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Biomedical subjects

M S Khwaja

Publications and source records attributed to M S Khwaja.

At least 19 recordsLinked to original sources
PubMed1991

Massive hiatal hernia in children.

Ten children had massive hiatal hernias repaired between January 1982 and February 1991. Their clinical presentation, association with other congenital abnormalities, and postoperative complications were different from those seen in adults. Vomiting (n = 7) and anaemia (n = 7) were the most common symptoms, followed by respiratory distress (n = 5), cough (n = 3), and regurgitation (n = 3). Abdominal pain was uncommon. The clinical diagnosis was confirmed in seven cases by barium meal examination. The most common operation was Nissen's fundoplication (n = 7); the hiatus alone was repaired in the remainder. Five patients developed postoperative complications and two died probably as a result of delay in diagnosis and associated malformations.

Child, Preschool↗
PubMed1989

Congenital right-sided diaphragmatic hernia: a heterogeneous lesion.

A clinical and radiological analysis of 13 right-sided diaphragmatic hernias is described. Four anatomically distinct though clinically similar variants (Bochdalek; paraoesophageal; eventration and Morgagni) of equal frequency make it a heterogeneous disease. Associated anomalies, found in ten out of 13 (77%), are a strong diagnostic indicator. The presence of congenital hypertrophic pyloric stenosis in 25% of infants suggests a degree of predisposition. Delay in pre-admission diagnosis was a median of 23.5 weeks from onset of symptoms and median age of diagnosis was 9 months, despite the onset of symptoms in the first week of life. A significant perinatal morbidity emphasizes the need for early diagnosis. Possible diagnostic indicators are: multiple anomalies, including chromosomal disease; an early recurrence of apparently 'cured' respiratory infection; and early onset of gastric outlet obstruction. Barium studies are the mainstay of diagnosis and were needed in ten patients. Fundoplication is a useful deterrent to recurrence in paraoesophageal hernias.

Abnormalities, Multiple↗
PubMed1987

Childhood burns in Zaria, Nigeria.

From 1971 to 1980, 429 children with burn injuries were admitted to the Ahmadu Bello University Hospital, Zaria. These were major burns in 275 patients, moderate in 82 and minor in 72. Fourteen of the patients were neonates, 102 infants, 228 were 5 years old or younger and 85 were older. Socioeconomic factors contributing to the injuries included the use of firewood for cooking at ground-level and for warming the house and body during the cold season; loose indigenous garments; thatch-roofed huts and the post-partum rituals of mud-bed heating and hot baths. Flame burns exceeded scalds with a seasonal frequency which peaked during the harmattan. In the absence of a 'burn's unit', burned children were nursed on the general ward together with other sick children by the same nursing personnel supervised by general surgeons. Complications included wound infection, respiratory distress, measles, malnutrition and tetanus. One-fifth of the patients absconded. Overall mortality was 13 per cent but 29 per cent of the neonates died. Preventive strategy should include public information, nursery school supervision, economic development and architectural improvements.

Adolescent↗
PubMed1981

Surgical management of pericarditis in Zaria, Nigeria.

Over eight years, 58 rural Nigerians with pericarditis were treated surgically in Zaria using basic surgical facilities. Eighteen patients had purulent pericarditis, associated with staphylococcal pneumonia in children, or pneumococcal pneumonia in adults. Treatment with antibiotics and prompt pericardiectomy appeared to be superior to drainage, since a quarter of those initially treated with surgical drainage developed early constriction and required pericardiectomy soon after. Thirteen patients had chronic pericardial effusions, of whom one had epicardial constriction and two had cardiomyopathy. Twenty-seven patients had chronic constrictive pericarditis but tuberculosis was confirmed histologically in three only. Echocardiographic findings remained unchanged in five patients evaluated before and after pericardiectomy. Eight of the 13 patients who died had already developed myocardial or hepatic insufficiency before operation, because of late presentation or diagnosis. Greater awareness of the significance of precordial pain in this rural population where ischaemic heart disease is rare would help in making an earlier diagnosis.

Adolescent↗
PubMedDate not supplied

Splenectomy in children with sickle cell disease and thalassemia.

A number of Saudi children (31) with sickle cell disease and thalassemia underwent splenectomy: 12 for frequent blood transfusions, 15 for chronic hypersplenism (most of whom were also the recipients of periodic blood transfusion) and 4 for splenic abscess. The mean age of splenectomy was 8.8 years (8 months-18 years). Eight patients had sickle cell disease, 14 beta-thalassemia and 9 had sickle cell thalassemia. All patients received prophylaxis against pneumococcal infection. There was one postoperative death most probably due to sepsis. Sixteen of those who required frequent preoperative blood transfusions needed no more transfusions, while in 7 the need for transfusions decreased significantly (p less than 0.05). For those with hypersplenism, there was a significant postoperative increase in total hemoglobin (P less than 0.001), RBC (P less than 0.001) and platelet counts (p less than 0.02); and a substantial decrease in reticulocyte counts (p less than 0.05). The common post splenectomy complications were chest infection and a brief episode of pyrexia, but without undue morbidity. The study establishes a definite place for splenectomy in a selected population of children with sickle cell disease and thalassemia.

Adolescent↗