Altaf H Hashmi - Academia.edu (original) (raw)
Papers by Altaf H Hashmi
Transplantation Proceedings, Dec 1, 1999
Pakistan Journal of Health Sciences, Feb 28, 2023
Renal cell carcinoma (RCC) comprises for between 90-95% of renal malignancies, is the sixth most ... more Renal cell carcinoma (RCC) comprises for between 90-95% of renal malignancies, is the sixth most common cancer in men and tenth in women [1]. In developed nations, where incidence rates are higher and up to half of cases discovered incidentally [2]. Due to the widespread use of abdominal imaging for a variety of renal speci c and nonspeci c complaints, the incidental identi cation of renal masses has signi cantly increased over time [3]. According to current estimates, accidental detection accounts for more than half of all kidney masses [4, 5]. The majority of renal mass lesions were once considered to be cancerous, while benign lesions like oncocytoma(3-5%), a n g i o m y o l i p o m a (0. 7-2 %) , a n d m e t a n e p h r i c adenoma(0.1%) were believed to occur just as commonly in
Transplantation, Jul 27, 2008
Our incidence of urological complications in 860 consecutive renal transplants is 3 .4 per cent. ... more Our incidence of urological complications in 860 consecutive renal transplants is 3 .4 per cent. A further reduction in incidence is demonstrated in the most recent 250 transplants of this series. Urological complications have been kept to a minimum by strict adherence to certain principles in donor nephrectomy, management of multiple and small arteries, and the technique of graft implantation. When urological complications were suspected early and judicious use of 131 I hippurate scintiphotographic techniques has proved to be the most helpful method to evaluate patients. If a urological complication did occur prompt recognition and treatment were responsible for a high rate of graft salvage, low incidence of sepsis and absence of patient mortality.
PubMed, Mar 1, 2009
Objective: To compare the outcome of Extra corporeal shockwave lithotripsy for a renal pelvic sto... more Objective: To compare the outcome of Extra corporeal shockwave lithotripsy for a renal pelvic stone with and without JJ stent. Methods: A comparative cross sectional study was carried out at Sindh Institute of Urology and Transplantation from January 2007 to January 2008. Eighty patients with renal pelvic stone measuring 2cm +/- 2mm were selected for treatment with Extra Corporeal Shockwave Lithotripsy (ESWL). All of these patients were adults with normal renal function and had unilateral renal stones with negative urine cultures. Patients with renal failure and children were excluded. They were divided into two groups of 40 each. Group A patients underwent ESWL without a JJ stent and in Group B a JJ stent was placed before ESWL. SLX F2 electromagnetic ESWL machine was used to impart shock waves. 3000 shockwaves were given in a session. Both the groups were compared for renal colic, steinstrasse, fever, lower urinary tract symptoms (LUTS) emergency room visits and hospital admissions, stone clearance, number of ESWL sessions, auxilliary procedures, (percutaneous nephrostomy or ureterorenoscopy) and cost. Results: Ureteric colic occurred in 13 (32.5%) patients in group A and in 3 (7.5%) patient in group B. Steinstrasse developed in 4 (10%) patients with out JJ stent and in 3 (7.5%) patients with JJ stent. Fever was encountered in 1 (2.5%) patient in group A and in 3 (7.5%) patient in group B. Mean emergency room visits were 2.1 per patient in group A and 0.7 per patient in group B. Stone clearance occurred in 33 (82.5%) patients in group A and 31 (77.5%) in group B. In group B lower urinary tract symptoms were found in 50% versus 20% in group A. Auxillary procedure was performed in one (2.5%) patient each in both groups. Conclusion: Pre ESWL JJ stenting for a 2 cm +/- 2 mm renal stone was not beneficial in terms of steinstrasse, fever, stone clearance and number of ESWL sessions. However ureteric colic was significantly less in the stented group. Lower urinary tract symptoms (LUTS) was also significantly high in the patients having a JJ stent. The cost of the treatment doubled in the stented group which is an important factor in our country. JJ stenting does not prove to be a cost effective procedure when compared to the reduction in complications.
Transplantation Proceedings, Dec 1, 1999
... transplantation program at SIUT. Auteur(s) / Author(s). HUSSAIN M. (1) ; KHALIQUE M. (1) ; AS... more ... transplantation program at SIUT. Auteur(s) / Author(s). HUSSAIN M. (1) ; KHALIQUE M. (1) ; ASKARI H. (1) ; LAL M. (1) ; HASHMI A. (1) ; HUSSAIN Z. (1) ; NAQVI A. (1) ; RIZVI A. (1) ; Affiliation(s) du ou des auteurs / Author(s) Affiliation(s). ...
