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Mehraj Sheikh

Publications and source records attributed to Mehraj Sheikh.

12 recordsLinked to original sources
PubMed2005

Patients' tolerance and early complications of transrectal sonographically guided prostate biopsy: prospective study of 300 patients.

PURPOSE: To determine the degree of pain and discomfort associated with transrectal sonography (TRS)-guided biopsy of the prostate and to analyze the complications associated with this procedure. METHODS: Three hundred men referred as part of an investigation to exclude prostate cancer were studied. The reasons for referral were suspected prostate cancer due to increased serum prostate-specific antigen level (>4 ng/ml), the finding of a palpable nodule or greater firmness of one prostatic lobe than the other on digital rectal examination, or the finding of a suspicious area of neoplasm of the prostate on TRS biopsy. All TRS-guided biopsies were performed as outpatient procedures without anesthesia. Ciprofloxacin prophylaxis was used in all patients before biopsy. Tolerance of the procedure was recorded immediately after the examination and graded on a scale of 0-4 as follows: 0, no pain; 1, very mild pain; 2, moderate pain; 3, severe pain; 4, intolerable pain. Complications recorded in the first week after the procedure were analyzed. They included mild pain, self-limiting hematuria, hematospermia, rectal bleeding, severe hematuria, septicemia, severe hemorrhage of the anus, and vasovagal attack. RESULTS: Out of 300 TRS-guided biopsies, 10 early complications were recorded. The most frequent was septicemia, which was seen in 5 cases (1.7%). Hematuria occurred in 29 patients, 3 of which were severe. Rectal bleeding and vasovagal attack occurred in 1 patient each. All patients made a full recovery with appropriate conservative management. Ten cases (3.33%) of severe pain (grade 3) and intolerable pain (grade 4) were observed. Three out of these 10 patients completed the procedure. The procedure was terminated in 1 patient, and 6 patients required local anesthetic due to perianal disease. CONCLUSIONS: TRS-guided prostate biopsy can be performed without local anesthesia in 90% of patients. Prophylactic antibiotics are mandatory to minimize approximately infectious complications.

Adult↗
PubMed2005

Age-specific reference levels of serum prostate-specific antigen and prostate volume in healthy Arab men.

UNLABELLED: OBJECTIVE; To determine age-specific reference ranges for serum prostate-specific antigen (PSA) concentration and prostate volumes in a population of healthy Arab men. SUBJECTS AND METHODS: Blood samples were taken from 396 healthy Arab men (from Kuwait and Oman) aged 15-79 years and from across the social spectrum. Men aged >40 years had a digital rectal examination and transrectal ultrasonography of the prostate to determine prostate volume. The serum PSA level was measured using commercial kits, and age-specific ranges for PSA levels and prostate volume determined. RESULTS: The serum PSA ranges (ng/mL) for each age range in Arab men were: 40-49 years, 0-0.9; 60-69, 0-2.7; 70-79, 0-5.5 ng/mL; the respective prostate volumes were 8-22, 9-30 and 10-33 mL. The serum PSA level and prostate volume correlated with age (P < 0.001). Arab men had lower serum PSA levels and prostate volumes than those reported for Caucasians, but similar to those reported for Asians (Japanese and Chinese). CONCLUSION: These results indicate that Arab men have lower PSA levels and prostate volumes than Caucasians. The levels are slightly lower than those reported in the Japanese and, as in the Japanese, low PSA levels and small prostate volumes might be related to the low incidence of clinical prostate cancer in Arab men.

Adolescent↗
PubMed2004

Technical observations on the assessment of thyroid volume by palpation and ultrasonography.

