Dr Parveen Shah - Academia.edu (original) (raw)

Papers by Dr Parveen Shah

Introduction Breast carcinoma in men is extremely rare comprising less than 1% of all breast canc... more Introduction Breast carcinoma in men is extremely rare comprising less than 1% of all breast cancers (1-3). The most common invasive subtypes are infiltrating ductal carcinomas (about 85% of tumors) and papillary carcinoma(5% of tumors) (4).Lobular carcinoma represents ...

Asian Pacific journal of cancer prevention : APJCP, 2014

Lymphadenopathy is a common presentation in both benign and malignant diseases which need to be d... more Lymphadenopathy is a common presentation in both benign and malignant diseases which need to be diagnosed without delay. Fine needle aspiration cytology (FNAC) helps us diagnose a disease and follow its course, including the response to therapy. This study aimed to analyze the clinicopathological features of metastatic lymphadenopathy and the diagnostic utility of FNAC in our setting. This two-year prospective study included all the patients with metastatic lymphadenopathy, diagnosed with FNAC. A total of 412 cases (male:female ratio, 1.3:1; age range, 3 to 90 years) were studied. Supraclavicular lymph nodes were involved most commonly (50.5%). The commonest metastatic tumor was squamous cell carcinoma in general (30.1%) and in males (37.6%), and infiltrating ductal carcinoma (25.3%) in females. Lung, with 64 (15.5%) cases followed by esophagus, 60 (14.6%) cases; breast, 49 (11.9%) cases; skin, 32 (7.8%) cases; and stomach, 25 (6.1%) cases were the most common primary sites of malig...

This study was conducted to evaluate the surgical management of splenic hydatidosis in an area wh... more This study was conducted to evaluate the surgical management of splenic hydatidosis in an area where the disease is endemic. Over a period of 16 years, 26 patients with splenic hydatidosis underwent surgery in our department. Preoperative investigations included plain abdominal X-ray, serology, ultrasonography, and computed tomography. In our series, splenic hydatidosis represented 3.5% of total abdominal hydatidosis. The majority of patients presented with abdominal discomfort and palpable swelling in the left hypochondrium. Twenty-two patients were operated on electively and 4 as emergency cases, including 2 with ruptured hydatids and 2 with infected hydatids of the spleen. Isolated splenic hydatid cysts were present in 21 patients, associated liver hydatid cysts in 4, and diffuse abdominal hydatidosis in 1 patient. All patients underwent splenectomy except for one patient who initially had partial splenectomy for a lower polar cyst. This patient also ended up undergoing a splenectomy for postoperative hemorrhage. One patient died on the sixth postoperative day (mortality rate 3.8%) as a result of multiorgan failure, and 4 developed minor complications (morbidity 15.4%). Splenic hydatidosis, although rare, is the third most common type of hydatidosis after liver and lung hydatidosis. This entity should thus be kept in mind when encountering a splenic cyst especially in areas where the disease is endemic. A splenectomy remains the treatment of choice because it demonstrates low morbidity and mortality rates.

Asian Pacific journal of cancer prevention : APJCP, 2012

Lymphadenopathy is one of the commonest and significant manifestations of local as well as system... more Lymphadenopathy is one of the commonest and significant manifestations of local as well as systemic ailments, especially malignancies. Fine needle aspiration cytology (FNAC) helps in diagnosing the disease itself, in general, but more importantly ruling out malignancy, in particular. Hence it saves much of the cost and use of resources incurred with excision biopsy of such lymph nodes. This prompted us to study the cytologic patterns of lymphadenopathy in our setting and the diagnostic utility of FNAC in the evaluation of lymphadenopathy. In this retrospective observational study, 1,579 patients (953 males and 626 females) with lymphadenopathy who were subjected to FNAC over a period of three years (January 2009 to December 2011) were studied. The cervical region was involved in most of the cases (76%) followed by the axillary region (17.5%). Metastatic malignancy (38.2%) was the commonest cause of lymphadenopathy followed by reactive lymphoid hyperplasia (36.9%), tuberculosis (9.1%...

Annals of Saudi medicine

... Kashmir, India. Correspondence: Dr. Omar Javed Shah Department of Surgical Gastroenterology S... more ... Kashmir, India. Correspondence: Dr. Omar Javed Shah Department of Surgical Gastroenterology Surgery Sher-i-Kashmir Institute of Medical Sciences Kral-sangri, Brein, Nishat Srinagar 1900010 Kashmir, India T: +91-194-246-3774 /+91-990-662-9333/+91-194-2401013 ext. ...

