Dr Hina Khan | Dow University of Health Sciences (original) (raw)

Papers by Dr Hina Khan

Egyptian Journal of Radiology and Nuclear Medicine, 2020

Background Leiomyosarcoma arising from mesentery is a rare tumor associated with worse prognosis.... more Background Leiomyosarcoma arising from mesentery is a rare tumor associated with worse prognosis. The tumor arises from smooth muscles in vascular wall. Ileal mesentery is common site of this tumor origin. Case presentation A middle age female was presented with complain of abdominal distension. A mass was palpable on abdominal examination. CT scan showed large mesenteric cyst. 15 × 10 cm large mass excised with associated mesentery and small bowel segment and on histopathology was found, and it was diagnosed as mesenteric leiomyosarcoma. The patient was discharged and referred to oncology for chemotherapy. Conclusion Leiomyosarcoma is a rare disease with grave prognosis. There is a paucity of literature and proper guidelines for its management; however, surgical excision with healthy margins is a mainstay of management. Close follow-up is recommended post-operatively because there are high chances of recurrence and metastasis.

Annals of Medicine and Surgery, 2021

Background: Hemangiopericytomas (HPC) are vascular tumors and can be found at any place where ves... more Background: Hemangiopericytomas (HPC) are vascular tumors and can be found at any place where vessels are present. These were previously known as 'extrapleural Solitary Fibrous Tumour'. These tumors may reoccur and metastasize after surgical excision. We present herein a HPC of the greater omentum, diagnosed as left inguinal hernia preoperatively. Case presentation: A 61-year-old male, presented with a huge painless mass in his left inguinoscrotal region secondary to weigh-lifting associated with malaise and vague abdominal pain. A well-defined, non-tender, and firm mass was found at the left lower abdomen extending to the left inguinoscrotal region. Based on the examination, a diagnosis of indirect inguinal hernia was made. Abdominal ultrasound showed a heterogeneous, hyporeflective, and vascularized mass. Contrast-enhanced computed tomography scan identified a localized, extraperitoneal, heterogeneously hypodense, well-defined, and lobulated mass, with marked contrast enhancement. On exploration, an encapsulated large mass originating from the omentum with enormously dilated blood vessels was excised. On histopathology, a neoplastic lesion, composed of spindle-shaped cells and moderate cytoplasm was identified. The blood vessels appeared thin-walled with a staghorn appearance in hemangiopericytic pattern. Omental sections showed fibro adipose tissue with dilated lymphatics and thick-walled blood vessels. Features were consistent with a malignant HPC of 20 × 14 × 10 cm. Conclusion: We present an unusual presentation of primary omental malignant HPC as an inguinal hernia, treated by complete surgical resection. These tumors are rare therefore, timely diagnosis is important for proper evaluation, diagnosis, and treatment. It also requires long-term follow up for better survival.

Cureus, 2020

Malignant melanoma of the rectum comprises 0.5%-4% of all anorectal cancers. Malignant melanoma o... more Malignant melanoma of the rectum comprises 0.5%-4% of all anorectal cancers. Malignant melanoma of the rectum is exceptionally a rare disease. It commonly affects the fifth or sixth decade, with nonspecific symptoms such as rectal bleeding or anal pain. After skin and retina, anorectum is the third common site for malignant melanoma. Proper diagnosis is difficult in the majority of cases due to lack of pigmentation and amelanotic histological appearance. Prognosis is very poor with a median survival of 24 months and fiveyear survival of 10%-15%. Anorectal malignant melanomas disseminate along the submucosal planes, therefore complete resection at the time of diagnosis is usually not possible.

Objective: To evaluate the neurological outcome of anterior decompression and fixation with Webb-... more Objective: To evaluate the neurological outcome of anterior decompression and fixation with Webb-Morley procedure in dorsolumbar spinal injuries. Study Design: A case series study.

