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Research paper thumbnail of Granular cell tumors of the urinary bladder

World journal of surgical oncology, 2007

Granular cell tumors (GCTs) are extremely rare lesions of the urinary bladder with only nine case... more Granular cell tumors (GCTs) are extremely rare lesions of the urinary bladder with only nine cases being reported in world literature of which one was malignant. Generally believed to be of neural origin based on histochemical, immunohistochemical, and ultrastructural studies; they mostly follow a clinically benign course but are commonly mistaken for malignant tumors since they are solid looking, ulcerated tumors with ill-defined margins.

Research paper thumbnail of Case Report Mediastinal Parathyroid Adenoma

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 recur-rent primary hyperparathyroidism (PHPT) and is recog-nized as an important cause of failed primary neck explo-ration. 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 explo-rations, an ectopically placed parathyroid adenoma should be considered and once localized, should be surgically removed for cure.

Research paper thumbnail of Primary hyperoxaluria in populations of Pakistan origin: results from a literature review and two major registries

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 ...

Research paper thumbnail of Electoral Politics in the North West Frontier Province of Colonial India 1946-47

History and Sociology of South Asia, 2014

The period 1946-47 was very crucial in the electoral history of the North West Frontier Province ... more The period 1946-47 was very crucial in the electoral history of the North West Frontier Province (NWFP) within the context of suddenly changed electoral trends. Political and electoral trends suddenly changed in the NWFP during 1946-47. The electoral trends during the 1946 elections were favourable towards the All India National Congress. It was also observed that during the next one year, that is, in the 1947 referendum, electoral behaviour turned towards the All India Muslim League. The study of this surprising change in electoral behaviour during 1946-47 is unique in the colonial electoral history of the NWFP. In this article, an attempt has been made to explore the electoral trends in the NWFP during the 1946 elections and the referendum in 1947. Some basic questions are also addressed, that is, why did the Congress get a considerable electoral victory in the NWFP in 1946? How did electoral trends change in favour of the Muslim League after one year in the 1947 referendum? How did de-alignment occur in the electoral politics of the NWFP? What were those leading factors that affected electoral behaviour during period under study? Many social scientists and historians focused on electoral trends in descriptive form and no compact study was undertaken on the basis of electoral theories. In this article, the changing dynamics of electoral politics has been explored within the framework of existing models of electoral politics.

Research paper thumbnail of Uroflowmetry and evaluation of voiding disorders

Research paper thumbnail of A critical step in the operative management of non-functioning asymptomatic Incidentaloma

Research paper thumbnail of Three techniques for simpler, safer, and cost-effective rigid ureteroscopy

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.

Research paper thumbnail of Acute urinary retention: a primary manifestation of chronic lymphocytic leukemia and organ confined prostate cancer

Research paper thumbnail of Urolithiasis

Research paper thumbnail of Epidemiology of Stone Disease in Pakistan

Urolithiasis, 2012

Urinary tract stones are a common affliction across river, desert, and mountainous regions of Pak... more Urinary tract stones are a common affliction across river, desert, and mountainous regions of Pakistan. A third of the stones have a single component. The commonest stone is composed of oxalate, with phosphate and uric acid as additional components. Calcium oxalate monohydrate is more abundantly present than the dihydrate. Phosphate stones comprise only about 7 % of all stones, and struvite is uncommon. Populations in the north have a greater proportion of pure and predominantly oxalate stones. Rural areas in the south have phosphate stones. The government of British India documented the frequent occurrence of stone in this region from the nineteenth century. The commonest stone was vesical. Noted stone transitions include (1) the marked increase in the discovery of renal stones, (2) the disappearance (except in pockets) of the idiopathic adult vesical stone, and (3) the decrease in children in the proportions of stones that are vesical. Late presentation for treatment and consequent renal destruction are still frequent.

Research paper thumbnail of Therapeutic efficacy of Dornier MPL 9000 for prevesical calculi as judged by efficiency quotient

Journal of endourology, 2000

Purpose: To study the efficacy and safety of the Dornier MPL 9000 lithotripter in the treatment o... more Purpose: 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). Patients and Methods: Seventy-six ...