Annals of Saudi medicine

Because breast cancer in men is rare, few patients are available for prospective studies. To lear... more Because breast cancer in men is rare, few patients are available for prospective studies. To learn more about its epidemiology, risk factors, clinical features, genetics and pathology in our country, we conducted a retrospective study of all cases seen in recent decades at our institution. We identified each case of male breast cancer in the database at the Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India, between the years 1983 to 2007. We identified only 32 cases of male breast cancer over the 24-year period. Male breast cancer accounted for 32 (2.8%) of 1141 resected breast specimens, which included all breast lesions and 32 (4.1%) of 780 breast cancer cases. Of the 32 cases, 20 (62.5%) had various associated risk factors. Invasive ductal carcinoma was seen in 30 cases (93.7%). Of 20 cases that underwent molecular studies, 16 (80%) patients had estrogen receptor positivity whereas 14 (70%) had progesterone receptor positivity. Six cases (30%) overexpressed H...

JOP : Journal of the pancreas, 2010

The pancreas is an infrequent site of hydatid disease. This study aims at giving better insight i... more The pancreas is an infrequent site of hydatid disease. This study aims at giving better insight into the diagnostic and managerial approach to the disease. Six patients with hydatid cysts of the pancreas. Retrospective review of the clinical records. The six patients (four men, two women) ranged in age from 18 to 68 years. Five of the cysts were primary while one had an associated cyst in the liver. Abdominal pain, vomiting, abdominal mass and dyspeptic symptoms were seen in cysts involving the body and tail. Two patients having cysts in the head of the pancreas presented with obstructive jaundice. An indirect hemagglutination test and an enzyme-linked immunoabsorbent assay were positive for the presence of specific hydatid antibodies in four patients. Abdominal ultrasonography, computed tomography and magnetic resonance cholangiopancreatography (MRCP) successfully imaged the cysts and also defined the relationship of the lesion with the pancreatic duct. All patients underwent surgi...

International Journal of Research in Medical Sciences, 2014

Background: Aim of current study was to study the histopathological spectrum of neoplastic lesion... more Background: Aim of current study was to study the histopathological spectrum of neoplastic lesions of large intestine and histopathological pattern of colorectal carcinoma in young adults. Methods: We took a combined retrospective & prospective study in the department of pathology. The specimens were collected from subjects diagnosed as colorectal carcinomas in histopathology department and clinical details were sought from the medical records. Variables like age, sex, dietary habit, relevant history, tumor size, location, type of lesion, histological pattern of patients were checked. Results: In the series of 446 patients of colorectal neoplasm, maximum number of patients presented in 4 th to 6 th decade of life (47.30%), while as (15.46%) were between 20-40 years. The youngest patient with an adenocarcinoma was 18 years (male) of age and the oldest one was 80 years (male) of age. Average age of patients was 50.50 years. The male to female ratio was 1.3:1. The study revealed that the carcinoma of ascending colon was much more prevalent, constituting 107 (40.07%) cases. The proportion of well differentiated carcinoma was highest in left side colon and rectum. The incidence of moderately differentiated and poorly differentiated carcinoma was greater on right side colon. Conclusion: Adenocarcinoma is the most common histological variant of colon carcinomas.

ANZ Journal of Surgery

Role of endoscopic ultrasonography in preoperative staging of gastric carcinoma. 2004: Gul Javaid... more Role of endoscopic ultrasonography in preoperative staging of gastric carcinoma. 2004: Gul Javaid; Omar Javed Shah; MANZOOR DAR; Parveen Shah; Nazir A Wani; Showkat Ali Zargar ANZ journal of surgery 2004;74(3):108-11. Abstract BACKGROUND: Preoperative staging of tumour extent in upper gastrointestinal malignancy greatly facilitates planning of therapy. The present study was undertaken to see whether preoperative endoscopic ultrasonography (EUS) accurately predicts the tumour stage in gastric carcinoma. METHODS: Endoscopic ultrasonography was performed preoperatively on 112 patients with gastric cancer. All 112 patients underwent surgery. The results of EUS were compared with postoperative histological staging. RESULTS: Endoscopic ultrasonography was correct in determining the primary tumour (T) and regional lymph node (N) staging in 83.0% and 64.2% of patients, respectively. EUS was correct in determining the absence of lymph node metastasis in 87.5% but was not reliable in determin...

Left-sided hepatic resection for hepatolithiasis: a longitudinal study of 110 patients. 2012: Oma... more Left-sided hepatic resection for hepatolithiasis: a longitudinal study of 110 patients. 2012: Omar Javed Shah; Parveen Shah; Ghulam Nabi Yattoo; Showkat Ali Zargar; Gul Javaid; Irfan Robbani; Altaf Shah; Farhat Mustafa HPB : the official journal of the International Hepato Pancreato Biliary Association 2012;14(11):764-71. Abstract BACKGROUND: Hepatolithiasis affecting the left hepatobiliary system is common in the Asia Pacific region. This aim of this study was to describe an experience with the diagnosis and treatment of patients with isolated left-sided hepatolithiasis. METHODS: One hundred and ten patients with isolated left-sided hepatolithiasis who underwent a left-sided hepatic resection between January 1999 and February 2010 were included for further analysis. The clinical profile, cholangiograms, operative procedures and early and late results were examined. RESULTS: Analysis of magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatogr...