OBJECTIVE: The diagnosis of increased thyroid volume, in field studies of goiter prevalence, has been based on inspection and palpation of the thyroid. Because clinical examination, compared with ultrasonography, has a low positive predictive value for the presence of a goiter, it overestimates goiter prevalence. It also has the problem of marked interobserver variability. This led to the use of ultrasonographic scanners in field studies. The problem with the latter is the cost and skill required for the complicated linear measures and their translation to lobe volume and then thyroid volume. We studied patients to determine whether this complicated assessment could be simplified. METHODS: We studied palpation in 31 patients with thyroid disease in whom individual ultrasonographic linear dimensions were also obtained in their 62 thyroid lobes to determine their relationship to thyroid lobe volume. RESULTS: Palpation revealed poor discrimination of smaller thyroid sizes as determined by ultrasonography. Stepwise linear regression (backward selection) revealed that of the 3 thyroid dimensions, only the lateromedial dimension of the thyroid lobe had a significant correlation to lobe volume, accounting for 82.5% of the variability in lobe volume. The lobe volume (in milliliters) is given by the lobe lateromedial dimension (in centimeters) multiplied by 13 minus a constant of 15. CONCLUSIONS: A simple linear ultrasonographic measurement of the thyroid lateromedial dimension, which can be done with little training, is as good as more complicated measures of thyroid volume estimation by ultrasonography and is an ideal method for identifying goiters in field surveys.

Adult↗
PubMed2003

Is fasting a necessary preparation for abdominal ultrasound?

OBJECTIVE: To study the effect of fasting on the technical success of abdominal ultrasound examination. METHODS: In a randomized, prospective study, 150 patients for abdominal ultrasound were divided into two groups of 75 patients each with instructions to fast for six hours or have normal breakfast respectively. RESULT: The technical success of the abdominal ultrasound performed by radiologists blinded to the instruction did not differ significantly between the groups. CONCLUSION: It appears that routine fasting before abdominal ultrasound is not necessary.

Journal Article↗
PubMed2003

Seminal vesicle masses detected incidentally during transrectal sonographic examination of the prostate.

PURPOSE: The aim of this study was to review the incidence and type of seminal vesicle (SV) masses discovered during transrectal sonography (TRUS) of the prostate. METHODS: Patients were a consecutive series of men referred for TRUS of the prostate because of lower urinary tract symptoms or elevated prostate-specific antigen levels, who were found on TRUS to have SV masses. Patients with prostate cancer involving the SVs were excluded. Cystic lesions were sampled by fine-needle aspiration and solid lesions by core biopsy, all under sonographic guidance. RESULTS: Of the 450 patients who underwent TRUS between January 1997 and December 2001, 10 (2%) were found to have SV masses; 5 masses were cystic and 5 were solid. Cytologic evaluation of aspirated specimens revealed benign findings in all 5 cysts. Four of the 5 patients with solid SV masses had chronic schistosomiasis, and the mass in the fifth patient was a metastatic deposit from a renal cell carcinoma. CONCLUSIONS: SV masses may be responsible for lower urinary tract symptoms in a small fraction of cases. A cystic mass is presumptively benign, whereas a solid lesion has a small probability of being malignant, especially if the patient has a primary neoplasm elsewhere. Schistosomiasis should always be considered when making a differential diagnosis in patients who live in areas where infestation is endemic.

Adult↗
PubMed2002

CT features in abdominal tuberculosis: 20 years experience.

BACKGROUND: Abdominal tuberculosis (TB) is endemic in the developing world and is reemerging in the West. Since computed tomography (CT) has the ability to demonstrate changes in the peritonium, mesentry, lymphnodes, bowel and solid organs and is being increasingly used for primary evaluation of abdominal conditions, it is important to be familiar with the CT features of the disease. METHODS: CT findings were retrospectively analysed in 49 patients with proved abdominal TB. Patients with genitourinary TB and with AIDS/HIV were not included in the study. RESULTS: Peritoneal involvement was the most common feature (77.5%) with ascites (wet peritonitis) seen in more than half the cases (55.2%). The rest showed peritoneal, mesenteric or omental thickening or mass formation but no ascites (dry peritonitis). Other findings included lymphadenopathy (46.9% mainly of diffuse nature, bowel wall thickening (38%) and solid organ involvement (20.4%). CONCLUSIONS: CT reliably demonstrates the entire range of findings which need interpretation in the light of clinical and laboratory data.

