Ismail Hassan - Academia.edu (original) (raw)

Papers by Ismail Hassan

Research paper thumbnail of Delayed presentation of penetrating craniocerebral injury caused by a nail

Research paper thumbnail of Posterior surgical approach to tuberculous spondylitis

Journal of Surgical …, 2009

Objectives: Foraminotomy is a simple posterior surgical approach useful for treatment of radicula... more Objectives: Foraminotomy is a simple posterior surgical approach useful for treatment of radicular (nerve root) pain in TB spondylitis. It doesn't affect the stability of the facet joint, requires neither fusion nor implants. It is therefore cheap and affordable for patients with low income. We ...

Research paper thumbnail of Chiari I Malformation: A Missed Diagnosis

Annals of African …, 2006

Chiari I malformation is a complex congenital malformation of the hindbrain, characterized by her... more Chiari I malformation is a complex congenital malformation of the hindbrain, characterized by herniation of the cerebellar tonsils through the foramen magnum into the cervical spinal canal. There may be mild caudal displacement and flattening or kinking of the medulla with an associated small posterior fossa. We present a case of a 30 year old man who presented with a 2 year history of worsening nystagmus and ataxia with associated occipital headache and diplopia. Examination showed a young man with horizontal and vertical nystagmus, he had truncal ataxia and Rhomberg's sign was positive. Diagnosis was missed by several clinicians during the 2 year period. Repeated brain CT scans were normal. Brain MRI confirmed the diagnosis of Chiari I malformation and cervical syringomyelia. He had decompressive occipital craniectomy durotomy and duroplasty. The patient recovered fully from ataxia headache and diplopia but still has residual nystagmus.

Research paper thumbnail of Knotting of a nasogastric feeding tube in a child with head injury: A case report and review of literature

African Journal of Paediatric Surgery, 2014

Research paper thumbnail of Subpericranial shunt valve placement: a technique in patients with friable skin

Child's Nervous System, 2014

One of the nightmares of placing a shunt in patients with friable skin is an exposed shunt or shu... more One of the nightmares of placing a shunt in patients with friable skin is an exposed shunt or shunt valve with risk of infection of the hardware which may lead to meningitis or ventriculitis with poor outcome. Another feared complication is cerebrospinal fluid (CSF) leak from the wound with subsequent wound dehiscence. The patients at risk of shunt hardware exposure include children who have fragile skin or skin at risk (either from prematurity, malnutrition, steroid therapy or very large head with pressure on the skin). This technique involves making a scalp incision with the pericranium taken in one layer with the galea or if the galeal flap has been raised, a pericranial incision is made and a pericranial flap is raised. A subpericranial pouch is developed and a shunt passer used to tunnel the shunt to the abdomen. The pericranial layer is closed, the galea and subcutaneous layer also approximated, and a continuous subcurticular stitch applied. We present a malnourished infant with postinfective hydrocephalus having a thin skin requiring a ventriculoperitoneal shunt. A subpericranial technique was used and the patient did well. This technique is simple and provides a water-tight wound cover, with the pericranium giving reinforcement and better tensile strength, as well as a fairly good protection for the shunt valve. This is useful in preventing CSF leaks and exposure of the shunt with the associated morbidity and mortality.

Research paper thumbnail of Spontaneous Severe Haemoperitoneum in the Third Trimester Leading to Intrauterine Death: Case Report

Case Reports in Obstetrics and Gynecology, 2011

Spontaneous haemoperitoneum during pregnancy is a rare but potentially catastrophic cause of acut... more Spontaneous haemoperitoneum during pregnancy is a rare but potentially catastrophic cause of acute abdominal pain. A healthy 37-year-old primigravida presented with acute abdominal pain and hypovolaemic shock at 37-weeks gestation. An emergency caesarean section was indicated on the clinical suspicion of placental abruption. However, an ultrasound scan confirmed the absence of a fetal heartbeat, and, in light of the mother's haemodynamic stability, a vaginal delivery was deemed most appropriate. Subsequent imaging, due to deterioration over the following 24-hours, revealed a large heterogenous haematoma within the pelvic cavity, which was later found to be caused by severe pelvic endometriosis. Despite fertility problems associated with severe endometriosis, advanced assisted reproductive technology enables more of these patients to become pregnant, highlighting the need to be aware of this rare complication in pregnancy.

