Arslan Malik - Academia.edu (original) (raw)

Papers by Arslan Malik

Research paper thumbnail of Evaluation of Foam Sclerotherapy as Minimally Invasive and First Line Treatment of Varicose Veins in Military Setup

DOAJ (DOAJ: Directory of Open Access Journals), Jun 1, 2022

Research paper thumbnail of Relationship Between Recurrent Laryngeal Nerve (RLN) and Inferior Thyroid Artery (Ita) in Our Population

DOAJ (DOAJ: Directory of Open Access Journals), Oct 1, 2018

Objective: To find out the relationship between recurrent laryngeal nerve(s) (RLN) and inferior t... more Objective: To find out the relationship between recurrent laryngeal nerve(s) (RLN) and inferior thyroid artery(ITA) in patients undergoing thyroid surgery in our population.Study Design: Descriptive, cross-sectional study.Place and Duration of Study: Pak Emirates Military Hospital Rawalpindi and Combined Military HospitalRawalpindi from Aug 2008 to Dec 2014.Material; and Methods: One hundred recurrent laryngeal nerves, 50 right and 50 left were studied in 64 patients.All cases of benign goiter, malignant T1, T2 goiter, completion thyroidectomy cases on virgin side were included.Malignant T3, T4 cases, redo surgery, and large multi nodular goiter, cases in which posterior nodules havedisplaced the nerve (s) were excluded from the study. The course of the nerve was dissected in the thyroid vicinityand its relation with the inferior thyroid artery was recorded and photographed. All the data and special pointswere noted by the surgeons themselves in a register in all the cases and photographs were also taken. The data wasentered and analyzed using statistical package for social sciences (SPSS) version 16. A p-value of <0.05 wasconsidered significant.Results: Hundred RLN were studied in 64 patients. In 36 patient RLN on both sides and in 14 patients the rightand in 14 patients the left RLN were studied. The age ranged from 15-65 years with mean age 36.4 years. Male tofemale ratio was, 1: 4.3. Percentage of male patients was 18.75% as compared to female was 81.25%. In our studythe nerve was more commonly found passing posterior to inferior thyroid artery on both sides and in both sexes.On the right side it was seen in 60% of cases and on the left side it was seen in 70% of the casesConclusion: Relationship of RLN with ITA is variable in our population. The surgeon should be aware of thesevariations and meticulous dissection of RLN is mandatory in tumor surgery and redoes thyroid surgery to avoidinjury to these nerves.

Research paper thumbnail of Relationship between the recurrent laryngeal nerve and the inferior thyroid artery: a study in corpses

Revista do Hospital das Clínicas, 2000

The anatomical relationship between the recurrent laryngeal nerve (RLN) and the inferior thyroid ... more The anatomical relationship between the recurrent laryngeal nerve (RLN) and the inferior thyroid artery (ITA) was studied in 76 embalmed corpses, 8 females and 68 males. In both sexes, the RLN lay more frequently between branches of the ITA.; it was found in this position in 47.3% of male corpses and 42.8% of female ones. On the right, RLN was found between branches of the ITA in 49.3% of the cases, anterior to it in 38.04%, and posterior in 11.26%. On the left, the RLN lay between branches of the ITA in 44.45%, posterior to the ITA in 37.05%, and anterior to it in 18.05% of the cases. In 62.68% of the cases, the relationship found on one side did not occur again on the opposite side. There was a significant difference (p<0.05) in the distribution of the 3 types of relationships between the RLN and the ITA, on the right and on the left. Racial variations could contribute to an explanation of the differences observed by authors of different countries in the relationship between th...

Research paper thumbnail of Distal Based Sural Fascio-Cutaneous Flap: A Practical Limb Saviour for Wounds of War and Peace

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2016

OBJECTIVE To determine the effect of mechanism of injury on wound healing, and on the viability a... more OBJECTIVE To determine the effect of mechanism of injury on wound healing, and on the viability and success of distally based sural flap when used for the coverage of defects of lower leg, ankle and foot. STUDY DESIGN Descriptive study. PLACE AND DURATION OF STUDY Department of Surgery, Combined Military Hospital, Peshawar and Khariyan, from January 2012 to December 2014. METHODOLOGY Patients with soft tissue defects over the distal leg, ankle and foot were selected by purposive sampling technique and divided into 2 groups of 19 patients each. Group A(road traffic accidents) and group B (war injuries). Sural fascio-cutaneous flap was the reconstructive tool used in all the cases using single technique by the same surgical team; and time for recipient site preparation, size of the defect, graft survival, its healing time and complications, were studied. RESULTS The mean age of the 38 patients in the study was 28.2 ±13.4 years. There were 36 male and 2 female patients. The most common...