JOP: Journal of the pancreas

Hydatid cyst of the pancreas. An experience with six cases. 2010: Omar Javed Shah; Irfan Robbani;... more Hydatid cyst of the pancreas. An experience with six cases. 2010: Omar Javed Shah; Irfan Robbani; Showkat Ali Zargar; Ghulam N Yattoo; Parveen Shah; Sadaf Ali; Gul Javaid; Altaf Shah; Bashir A Khan JOP : Journal of the pancreas 2010;11(6):575-81. Abstract CONTEXT: The pancreas is an infrequent site of hydatid disease. OBJECTIVE: This study aims at giving better insight into the diagnostic and managerial approach to the disease. PATIENTS: Six patients with hydatid cysts of the pancreas. DESIGN: Retrospective review of the clinical records. RESULTS: The six patients (four men, two women) ranged in age from 18 to 68 years. Five of the cysts were primary while one had an associated cyst in the liver. Abdominal pain, vomiting, abdominal mass and dyspeptic symptoms were seen in cysts involving the body and tail. Two patients having cysts in the head of the pancreas presented with obstructive jaundice. An indirect hemagglutination test and an enzyme-linked immunoabsorbent assay were positi...

Case Reports in Gastroenterology, 2008

A 60-year-old lady presented to us with a right upper abdominal mass. With a clinical diagnosis o... more A 60-year-old lady presented to us with a right upper abdominal mass. With a clinical diagnosis of liver tumor, she was evaluated with abdominal CT, MRI, nuclear scan, tumor markers, USG guided FNAC and other baseline investigations. On evaluation she had a massive right lobe tumor crossing the midline. In view of the ambiguous diagnosis she was subjected to laparotomy where the lesion was judged unresectable and a biopsy was taken. Histopathological examination showed the rare pathology of primary fibrosarcoma of the liver with features of homogeneous, spindle-shaped cells with abundant collagen fibers showing a classic herringbone pattern. Tissue samples were then sent to another referral cancer hospital for immunohistochemistry and immunoreactive vimentin was found in the tumor cells. Electron microscopically, the tumor cells were rich in rough endoplasmic reticulum without a basement membrane, and were surrounded by large amounts of collagen fibers. The fibroblastic character of the tumor cells was suggested by light and electron microscopy.

Surgery today, 2002

This study was conducted to evaluate the surgical management of splenic hydatidosis in an area wh... more This study was conducted to evaluate the surgical management of splenic hydatidosis in an area where the disease is endemic. Over a period of 16 years, 26 patients with splenic hydatidosis underwent surgery in our department. Preoperative investigations included plain abdominal X-ray, serology, ultrasonography, and computed tomography. In our series, splenic hydatidosis represented 3.5% of total abdominal hydatidosis. The majority of patients presented with abdominal discomfort and palpable swelling in the left hypochondrium. Twenty-two patients were operated on electively and 4 as emergency cases, including 2 with ruptured hydatids and 2 with infected hydatids of the spleen. Isolated splenic hydatid cysts were present in 21 patients, associated liver hydatid cysts in 4, and diffuse abdominal hydatidosis in 1 patient. All patients underwent splenectomy except for one patient who initially had partial splenectomy for a lower polar cyst. This patient also ended up undergoing a splenec...

Indian Journal of Surgery, 2013

Choledochal cysts of the cystic duct are extremely unusual and only single case reports are docum... more Choledochal cysts of the cystic duct are extremely unusual and only single case reports are documented in the literature. The widely used Todani classification does not include such type of lesions. We present a case of a young girl with a cystic duct choledochal cyst diagnosed preoperatively and confirmed intraoperatively. Due to the site and mass effect of the cyst, excision of the lesion included a part of bile duct. Reconstruction was achieved by Roux-en-Y hepaticojejunostomy. While such lesions are extremely rare, they do occur and need to be recognized as a separate entity in the Todani classification.

Cellular Oncology, 2014

Purpose Inactivation of tumor suppressor and DNA repair genes by promoter hypermethylation does c... more Purpose Inactivation of tumor suppressor and DNA repair genes by promoter hypermethylation does commonly occur in human cancers. O 6 -methylguanine-DNA methyltransferase (MGMT) is a DNA repair enzyme that removes methyl groups as well as larger adducts at the O 6 position of guanine. In the absence of MGMT activity, O 6 -methylguanine mispairs with thymine during DNA replication, resulting in G:C to A:T transitions. Promoter hypermethylation of the MGMT gene has been observed in various cancers, including gastric cancer.