Research paper thumbnail of Transrectal elastographic monitoring of the transurethral balloon pressure in urethral dilation for catheter-dependent patients with benign prostatic hyperplasia

The Egyptian Journal of Radiology and Nuclear Medicine, 2014

ABSTRACT Background Foley’s catheter indwelling gives temporary relief for lower urinary tract ob... more ABSTRACT Background Foley’s catheter indwelling gives temporary relief for lower urinary tract obstruction, especially in case of severely symptomatizing benign prostatic hyperplasia (BPH). Several complications of long-term or frequent catheter indwelling have been reported in catheter dependent patients, specifically to those who are unfit for operative intervention. Objectives Our aim was to find a safe, non-invasive relief from symptom severity, as well as, incapacitating complications of Foley’s catheter in catheter-dependent patients. Methods A total of 107 catheter-dependent men, or who had frequent Foley’s catheter indwelling in case of BPH, participated in the present study. Preliminary estimation of the post-micturition residual urine was obtained. Ultrasound elastography was used to assess the transurethral balloon pressure of the double balloon silicon-coated catheter, adjudicated by ureteromat, and maintained in situ for 6 days in all patients. Basic follow up once-a-month has been performed up to 6 months. Results Effectual urethral patency was noted in 89.7% patients at the end of the third month. The procedure was repeated for 11 patients shortly after 3 months, for 7 patients after 4 months and for 28 patients after 5 months, with no reported prostatic urethral injury. No stricture recurrence was noted in 61 patients up to 6 months. Conclusions Preliminary results indicate that prostatic urethral balloon dilation in BPH catheter-dependent patients is inexpensive, safe, and would be a potentially effective option in maintaining the prostatic urethral patency. Elastographic justification of the transurethral balloon has proved to be helpful.

Research paper thumbnail of Subpericranial shunt valve placement: a technique in patients with friable skin

Child's Nervous System, 2014

One of the nightmares of placing a shunt in patients with friable skin is an exposed shunt or shu... more One of the nightmares of placing a shunt in patients with friable skin is an exposed shunt or shunt valve with risk of infection of the hardware which may lead to meningitis or ventriculitis with poor outcome. Another feared complication is cerebrospinal fluid (CSF) leak from the wound with subsequent wound dehiscence. The patients at risk of shunt hardware exposure include children who have fragile skin or skin at risk (either from prematurity, malnutrition, steroid therapy or very large head with pressure on the skin). This technique involves making a scalp incision with the pericranium taken in one layer with the galea or if the galeal flap has been raised, a pericranial incision is made and a pericranial flap is raised. A subpericranial pouch is developed and a shunt passer used to tunnel the shunt to the abdomen. The pericranial layer is closed, the galea and subcutaneous layer also approximated, and a continuous subcurticular stitch applied. We present a malnourished infant with postinfective hydrocephalus having a thin skin requiring a ventriculoperitoneal shunt. A subpericranial technique was used and the patient did well. This technique is simple and provides a water-tight wound cover, with the pericranium giving reinforcement and better tensile strength, as well as a fairly good protection for the shunt valve. This is useful in preventing CSF leaks and exposure of the shunt with the associated morbidity and mortality.

Research paper thumbnail of Prediction of Preeclampsia: Can It Be Achieved?