Urology Annals, 2011
Peripheral primitive neuroectodermal tumor/Ewing's sarcoma (PNET/EWS) is primarily a tumor of sof... more Peripheral primitive neuroectodermal tumor/Ewing's sarcoma (PNET/EWS) is primarily a tumor of soft tissues and bones. Primary localization of PNET/EWS in genitourinary organs is rare. No data on this localization of PNET/EWS are available in literature from Pakistan. We searched our adult uro-oncology records from 1994 till date and identified all cases of adult genitourinary and adrenal PNET/EWS diagnosed on histology and immunohistochemistry. Their case records were reviewed to obtain data on demographics, presentation, pathologic features, management and outcome. Six cases were found; all were young and had aggressive disease at presentation. Four had renal PNET/EWS. One case each of prostate and adrenal PNET/EWS was seen. Surgery and chemotherapy formed the mainstay of management. Three patients (50%) died during treatment, two were lost to follow-up and one case with renal PNET/EWS showed good initial response to chemotherapy but was later on lost to follow-up. In conclusion, PNET/EWS should be considered in the differential diagnosis of genitourinary malignant tumors in young patients. These tumors are aggressive with poor outcome.
Transplantation Proceedings, May 1, 1998
Chronic Kidney Disease in Disadvantaged Populations
Summary In low income settings rates of renal replacement therapy (RRT) range from 50%) in living... more Summary In low income settings rates of renal replacement therapy (RRT) range from 50%) in living related and Tacrolimus + Mycophenolate Mofetil (>50%) in deceased donor transplants. Graft and patient survival at 1 and 5 years are 83%–98%, 59%–90%, 90%–98%, and 85%–96%, respectively. Causes of graft and patient loss are interstitial fibrosis and tubular atrophy (up to 71%) and infections (up to 80%), respectively. In low resource settings it is important, when possible, for the government sector to establish freely accessible renal transplantation for all who need it where community becomes a part of the care of ESRD patients.
Journal of the Pakistan Medical Association, 2022
Since the declaration of a COVID-19 pandemic in March 2020 teaching institutions started the proc... more Since the declaration of a COVID-19 pandemic in March 2020 teaching institutions started the process of adjusting to the new challenge. Medical education could not be imparted the way it used to be and some new methods had to be taken to adapt to the pandemic. At our institute, each week two lectures were recorded and later uploaded on the Youtube Channel and shared with students. This was followed by an MCQs based test using Google forms. Ten lectures were delivered in 5 weeks to 55 participants. Majority of residents agreed that this activity increased their knowledge of the subject and opted to continue it in future. With help of short online lectures (< 30 mins) and short online tests (5 MCQs), the learning experience of residents can be enhanced. In future, more online resources can be used to incorporate this method of teaching.
Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation, Jan 2, 2018
The aim of the present study was to evaluate the short- and intermediate-term outcomes of living-... more The aim of the present study was to evaluate the short- and intermediate-term outcomes of living-related kidney donors in terms of renal function and postnephrectomy complications at a single center in Pakistan. Our study included healthy donors who underwent unilateral nephroureterectomy for living-related renal transplant procedures at the Sindh Institute of Urology and Transplantation (Karachi, Pakistan) between January 2005 and January 2006. All patients were evaluated for early postoperative complications and renal functions at last follow-up. The mean follow-up duration was 1.7 ± 1.3 years. A total of 256 living-related donors underwent nephroureterectomy during the study period, which included 142 men (55.5%) and 114 women (44.5%). The mean age of donors was 33.7 ± 10.0 years. Most donors were between 21 and 40 years old. Of total donors, most were siblings (n = 143, 55.8%), followed by offspring, parents, and spouses. Left nephrectomy was performed in 206 donors (80.4%) and ...
Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation, Jan 13, 2017
Laparoscopic donor nephrectomy has become the criterion standard for kidney retrieval from living... more Laparoscopic donor nephrectomy has become the criterion standard for kidney retrieval from living donors. There is no information on the experience and outcomes of laparoscopic donor nephrectomy in Pakistan. The objective of the study was to identify benefits and harms of using laparoscopic compared with open nephrectomy techniques for renal allograft retrieval. In this a retrospective study, patient files from May 2014 to September 2015 were analyzed. Patients were divided into 2 groups: those with open donor nephrectomy and those with laparoscopic donor nephrectomy. Donor case files and operative notes were analyzed for age, sex, laterality, body mass index, warm ischemia time, perioperative and postoperative complications, surgery time, and length of hospital stay. Finally, serum creatinine patterns of both donors and recipients were analyzed. Data were analyzed using SPSS version 10 (SPSS: An IBM Company, IBM Corporation, Armonk, NY, USA). Of 388 total donors, 190 (49%) had open...
