Aneela Shah - Academia.edu (original) (raw)
Papers by Aneela Shah
Case Reports in Surgery
Necrotizing soft tissue infection (NSTI) of the breast is an extremely rare event in surgical pra... more Necrotizing soft tissue infection (NSTI) of the breast is an extremely rare event in surgical practice. It is considered the most aggressive form of soft tissue infection and a true surgical emergency. It is also associated with a high risk of mortality if not diagnosed promptly. Few cases have been documented in the literature; the exact etiology and risk factors vary from those involving the limbs, trunk, and perineum. Early recognition, prompt surgical treatment, and broad-spectrum antibiotic therapy are crucial for reducing morbidity and mortality. These reports present cases of NSTIs in breasts with unique etiologies and challenges in their management.
Journal of Medical - Clinical Research & Reviews, 2021
Background: Major lower extremity amputation is defined as any amputation of the limb performed a... more Background: Major lower extremity amputation is defined as any amputation of the limb performed above the level of the ankle. Indications often include severe infection, ischemia, trauma and tumours. Total amputation rate in Trinidad and Tobago (T&T) is not yet known. Data is only available from a single center in Trinidad and Tobago over a two year period and not from the entire country and the number of total amputation was based on simple speculation and general estimate. The aim of this study is to first time document the exact annual amputation rate in T&T with their demographic characteristics and also to find out whether the existing methods of health education are effective in reducing amputations. Methods: A retrospective review of all lower limb amputations was performed in all 5 public hospitals in Trinidad and Tobago from January 2012 to December 2018. Annual major lower limb amputations in the 10 private hospitals were also documented. Data collected on patients demogra...
Biomedical Journal of Scientific & Technical Research, 2020
The commonest sites of distal colorectal cancer spread are the liver and the lungs. Metastesis to... more The commonest sites of distal colorectal cancer spread are the liver and the lungs. Metastesis to the skin, breast and axilla are very rare. Very little data exists regarding the optimal treatment methods and its long-term outcomes. We present a unique case of colorectal cancer patient who initially presented with solitary hepatic metastesis, subsequently underwent low anterior resection with synchronous resection of the hepatic mets after neoadjuvant chemotherapy. At one year followup, she developed a cutaneous, mets to right lateral chest wall and treated with wide local excision and adjuvant therapy. At four years of follow up she again develops metastasis to the right breast and axillary lymph node. Wide local excision of the breast lump and axillary lymph node dissection were performed. Despite recurrent metastesis the patient has maintained a good functional status. A literature review was done to highlight the best treatment options in these rare cases.
International Journal of Surgery Case Reports, 2020
INTRODUCTION: Achalasia is an uncommon oesophageal motility disorder caused by failed relaxation ... more INTRODUCTION: Achalasia is an uncommon oesophageal motility disorder caused by failed relaxation of a hypertensive lower oesophageal sphincter in response to swallowing. It often manifests clinically with symptoms such as dysphagia, regurgitation, and weight loss. Manometry is considered the gold standard diagnostic test in diagnosing this condition. However, it is not always accessible, especially in the resource-limited setting. Other radiological adjuncts, such as barium oesophagram, often show features that are highly suggestive of achalasia: the bird-beak appearance of the distal oesophagus, and a dilated oesophagus (megaoesophagus) containing food residue, which may then progress to become tortuous (sigmoid) or aperistaltic. Thus, the use of these tests play a significant role in the identification of this condition. CASE PRESENTATION: Three patients were diagnosed with achalasia at the San Fernando General Hospital, Trinidad and Tobago. Together with characteristic symptoms, barium oesophagrams demonstrated features of achalasia, bearing a close resemblance to those of a caged bird. The barium oesophagrams were scrutinized by a fellowship trained, upper GI advanced laparoscopic surgeon, and the consistent features described were noted. CONCLUSION: In the setting where manometry is not accessible, barium oesophagram plays an important role. We propose that recognition of easily identifiable features such as the "caged bird sign of achalasia" on this imaging modality can assist in the diagnosis of this entity.
J. Chem. Soc., Perkin Trans. 2, 1993
A dynamic NMR determination of barriers to chair–chair interconversion in some tetra-and hexa-sub... more A dynamic NMR determination of barriers to chair–chair interconversion in some tetra-and hexa-substituted 1, 2, 4-trioxanes and 1, 3-dioxanes is reported. Two comparisons of trioxanes and equivalently substituted dioxanes show that trioxane barriers are strikingly ...