Obstetrical & Gynecological Survey, 2004

In this review, the various biochemical tests that have been proposed for the prediction of preec... more In this review, the various biochemical tests that have been proposed for the prediction of preeclampsia are described and evaluated. Placenta hormone markers do not predict future disease. They denounce the early placental changes that are part of the evolving disease and only predict the imminent of preeclamptic syndrome. This explains why tests are better predictors when preeclampsia supervenes shortly, and why screening in the first trimester is unlikely to work as well as in the second trimester. The use of multiple markers in the screening should reflect different aspects of the disease process and could increase the specificity and sensitivity of the screening and work on different etiologic factors. The possible use of second-trimester biochemical screening to predict the risk of preeclampsia remains to be investigated in the high-risk population.

Research paper thumbnail of Inferior vena cava thrombosis and recurrent pancreatitis in pregnancy

Journal of Obstetrics & Gynaecology, 2006

Research paper thumbnail of Ectopic Pregnancy Within a Cesarean Section Scar

Journal of Diagnostic Medical Sonography, 2006

Research paper thumbnail of Inpatient bladder retraining: is it beneficial on its own?

International Urogynecology Journal, 2010

Introduction and hypothesis Urinary incontinence is a common problem with serious effect on the q... more Introduction and hypothesis Urinary incontinence is a common problem with serious effect on the quality of life. Bladder training aims to increase the interval between voids, either by a mandatory or self-adjustable schedule, so that incontinence is avoided. This study aimed to assess the effectiveness of inpatient bladder retraining. Methods A retrospective case-note analysis was conducted over a period of 24 months. Outcome measures were decrease in incontinence episode frequency (IEF) and nocturia and increase in interval between voids. Subjective improvement was assessed on a four-point scale.

Research paper thumbnail of Urinary ascites following caesarean section: An unusual presentation of bladder injury

European Journal of Obstetrics & Gynecology and Reproductive Biology, 2009

1. Eur J Obstet Gynecol Reprod Biol. 2009 Dec;147(2):237-8. Epub 2009 Sep 18. Urinary ascites fol... more 1. Eur J Obstet Gynecol Reprod Biol. 2009 Dec;147(2):237-8. Epub 2009 Sep 18. Urinary ascites following caesarean section: an unusual presentation of bladder injury. Hassan I, López C, Gee H, Toozs-Hobson P. PMID: 19766378 [PubMed - indexed for MEDLINE]. ...

Research paper thumbnail of Knowledge and beliefs concerning evidence-based practice amongst complementary and alternative medicine health care practitioners and allied health care professionals: A questionnaire survey

BMC Complementary and Alternative Medicine, 2008

Background: Evidence-based practice (EBP) has become an important competency in many allied and c... more Background: Evidence-based practice (EBP) has become an important competency in many allied and complementary and alternative medicine (CAM) health care practitioners' professional standards of proficiency.

Research paper thumbnail of A sternal stress fracture in a gymnast: A case report and literature review

South African Journal of Sports Medicine, 2010

A 15-year-old male competitive gymnast presented 1 week after rou-tine training. While performing... more A 15-year-old male competitive gymnast presented 1 week after rou-tine training. While performing a floor exercise routine and following a tumble, he experienced central chest pain. As a result he with-held further training and consulted 1 week later, due to ongoing pain. There were ...

Research paper thumbnail of Knotting of a nasogastric feeding tube in a child with head injury: A case report and review of literature

African Journal of Paediatric Surgery, 2014

Nasogastric intubation is one of the most common routine nonoperative procedures available for th... more Nasogastric intubation is one of the most common routine nonoperative procedures available for the hospital care of patients. The insertion and removal of this tube is associated with many complications. The complications include trauma, nasal septal abscess and inadvertent entry into the cranial cavity and trachea, ulceration, bleeding from varices and perforation. Knotting of the nasogastric tube is one of the very rare complications of nasogastric intubation particularly in children. To the best of our knowledge there are very few reported cases in children. The technique used in the patient was the application of a steady tug which allows the lower oesophageal sphincter to open, therefore enabling the removal of the nasogastric tube. The possible predispositions to knotting of a nasogastric tube include small bore tubes, excess tube length and gastric surgery. We postulate that reduced gastric tone is another possible predisposing factor with head injury being the most likely reason in the index patient. We also challenge the fact that the small sized stomach is a risk factor for knotting of a feeding tube if the functional status and tone are normal, because of the rarity in children.