Pakistan Journal of Medical Sciences, 1969

Objective: To find out the short term outcomes of laparoscopic ventral hernia repair (LVHR) durin... more Objective: To find out the short term outcomes of laparoscopic ventral hernia repair (LVHR) during the last four years. Methods: It was a descriptive and prospective case series of 53 consecutive patients out of 107 at

Journal of the College of Physicians and Surgeons Pakistan, 2020

Background: Hemangiopericytomas (HPC) are vascular tumors and can be found at any place where ves... more Background: Hemangiopericytomas (HPC) are vascular tumors and can be found at any place where vessels are present. These were previously known as 'extrapleural Solitary Fibrous Tumour'. These tumors may reoccur and metastasize after surgical excision. We present herein a HPC of the greater omentum, diagnosed as left inguinal hernia preoperatively. Case presentation: A 61-year-old male, presented with a huge painless mass in his left inguinoscrotal region secondary to weigh-lifting associated with malaise and vague abdominal pain. A well-defined, non-tender, and firm mass was found at the left lower abdomen extending to the left inguinoscrotal region. Based on the examination, a diagnosis of indirect inguinal hernia was made. Abdominal ultrasound showed a heterogeneous, hyporeflective, and vascularized mass. Contrast-enhanced computed tomography scan identified a localized, extraperitoneal, heterogeneously hypodense, well-defined, and lobulated mass, with marked contrast enhancement. On exploration, an encapsulated large mass originating from the omentum with enormously dilated blood vessels was excised. On histopathology, a neoplastic lesion, composed of spindle-shaped cells and moderate cytoplasm was identified. The blood vessels appeared thin-walled with a staghorn appearance in hemangiopericytic pattern. Omental sections showed fibro adipose tissue with dilated lymphatics and thick-walled blood vessels. Features were consistent with a malignant HPC of 20 × 14 × 10 cm. Conclusion: We present an unusual presentation of primary omental malignant HPC as an inguinal hernia, treated by complete surgical resection. These tumors are rare therefore, timely diagnosis is important for proper evaluation, diagnosis, and treatment. It also requires long-term follow up for better survival.

Background: CRC incidence is increasing in our region. There is no specific CRC control program o... more Background: CRC incidence is increasing in our region. There is no specific CRC control program or national cancer registry in Pakistan. Previously no data has been published on presentation and diagnosis delay of CRC in our region. This study is conducted to determine the factor affecting delay in presentation and diagnosis and to provide baseline information to launch a CRC control program. Primary objective is to determine factor causing delay in diagnosis of CRC. Secondary objective is to evaluate relationship between tumor site and stage of CRC with presenting symptoms and symptom duration. Methods: This project is a prospective cross-sectional study on 113 biopsy-proven CRC patients admitted to the surgical ward of civil hospital Karachi. Results: A total number of participants was 113. Presentation delay was observed in 83.2% of patients. The main reasons for a reported delay in the presentation were lack of patients' knowledge that these symptoms may be cancer (60.4%), the wrong diagnosis by the primary physician (34.6%), or the patient didn't want to visit the doctor (0.04%). Most tumors (95%) originated from the sigmoid and rectum. 38.9% and 44.2% of the patients diagnosed at Stage 4 and 3 respectively. Conclusions: This study revealed that CRC patients in Pakistan are facing delays in presentation and diagnosis. This is the reason behind diagnosis at the advanced stage with a poor prognosis. Based on this study findings CRC control program should be introduced to detect CRC at an early stage.

Objective: To determine the diagnostic accuracy of RIPASA score in acute appendicitis compared to... more Objective: To determine the diagnostic accuracy of RIPASA score in acute appendicitis compared to modified Alvarado score. Methodology: The study included 65 patients who underwent appendectomy. The histopathological assessment was done and compared with the scores for diagnostic accuracy. Results: The sensitivity of RIPASA score was 98.3%, with specificity of 100%, a positive predictive value of 100%, and negative predictive value of 80%. The Alvarado score had sensitivity and specificity of 65.6% and 75.0%, respectively. Conclusion: We found that RIPASA was a better scoring system in our population when compared to modified Alvarado for the diagnosis of acute appendicitis.

