Amanullah Memon - Academia.edu (original) (raw)

Papers by Amanullah Memon

JPMA. The Journal of the Pakistan Medical Association, 1994

JOURNAL OF PAKISTAN MEDICAL ASSOCIATION, 1999

JPMA. The Journal of the Pakistan Medical Association, 1999

Luekemic infiltration of the prostate is unusual. Acute urinary retention as an initial presentat... more Luekemic infiltration of the prostate is unusual. Acute urinary retention as an initial presentation of chronic lymphocytic leukemia is found only in sporadic cases. Organ confmed adenocarcinoma of prostate associated with chronic lymphocytic leukemia and presenting as acute urinary retention is to our knowledge not reported in literature. This report documents a case of acute urinary retention in a 74-year-old man with chronic lymphocytic leukemia and adenocarcinoma of the prostate.

Urethral adenocarcinoma is the least common histologic subtype of a rare primary carcinoma of the... more Urethral adenocarcinoma is the least common histologic subtype of a rare primary carcinoma of the male urethra. Its site of origin remains speculative. The scarcity of reported cases in the literature makes it difficult to define the optimal management. This report is of a 40-year-old morbidly obese man with synchronous adenocarcinoma of the bulbar urethra and bladder, treated surgically by en bloc abdominoperineal penoprostatocystectomy. The pleural recurrence, after a disease-free period of 2 years, responded well to platinum-docetaxel-based systemic chemotherapy. Synchronous occurrence of adenocarcinoma of the urethra and bladder has not been previously reported. This case also highlights the possible role of upcoming adjuvant chemotherapeutic agents.

Tlie far infrared optical properties and complex dielectric response functions of two alkali hali... more Tlie far infrared optical properties and complex dielectric response functions of two alkali halide crystals (Csl and KT) and two III-V compound semiconductor crystals (TnAs and TnP) have been studied using the technique of dispersive Fourier transform spectroscopy. The values of the transverse optic and longitudinal optic phonon frequencies at wave vector q=0 determined from these results agree quite well with published values, and the dielectric functions were used to calculate the imaginary parts of the anharmonic self-energies P (oj,V) of the q=0 transverse optic modes. These are the first reported measurements on Csl by dispersive Fourier transform spectroscopy, and reasonable agreement is obtained between the frequencies of measured fea tures in P (oj,V ) and published two-phonon frequencies. In the case of KI the present measurements have been made at a higher resolution than any reported previously, and they provide a sensitive test of the validity of various theoretical ca...

An ectopically placed parathyroid adenoma in the anterior mediastinum is a rare cause of persiste... more An ectopically placed parathyroid adenoma in the anterior mediastinum is a rare cause of persistent or recurrent primary hyperparathyroidism (PHPT) and is recognized as an important cause of failed primary neck exploration. We encountered 3 such cases amongst 70 surgically treated patients with PHPT (4.3%) over a 20-year period. In 2 cases, the offending adenoma could be removed at first exploration whereas in the 3rd case, it was successfully removed with mediastinal exploration after 2 failed neck explorations. In established cases of PHPT with equivocal preoperative localization studies or negative neck explorations, an ectopically placed parathyroid adenoma should be considered and once localized, should be surgically removed for cure.

Urolithiasis, Jan 28, 2017

Primary hyperoxalurias (PH) are devastating, autosomal recessive diseases causing renal stones. U... more Primary hyperoxalurias (PH) are devastating, autosomal recessive diseases causing renal stones. Undifferentiated hyperoxaluria is seen in up to 43% of Pakistani paediatric stone patients. High rates of consanguinity in Pakistan suggest significant local prevalence. There is no detailed information regarding number of cases, clinical features, and genetics in Pakistan-origin (P-o) patients. We reviewed available information on P-o PH patients recorded in the literature as well as from two major PH registries (the Rare Kidney Stone Consortium PH Registry (RKSCPHR) and the OxalEurope PH Registry (OxER); and the Aga Khan University Hospital in Pakistan. After excluding overlaps, we noted 217 P-o PH subjects (42 in OxER and 4 in RKSCPHR). Presentations were protean. Details of mutations were available for 94 patients of 201 who had genetic analyses. Unique mutations were noted. Mutation [c.508G>A (p. Gly170Arg)] (present in up to 25% in the West) was reported in only one case. In one ...