Research paper thumbnail of Staged corrective surgery for complex congenital scoliosis and split cord malformation

European Spine Journal, 2009

Research paper thumbnail of Os-Odontoidcum leading to Atlanto-Axial instability — Report of surgery in four cases

Journal of the Pakistan Medical Association, 2008

Research paper thumbnail of Os-odontoideum leading to atlanto-axial instability - Report of surgery in four cases

Journal of the Pakistan Medical Association

Os odontoideum can lead to atlantoaxial instability, which can be either reducible or a fixed dis... more Os odontoideum can lead to atlantoaxial instability, which can be either reducible or a fixed dislocation. We present surgical management in four patients with os odontoideum at our center. Two of these had reducible dislocations and were managed by posterior transarticular screw fixation. Other two had fixed dislocations necessitating posterior decompression and occipitocervical fixation.

Research paper thumbnail of Epidemiology of non-disaster spinal injuries at a spine unit

Journal of the College of Physicians and Surgeons--Pakistan: JCPSP

To describe the demography, types of injuries and their management in all non-disaster spinal inj... more To describe the demography, types of injuries and their management in all non-disaster spinal injury patients admitted to the Spine Unit of a tertiary care hospital in Pakistan from 2001-2008. Case series. Spine Unit, Orthopaedic Department, Combined Military Hospital, Rawalpindi, from April 2001 to December 2008. Data of all new non-disaster spinal injury patient admissions, kept in a custom-built database at Spine Unit, was analyzed. Demography, type of injuries and their management was described in percentages. Five hundred and twenty one non-disaster patients were selected out of a total 671 new admissions with spinal injuries. Mean age was 39.1 years and 77% were males. Mechanisms of injury included; fall in 62% and road traffic accidents in 32%. Fracture dislocations and burst fractures were equally distributed (36% each). Most of the injuries (43.6%) were at T11-L1 level. Forty three percent patients had complete spinal cord injury (SCI), 33% had incomplete SCI and 24% did no...

Research paper thumbnail of Os-odontoideum leading to atlanto-axial instability--report of surgery in four cases

JPMA. The Journal of the Pakistan Medical Association, 2008

Os odontoideum can lead to atlantoaxial instability, which can be either reducible or a fixed dis... more Os odontoideum can lead to atlantoaxial instability, which can be either reducible or a fixed dislocation. We present surgical management in four patients with os odontoideum at our center. Two of these had reducible dislocations and were managed by posterior transarticular screw fixation. Other two had fixed dislocations necessitating posterior decompression and occipitocervical fixation.

Research paper thumbnail of Expert’s comment concerning Grand Rounds case entitled “Spontaneous and idiopathic chronic spinal epidural hematoma: two case reports and review of the literature” (by S. Sarubbo, F. Garofano, G. Maida, E. Fainardi, E. Granieri, M. A. Cavallo)

European Spine Journal, 2009

Research paper thumbnail of Expert’s comment concerning Grand Rounds case entitled “Staged corrective surgery for complex congenital scoliosis and split cord malformation” (by Muhammad Asad Qureshi, Ambreen Asad, Ibrahim Farooq Pasha, Arslan Sharif Malik, Vincent Arlet)

European Spine Journal, 2009

Research paper thumbnail of Staged corrective surgery for complex congenital scoliosis and split cord malformation

European Spine Journal, 2009

Congenital scoliosis associated with split cord malformation raises the issue on how to best mana... more Congenital scoliosis associated with split cord malformation raises the issue on how to best manage these patients to avoid neurologic injury while achieving satisfactory correction. We present the case of a 12-year-old girl who first presented when she was 11-year old with such combination but without much physical handicap or neurological deficit. The corrective surgery offered at that time was refused by the family. She again presented after 1 year with documented severe aggravation of the curve resulting in unstable walking and psychological upset. Her imaging studies showed multiple malformations in lower cervical and thoracic spine and a split cord malformation type 2 (fibrous septum with diplomyelia) at the apex of the deformity. A one-stage correction was deemed neurologically too risky. We therefore performed during a first stage a thoracotomy with anterior release. This was followed by skeletal traction with skull tongs and bilateral femoral pins. After gradual increase in traction weights a reasonable correction was achieved without any neurological deficit, over the next 10 days. A second-stage operation was done on the 11th day and a posterior instrumented fusion was performed. Post-operative recovery was uneventful and there were no complications. She was discharged with a Boston Brace to be worn for 3 months. At 2-year follow-up the patient outcome is excellent with excellent balance and correction of the deformity. In this grand round case, we discuss all the different option of treatment of congenital scoliosis associated with split cord malformation. In a medical environment where spinal cord monitoring is lacking, we recommend an initial release followed by skull and bifemoral traction over several days to monitor the neurologic status of the patient. Once optimal correction is achieved with the traction, a posterior instrumentation can be safely done.