World Journal of Gastrointestinal Endoscopy, 2014
The development of intramural intestinal gas may indicate a serious postoperative complication an... more The development of intramural intestinal gas may indicate a serious postoperative complication and therefore any radiological indication of such "pneumatosis intestinalis" (PI) in an unwell patient after surgery should put the clinical team on high-alert. However immediate recourse to relook laparotomy may not be always necessary and, further, in some cases may possibly accelerate the deterioration especially if it proves to be non-therapeutic. Careful and close clinical monitoring, as is described in this clinical report, may allow discriminative identification of those in whom this finding is in fact transient and therefore benign and who therefore can be successfully treated without operative re-intervention. We describe the presenting features and background scenario of PI early after laparoscopic total colectomy for medically refractory, severe ulcerative colitis and detail the critical postoperative decision pivots.
Journal of the Chemical Society, Chemical Communications, 1991
Tetrahedron Letters, 1993
Hemiperoxyacetals derived from 2,3-dimethylbut-1-en-3-yl hydroperoxide and aliphatic aldehydes un... more Hemiperoxyacetals derived from 2,3-dimethylbut-1-en-3-yl hydroperoxide and aliphatic aldehydes undergo cyclisation with NIS or NBS to afford the corresponding 3-alkyl-5-halogenomethyl-5,6,6-trimethyl-5,6,6-trimethyl-1,2,4-trioxanes in yields of 20–65%
Tetrahedron, 1997
Reaction of fluorine with water in the presence of acids provides new oxidants for 'in-situ' oxid... more Reaction of fluorine with water in the presence of acids provides new oxidants for 'in-situ' oxidation of ketones. Direct reaction of fluorine with anhydrous alcohols and 1,2-diols provides simple methodology for oxidation to corresponding secondary ketones or cc-hydroxy ketones.
Synthetic Communications, 1996
... A prime factor of * To whom correspondence should be addressed. 1861 Copyright @ 1996 by Marc... more ... A prime factor of * To whom correspondence should be addressed. 1861 Copyright @ 1996 by Marcel Dekker, Inc. Page 2. 1862 CHAMBERS, SANDFORD, AND SHAH importance in these preparatively useful reactions is in the choice of solvent, which ...
Tetrahedron Letters, 1995
Five 3-alkyl- or 3-aryl-5,5,6,6-tetramethyl-1,2,4-trioxanes 4 upon treatment with iron(II) sulfat... more Five 3-alkyl- or 3-aryl-5,5,6,6-tetramethyl-1,2,4-trioxanes 4 upon treatment with iron(II) sulfate in aqueous acetonitrile under nitrogen for 12–72H are cleanly isomerised into the corresponding 2,3-dimethylbutan-2,3-diol monoesters 5; it is suggested that the reactions involve reduction to oxyl radicals followed by 1,5-hydrogen transfer, a sequence that has recently been implicated in the molecular mechanism of action of the antimalarial artemisinin.
American Journal of Case Reports, 2021
Internal hernias involve protrusion of the small bowel through a peritoneal or mesenteric space i... more Internal hernias involve protrusion of the small bowel through a peritoneal or mesenteric space in the abdominal or pelvic cavity. Congenital internal small bowel hernias are rare and patients with them usually present with small bowel obstruction (SBO) at a young age, whereas in older patients, internal small bowel hernias usually are acquired secondary to previous surgery. The present report is of a rare case of SBO due to dual congenital internal small bowel hernias in a 51-year-old man with no history of abdominal surgery. Case Report: We report a case of dual congenital internal hernias of the small bowel in a patient who presented with symptoms and signs of SBO. He had no history of abdominal trauma, surgery, or comorbid conditions. His abdomen was mildly distended with minimal tenderness in the upper left quadrant but there was no guarding or rebound tenderness. Abdominal X-rays confirmed the SBO. A contrast-enhanced computed tomography scan of the patient's abdomen revealed SBO with transition at 2 points, suggestive of a closed-loop obstruction. However, the exact cause of the SBO was confirmed at laparotomy, which revealed dual internal hernias (intramesosigmoid and paraduodenal). The hernias were managed individually and the patient had a successful outcome after surgery. Conclusions: Although the present report is of a rare presentation of internal small bowel hernia, the case underscores that patients with this condition may present with SBO. Successful surgical management requires knowledge of the intra-abdominal peritoneal spaces and management of the hernia sac.