Research paper thumbnail of Urolithiasis: Composition, symptomatology and pathology

Urinary tract stones come in all shapes and sizes. They may lie in the pelvis, calyces, ureter, b... more Urinary tract stones come in all shapes and sizes. They may lie in the pelvis, calyces, ureter, bladder or urethra. Those in the ureter are usually spindle shaped. Some may resemble an ice-cream cone, with a dimple at the top suggesting the site of previous attachment to a renal papilla. In the bladder, they may be rounded and multiple when they form in a post-prostatic pouch, in older men. In children the stone may assume a jack stone appearance or become ovoid, depending on whether it is composed of oxalates or urates.

Research paper thumbnail of MP-03.08: Predictors of blood transfusion in percutaneous nephrolithotomy (PCNL)

Research paper thumbnail of Incidental intrarenal-pelvic hydatid cyst discovered during percutaneous nephrolithotomy (PCNL)

Echinococcosis is an infestation caused in humans by the larval form of tenia echinococcus (E. gr... more Echinococcosis is an infestation caused in humans by the larval form of tenia echinococcus (E. granulosus). Humans are accidental intermediary hosts. The incidence of hydatid disease is 0.4/100,000, and renal infestation occurs in 2% to 3% of all cases. 1,2 Most cases are symptomatic. We present a case of incidentally discovered hydatid disease encountered during percutaneous nephrolithotomy (PCNL) managed without sacrificing the kidney.

Research paper thumbnail of Abdominoperineal excision of male lower urinary tract for synchronous adenocarcinoma of urethra and urinary bladder

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.

Research paper thumbnail of Triggers of blood transfusion in percutaneous nephrolithotomy

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).

Research paper thumbnail of Mediastinal Parathyroid Adenoma causing primary Hyperparathyroidism

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.

Research paper thumbnail of Candidal infections as a cause of recurrent uretero‐ileal anastomotic dehiscence

International Journal of …, 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 ...

Research paper thumbnail of Granular cell tumors of the urinary bladder

World journal of surgical oncology, 2007

Granular cell tumors (GCTs) are extremely rare lesions of the urinary bladder with only nine case... more Granular cell tumors (GCTs) are extremely rare lesions of the urinary bladder with only nine cases being reported in world literature of which one was malignant. Generally believed to be of neural origin based on histochemical, immunohistochemical, and ultrastructural studies; they mostly follow a clinically benign course but are commonly mistaken for malignant tumors since they are solid looking, ulcerated tumors with ill-defined margins.

Research paper thumbnail of Case Report Mediastinal Parathyroid Adenoma

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 recur-rent primary hyperparathyroidism (PHPT) and is recog-nized as an important cause of failed primary neck explo-ration. 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 explo-rations, an ectopically placed parathyroid adenoma should be considered and once localized, should be surgically removed for cure.

Research paper thumbnail of Primary hyperoxaluria in populations of Pakistan origin: results from a literature review and two major registries

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 ...

Research paper thumbnail of Electoral Politics in the North West Frontier Province of Colonial India 1946-47

History and Sociology of South Asia, 2014

The period 1946-47 was very crucial in the electoral history of the North West Frontier Province ... more The period 1946-47 was very crucial in the electoral history of the North West Frontier Province (NWFP) within the context of suddenly changed electoral trends. Political and electoral trends suddenly changed in the NWFP during 1946-47. The electoral trends during the 1946 elections were favourable towards the All India National Congress. It was also observed that during the next one year, that is, in the 1947 referendum, electoral behaviour turned towards the All India Muslim League. The study of this surprising change in electoral behaviour during 1946-47 is unique in the colonial electoral history of the NWFP. In this article, an attempt has been made to explore the electoral trends in the NWFP during the 1946 elections and the referendum in 1947. Some basic questions are also addressed, that is, why did the Congress get a considerable electoral victory in the NWFP in 1946? How did electoral trends change in favour of the Muslim League after one year in the 1947 referendum? How did de-alignment occur in the electoral politics of the NWFP? What were those leading factors that affected electoral behaviour during period under study? Many social scientists and historians focused on electoral trends in descriptive form and no compact study was undertaken on the basis of electoral theories. In this article, the changing dynamics of electoral politics has been explored within the framework of existing models of electoral politics.