Research paper thumbnail of Evaluation of Foam Sclerotherapy as Minimally Invasive and First Line Treatment of Varicose Veins in Military Setup

DOAJ (DOAJ: Directory of Open Access Journals), Jun 1, 2022

Research paper thumbnail of Relationship Between Recurrent Laryngeal Nerve (RLN) and Inferior Thyroid Artery (Ita) in Our Population

DOAJ (DOAJ: Directory of Open Access Journals), Oct 1, 2018

Objective: To find out the relationship between recurrent laryngeal nerve(s) (RLN) and inferior t... more Objective: To find out the relationship between recurrent laryngeal nerve(s) (RLN) and inferior thyroid artery(ITA) in patients undergoing thyroid surgery in our population.Study Design: Descriptive, cross-sectional study.Place and Duration of Study: Pak Emirates Military Hospital Rawalpindi and Combined Military HospitalRawalpindi from Aug 2008 to Dec 2014.Material; and Methods: One hundred recurrent laryngeal nerves, 50 right and 50 left were studied in 64 patients.All cases of benign goiter, malignant T1, T2 goiter, completion thyroidectomy cases on virgin side were included.Malignant T3, T4 cases, redo surgery, and large multi nodular goiter, cases in which posterior nodules havedisplaced the nerve (s) were excluded from the study. The course of the nerve was dissected in the thyroid vicinityand its relation with the inferior thyroid artery was recorded and photographed. All the data and special pointswere noted by the surgeons themselves in a register in all the cases and photographs were also taken. The data wasentered and analyzed using statistical package for social sciences (SPSS) version 16. A p-value of <0.05 wasconsidered significant.Results: Hundred RLN were studied in 64 patients. In 36 patient RLN on both sides and in 14 patients the rightand in 14 patients the left RLN were studied. The age ranged from 15-65 years with mean age 36.4 years. Male tofemale ratio was, 1: 4.3. Percentage of male patients was 18.75% as compared to female was 81.25%. In our studythe nerve was more commonly found passing posterior to inferior thyroid artery on both sides and in both sexes.On the right side it was seen in 60% of cases and on the left side it was seen in 70% of the casesConclusion: Relationship of RLN with ITA is variable in our population. The surgeon should be aware of thesevariations and meticulous dissection of RLN is mandatory in tumor surgery and redoes thyroid surgery to avoidinjury to these nerves.

Research paper thumbnail of Relationship between the recurrent laryngeal nerve and the inferior thyroid artery: a study in corpses

Revista do Hospital das Clínicas, 2000

The anatomical relationship between the recurrent laryngeal nerve (RLN) and the inferior thyroid ... more The anatomical relationship between the recurrent laryngeal nerve (RLN) and the inferior thyroid artery (ITA) was studied in 76 embalmed corpses, 8 females and 68 males. In both sexes, the RLN lay more frequently between branches of the ITA.; it was found in this position in 47.3% of male corpses and 42.8% of female ones. On the right, RLN was found between branches of the ITA in 49.3% of the cases, anterior to it in 38.04%, and posterior in 11.26%. On the left, the RLN lay between branches of the ITA in 44.45%, posterior to the ITA in 37.05%, and anterior to it in 18.05% of the cases. In 62.68% of the cases, the relationship found on one side did not occur again on the opposite side. There was a significant difference (p<0.05) in the distribution of the 3 types of relationships between the RLN and the ITA, on the right and on the left. Racial variations could contribute to an explanation of the differences observed by authors of different countries in the relationship between th...

Research paper thumbnail of Distal Based Sural Fascio-Cutaneous Flap: A Practical Limb Saviour for Wounds of War and Peace

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2016

OBJECTIVE To determine the effect of mechanism of injury on wound healing, and on the viability a... more OBJECTIVE To determine the effect of mechanism of injury on wound healing, and on the viability and success of distally based sural flap when used for the coverage of defects of lower leg, ankle and foot. STUDY DESIGN Descriptive study. PLACE AND DURATION OF STUDY Department of Surgery, Combined Military Hospital, Peshawar and Khariyan, from January 2012 to December 2014. METHODOLOGY Patients with soft tissue defects over the distal leg, ankle and foot were selected by purposive sampling technique and divided into 2 groups of 19 patients each. Group A(road traffic accidents) and group B (war injuries). Sural fascio-cutaneous flap was the reconstructive tool used in all the cases using single technique by the same surgical team; and time for recipient site preparation, size of the defect, graft survival, its healing time and complications, were studied. RESULTS The mean age of the 38 patients in the study was 28.2 ±13.4 years. There were 36 male and 2 female patients. The most common...