Case Reports in Surgery
Necrotizing soft tissue infection (NSTI) of the breast is an extremely rare event in surgical pra... more Necrotizing soft tissue infection (NSTI) of the breast is an extremely rare event in surgical practice. It is considered the most aggressive form of soft tissue infection and a true surgical emergency. It is also associated with a high risk of mortality if not diagnosed promptly. Few cases have been documented in the literature; the exact etiology and risk factors vary from those involving the limbs, trunk, and perineum. Early recognition, prompt surgical treatment, and broad-spectrum antibiotic therapy are crucial for reducing morbidity and mortality. These reports present cases of NSTIs in breasts with unique etiologies and challenges in their management.
Journal of Medical - Clinical Research & Reviews, 2021
Background: Major lower extremity amputation is defined as any amputation of the limb performed a... more Background: Major lower extremity amputation is defined as any amputation of the limb performed above the level of the ankle. Indications often include severe infection, ischemia, trauma and tumours. Total amputation rate in Trinidad and Tobago (T&T) is not yet known. Data is only available from a single center in Trinidad and Tobago over a two year period and not from the entire country and the number of total amputation was based on simple speculation and general estimate. The aim of this study is to first time document the exact annual amputation rate in T&T with their demographic characteristics and also to find out whether the existing methods of health education are effective in reducing amputations. Methods: A retrospective review of all lower limb amputations was performed in all 5 public hospitals in Trinidad and Tobago from January 2012 to December 2018. Annual major lower limb amputations in the 10 private hospitals were also documented. Data collected on patients demogra...
Biomedical Journal of Scientific & Technical Research, 2020
The commonest sites of distal colorectal cancer spread are the liver and the lungs. Metastesis to... more The commonest sites of distal colorectal cancer spread are the liver and the lungs. Metastesis to the skin, breast and axilla are very rare. Very little data exists regarding the optimal treatment methods and its long-term outcomes. We present a unique case of colorectal cancer patient who initially presented with solitary hepatic metastesis, subsequently underwent low anterior resection with synchronous resection of the hepatic mets after neoadjuvant chemotherapy. At one year followup, she developed a cutaneous, mets to right lateral chest wall and treated with wide local excision and adjuvant therapy. At four years of follow up she again develops metastasis to the right breast and axillary lymph node. Wide local excision of the breast lump and axillary lymph node dissection were performed. Despite recurrent metastesis the patient has maintained a good functional status. A literature review was done to highlight the best treatment options in these rare cases.
International Journal of Surgery Case Reports, 2020
INTRODUCTION: Achalasia is an uncommon oesophageal motility disorder caused by failed relaxation ... more INTRODUCTION: Achalasia is an uncommon oesophageal motility disorder caused by failed relaxation of a hypertensive lower oesophageal sphincter in response to swallowing. It often manifests clinically with symptoms such as dysphagia, regurgitation, and weight loss. Manometry is considered the gold standard diagnostic test in diagnosing this condition. However, it is not always accessible, especially in the resource-limited setting. Other radiological adjuncts, such as barium oesophagram, often show features that are highly suggestive of achalasia: the bird-beak appearance of the distal oesophagus, and a dilated oesophagus (megaoesophagus) containing food residue, which may then progress to become tortuous (sigmoid) or aperistaltic. Thus, the use of these tests play a significant role in the identification of this condition. CASE PRESENTATION: Three patients were diagnosed with achalasia at the San Fernando General Hospital, Trinidad and Tobago. Together with characteristic symptoms, barium oesophagrams demonstrated features of achalasia, bearing a close resemblance to those of a caged bird. The barium oesophagrams were scrutinized by a fellowship trained, upper GI advanced laparoscopic surgeon, and the consistent features described were noted. CONCLUSION: In the setting where manometry is not accessible, barium oesophagram plays an important role. We propose that recognition of easily identifiable features such as the "caged bird sign of achalasia" on this imaging modality can assist in the diagnosis of this entity.
J. Chem. Soc., Perkin Trans. 2, 1993
A dynamic NMR determination of barriers to chair–chair interconversion in some tetra-and hexa-sub... more A dynamic NMR determination of barriers to chair–chair interconversion in some tetra-and hexa-substituted 1, 2, 4-trioxanes and 1, 3-dioxanes is reported. Two comparisons of trioxanes and equivalently substituted dioxanes show that trioxane barriers are strikingly ...