Journal Article↗
PubMed2002

Sonographic appearances of galactoceles.

PURPOSE: The aim of this study was to investigate and summarize the sonographic appearances of galactoceles. METHODS: We retrospectively reviewed the sonograms and clinical records of 10 patients with galactoceles who had been examined over a 5-year period to evaluate breast lumps that had occurred during lactation or the puerperium. RESULTS: Sonograms from all patients showed well-defined lesions with thin, echogenic walls. The internal appearances of the lesions included homogeneous contents with medium-level echoes in 6 patients and heterogeneous contents with fluid clefts and anechoic rims in 4 patients. Focal echogenic areas with distal shadowing were seen in 2 patients. Most of the lesions showed some distal acoustic enhancement, depending on the internal contents. The diagnosis of a galactocele was established by needle aspiration in 9 patients and by excision biopsy in 1 patient. Needle aspiration alone was therapeutic in 8 patients. CONCLUSIONS: Galactoceles can have a wide range of sonographic appearances and can mimic other lesions of the breast, both benign and malignant. The clues to the diagnosis are recent childbirth and lactation and the presence of a well-defined lesion with some distal acoustic enhancement. Needle aspiration of the lesion is both a diagnostic tool and an effective treatment in most patients with galactoceles.

Adult↗
PubMedDate not supplied

Diagnosis of abdominal hydatid cyst disease: the role of ultrasound and ultrasound-guided fine needle aspiration cytology.

OBJECTIVE: To retrospectively analyze the role of ultrasound (US) imaging and US-guided fine needle aspiration cytology in the diagnosis and management of abdominal hydatid cyst disease (HCD). SUBJECTS AND METHODS: The medical records of 55 diagnosed cases of HCD seen between January 1986 and December 2000 at Mubarak Al-Kabeer Hospital and Al-Amiri Hospital in Kuwait were reviewed for demographic and clinical data, including radiology and serology. The US findings of the patients were classified into four types as follows: type I: single or multiple well-defined cysts, with or without detached or collapsed wall and with or without echogenic contents; type II: single or multiple cysts with peripheral cysts, with or without echogenic contents; type III: solid or semisolid lesions, and type IV: cysts with calcified walls. RESULTS: The overall accuracy of US in the diagnosis of HCD was 80% (44/55 cases). US examination was suggestive of HCD type I, 16/19 (84%), type II, 21/23 (91%), type III, 3/8 (38%), and type IV, 4/5 (80%). For the 11 remaining undiagnosed cases, US was useful for localizing the lesions for US-guided fine needle aspiration cytology. It established the diagnosis in all the 11 cases, without precipitating complications. CONCLUSION: US alone was valuable for diagnosing and localizing HCD in the abdomen except for solid-type lesions. US-guided fine needle aspiration cytology was useful in localizing and establishing the diagnosis of HCD in the cases where US alone was ineffective.

Abdomen↗
PubMedDate not supplied

Contrast media extravasation: manual versus power injector.

OBJECTIVE: To compare the incidence and complications of extravasation of low-osmolar nonionic contrast media, injected manually and by the automatic power injector (API). SUBJECTS AND METHODS: Three thousand five hundred and sixty patients underwent contrast-enhanced abdominal and thoracic computerized tomography scan in the Department of Clinical Radiology, Al-Amiri Hospital, Kuwait, between June 1998 and December 2002. These patients were prospectively analyzed for contrast media extravasation, its relation to injection rate, cannula insertion and gauge and its complications. 920 patients were administered low-osmolar nonionic contrast media (Ultravist 300, Omni Paque 240 or 300) intravenously by manual injection and 2,640 patients by automatic power injector. RESULTS: Of the 3,560 patients contrast media extravasation occurred in 11 (0.3%). The symptoms were observed in 9 patients (0.3%) in the API group and 2 patients (0.2%) in the manual injection group, respectively. None of the patients had any soft tissue injury. CONCLUSION: The incidence of contrast media extravasation is not significantly increased by the use of the API. Low-osmolar nonionic contrast media extravasation resulting from the use of API does not cause any morbidity.