The Management of Lithiasis, 1997

Journal of the College of Physicians and Surgeons Pakistan Jcpsp, Mar 1, 2011

Objective: To determine the triggers of blood transfusion in patients undergoing percutaneous nep... more Objective: To determine the triggers of blood transfusion in patients undergoing percutaneous nephrolithotomy (PCNL). Study Design: Observational study. Place and Duration of Study: The Aga Khan University Hospital, Karachi, from 1988 to 2007. Methodology: The percutaneous surgery database was retrospectively reviewed to identify patients with postoperative haemorrhage and need for blood transfusion. Blood loss was estimated by the postoperative drop in haemoglobin factored by the quantity of any blood transfusion. Various patients and procedure-related factors were assessed for association with total blood loss or blood transfusion requirement using stepwise univariate, forward multivariate regression analysis. Results: A total of 326 procedures were performed in 316 patients. Two hundred and thirty two procedures were included in the study. There were 167 males and 65 females. The mean age was 41+14 years. The mean haemoglobin drop was 1.68 +1.3 gm/dL. The overall blood transfusion rate was 14.2%. Stepwise multivariate regression analysis showed that female gender (p = 0.003), staghorn stone (p = 0.023), stone fragmentation with ultrasound (p = 0.054) and chronic renal failure (p = 0.001) were significantly predictive of the need for blood transfusion. Conclusion: Chronic renal failure, female gender, presence of staghorn calculi and stone fragmentation using ultrasonic device were predictive of blood transfusion in this cohort of patients.

The Journal of Urology

Colovesical fistula as a sequela to long-term bladder outflow obstruction is to our knowledge a p... more Colovesical fistula as a sequela to long-term bladder outflow obstruction is to our knowledge a previously unreported complication. We report a case in which single stage colonic resection and anastomosis with bladder repair and transurethral resection of the prostate resolved the condition.

Techniques in urology

Uroflowmetry (UFM) is a simple, noninvasive way of evaluating the dynamics of micturition. The am... more Uroflowmetry (UFM) is a simple, noninvasive way of evaluating the dynamics of micturition. The amount of information provided by UFM, along with ultrasonic estimation of residual urine in the bladder, usually is enough in the routine evaluation of elderly men with lower urinary tract symptoms (LUTS). A small subgroup, however, will require more detailed urodynamic testing. It also has made the decision concerning treatment of patients with stricture urethrae, managed by urethrotomy or dilatation, more objective. The role of UFM as an initial tool in the evaluation of all patients presenting with LUTS, irrespective of age and gender, is evolving. The addition of new parameters, performing UFM in the domiciliary setup, and the introduction of new software to facilitate interpretation will further enhance its ability in the evaluation of micturition disorders. The main limitation of UFM is its inability to discriminate between poor detrusor function and bladder outlet obstruction (BOO)...

Journal of the Pakistan Medical Association

Techniques in urology, 2000

Postureteroscopy colic, accumulation of irrigant fluid in the bladder, and advancement of the ure... more Postureteroscopy colic, accumulation of irrigant fluid in the bladder, and advancement of the ureteroscope through narrow ureters are some of the problems commonly encountered during ureteroscopy. Three methods to overcome these problems and to make ureteroscopy technically easy, safe and cost-effective are described.

JPMA. The Journal of the Pakistan Medical Association, 2007

JPMA. The Journal of the Pakistan Medical Association, 2004

Urology, 2007

are composed of calcium oxalate. Oxalateinduced free radical mediated renal cell injury appears t... more are composed of calcium oxalate. Oxalateinduced free radical mediated renal cell injury appears to play a significant role in kidney stone formation. We previously demonstrated that the oxalate induces free radical production via activation of NADPH oxidase in renal tubular cells. In continuation of our previous studies, we now studied whether oxalate-induced NADPH oxidase mediated reactive oxygen species (ROS) production requires protein kinase C (PKC) activation in LLC-PK1 cells. Methods: Confluent monolayers of LLC-PK1 cells were incubated with or without PKC inhibitors (Calphostin C or Chelerythrine chloride), NADPH oxidase inhibitors (DPI or apocyanin) were exposed to 0.5 to 1mM oxalate for different time periods. PKC activator, phorbol 12-myristate 13-acetate (PMA) was used as positive Results: Oxalate significantly increased ROS production and LDH release in LLC-PK1 cells in a dose and time dependent manner. Pretreatment with PKC inhibitors significantly attenuated oxalate induced superoxide, hydrogen peroxide production and LDH release. Oxalate exposure significantly increased PKC activity in membrane fraction and, translocates PKC isoforms from cytosol to membrane fraction in LLC-PK1 cells. PMA significantly increased ROS generation, LDH release and isoforms translocation in LLC-PK1 cells. Pretreatment with DPI or apocyanin significantly decreased oxalate or PMA induced ROS production and LDH release. Conclusion: Our data demonstrate that PKC dependent activation of NADPH oxidase might be a crucial mechanism responsible for increased ROS generation in renal epithelial cells during oxalate toxicity. (Sources of Funding: NIH RO1 DK 56249).