Hepatobiliary & Pancreatic Diseases International, 2014

Pancreaticoduodenectomy is a high risk, complex, technically challenging operation associated wit... more Pancreaticoduodenectomy is a high risk, complex, technically challenging operation associated with significant perioperative morbidity and mortality. This study on the surgical management of periampullary cancer patients is based on our experience in a period of nearly 13 years. The study was conducted on two groups of patients: group A included 42 patients who were treated between January 2000 and September 2005 and group B included 134 patients who were treated between October 2005 to October 2012. Preoperative, intraoperative and postoperative details of all these patients were collected, tabulated and analyzed to assess the impact of the selective approach introduced in the department with effect from October 2005. Intraoperative details revealed highly significant differences in the management of the two groups of patients in respect of operative time (250.4 vs 126.6 minutes; P<0.001), operative blood loss (1070.2 vs 414.9 mL; P<0.001) and intraoperative blood transfusion (1.4 vs 0.2 units; P<0.001). Variations between the two groups in the frequency of complications were found to be statistically insignificant. However, the difference between the two groups in the overall morbidity of patients (47.6% vs 26.1%; P=0.009) and the length of their hospital stay (11.8 vs 7.8 days; P<0.001) were significant. A selective approach applied to the surgical management of periampullary cancer patients is a step in the right direction.

World Journal of Surgery, 2009

Background Choledochal cyst is a surgical problem usually related to infancy and childhood. Despi... more Background Choledochal cyst is a surgical problem usually related to infancy and childhood. Despite advancements in management, a large number of cases still present during adulthood. The clinical course and outcome in children varies from that in adults. This study focuses on these variations in terms of presentation, management, histopathology, and outcome. Methods An in-depth retrospective analysis was carried out on 79 patients presenting with choledochal cysts between December 2007 and January 1997. The patients were segregated into two groups: group A comprising 32 children and group B with 47 adults. The presentation, clinical evaluation, radiologic, and biochemical findings; operative details; pathologic findings; and early and longterm complications in the two groups were studied on a comparative basis. Results The male/female ratios were 1:3 and 1.0:2.3 in groups A and B, respectively. A history of previous biliary surgery, pancreatitis, cholangitis, peroperative difficulties, and early and late postoperative complications were 5.1, 5.4, 6.4, 5.4, 2.0, and 3.3 times more common in group B than in group A. However, the classic triad of jaundice, abdominal pain, and a mass was 6.7 times more common in group A than in group B. The classic triad and cholangitis were the only parameters that were statistically significant. Rare presentations of spontaneous perforation of the cyst or cachexia manifested only in group A patients. The methods of detection and operative treatment were identical for both groups. Histologically, fibrosis of the cyst wall was a feature peculiar to group A, whereas signs of inflammation and hyperplasia were predominantly seen in group B. In the group B series, one patient had cholangiocarcinoma and another gallbladder carcinoma; one more patient developed malignancy during follow-up. Long-term complications were seen in 29.7% of patients in group B versus 9.3% in group A; the most rampant complication was a type IVa cyst, seen in 68.7% of patients. Conclusions Choledochal cysts present differently in adults and children; whereas children present with the classic triad, adults present with common biliary or infective complications. Although the methods of detection and surgical treatment are similar for the two groups, the type IVa cyst typically seen in the adult group creates a marked deviation with respect to long-term complications such as ascending cholangitis, anastomotic strictures, stone formation, and development of cholangiocarcinoma. These are areas of grave concern that can be addressed to a large extent by providing an access loop during the initial

Neurosurgery Quarterly, 2009

Advertisement. Close Window. Close Window. Thank you for choosing to subscribe to the eTOC for Ne... more Advertisement. Close Window. Close Window. Thank you for choosing to subscribe to the eTOC for Neurosurgery Quarterly. Enter your Email address: Wolters Kluwer Health may email you for journal alerts and information, but ...

HPB: Official Journal of The International Hepato Pancreato Biliary Association, 2006

ANZ Journal of Surgery, 2004

Background: Preoperative staging of tumour extent in upper gastrointestinal malignancy greatly fa... more Background: Preoperative staging of tumour extent in upper gastrointestinal malignancy greatly facilitates planning of therapy. The present study was undertaken to see whether preoperative endoscopic ultrasonography (EUS) accurately predicts the tumour stage in gastric carcinoma. Methods: Endoscopic ultrasonography was performed preoperatively on 112 patients with gastric cancer. All 112 patients underwent surgery. The results of EUS were compared with postoperative histological staging. Results: Endoscopic ultrasonography was correct in determining the primary tumour (T) and regional lymph node (N) staging in 83.0% and 64.2% of patients, respectively. EUS was correct in determining the absence of lymph node metastasis in 87.5% but was not reliable in determining metastasis in one to six regional lymph nodes (N1) and metastasis in seven to 15 regional lymph nodes (N2) stages; (61.5% and 33.3%, respectively). Of 26 patients with N1 stage, 10 had false negative results, whereas 11 patients in stage N2 were diagnosed endoscopically as stage N1. The sensitivity and specificity were 67.2% and 89%, respectively. The actual resection rate (75%) was almost identical to the rate predicted preoperatively by EUS (78%). Conclusion: Endoscopic ultrasonography staging is the most accurate method for discriminating between potentially resectable (tumour invading lamina propria or submucosa (T1) to tumour that penetrates the serosa (visceral peritoneum) without invading adjacent structures (T3)) and potentially non-resectable (tumour invading adjacent structures (T4)) cases of upper gastrointestinal cancer.