Extravasation of Diagnostic and Therapeutic Materi↗
PubMedDate not supplied

Papillary thyroid carcinoma and its variants in fine needle aspiration smears. A cytomorphologic study with special reference to tall cell variant.

OBJECTIVE: To study the fine needle aspiration (FNA) cytologic features of papillary thyroid carcinoma (PTC) with special reference to its tall cell variant (TCV), which is the most aggressive of the variants. STUDY DESIGN: Fifty-four PTC cases were classified into variants, and the frequency of well-known morphologic criteria was determined. Four parameters were quantitatively analyzed based on a study of 200 consecutive neoplastic follicular cells: shape of cells, color of cytoplasm, intranuclear cytoplasmic inclusion (INCI) and nuclear grooves. RESULTS: The PTC cases included 6 TCV (> or = 30% tall cells), 8 cases with a significant tall cell component (sig. TCC) having 10-29% tall cells, 17 usual variant (UV), 17 follicular variant (FV) and 6 miscellaneous variants. TCV differed significantly from UV and FV in having a higher tall cell count, higher count of cells with reddish cytoplasm and INCI, and higher frequency of cases with lymphocytic infiltration. PTC (with significant tall cell component [TCC]) differed significantly from TCV with regard to tall cell count and lymphocytic infiltration, from UV with respect to tall cell count and monolayered sheets, and from FV with respect to tall cells, INCI, grooved nuclei, acinar formation, fire-flare appearance and giant cells. CONCLUSION: TCV was cytologically distinct from other variants. The biologic behavior of PTC cases with significant TCC, which morphologically seem to be a group intermediate between TCV on the one hand and UV and FV on the other, however, needs to be carefully monitored.

Adolescent↗
PubMedDate not supplied

Spinal tuberculosis: CT and MRI feature.

BACKGROUND: Spinal tuberculosis (TB) is perhaps the most clinically important extrapulmonary form of the disease. Early recognition is therefore necessary to minimize residual spinal deformity and/or permanent neurological deficit. We defined the CT and MRI image morphology of spinal TB and correlated the imaging features of these two modalities. METHODS: CT (29 patients) and MRI (11 patients) images were retrospectively analyzed in 30 patients with proved spinal TB. CT and MRI findings were compared in cases with both imaging tests (10 cases). The parameters assessed were the type and extent of bone and soft tissue involvement. RESULTS: The majority of the 30 patients were males (n=18) in the 30-49 year age group (43%). The most common clinical presentation was backache (73.3%) followed by fever (63.3%) and malaise (36.6%). The lumbar spine was the commonest site of the disease (43.3%) followed by the thoracic region (36.6%). A fragmentary type of bone destruction was the most frequent CT feature of the disease (48.2%) followed by the lytic type (24.1%). Intervertebral disc destruction (72%) and paravertebral mass/abscess (65.5%) were other features. Of the 11 patients who had an MRI, contiguous vertebral disease with disc destruction was seen in 10 cases. In 4 patients, there was distant vertebral disease in addition to the disease at the symptomatic site. CONCLUSIONS: MRI offers excellent visualization of the bone and soft tissue components of spinal tuberculosis and helps to identify disease at distant asymptomatic sites. CT is useful in assessing bone destruction, but is less accurate in defining the epidural extension of the disease and therefore its effect on neural structures. MR imaging clearly demonstrated the extent of soft tissue disease and its effect on the theca/cord and foramen in cases with doubtful CT findings.

Adult↗