishmania parasites in bone marrow aspiration. The demographic information, physical signs at presentations and results of complete blood picture and formol gel test were recorded. RESULTS: Median age of the patients was 18 months. Eighty four percent children were malnourished. Mean duration of fever before diagnosis was 45 days. Hepatosplenomegaly was present in all cases with mean enlargement of spleen and liver 6.8 and 3.2 cm respectively. Mean haemoglobin level. WBC and platelet counts were 6.7 g/dl, 4.8 x 109 /l and 70 x 109 /l respectively. Absolute neutrophil count was <1.5 x 109 /l in 61% cases. Mean reticulocyte count was 6.2%. There was significant negative correlation (p= 0.014) between haemoglobin level and spleen size. Formol gel test was positive in all cases. Mean hospital stay to established diagnosis was 8.6 days. CONCLUSION: The clinical and laboratory features of childhood VL in Azad Jammu and Kashmir are similar to Mediterranean type of disease caused by leishmania infantum. Cytopenia with high or normal reticulocyte count provides a useful clue to diagnosis in a febrile patient with hepatosplenomegally in an endemic area.

Animals↗