Introduction Breast carcinoma in men is extremely rare comprising less than 1% of all breast canc... more Introduction Breast carcinoma in men is extremely rare comprising less than 1% of all breast cancers (1-3). The most common invasive subtypes are infiltrating ductal carcinomas (about 85% of tumors) and papillary carcinoma(5% of tumors) (4).Lobular carcinoma represents ...

Asian Pacific journal of cancer prevention : APJCP, 2014

Lymphadenopathy is a common presentation in both benign and malignant diseases which need to be d... more Lymphadenopathy is a common presentation in both benign and malignant diseases which need to be diagnosed without delay. Fine needle aspiration cytology (FNAC) helps us diagnose a disease and follow its course, including the response to therapy. This study aimed to analyze the clinicopathological features of metastatic lymphadenopathy and the diagnostic utility of FNAC in our setting. This two-year prospective study included all the patients with metastatic lymphadenopathy, diagnosed with FNAC. A total of 412 cases (male:female ratio, 1.3:1; age range, 3 to 90 years) were studied. Supraclavicular lymph nodes were involved most commonly (50.5%). The commonest metastatic tumor was squamous cell carcinoma in general (30.1%) and in males (37.6%), and infiltrating ductal carcinoma (25.3%) in females. Lung, with 64 (15.5%) cases followed by esophagus, 60 (14.6%) cases; breast, 49 (11.9%) cases; skin, 32 (7.8%) cases; and stomach, 25 (6.1%) cases were the most common primary sites of malig...

This study was conducted to evaluate the surgical management of splenic hydatidosis in an area wh... more This study was conducted to evaluate the surgical management of splenic hydatidosis in an area where the disease is endemic. Over a period of 16 years, 26 patients with splenic hydatidosis underwent surgery in our department. Preoperative investigations included plain abdominal X-ray, serology, ultrasonography, and computed tomography. In our series, splenic hydatidosis represented 3.5% of total abdominal hydatidosis. The majority of patients presented with abdominal discomfort and palpable swelling in the left hypochondrium. Twenty-two patients were operated on electively and 4 as emergency cases, including 2 with ruptured hydatids and 2 with infected hydatids of the spleen. Isolated splenic hydatid cysts were present in 21 patients, associated liver hydatid cysts in 4, and diffuse abdominal hydatidosis in 1 patient. All patients underwent splenectomy except for one patient who initially had partial splenectomy for a lower polar cyst. This patient also ended up undergoing a splenectomy for postoperative hemorrhage. One patient died on the sixth postoperative day (mortality rate 3.8%) as a result of multiorgan failure, and 4 developed minor complications (morbidity 15.4%). Splenic hydatidosis, although rare, is the third most common type of hydatidosis after liver and lung hydatidosis. This entity should thus be kept in mind when encountering a splenic cyst especially in areas where the disease is endemic. A splenectomy remains the treatment of choice because it demonstrates low morbidity and mortality rates.

Asian Pacific journal of cancer prevention : APJCP, 2012

Lymphadenopathy is one of the commonest and significant manifestations of local as well as system... more Lymphadenopathy is one of the commonest and significant manifestations of local as well as systemic ailments, especially malignancies. Fine needle aspiration cytology (FNAC) helps in diagnosing the disease itself, in general, but more importantly ruling out malignancy, in particular. Hence it saves much of the cost and use of resources incurred with excision biopsy of such lymph nodes. This prompted us to study the cytologic patterns of lymphadenopathy in our setting and the diagnostic utility of FNAC in the evaluation of lymphadenopathy. In this retrospective observational study, 1,579 patients (953 males and 626 females) with lymphadenopathy who were subjected to FNAC over a period of three years (January 2009 to December 2011) were studied. The cervical region was involved in most of the cases (76%) followed by the axillary region (17.5%). Metastatic malignancy (38.2%) was the commonest cause of lymphadenopathy followed by reactive lymphoid hyperplasia (36.9%), tuberculosis (9.1%...

Annals of Saudi medicine

... Kashmir, India. Correspondence: Dr. Omar Javed Shah Department of Surgical Gastroenterology S... more ... Kashmir, India. Correspondence: Dr. Omar Javed Shah Department of Surgical Gastroenterology Surgery Sher-i-Kashmir Institute of Medical Sciences Kral-sangri, Brein, Nishat Srinagar 1900010 Kashmir, India T: +91-194-246-3774 /+91-990-662-9333/+91-194-2401013 ext. ...

Annals of Saudi medicine

Because breast cancer in men is rare, few patients are available for prospective studies. To lear... more Because breast cancer in men is rare, few patients are available for prospective studies. To learn more about its epidemiology, risk factors, clinical features, genetics and pathology in our country, we conducted a retrospective study of all cases seen in recent decades at our institution. We identified each case of male breast cancer in the database at the Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India, between the years 1983 to 2007. We identified only 32 cases of male breast cancer over the 24-year period. Male breast cancer accounted for 32 (2.8%) of 1141 resected breast specimens, which included all breast lesions and 32 (4.1%) of 780 breast cancer cases. Of the 32 cases, 20 (62.5%) had various associated risk factors. Invasive ductal carcinoma was seen in 30 cases (93.7%). Of 20 cases that underwent molecular studies, 16 (80%) patients had estrogen receptor positivity whereas 14 (70%) had progesterone receptor positivity. Six cases (30%) overexpressed H...

