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Biomedical subjects

Kashif Ashraf

Publications and source records attributed to Kashif Ashraf.

9 recordsLinked to original sources

Colorectal carcinoma, preoperative evaluation by spiral computed tomography.

OBJECTIVES: To assess the capability of spiral computed tomography (CT) scan in preoperative evaluation of colorectal carcinoma (CRC). METHODS: A cross sectional study on 52 patients with recent histopathologic diagnosis of CRC was conducted over a period of one year at the Aga Khan University Hospital, Karachi. All these patients underwent spiral CT with oral and intravenous contrast administration. Surgery was subsequently done in all cases and surgical specimens were sent for detailed pathologic analysis. The radiologic findings on the CT scans were compared with the pathological findings. RESULTS: The results proved that spiral CT had 60% sensitivity and 83% specificity for assessment of local spread of disease, 66% sensitivity and 76% specificity for the evaluation of lymph nodal metastases and 89% sensitivity and 94% specificity for hepatic metastases. In all the cases, the visualized tumour growth with wide zone of resection and regional nodal chains were surgically removed. It was however, the distant metastases which made a difference to the type of curative or palliative surgery planned and in this study spiral CT had 92% accuracy for detection of hepatic metastases. CONCLUSION: With technological advances and improvement in imaging protocols the results for local tumor spread are expected to improve, however based on the accuracy in detecting hepatic metastases in clinically unsuspected patients, this study proves that spiral CT has a significant role in preoperative evaluation and subsequent management of CRC.

Adult↗

Role of focused appendiceal computed tomography in clinically equivocal acute appendicitis.

OBJECTIVE: To determine the accuracy of FACT (focused appendiceal computed tomography) in evaluation of acute appendicitis. METHODS: The study was conducted in Aga Khan University Hospital, Karachi, over a period of one year. Sixty-three patients with clinically equivocal acute appendicitis underwent thin-section non-enhanced helical CT. Axial scans were obtained in a single breath hold from L2 vertebral level to the pubic symphysis with 5-mm collimation and a pitch of 1.5. All scans were obtained without oral, intravenous, or rectal contrast material. Criteria for diagnosis of acute appendicitis included an enlarged appendix (>6 mm diameter) and periappendiceal inflammation. Final diagnoses were established with the results of surgical or clinical follow-up. RESULTS: There were 21 true-positive diagnoses, 38 true-negative diagnoses, no false-positive diagnoses, and 2 false-negative diagnoses, which yielded a sensitivity of 91% and a specificity of 100%. CONCLUSION: Non-enhanced FACT is a highly accurate problem solving technique in clinically equivocal cases of acute appendicitis.

Acute Disease↗

Evaluation of erectile dysfunction with color Doppler sonography.

OBJECTIVE: To assess the role of Color Doppler Sonography in the evaluation of erectile dysfunction. METHODS: A cross-sectional study was conducted at the Radiology Department, Aga Khan University Hospital Karachi from 5-6-2002 to 2-9-2003. All consecutive patients presenting with erectile dysfunction and undergoing penile color Doppler evaluation with injection PGE1 20 mcg were included in this study. RESULTS: A total of 70 patients with an age range of 24-70 years (mean 41 +/- 12.25 years) were included in the study. A normal response was noted in 45 (psychogenic) cases. Vasculogenic causes were observed in 23 patients, 12 with arterial insufficiency and 11 with venous leak. Peyronie's disease was diagnosed in 2 patients. CONCLUSION: Color Doppler evaluation of erectile dysfunction is an effective method for differentiating psychogenic and vasculogenic causes of erectile dysfunction.

Adult↗

A case of non-resolving cough and weight loss.

Sarcoidosis is a chronic granulomatous multi-system disease with a clinical picture often mimicking tuberculosis. We present a case of a patient who presented with a clinical picture akin to both of these granulomatous disorders and was started on anti-tuberculous regimen despite the lack of any solid evidence pointing towards tuberculosis. As a result her clinical condition continued to deteriorate for months until finally a bronchoscopic biopsy established her disease process as sarcoidosis. She was then started on systemic corticosteroid therapy for sarcoidosis and during the ensuing period has shown marked improvement in her clinical picture with near normalization of the biochemical and radiographic parameters of her pathology. This case illustrates the need for vigilant interpretation of the clinical scenario in patients such as these where a misdiagnosis may lead to significant patient distress as well as weighing down on the economic and health resources.

Chronic Disease↗

Mesenteric panniculitis.

Mesenteric panniculitis is a rare condition of unknown etiology that causes inflammation of the adipose tissue in the mesentery. We describe a case in which mesenteric panniculitis was diagnosed on the basis of imaging and resolved spontaneously.

Aged↗