Research paper thumbnail of Uroflowmetry and evaluation of voiding disorders

Research paper thumbnail of A critical step in the operative management of non-functioning asymptomatic Incidentaloma

Research paper thumbnail of Three techniques for simpler, safer, and cost-effective rigid ureteroscopy

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.

Research paper thumbnail of Acute urinary retention: a primary manifestation of chronic lymphocytic leukemia and organ confined prostate cancer

Research paper thumbnail of Urolithiasis

Research paper thumbnail of Epidemiology of Stone Disease in Pakistan

Urolithiasis, 2012

Urinary tract stones are a common affliction across river, desert, and mountainous regions of Pak... more Urinary tract stones are a common affliction across river, desert, and mountainous regions of Pakistan. A third of the stones have a single component. The commonest stone is composed of oxalate, with phosphate and uric acid as additional components. Calcium oxalate monohydrate is more abundantly present than the dihydrate. Phosphate stones comprise only about 7 % of all stones, and struvite is uncommon. Populations in the north have a greater proportion of pure and predominantly oxalate stones. Rural areas in the south have phosphate stones. The government of British India documented the frequent occurrence of stone in this region from the nineteenth century. The commonest stone was vesical. Noted stone transitions include (1) the marked increase in the discovery of renal stones, (2) the disappearance (except in pockets) of the idiopathic adult vesical stone, and (3) the decrease in children in the proportions of stones that are vesical. Late presentation for treatment and consequent renal destruction are still frequent.

Research paper thumbnail of Therapeutic efficacy of Dornier MPL 9000 for prevesical calculi as judged by efficiency quotient

Journal of endourology, 2000

Purpose: To study the efficacy and safety of the Dornier MPL 9000 lithotripter in the treatment o... more Purpose: 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). Patients and Methods: Seventy-six ...

Research paper thumbnail of Urolithiasis: Composition, symptomatology and pathology

Urinary tract stones come in all shapes and sizes. They may lie in the pelvis, calyces, ureter, b... more Urinary tract stones come in all shapes and sizes. They may lie in the pelvis, calyces, ureter, bladder or urethra. Those in the ureter are usually spindle shaped. Some may resemble an ice-cream cone, with a dimple at the top suggesting the site of previous attachment to a renal papilla. In the bladder, they may be rounded and multiple when they form in a post-prostatic pouch, in older men. In children the stone may assume a jack stone appearance or become ovoid, depending on whether it is composed of oxalates or urates.

Research paper thumbnail of MP-03.08: Predictors of blood transfusion in percutaneous nephrolithotomy (PCNL)

Research paper thumbnail of Incidental intrarenal-pelvic hydatid cyst discovered during percutaneous nephrolithotomy (PCNL)

Echinococcosis is an infestation caused in humans by the larval form of tenia echinococcus (E. gr... more Echinococcosis is an infestation caused in humans by the larval form of tenia echinococcus (E. granulosus). Humans are accidental intermediary hosts. The incidence of hydatid disease is 0.4/100,000, and renal infestation occurs in 2% to 3% of all cases. 1,2 Most cases are symptomatic. We present a case of incidentally discovered hydatid disease encountered during percutaneous nephrolithotomy (PCNL) managed without sacrificing the kidney.

Research paper thumbnail of Abdominoperineal excision of male lower urinary tract for synchronous adenocarcinoma of urethra and urinary bladder

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.

Research paper thumbnail of Triggers of blood transfusion in percutaneous nephrolithotomy

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).

Research paper thumbnail of Mediastinal Parathyroid Adenoma causing primary Hyperparathyroidism

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.

Research paper thumbnail of Candidal infections as a cause of recurrent uretero‐ileal anastomotic dehiscence

International Journal of …, 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 ...