Research paper thumbnail of Delayed presentation of penetrating craniocerebral injury caused by a nail

Research paper thumbnail of Posterior surgical approach to tuberculous spondylitis

Journal of Surgical …, 2009

Objectives: Foraminotomy is a simple posterior surgical approach useful for treatment of radicula... more Objectives: Foraminotomy is a simple posterior surgical approach useful for treatment of radicular (nerve root) pain in TB spondylitis. It doesn't affect the stability of the facet joint, requires neither fusion nor implants. It is therefore cheap and affordable for patients with low income. We ...

Research paper thumbnail of Chiari I Malformation: A Missed Diagnosis

Annals of African …, 2006

Chiari I malformation is a complex congenital malformation of the hindbrain, characterized by her... more Chiari I malformation is a complex congenital malformation of the hindbrain, characterized by herniation of the cerebellar tonsils through the foramen magnum into the cervical spinal canal. There may be mild caudal displacement and flattening or kinking of the medulla with an associated small posterior fossa. We present a case of a 30 year old man who presented with a 2 year history of worsening nystagmus and ataxia with associated occipital headache and diplopia. Examination showed a young man with horizontal and vertical nystagmus, he had truncal ataxia and Rhomberg's sign was positive. Diagnosis was missed by several clinicians during the 2 year period. Repeated brain CT scans were normal. Brain MRI confirmed the diagnosis of Chiari I malformation and cervical syringomyelia. He had decompressive occipital craniectomy durotomy and duroplasty. The patient recovered fully from ataxia headache and diplopia but still has residual nystagmus.

Research paper thumbnail of Knotting of a nasogastric feeding tube in a child with head injury: A case report and review of literature

African Journal of Paediatric Surgery, 2014

Research paper thumbnail of Subpericranial shunt valve placement: a technique in patients with friable skin

Child's Nervous System, 2014

One of the nightmares of placing a shunt in patients with friable skin is an exposed shunt or shu... more One of the nightmares of placing a shunt in patients with friable skin is an exposed shunt or shunt valve with risk of infection of the hardware which may lead to meningitis or ventriculitis with poor outcome. Another feared complication is cerebrospinal fluid (CSF) leak from the wound with subsequent wound dehiscence. The patients at risk of shunt hardware exposure include children who have fragile skin or skin at risk (either from prematurity, malnutrition, steroid therapy or very large head with pressure on the skin). This technique involves making a scalp incision with the pericranium taken in one layer with the galea or if the galeal flap has been raised, a pericranial incision is made and a pericranial flap is raised. A subpericranial pouch is developed and a shunt passer used to tunnel the shunt to the abdomen. The pericranial layer is closed, the galea and subcutaneous layer also approximated, and a continuous subcurticular stitch applied. We present a malnourished infant with postinfective hydrocephalus having a thin skin requiring a ventriculoperitoneal shunt. A subpericranial technique was used and the patient did well. This technique is simple and provides a water-tight wound cover, with the pericranium giving reinforcement and better tensile strength, as well as a fairly good protection for the shunt valve. This is useful in preventing CSF leaks and exposure of the shunt with the associated morbidity and mortality.