The Lancet, 1996
RefDoc, THE reference in scientific document supply / Refdoc, la référence en fourniture de docum... more RefDoc, THE reference in scientific document supply / Refdoc, la référence en fourniture de documents scientifiques ...
Pediatric Transplantation, 2002
Living-related pediatric renal transplants: A single-center experience from a developing country.
Journal of the College of Physicians and Surgeons Pakistan
Objective: To compare the drop in eGFR after nephron-sparing surgery in T1 and T2 renal tumours.
World Academy of Science, Engineering and Technology, International Journal of Medical and Health Sciences, 2015
Physica Medica, 2016
Introduction Linear accelerator is a device that can able to generate high energy photon from 4 M... more Introduction Linear accelerator is a device that can able to generate high energy photon from 4 MV to 25 MV, and these beams are used for radiation therapy. There are different treatment techniques using now a days to deliver radiation externally but most common is 3DCRT (3D conformal radiotherapy) and Intensity modulated radiation therapy. The major issue arises using photon beam having energy ∼10 MV and above is the productions of secondary neutron which can maximize the patient absorb doses. Purpose The aim of the study is to evaluate 3D conformal radiation therapy and step and shoot intensity modulated radiation therapy (ssIMRT) techniques for less neutron contamination that lead to minimum patient exposure from neutrons. Material and methods For this purpose five treatment plan of breast were made on both 3DCRT and ssIMRT using 10MV photon. Linear accelerator Elekta Synergy is used to deliver these plans and for measuring neutrons dose in primary beam, a portable, Ludlum neutron detector is used which is placed on patient’s couch. Results Obtained data shows that the mean values with standard error for each technique was found to be 14.56 mSv ± 0.38 and 25.07 mSv ± 1.2 for 3D CRT and ssIMRT, respectively. Mean difference between two techniques for neutron contamination was found to be 10.5 mSv. Conclusion It can be concluded from the study that contamination of neutrons increases by a factor of 10.5 when we move from 3D CRT to ssIMRT. This is because of increase no. of MUs that are being used in ssIMRT. Although ssIMRT therapy provides better plan optimization for target than 3DCTR but contains greater neutron contamination.
Transplantation Proceedings, Dec 1, 1999
Pakistan Journal of Health Sciences, Feb 28, 2023
Renal cell carcinoma (RCC) comprises for between 90-95% of renal malignancies, is the sixth most ... more Renal cell carcinoma (RCC) comprises for between 90-95% of renal malignancies, is the sixth most common cancer in men and tenth in women [1]. In developed nations, where incidence rates are higher and up to half of cases discovered incidentally [2]. Due to the widespread use of abdominal imaging for a variety of renal speci c and nonspeci c complaints, the incidental identi cation of renal masses has signi cantly increased over time [3]. According to current estimates, accidental detection accounts for more than half of all kidney masses [4, 5]. The majority of renal mass lesions were once considered to be cancerous, while benign lesions like oncocytoma(3-5%), a n g i o m y o l i p o m a (0. 7-2 %) , a n d m e t a n e p h r i c adenoma(0.1%) were believed to occur just as commonly in
Transplantation, Jul 27, 2008
Our incidence of urological complications in 860 consecutive renal transplants is 3 .4 per cent. ... more Our incidence of urological complications in 860 consecutive renal transplants is 3 .4 per cent. A further reduction in incidence is demonstrated in the most recent 250 transplants of this series. Urological complications have been kept to a minimum by strict adherence to certain principles in donor nephrectomy, management of multiple and small arteries, and the technique of graft implantation. When urological complications were suspected early and judicious use of 131 I hippurate scintiphotographic techniques has proved to be the most helpful method to evaluate patients. If a urological complication did occur prompt recognition and treatment were responsible for a high rate of graft salvage, low incidence of sepsis and absence of patient mortality.