Egyptian Journal of Radiology and Nuclear Medicine, 2020

Background Leiomyosarcoma arising from mesentery is a rare tumor associated with worse prognosis.... more Background Leiomyosarcoma arising from mesentery is a rare tumor associated with worse prognosis. The tumor arises from smooth muscles in vascular wall. Ileal mesentery is common site of this tumor origin. Case presentation A middle age female was presented with complain of abdominal distension. A mass was palpable on abdominal examination. CT scan showed large mesenteric cyst. 15 × 10 cm large mass excised with associated mesentery and small bowel segment and on histopathology was found, and it was diagnosed as mesenteric leiomyosarcoma. The patient was discharged and referred to oncology for chemotherapy. Conclusion Leiomyosarcoma is a rare disease with grave prognosis. There is a paucity of literature and proper guidelines for its management; however, surgical excision with healthy margins is a mainstay of management. Close follow-up is recommended post-operatively because there are high chances of recurrence and metastasis.

Annals of Medicine and Surgery, 2021

Background: Hemangiopericytomas (HPC) are vascular tumors and can be found at any place where ves... more Background: Hemangiopericytomas (HPC) are vascular tumors and can be found at any place where vessels are present. These were previously known as 'extrapleural Solitary Fibrous Tumour'. These tumors may reoccur and metastasize after surgical excision. We present herein a HPC of the greater omentum, diagnosed as left inguinal hernia preoperatively. Case presentation: A 61-year-old male, presented with a huge painless mass in his left inguinoscrotal region secondary to weigh-lifting associated with malaise and vague abdominal pain. A well-defined, non-tender, and firm mass was found at the left lower abdomen extending to the left inguinoscrotal region. Based on the examination, a diagnosis of indirect inguinal hernia was made. Abdominal ultrasound showed a heterogeneous, hyporeflective, and vascularized mass. Contrast-enhanced computed tomography scan identified a localized, extraperitoneal, heterogeneously hypodense, well-defined, and lobulated mass, with marked contrast enhancement. On exploration, an encapsulated large mass originating from the omentum with enormously dilated blood vessels was excised. On histopathology, a neoplastic lesion, composed of spindle-shaped cells and moderate cytoplasm was identified. The blood vessels appeared thin-walled with a staghorn appearance in hemangiopericytic pattern. Omental sections showed fibro adipose tissue with dilated lymphatics and thick-walled blood vessels. Features were consistent with a malignant HPC of 20 × 14 × 10 cm. Conclusion: We present an unusual presentation of primary omental malignant HPC as an inguinal hernia, treated by complete surgical resection. These tumors are rare therefore, timely diagnosis is important for proper evaluation, diagnosis, and treatment. It also requires long-term follow up for better survival.

Cureus, 2020

Malignant melanoma of the rectum comprises 0.5%-4% of all anorectal cancers. Malignant melanoma o... more Malignant melanoma of the rectum comprises 0.5%-4% of all anorectal cancers. Malignant melanoma of the rectum is exceptionally a rare disease. It commonly affects the fifth or sixth decade, with nonspecific symptoms such as rectal bleeding or anal pain. After skin and retina, anorectum is the third common site for malignant melanoma. Proper diagnosis is difficult in the majority of cases due to lack of pigmentation and amelanotic histological appearance. Prognosis is very poor with a median survival of 24 months and fiveyear survival of 10%-15%. Anorectal malignant melanomas disseminate along the submucosal planes, therefore complete resection at the time of diagnosis is usually not possible.

Objective: To evaluate the neurological outcome of anterior decompression and fixation with Webb-... more Objective: To evaluate the neurological outcome of anterior decompression and fixation with Webb-Morley procedure in dorsolumbar spinal injuries. Study Design: A case series study.