Journal of Endourology, 2000

To study the efficacy and safety of the Dornier MPL 9000 lithotripter in the treatment of prevesi... more To study the efficacy and safety of the Dornier MPL 9000 lithotripter in the treatment of prevesical calculi using real-time ultrasound monitoring and to see if efficacy is adequately judged by the efficiency quotient (EQ). Seventy-six patients underwent ultrasound-guided extracorporeal shockwave lithotripsy (SWL) for prevesical calculi over a period of 43 months. Their age ranged from 8 to 68 (mean 37.6) years, and the male:female ratio was 2.6:1. The size of the stones, measured in two dimensions, ranged from 4 to 25 mm (mean 9.3 mm) and 2 to 15 mm (mean 6.0 mm). No general or regional anesthesia or ureteral stents were used, and all patients were treated in the prone position. The EQ was calculated using the formula: Stone free (%) x 100/(100 + retreatment rate (%) + auxiliary procedures (%). Seventy patients were stone free in a mean time of 15 +/- 14.11 days. The average number of shockwaves used was 2,831 +/- 1,612, and the average number of sessions per patient was 1.7. About 92% of the patients were rendered stone free using in situ SWL alone. No major complication was encountered, and none of the patients required an inpatient stay after SWL. The EQ was 65. Five patients with failed SWL subsequently were rendered stone free, four with salvage ureteroscopy and pneumatic lithotripsy and one with cystolitholapaxy for a symptomatic fragment in the bladder. One patient was lost to follow-up. In situ SWL is a safe and effective treatment for prevesical calculi. It should be used as a first-line treatment for most such stones. Efficiency can be assessed objectively by the EQ.

Journal of Endourology, 1997

Between November 7, 1988 and December 31, 1989, 881 treatments were given with the MPL 9000 litho... more Between November 7, 1988 and December 31, 1989, 881 treatments were given with the MPL 9000 lithotriptor to 513 sites in 510 renal units in 464 patients. Of the stones 447 (87.1%) were in the kidney, 64 (12.5%) in the ureter and 2 (0.4%) in the bladder. Stone size was up to 2 cm. in 58.5% of the cases, greater than 2 to 3 cm. in 25.8% and more than 3 cm. in 15.7%, including complete or partial staghorn, or multiple stones. Of the patients 54.2% received only 1 treatment, 17.6% received 2 treatments and 28.2% received more than 2 treatments (re-treatment was necessary in 45.8%). The number of shocks used varied from 610 to 4,000 at 14 to 24 kv., the usual energy used being 18 kv. Of the stones 30.2% were treated after Double-J stents were inserted. A patient was declared stone-free only when no stone particle was visible on a plain abdominal x-ray (or ultrasound if the stone was radiolucent). X-rays 3 months after extracorporeal shock wave lithotripsy (ESWL) were available for review in 397 patients (79.9%) and 72.8% were stone-free (with the aforementioned criteria) at 6 months (61.5% without ancillary procedures and 11.3% after ancillary procedures). Of a subset of 106 patients 84% were stone-free within 3 months when ESWL was restricted to a smaller stone burden, the number of shock waves administered was increased and energy was restricted to 14 to 18 kv. Over-all, 9.1% of the patients needed ancillary measures, including percutaneous nephrostomy in 1.6%, push-back for ESWL in 1.9%, ureterorenoscopy in 5.4%, percutaneous nephrolithotomy in 0.6% and pyelolithotomy/ureterolithotomy in 2.8%. The MPL 9000 device has the unique combination of electrohydraulic shock wave generation and ultrasound monitoring. The latter attribute has the distinct advantage of avoiding radiation to allow for visualization of nonopaque renal and gallbladder calculi. In addition, because there is continuous stone visualization during fragmentation accurate stone targeting can be maintained. The combination of ultrasound monitoring and spark gap technology allows for effective stone fragmentation.

International Journal of Urology, 2001

Fungal infections are common in immunocompromised patients. The presentation is often subtle and ... more Fungal infections are common in immunocompromised patients. The presentation is often subtle and therefore treatment is delayed. Uretero-ileal anastomotic dehiscence due to candidal infection has never been reported before. This case represents an uncommon but potentially life-threatening complication in reconstructive surgery; that is, anastomotic dehiscence due to a unique etiology.