PubMed, Mar 1, 2009
Objective: To compare the outcome of Extra corporeal shockwave lithotripsy for a renal pelvic sto... more Objective: To compare the outcome of Extra corporeal shockwave lithotripsy for a renal pelvic stone with and without JJ stent. Methods: A comparative cross sectional study was carried out at Sindh Institute of Urology and Transplantation from January 2007 to January 2008. Eighty patients with renal pelvic stone measuring 2cm +/- 2mm were selected for treatment with Extra Corporeal Shockwave Lithotripsy (ESWL). All of these patients were adults with normal renal function and had unilateral renal stones with negative urine cultures. Patients with renal failure and children were excluded. They were divided into two groups of 40 each. Group A patients underwent ESWL without a JJ stent and in Group B a JJ stent was placed before ESWL. SLX F2 electromagnetic ESWL machine was used to impart shock waves. 3000 shockwaves were given in a session. Both the groups were compared for renal colic, steinstrasse, fever, lower urinary tract symptoms (LUTS) emergency room visits and hospital admissions, stone clearance, number of ESWL sessions, auxilliary procedures, (percutaneous nephrostomy or ureterorenoscopy) and cost. Results: Ureteric colic occurred in 13 (32.5%) patients in group A and in 3 (7.5%) patient in group B. Steinstrasse developed in 4 (10%) patients with out JJ stent and in 3 (7.5%) patients with JJ stent. Fever was encountered in 1 (2.5%) patient in group A and in 3 (7.5%) patient in group B. Mean emergency room visits were 2.1 per patient in group A and 0.7 per patient in group B. Stone clearance occurred in 33 (82.5%) patients in group A and 31 (77.5%) in group B. In group B lower urinary tract symptoms were found in 50% versus 20% in group A. Auxillary procedure was performed in one (2.5%) patient each in both groups. Conclusion: Pre ESWL JJ stenting for a 2 cm +/- 2 mm renal stone was not beneficial in terms of steinstrasse, fever, stone clearance and number of ESWL sessions. However ureteric colic was significantly less in the stented group. Lower urinary tract symptoms (LUTS) was also significantly high in the patients having a JJ stent. The cost of the treatment doubled in the stented group which is an important factor in our country. JJ stenting does not prove to be a cost effective procedure when compared to the reduction in complications.
Transplantation Proceedings, Dec 1, 1999
... transplantation program at SIUT. Auteur(s) / Author(s). HUSSAIN M. (1) ; KHALIQUE M. (1) ; AS... more ... transplantation program at SIUT. Auteur(s) / Author(s). HUSSAIN M. (1) ; KHALIQUE M. (1) ; ASKARI H. (1) ; LAL M. (1) ; HASHMI A. (1) ; HUSSAIN Z. (1) ; NAQVI A. (1) ; RIZVI A. (1) ; Affiliation(s) du ou des auteurs / Author(s) Affiliation(s). ...
Urology Annals, 2011
Peripheral primitive neuroectodermal tumor/Ewing's sarcoma (PNET/EWS) is primarily a tumor of sof... more Peripheral primitive neuroectodermal tumor/Ewing's sarcoma (PNET/EWS) is primarily a tumor of soft tissues and bones. Primary localization of PNET/EWS in genitourinary organs is rare. No data on this localization of PNET/EWS are available in literature from Pakistan. We searched our adult uro-oncology records from 1994 till date and identified all cases of adult genitourinary and adrenal PNET/EWS diagnosed on histology and immunohistochemistry. Their case records were reviewed to obtain data on demographics, presentation, pathologic features, management and outcome. Six cases were found; all were young and had aggressive disease at presentation. Four had renal PNET/EWS. One case each of prostate and adrenal PNET/EWS was seen. Surgery and chemotherapy formed the mainstay of management. Three patients (50%) died during treatment, two were lost to follow-up and one case with renal PNET/EWS showed good initial response to chemotherapy but was later on lost to follow-up. In conclusion, PNET/EWS should be considered in the differential diagnosis of genitourinary malignant tumors in young patients. These tumors are aggressive with poor outcome.
Transplantation Proceedings, May 1, 1998
Chronic Kidney Disease in Disadvantaged Populations
Summary In low income settings rates of renal replacement therapy (RRT) range from 50%) in living... more Summary In low income settings rates of renal replacement therapy (RRT) range from 50%) in living related and Tacrolimus + Mycophenolate Mofetil (>50%) in deceased donor transplants. Graft and patient survival at 1 and 5 years are 83%–98%, 59%–90%, 90%–98%, and 85%–96%, respectively. Causes of graft and patient loss are interstitial fibrosis and tubular atrophy (up to 71%) and infections (up to 80%), respectively. In low resource settings it is important, when possible, for the government sector to establish freely accessible renal transplantation for all who need it where community becomes a part of the care of ESRD patients.