Pakistan Journal of Medical Sciences, 1969

Objective: To find out the short term outcomes of laparoscopic ventral hernia repair (LVHR) durin... more Objective: To find out the short term outcomes of laparoscopic ventral hernia repair (LVHR) during the last four years. Methods: It was a descriptive and prospective case series of 53 consecutive patients out of 107 at

Journal of the College of Physicians and Surgeons Pakistan, 2020

Background: Hemangiopericytomas (HPC) are vascular tumors and can be found at any place where ves... more Background: Hemangiopericytomas (HPC) are vascular tumors and can be found at any place where vessels are present. These were previously known as 'extrapleural Solitary Fibrous Tumour'. These tumors may reoccur and metastasize after surgical excision. We present herein a HPC of the greater omentum, diagnosed as left inguinal hernia preoperatively. Case presentation: A 61-year-old male, presented with a huge painless mass in his left inguinoscrotal region secondary to weigh-lifting associated with malaise and vague abdominal pain. A well-defined, non-tender, and firm mass was found at the left lower abdomen extending to the left inguinoscrotal region. Based on the examination, a diagnosis of indirect inguinal hernia was made. Abdominal ultrasound showed a heterogeneous, hyporeflective, and vascularized mass. Contrast-enhanced computed tomography scan identified a localized, extraperitoneal, heterogeneously hypodense, well-defined, and lobulated mass, with marked contrast enhancement. On exploration, an encapsulated large mass originating from the omentum with enormously dilated blood vessels was excised. On histopathology, a neoplastic lesion, composed of spindle-shaped cells and moderate cytoplasm was identified. The blood vessels appeared thin-walled with a staghorn appearance in hemangiopericytic pattern. Omental sections showed fibro adipose tissue with dilated lymphatics and thick-walled blood vessels. Features were consistent with a malignant HPC of 20 × 14 × 10 cm. Conclusion: We present an unusual presentation of primary omental malignant HPC as an inguinal hernia, treated by complete surgical resection. These tumors are rare therefore, timely diagnosis is important for proper evaluation, diagnosis, and treatment. It also requires long-term follow up for better survival.

Background: CRC incidence is increasing in our region. There is no specific CRC control program o... more Background: CRC incidence is increasing in our region. There is no specific CRC control program or national cancer registry in Pakistan. Previously no data has been published on presentation and diagnosis delay of CRC in our region. This study is conducted to determine the factor affecting delay in presentation and diagnosis and to provide baseline information to launch a CRC control program. Primary objective is to determine factor causing delay in diagnosis of CRC. Secondary objective is to evaluate relationship between tumor site and stage of CRC with presenting symptoms and symptom duration. Methods: This project is a prospective cross-sectional study on 113 biopsy-proven CRC patients admitted to the surgical ward of civil hospital Karachi. Results: A total number of participants was 113. Presentation delay was observed in 83.2% of patients. The main reasons for a reported delay in the presentation were lack of patients' knowledge that these symptoms may be cancer (60.4%), the wrong diagnosis by the primary physician (34.6%), or the patient didn't want to visit the doctor (0.04%). Most tumors (95%) originated from the sigmoid and rectum. 38.9% and 44.2% of the patients diagnosed at Stage 4 and 3 respectively. Conclusions: This study revealed that CRC patients in Pakistan are facing delays in presentation and diagnosis. This is the reason behind diagnosis at the advanced stage with a poor prognosis. Based on this study findings CRC control program should be introduced to detect CRC at an early stage.

Objective: To determine the diagnostic accuracy of RIPASA score in acute appendicitis compared to... more Objective: To determine the diagnostic accuracy of RIPASA score in acute appendicitis compared to modified Alvarado score. Methodology: The study included 65 patients who underwent appendectomy. The histopathological assessment was done and compared with the scores for diagnostic accuracy. Results: The sensitivity of RIPASA score was 98.3%, with specificity of 100%, a positive predictive value of 100%, and negative predictive value of 80%. The Alvarado score had sensitivity and specificity of 65.6% and 75.0%, respectively. Conclusion: We found that RIPASA was a better scoring system in our population when compared to modified Alvarado for the diagnosis of acute appendicitis.