World Journal of Gastrointestinal Endoscopy, 2014
The development of intramural intestinal gas may indicate a serious postoperative complication an... more The development of intramural intestinal gas may indicate a serious postoperative complication and therefore any radiological indication of such "pneumatosis intestinalis" (PI) in an unwell patient after surgery should put the clinical team on high-alert. However immediate recourse to relook laparotomy may not be always necessary and, further, in some cases may possibly accelerate the deterioration especially if it proves to be non-therapeutic. Careful and close clinical monitoring, as is described in this clinical report, may allow discriminative identification of those in whom this finding is in fact transient and therefore benign and who therefore can be successfully treated without operative re-intervention. We describe the presenting features and background scenario of PI early after laparoscopic total colectomy for medically refractory, severe ulcerative colitis and detail the critical postoperative decision pivots.
Journal of the Chemical Society, Chemical Communications, 1991
Tetrahedron Letters, 1993
Hemiperoxyacetals derived from 2,3-dimethylbut-1-en-3-yl hydroperoxide and aliphatic aldehydes un... more Hemiperoxyacetals derived from 2,3-dimethylbut-1-en-3-yl hydroperoxide and aliphatic aldehydes undergo cyclisation with NIS or NBS to afford the corresponding 3-alkyl-5-halogenomethyl-5,6,6-trimethyl-5,6,6-trimethyl-1,2,4-trioxanes in yields of 20–65%
Tetrahedron, 1997
Reaction of fluorine with water in the presence of acids provides new oxidants for 'in-situ' oxid... more Reaction of fluorine with water in the presence of acids provides new oxidants for 'in-situ' oxidation of ketones. Direct reaction of fluorine with anhydrous alcohols and 1,2-diols provides simple methodology for oxidation to corresponding secondary ketones or cc-hydroxy ketones.
Synthetic Communications, 1996
... A prime factor of * To whom correspondence should be addressed. 1861 Copyright @ 1996 by Marc... more ... A prime factor of * To whom correspondence should be addressed. 1861 Copyright @ 1996 by Marcel Dekker, Inc. Page 2. 1862 CHAMBERS, SANDFORD, AND SHAH importance in these preparatively useful reactions is in the choice of solvent, which ...
Tetrahedron Letters, 1995
Five 3-alkyl- or 3-aryl-5,5,6,6-tetramethyl-1,2,4-trioxanes 4 upon treatment with iron(II) sulfat... more Five 3-alkyl- or 3-aryl-5,5,6,6-tetramethyl-1,2,4-trioxanes 4 upon treatment with iron(II) sulfate in aqueous acetonitrile under nitrogen for 12–72H are cleanly isomerised into the corresponding 2,3-dimethylbutan-2,3-diol monoesters 5; it is suggested that the reactions involve reduction to oxyl radicals followed by 1,5-hydrogen transfer, a sequence that has recently been implicated in the molecular mechanism of action of the antimalarial artemisinin.
American Journal of Case Reports, 2021
Internal hernias involve protrusion of the small bowel through a peritoneal or mesenteric space i... more Internal hernias involve protrusion of the small bowel through a peritoneal or mesenteric space in the abdominal or pelvic cavity. Congenital internal small bowel hernias are rare and patients with them usually present with small bowel obstruction (SBO) at a young age, whereas in older patients, internal small bowel hernias usually are acquired secondary to previous surgery. The present report is of a rare case of SBO due to dual congenital internal small bowel hernias in a 51-year-old man with no history of abdominal surgery. Case Report: We report a case of dual congenital internal hernias of the small bowel in a patient who presented with symptoms and signs of SBO. He had no history of abdominal trauma, surgery, or comorbid conditions. His abdomen was mildly distended with minimal tenderness in the upper left quadrant but there was no guarding or rebound tenderness. Abdominal X-rays confirmed the SBO. A contrast-enhanced computed tomography scan of the patient's abdomen revealed SBO with transition at 2 points, suggestive of a closed-loop obstruction. However, the exact cause of the SBO was confirmed at laparotomy, which revealed dual internal hernias (intramesosigmoid and paraduodenal). The hernias were managed individually and the patient had a successful outcome after surgery. Conclusions: Although the present report is of a rare presentation of internal small bowel hernia, the case underscores that patients with this condition may present with SBO. Successful surgical management requires knowledge of the intra-abdominal peritoneal spaces and management of the hernia sac.