Biomedical subjects

Zafar Zaidi

Publications and source records attributed to Zafar Zaidi.

6 recordsLinked to original sources

PubMed2006

Paediatric percutaneous nephrolithotomy: setting new frontiers.

OBJECTIVE: To assess the safety and outcome of paediatric percutaneous nephrolithotomy (PCNL) for atypical cases and compare the results with 'standard' unilateral paediatric PCNL. PATIENTS AND METHODS: We retrospectively reviewed children who had had a PCNL between December 1997 and December 2004. Patients were grouped as follows: group 1, aged >5-16 years with normal anatomy and normal renal function undergoing unilateral PCNL or staged bilateral PCNL; group 2, < or = 5 years with normal anatomy and renal function undergoing unilateral PCNL; group 3, undergoing bilateral simultaneous PCNL; group 4, impaired renal function in addition to renal stone disease; group 5, renal anatomical abnormality with calculi in the same kidney. Demographics, stone profile, procedure and outcome indicators were analysed for each group. RESULTS: In all, 188 consecutive PCNLs in 169 children were included (mean age 3.3-10.3 years, mean stone burden 19.1-33.3 mm in the five groups). The mean duration of PCNL was 69-115 min. Stone clearance was satisfactory with single tract access in 90-100% of patients. Transient postoperative fever was the commonest complication (12.5-51%) followed by hyponatraemia and hypokalaemia. Blood transfusion was required in 0-7.7%. The mean stone clearance rates were 47-90% in the five groups; additional extracorporeal shockwave lithotripsy increased the cumulative clearance rates to 90-100%. CONCLUSION: PCNL is safe for treating renal stones, with excellent results and minimal complications. Comparable results are achieved in the very young child, children with anatomically abnormal kidneys, children with impaired renal function and children with bilateral renal stones undergoing simultaneous bilateral PCNL. Hence none of these factors should be considered as relative contraindications.

Adolescent↗

PubMed2006

Laparoscopic assisted percutaneous nephrolithotomy (PCNL) in ectopic pelvic kidney.

We report the case of a patient with pain and an abdominal palpable mass whose tests showed a right pelvic kidney with a 4-cm stone in the renal pelvis. We describe the successful management through laparoscopic assisted percutaneous nephrolithotomy (PCNL) in ectopic pelvic kidney, stressing that this method is a minimally invasive therapeutic option in such cases.

Adult↗

PubMed2006

Pregnancy after augmentation cystoplasty.

We report a case of 26 year old female who underwent ileo-cystoplasty for interstitial cystitis and two years later delivered a live baby through a lower segment caesarean section (LSCS) at 36 weeks.

Adult↗

PubMed2005

Bed wetting in school children of Karachi.

OBJECTIVES: To estimate the frequency of primary nocturnal enuresis (PNE) in Pakistani children and to examine the factors associated with it. METHODS: A randomly selected cross-sectional study was conducted in five elementary schools, one in each of five districts of Karachi. The parents of 5000 children age between 3-13 years were asked to complete a questionnaire which included items about the frequency of daytime wetting and nocturnal enuresis, family history, urinary tract infection, parents and child's own concern about this problem and acquisition of treatments. RESULTS: Over all corrected response rate to the questionnaire was 69% (3395). Enuresis was present in 9.1% (308). There were 166 (53.9%) boys and 142 (46%) girls with a median age of 7 years. Only 54% (166) children sought help for their problem of which 26% consulted doctors, 16% visited homeopaths while 11% used hakeems and home remedies. Of the bed wetters, 30% were wet every night, 30% for more than three nights a week and 40% for less than three nights every week. Parents of 68.5% (211) children reported concern for the problem while 69.8% (215) children were also anxious about their enuresis. Among the concerned children group, 22% parents were not concerned about their child's problem. Family history of enuresis was present in 25.6% (79) children. CONCLUSION: The frequency of enuresis among the school going children in Karachi is 9.1% and is similar to that reported in European countries and other Asian countries including Korea and Taiwan. Enuresis causes concern to both parents and children, but only a small percentage of parents seek medical help for this problem.

Adolescent↗

PubMed2005

Comparison of 24 hours urinary citrate levels in urolithiasis patients and healthy controls.

OBJECTIVE: To identify the difference in urinary citrate excretion between Stone Formers (SF) and Healthy Volunteers (HV) as a metabolic risk factor, that predisposes to urinary stone formation and to compare levels of urinary citrate in (HV) with reference values. METHODS: The 24 hours urinary citrate was evaluated in 40 patients treated for renal citrate and declared stone free, and 40 age matched healthy adults taken as controls. Both the groups had a similar living environment, extrinsic factors, diet and similar genetic descent. RESULTS: There was no significant difference in urinary citrate excretion level among stone formers (mean 262 SD 197) and normal volunteer subjects (mean 269 SD 140). Using the previously defined normal values (200) of urinary citrate in the local population, 55% of stone patients in our study group were hypocitric. While using the same value, 45% of our normal volunteers were also hypocitric. If 320 was taken as normal limit, 70% of the patient's population and 72% of controls were hypocitric. The prevalence of hypocitraturia was similar in the age matched adult groups. CONCLUSION: Certain intrinsic factors in our local subjects may account for the high prevalence of urolithiasis than in western population. Although the urinary citrate excretion of stone patients is similar to normal volunteers, uniformly low urinary citrate excretion may be a feature as a nation and not a predisposing factor for the lithogenesis. This supports the view that there may be more often prominent influences in stone formers possibly of genetic origin.

Adult↗

PubMed2004

Percutaneous nephrolithotomy in children before school age: experience of a Pakistani centre.

OBJECTIVE: To review our experience of percutaneous nephrolithotomy (PCNL) in children before school age, and determine its efficacy and safety in this age group. PATIENTS AND METHODS: The records of children aged < or = 5 years undergoing PCNL were reviewed. Variables assessed included stone number, size, location and type. The PCNL puncture site and number were also recorded. We reviewed stone clearance with PCNL, ancillary procedures used, complication rates and follow-up status of the children. RESULTS: There were 30 renal units in 29 children (median age 3.8 years, range 1.4-5). Because of poor growth the mean (SD) body weight of the children was only 12.2 (2.8) kg, which is near the 50th percentile for children of mean age 3.5 years. The median (range) stone burden was 2.35 (1.3-6) cm; 60% of the patients had single stones while 28% had more than five. There were five staghorn stones. All PCNL was primary and with one puncture, using a 17 F angled nephroscope; stones were fragmented using a pneumatic lithoclast. After PCNL stones were completely cleared in 60% of the renal units, which increased to 100% after combining it with extracorporeal shockwave lithotripsy. The median (range) follow-up was 24.9 (4-51) months; the overall complication rate was 6%. In the long follow-up hypertension was not detected in any child and isotopic renograms in 17 kidneys detected no new scarring or loss of renal function. CONCLUSION: PCNL is a safe and effective for treating renal stones in very young children.

Child, Preschool↗