Research paper thumbnail of Staged corrective surgery for complex congenital scoliosis and split cord malformation

European Spine Journal, 2009

Research paper thumbnail of Os-Odontoidcum leading to Atlanto-Axial instability — Report of surgery in four cases

Journal of the Pakistan Medical Association, 2008

Research paper thumbnail of Os-odontoideum leading to atlanto-axial instability - Report of surgery in four cases

Journal of the Pakistan Medical Association

Os odontoideum can lead to atlantoaxial instability, which can be either reducible or a fixed dis... more Os odontoideum can lead to atlantoaxial instability, which can be either reducible or a fixed dislocation. We present surgical management in four patients with os odontoideum at our center. Two of these had reducible dislocations and were managed by posterior transarticular screw fixation. Other two had fixed dislocations necessitating posterior decompression and occipitocervical fixation.

Research paper thumbnail of Epidemiology of non-disaster spinal injuries at a spine unit

Journal of the College of Physicians and Surgeons--Pakistan: JCPSP

To describe the demography, types of injuries and their management in all non-disaster spinal inj... more To describe the demography, types of injuries and their management in all non-disaster spinal injury patients admitted to the Spine Unit of a tertiary care hospital in Pakistan from 2001-2008. Case series. Spine Unit, Orthopaedic Department, Combined Military Hospital, Rawalpindi, from April 2001 to December 2008. Data of all new non-disaster spinal injury patient admissions, kept in a custom-built database at Spine Unit, was analyzed. Demography, type of injuries and their management was described in percentages. Five hundred and twenty one non-disaster patients were selected out of a total 671 new admissions with spinal injuries. Mean age was 39.1 years and 77% were males. Mechanisms of injury included; fall in 62% and road traffic accidents in 32%. Fracture dislocations and burst fractures were equally distributed (36% each). Most of the injuries (43.6%) were at T11-L1 level. Forty three percent patients had complete spinal cord injury (SCI), 33% had incomplete SCI and 24% did no...

Research paper thumbnail of Os-odontoideum leading to atlanto-axial instability--report of surgery in four cases

JPMA. The Journal of the Pakistan Medical Association, 2008

Os odontoideum can lead to atlantoaxial instability, which can be either reducible or a fixed dis... more Os odontoideum can lead to atlantoaxial instability, which can be either reducible or a fixed dislocation. We present surgical management in four patients with os odontoideum at our center. Two of these had reducible dislocations and were managed by posterior transarticular screw fixation. Other two had fixed dislocations necessitating posterior decompression and occipitocervical fixation.

Research paper thumbnail of Expert’s comment concerning Grand Rounds case entitled “Spontaneous and idiopathic chronic spinal epidural hematoma: two case reports and review of the literature” (by S. Sarubbo, F. Garofano, G. Maida, E. Fainardi, E. Granieri, M. A. Cavallo)

European Spine Journal, 2009

Research paper thumbnail of Expert’s comment concerning Grand Rounds case entitled “Staged corrective surgery for complex congenital scoliosis and split cord malformation” (by Muhammad Asad Qureshi, Ambreen Asad, Ibrahim Farooq Pasha, Arslan Sharif Malik, Vincent Arlet)

European Spine Journal, 2009

Research paper thumbnail of Staged corrective surgery for complex congenital scoliosis and split cord malformation

European Spine Journal, 2009

Congenital scoliosis associated with split cord malformation raises the issue on how to best mana... more Congenital scoliosis associated with split cord malformation raises the issue on how to best manage these patients to avoid neurologic injury while achieving satisfactory correction. We present the case of a 12-year-old girl who first presented when she was 11-year old with such combination but without much physical handicap or neurological deficit. The corrective surgery offered at that time was refused by the family. She again presented after 1 year with documented severe aggravation of the curve resulting in unstable walking and psychological upset. Her imaging studies showed multiple malformations in lower cervical and thoracic spine and a split cord malformation type 2 (fibrous septum with diplomyelia) at the apex of the deformity. A one-stage correction was deemed neurologically too risky. We therefore performed during a first stage a thoracotomy with anterior release. This was followed by skeletal traction with skull tongs and bilateral femoral pins. After gradual increase in traction weights a reasonable correction was achieved without any neurological deficit, over the next 10 days. A second-stage operation was done on the 11th day and a posterior instrumented fusion was performed. Post-operative recovery was uneventful and there were no complications. She was discharged with a Boston Brace to be worn for 3 months. At 2-year follow-up the patient outcome is excellent with excellent balance and correction of the deformity. In this grand round case, we discuss all the different option of treatment of congenital scoliosis associated with split cord malformation. In a medical environment where spinal cord monitoring is lacking, we recommend an initial release followed by skull and bifemoral traction over several days to monitor the neurologic status of the patient. Once optimal correction is achieved with the traction, a posterior instrumentation can be safely done.