Journal of the Pakistan Medical Association, 2022
Since the declaration of a COVID-19 pandemic in March 2020 teaching institutions started the proc... more Since the declaration of a COVID-19 pandemic in March 2020 teaching institutions started the process of adjusting to the new challenge. Medical education could not be imparted the way it used to be and some new methods had to be taken to adapt to the pandemic. At our institute, each week two lectures were recorded and later uploaded on the Youtube Channel and shared with students. This was followed by an MCQs based test using Google forms. Ten lectures were delivered in 5 weeks to 55 participants. Majority of residents agreed that this activity increased their knowledge of the subject and opted to continue it in future. With help of short online lectures (< 30 mins) and short online tests (5 MCQs), the learning experience of residents can be enhanced. In future, more online resources can be used to incorporate this method of teaching.
Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation, Jan 2, 2018
The aim of the present study was to evaluate the short- and intermediate-term outcomes of living-... more The aim of the present study was to evaluate the short- and intermediate-term outcomes of living-related kidney donors in terms of renal function and postnephrectomy complications at a single center in Pakistan. Our study included healthy donors who underwent unilateral nephroureterectomy for living-related renal transplant procedures at the Sindh Institute of Urology and Transplantation (Karachi, Pakistan) between January 2005 and January 2006. All patients were evaluated for early postoperative complications and renal functions at last follow-up. The mean follow-up duration was 1.7 ± 1.3 years. A total of 256 living-related donors underwent nephroureterectomy during the study period, which included 142 men (55.5%) and 114 women (44.5%). The mean age of donors was 33.7 ± 10.0 years. Most donors were between 21 and 40 years old. Of total donors, most were siblings (n = 143, 55.8%), followed by offspring, parents, and spouses. Left nephrectomy was performed in 206 donors (80.4%) and ...
Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation, Jan 13, 2017
Laparoscopic donor nephrectomy has become the criterion standard for kidney retrieval from living... more Laparoscopic donor nephrectomy has become the criterion standard for kidney retrieval from living donors. There is no information on the experience and outcomes of laparoscopic donor nephrectomy in Pakistan. The objective of the study was to identify benefits and harms of using laparoscopic compared with open nephrectomy techniques for renal allograft retrieval. In this a retrospective study, patient files from May 2014 to September 2015 were analyzed. Patients were divided into 2 groups: those with open donor nephrectomy and those with laparoscopic donor nephrectomy. Donor case files and operative notes were analyzed for age, sex, laterality, body mass index, warm ischemia time, perioperative and postoperative complications, surgery time, and length of hospital stay. Finally, serum creatinine patterns of both donors and recipients were analyzed. Data were analyzed using SPSS version 10 (SPSS: An IBM Company, IBM Corporation, Armonk, NY, USA). Of 388 total donors, 190 (49%) had open...
The Lancet, 1996
RefDoc, THE reference in scientific document supply / Refdoc, la référence en fourniture de docum... more RefDoc, THE reference in scientific document supply / Refdoc, la référence en fourniture de documents scientifiques ...
Pediatric Transplantation, 2002
Living-related pediatric renal transplants: A single-center experience from a developing country.
Journal of the College of Physicians and Surgeons Pakistan
Objective: To compare the drop in eGFR after nephron-sparing surgery in T1 and T2 renal tumours.
World Academy of Science, Engineering and Technology, International Journal of Medical and Health Sciences, 2015
Physica Medica, 2016
Introduction Linear accelerator is a device that can able to generate high energy photon from 4 M... more Introduction Linear accelerator is a device that can able to generate high energy photon from 4 MV to 25 MV, and these beams are used for radiation therapy. There are different treatment techniques using now a days to deliver radiation externally but most common is 3DCRT (3D conformal radiotherapy) and Intensity modulated radiation therapy. The major issue arises using photon beam having energy ∼10 MV and above is the productions of secondary neutron which can maximize the patient absorb doses. Purpose The aim of the study is to evaluate 3D conformal radiation therapy and step and shoot intensity modulated radiation therapy (ssIMRT) techniques for less neutron contamination that lead to minimum patient exposure from neutrons. Material and methods For this purpose five treatment plan of breast were made on both 3DCRT and ssIMRT using 10MV photon. Linear accelerator Elekta Synergy is used to deliver these plans and for measuring neutrons dose in primary beam, a portable, Ludlum neutron detector is used which is placed on patient’s couch. Results Obtained data shows that the mean values with standard error for each technique was found to be 14.56 mSv ± 0.38 and 25.07 mSv ± 1.2 for 3D CRT and ssIMRT, respectively. Mean difference between two techniques for neutron contamination was found to be 10.5 mSv. Conclusion It can be concluded from the study that contamination of neutrons increases by a factor of 10.5 when we move from 3D CRT to ssIMRT. This is because of increase no. of MUs that are being used in ssIMRT. Although ssIMRT therapy provides better plan optimization for target than 3DCTR but contains greater neutron contamination.