JOP : Journal of the pancreas, 2010

The pancreas is an infrequent site of hydatid disease. This study aims at giving better insight i... more The pancreas is an infrequent site of hydatid disease. This study aims at giving better insight into the diagnostic and managerial approach to the disease. Six patients with hydatid cysts of the pancreas. Retrospective review of the clinical records. The six patients (four men, two women) ranged in age from 18 to 68 years. Five of the cysts were primary while one had an associated cyst in the liver. Abdominal pain, vomiting, abdominal mass and dyspeptic symptoms were seen in cysts involving the body and tail. Two patients having cysts in the head of the pancreas presented with obstructive jaundice. An indirect hemagglutination test and an enzyme-linked immunoabsorbent assay were positive for the presence of specific hydatid antibodies in four patients. Abdominal ultrasonography, computed tomography and magnetic resonance cholangiopancreatography (MRCP) successfully imaged the cysts and also defined the relationship of the lesion with the pancreatic duct. All patients underwent surgi...

International Journal of Research in Medical Sciences, 2014

Background: Aim of current study was to study the histopathological spectrum of neoplastic lesion... more Background: Aim of current study was to study the histopathological spectrum of neoplastic lesions of large intestine and histopathological pattern of colorectal carcinoma in young adults. Methods: We took a combined retrospective & prospective study in the department of pathology. The specimens were collected from subjects diagnosed as colorectal carcinomas in histopathology department and clinical details were sought from the medical records. Variables like age, sex, dietary habit, relevant history, tumor size, location, type of lesion, histological pattern of patients were checked. Results: In the series of 446 patients of colorectal neoplasm, maximum number of patients presented in 4 th to 6 th decade of life (47.30%), while as (15.46%) were between 20-40 years. The youngest patient with an adenocarcinoma was 18 years (male) of age and the oldest one was 80 years (male) of age. Average age of patients was 50.50 years. The male to female ratio was 1.3:1. The study revealed that the carcinoma of ascending colon was much more prevalent, constituting 107 (40.07%) cases. The proportion of well differentiated carcinoma was highest in left side colon and rectum. The incidence of moderately differentiated and poorly differentiated carcinoma was greater on right side colon. Conclusion: Adenocarcinoma is the most common histological variant of colon carcinomas.

ANZ Journal of Surgery

Role of endoscopic ultrasonography in preoperative staging of gastric carcinoma. 2004: Gul Javaid... more Role of endoscopic ultrasonography in preoperative staging of gastric carcinoma. 2004: Gul Javaid; Omar Javed Shah; MANZOOR DAR; Parveen Shah; Nazir A Wani; Showkat Ali Zargar ANZ journal of surgery 2004;74(3):108-11. Abstract BACKGROUND: Preoperative staging of tumour extent in upper gastrointestinal malignancy greatly facilitates planning of therapy. The present study was undertaken to see whether preoperative endoscopic ultrasonography (EUS) accurately predicts the tumour stage in gastric carcinoma. METHODS: Endoscopic ultrasonography was performed preoperatively on 112 patients with gastric cancer. All 112 patients underwent surgery. The results of EUS were compared with postoperative histological staging. RESULTS: Endoscopic ultrasonography was correct in determining the primary tumour (T) and regional lymph node (N) staging in 83.0% and 64.2% of patients, respectively. EUS was correct in determining the absence of lymph node metastasis in 87.5% but was not reliable in determin...

Left-sided hepatic resection for hepatolithiasis: a longitudinal study of 110 patients. 2012: Oma... more Left-sided hepatic resection for hepatolithiasis: a longitudinal study of 110 patients. 2012: Omar Javed Shah; Parveen Shah; Ghulam Nabi Yattoo; Showkat Ali Zargar; Gul Javaid; Irfan Robbani; Altaf Shah; Farhat Mustafa HPB : the official journal of the International Hepato Pancreato Biliary Association 2012;14(11):764-71. Abstract BACKGROUND: Hepatolithiasis affecting the left hepatobiliary system is common in the Asia Pacific region. This aim of this study was to describe an experience with the diagnosis and treatment of patients with isolated left-sided hepatolithiasis. METHODS: One hundred and ten patients with isolated left-sided hepatolithiasis who underwent a left-sided hepatic resection between January 1999 and February 2010 were included for further analysis. The clinical profile, cholangiograms, operative procedures and early and late results were examined. RESULTS: Analysis of magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatogr...

