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Biomedical subjects

S Aslam Shah

Publications and source records attributed to S Aslam Shah.

4 recordsLinked to original sources
PubMed2005

Sentinel node localization in breast carcinoma.

OBJECTIVE: To determine the success rate of sentinel node dissection and the sensitivity of sentinel node to determine the presence of axillary node metastasis in women with clinically node negative breast cancer. DESIGN: Case series. PLACE AND DURATION OF STUDY: The study was conducted at Department of General Surgery Pakistan Institute of Medical Sciences, Islamabad (PIMS) and Nuclear Oncology and Radiotherapy Institute, Islamabad (NORI) from January 2002 to December 2003. PATIENTS AND METHODS: A total of 15 patients of early carcinoma breast were recruited in the study. Five patients were injected with radiocolloid and later with isosulfan blue in the subareolar region. Ten patients were given isosulfan blue only. All the patients were subjected to standard axillary clearance after sentinel node biopsy through separate incisions. Sentinel node was examined by intra-operative frozen section and all of the dissected lymph nodes were examined histopathologically for tumour deposits. RESULTS: Sentinel lymph node was successfully excised in all the cases 15/15 (100%). In 14 of the patients the sentinel node pathology was truly predictive of axillary nodal status. Sensitivity of the test was 93.33% and the positive predictive value was 100%. CONCLUSION: Sentinel node biopsy should be followed by standard axillary lymph adenectomy until the results of multiple prospective randomized trials define the role of this technique in the management of carcinoma breast.

Adult↗
PubMed2003

Unilateral exploration for primary hyperparathyroidism.

OBJECTIVE: To examine the efficacy of using pre-operative imaging studies (Sesta-MIBI scan and ultrasonography) to localize the pathology and allow for unilateral neck exploration to assess its safety. DESIGN: Descriptive analytical study. PLACE AND DURATION OF STUDY: Department of Surgery/ENT, Pakistan Institute of Medical Sciences (PIMS), Islamabad. SUBJECTS AND METHODS: Twenty-three patients were reviewed, who underwent operation for primary hyperparathyroidism (PHPT) in our institution between 1995 and 2002. A total of 49 enlarged parathyroid glands were removed. Patients were divided into two groups. In group-A (in which only unilateral exploration was done) there were 21 patients (42 glands). In group-B, bilateral exploration was done, which included 2 patients and 7 glands. Sesta-MIBI scan and ultrasonography were done in all cases. Results were analyzed statistically with appropriate tests of significance. RESULTS: Sesta-MIBI scan showed an accuracy of 91% (20 adenomas) whereas ultrasound was positive in 18 patients (78%). One case of adenoma and 2 cases of hyperplasia were not detected by pre-operative imaging. Unilateral exploration of neck was successful in 19 cases of adenoma. The parameters used for successful exploration were corrected serum calcium and parathyroid hormone levels. Ultrasound was positive in 18 patients (78%). There was a significant difference in surgical time between the unilateral and bilateral neck explorations (45 minutes). Unilateral neck exploration for hyperparathyroidism has been successful in curing hypocalcaemia 22/23(95%). CONCLUSION: At least two pre-operative localization tests, a Sesta-MIBI scan and ultrasonography, should be done for accurate localization of an abnormal parathyroid gland especially adenoma. Selective unilateral exploration is safe and reliable if the second ipsilateral gland is normal macroscopically or microscopically.

Adenoma↗
PubMedDate not supplied

Outcome of rubber band ligation of haemorrhoids using suction ligator.

BACKGROUND: Haemorrhoids are a common surgical problem seen in the outpatient department. Rubber band ligation using suction is an effective treatment for symptomatic haemorrhoids but associated with significant morbidity. This prospective observational study was carried out to assess the efficacy, effectiveness and complications of rubber band ligation performed in outpatient for symptomatic haemorhoids using suction ligator. The results and outcome of procedure performed by the consultants and senior residents were also compared. METHODS: 56 consecutive patients with symptomatic haemorrhoids underwent rubber band ligation in the outpatient clinic of the department of general surgery, Pakistan Institute of Medical Sciences. Outcome measures were symptomatic cure i.e. stoppage of bleeding and reduced mucosal prolapse. Complications were categorized as immediate, early (within one week) and late (within 3 months). RESULTS: Symptomatic cure was achieved in 50(89.20%) patients (stoppage of bleeding and reduced mucosal prolapse). Six (10.72%) patients required further banding. Pain (mild to severe) was most common immediate and intermediate complication (14 and 20 patient's respectively). CONCLUSION: Rubber band ligation is an effective, outdoor procedure for symptomatic haemorrhoids, but associated with certain degree of morbidity.

Adult↗