JOP: Journal of the pancreas

Hydatid cyst of the pancreas. An experience with six cases. 2010: Omar Javed Shah; Irfan Robbani;... more Hydatid cyst of the pancreas. An experience with six cases. 2010: Omar Javed Shah; Irfan Robbani; Showkat Ali Zargar; Ghulam N Yattoo; Parveen Shah; Sadaf Ali; Gul Javaid; Altaf Shah; Bashir A Khan JOP : Journal of the pancreas 2010;11(6):575-81. Abstract CONTEXT: The pancreas is an infrequent site of hydatid disease. OBJECTIVE: This study aims at giving better insight into the diagnostic and managerial approach to the disease. PATIENTS: Six patients with hydatid cysts of the pancreas. DESIGN: Retrospective review of the clinical records. RESULTS: The six patients (four men, two women) ranged in age from 18 to 68 years. Five of the cysts were primary while one had an associated cyst in the liver. Abdominal pain, vomiting, abdominal mass and dyspeptic symptoms were seen in cysts involving the body and tail. Two patients having cysts in the head of the pancreas presented with obstructive jaundice. An indirect hemagglutination test and an enzyme-linked immunoabsorbent assay were positi...

Case Reports in Gastroenterology, 2008

A 60-year-old lady presented to us with a right upper abdominal mass. With a clinical diagnosis o... more A 60-year-old lady presented to us with a right upper abdominal mass. With a clinical diagnosis of liver tumor, she was evaluated with abdominal CT, MRI, nuclear scan, tumor markers, USG guided FNAC and other baseline investigations. On evaluation she had a massive right lobe tumor crossing the midline. In view of the ambiguous diagnosis she was subjected to laparotomy where the lesion was judged unresectable and a biopsy was taken. Histopathological examination showed the rare pathology of primary fibrosarcoma of the liver with features of homogeneous, spindle-shaped cells with abundant collagen fibers showing a classic herringbone pattern. Tissue samples were then sent to another referral cancer hospital for immunohistochemistry and immunoreactive vimentin was found in the tumor cells. Electron microscopically, the tumor cells were rich in rough endoplasmic reticulum without a basement membrane, and were surrounded by large amounts of collagen fibers. The fibroblastic character of the tumor cells was suggested by light and electron microscopy.

Surgery today, 2002

This study was conducted to evaluate the surgical management of splenic hydatidosis in an area wh... more This study was conducted to evaluate the surgical management of splenic hydatidosis in an area where the disease is endemic. Over a period of 16 years, 26 patients with splenic hydatidosis underwent surgery in our department. Preoperative investigations included plain abdominal X-ray, serology, ultrasonography, and computed tomography. In our series, splenic hydatidosis represented 3.5% of total abdominal hydatidosis. The majority of patients presented with abdominal discomfort and palpable swelling in the left hypochondrium. Twenty-two patients were operated on electively and 4 as emergency cases, including 2 with ruptured hydatids and 2 with infected hydatids of the spleen. Isolated splenic hydatid cysts were present in 21 patients, associated liver hydatid cysts in 4, and diffuse abdominal hydatidosis in 1 patient. All patients underwent splenectomy except for one patient who initially had partial splenectomy for a lower polar cyst. This patient also ended up undergoing a splenec...

Indian Journal of Surgery, 2013

Choledochal cysts of the cystic duct are extremely unusual and only single case reports are docum... more Choledochal cysts of the cystic duct are extremely unusual and only single case reports are documented in the literature. The widely used Todani classification does not include such type of lesions. We present a case of a young girl with a cystic duct choledochal cyst diagnosed preoperatively and confirmed intraoperatively. Due to the site and mass effect of the cyst, excision of the lesion included a part of bile duct. Reconstruction was achieved by Roux-en-Y hepaticojejunostomy. While such lesions are extremely rare, they do occur and need to be recognized as a separate entity in the Todani classification.

Cellular Oncology, 2014

Purpose Inactivation of tumor suppressor and DNA repair genes by promoter hypermethylation does c... more Purpose Inactivation of tumor suppressor and DNA repair genes by promoter hypermethylation does commonly occur in human cancers. O 6 -methylguanine-DNA methyltransferase (MGMT) is a DNA repair enzyme that removes methyl groups as well as larger adducts at the O 6 position of guanine. In the absence of MGMT activity, O 6 -methylguanine mispairs with thymine during DNA replication, resulting in G:C to A:T transitions. Promoter hypermethylation of the MGMT gene has been observed in various cancers, including gastric cancer.

Hepatobiliary & Pancreatic Diseases International, 2014

Pancreaticoduodenectomy is a high risk, complex, technically challenging operation associated wit... more Pancreaticoduodenectomy is a high risk, complex, technically challenging operation associated with significant perioperative morbidity and mortality. This study on the surgical management of periampullary cancer patients is based on our experience in a period of nearly 13 years. The study was conducted on two groups of patients: group A included 42 patients who were treated between January 2000 and September 2005 and group B included 134 patients who were treated between October 2005 to October 2012. Preoperative, intraoperative and postoperative details of all these patients were collected, tabulated and analyzed to assess the impact of the selective approach introduced in the department with effect from October 2005. Intraoperative details revealed highly significant differences in the management of the two groups of patients in respect of operative time (250.4 vs 126.6 minutes; P<0.001), operative blood loss (1070.2 vs 414.9 mL; P<0.001) and intraoperative blood transfusion (1.4 vs 0.2 units; P<0.001). Variations between the two groups in the frequency of complications were found to be statistically insignificant. However, the difference between the two groups in the overall morbidity of patients (47.6% vs 26.1%; P=0.009) and the length of their hospital stay (11.8 vs 7.8 days; P<0.001) were significant. A selective approach applied to the surgical management of periampullary cancer patients is a step in the right direction.

World Journal of Surgery, 2009

Background Choledochal cyst is a surgical problem usually related to infancy and childhood. Despi... more Background Choledochal cyst is a surgical problem usually related to infancy and childhood. Despite advancements in management, a large number of cases still present during adulthood. The clinical course and outcome in children varies from that in adults. This study focuses on these variations in terms of presentation, management, histopathology, and outcome. Methods An in-depth retrospective analysis was carried out on 79 patients presenting with choledochal cysts between December 2007 and January 1997. The patients were segregated into two groups: group A comprising 32 children and group B with 47 adults. The presentation, clinical evaluation, radiologic, and biochemical findings; operative details; pathologic findings; and early and longterm complications in the two groups were studied on a comparative basis. Results The male/female ratios were 1:3 and 1.0:2.3 in groups A and B, respectively. A history of previous biliary surgery, pancreatitis, cholangitis, peroperative difficulties, and early and late postoperative complications were 5.1, 5.4, 6.4, 5.4, 2.0, and 3.3 times more common in group B than in group A. However, the classic triad of jaundice, abdominal pain, and a mass was 6.7 times more common in group A than in group B. The classic triad and cholangitis were the only parameters that were statistically significant. Rare presentations of spontaneous perforation of the cyst or cachexia manifested only in group A patients. The methods of detection and operative treatment were identical for both groups. Histologically, fibrosis of the cyst wall was a feature peculiar to group A, whereas signs of inflammation and hyperplasia were predominantly seen in group B. In the group B series, one patient had cholangiocarcinoma and another gallbladder carcinoma; one more patient developed malignancy during follow-up. Long-term complications were seen in 29.7% of patients in group B versus 9.3% in group A; the most rampant complication was a type IVa cyst, seen in 68.7% of patients. Conclusions Choledochal cysts present differently in adults and children; whereas children present with the classic triad, adults present with common biliary or infective complications. Although the methods of detection and surgical treatment are similar for the two groups, the type IVa cyst typically seen in the adult group creates a marked deviation with respect to long-term complications such as ascending cholangitis, anastomotic strictures, stone formation, and development of cholangiocarcinoma. These are areas of grave concern that can be addressed to a large extent by providing an access loop during the initial

Neurosurgery Quarterly, 2009

Advertisement. Close Window. Close Window. Thank you for choosing to subscribe to the eTOC for Ne... more Advertisement. Close Window. Close Window. Thank you for choosing to subscribe to the eTOC for Neurosurgery Quarterly. Enter your Email address: Wolters Kluwer Health may email you for journal alerts and information, but ...

HPB: Official Journal of The International Hepato Pancreato Biliary Association, 2006

ANZ Journal of Surgery, 2004

Background: Preoperative staging of tumour extent in upper gastrointestinal malignancy greatly fa... more Background: Preoperative staging of tumour extent in upper gastrointestinal malignancy greatly facilitates planning of therapy. The present study was undertaken to see whether preoperative endoscopic ultrasonography (EUS) accurately predicts the tumour stage in gastric carcinoma. Methods: Endoscopic ultrasonography was performed preoperatively on 112 patients with gastric cancer. All 112 patients underwent surgery. The results of EUS were compared with postoperative histological staging. Results: Endoscopic ultrasonography was correct in determining the primary tumour (T) and regional lymph node (N) staging in 83.0% and 64.2% of patients, respectively. EUS was correct in determining the absence of lymph node metastasis in 87.5% but was not reliable in determining metastasis in one to six regional lymph nodes (N1) and metastasis in seven to 15 regional lymph nodes (N2) stages; (61.5% and 33.3%, respectively). Of 26 patients with N1 stage, 10 had false negative results, whereas 11 patients in stage N2 were diagnosed endoscopically as stage N1. The sensitivity and specificity were 67.2% and 89%, respectively. The actual resection rate (75%) was almost identical to the rate predicted preoperatively by EUS (78%). Conclusion: Endoscopic ultrasonography staging is the most accurate method for discriminating between potentially resectable (tumour invading lamina propria or submucosa (T1) to tumour that penetrates the serosa (visceral peritoneum) without invading adjacent structures (T3)) and potentially non-resectable (tumour invading adjacent structures (T4)) cases of upper gastrointestinal cancer.