Research paper thumbnail of Spontaneous Severe Haemoperitoneum in the Third Trimester Leading to Intrauterine Death: Case Report

Case Reports in Obstetrics and Gynecology, 2011

Spontaneous haemoperitoneum during pregnancy is a rare but potentially catastrophic cause of acut... more Spontaneous haemoperitoneum during pregnancy is a rare but potentially catastrophic cause of acute abdominal pain. A healthy 37-year-old primigravida presented with acute abdominal pain and hypovolaemic shock at 37-weeks gestation. An emergency caesarean section was indicated on the clinical suspicion of placental abruption. However, an ultrasound scan confirmed the absence of a fetal heartbeat, and, in light of the mother's haemodynamic stability, a vaginal delivery was deemed most appropriate. Subsequent imaging, due to deterioration over the following 24-hours, revealed a large heterogenous haematoma within the pelvic cavity, which was later found to be caused by severe pelvic endometriosis. Despite fertility problems associated with severe endometriosis, advanced assisted reproductive technology enables more of these patients to become pregnant, highlighting the need to be aware of this rare complication in pregnancy.

Research paper thumbnail of Transrectal elastographic monitoring of the transurethral balloon pressure in urethral dilation for catheter-dependent patients with benign prostatic hyperplasia

The Egyptian Journal of Radiology and Nuclear Medicine, 2014

ABSTRACT Background Foley’s catheter indwelling gives temporary relief for lower urinary tract ob... more ABSTRACT Background Foley’s catheter indwelling gives temporary relief for lower urinary tract obstruction, especially in case of severely symptomatizing benign prostatic hyperplasia (BPH). Several complications of long-term or frequent catheter indwelling have been reported in catheter dependent patients, specifically to those who are unfit for operative intervention. Objectives Our aim was to find a safe, non-invasive relief from symptom severity, as well as, incapacitating complications of Foley’s catheter in catheter-dependent patients. Methods A total of 107 catheter-dependent men, or who had frequent Foley’s catheter indwelling in case of BPH, participated in the present study. Preliminary estimation of the post-micturition residual urine was obtained. Ultrasound elastography was used to assess the transurethral balloon pressure of the double balloon silicon-coated catheter, adjudicated by ureteromat, and maintained in situ for 6 days in all patients. Basic follow up once-a-month has been performed up to 6 months. Results Effectual urethral patency was noted in 89.7% patients at the end of the third month. The procedure was repeated for 11 patients shortly after 3 months, for 7 patients after 4 months and for 28 patients after 5 months, with no reported prostatic urethral injury. No stricture recurrence was noted in 61 patients up to 6 months. Conclusions Preliminary results indicate that prostatic urethral balloon dilation in BPH catheter-dependent patients is inexpensive, safe, and would be a potentially effective option in maintaining the prostatic urethral patency. Elastographic justification of the transurethral balloon has proved to be helpful.

Research paper thumbnail of Subpericranial shunt valve placement: a technique in patients with friable skin

Child's Nervous System, 2014

One of the nightmares of placing a shunt in patients with friable skin is an exposed shunt or shu... more One of the nightmares of placing a shunt in patients with friable skin is an exposed shunt or shunt valve with risk of infection of the hardware which may lead to meningitis or ventriculitis with poor outcome. Another feared complication is cerebrospinal fluid (CSF) leak from the wound with subsequent wound dehiscence. The patients at risk of shunt hardware exposure include children who have fragile skin or skin at risk (either from prematurity, malnutrition, steroid therapy or very large head with pressure on the skin). This technique involves making a scalp incision with the pericranium taken in one layer with the galea or if the galeal flap has been raised, a pericranial incision is made and a pericranial flap is raised. A subpericranial pouch is developed and a shunt passer used to tunnel the shunt to the abdomen. The pericranial layer is closed, the galea and subcutaneous layer also approximated, and a continuous subcurticular stitch applied. We present a malnourished infant with postinfective hydrocephalus having a thin skin requiring a ventriculoperitoneal shunt. A subpericranial technique was used and the patient did well. This technique is simple and provides a water-tight wound cover, with the pericranium giving reinforcement and better tensile strength, as well as a fairly good protection for the shunt valve. This is useful in preventing CSF leaks and exposure of the shunt with the associated morbidity and mortality.

Research paper thumbnail of Prediction of Preeclampsia: Can It Be Achieved?

Obstetrical & Gynecological Survey, 2004

In this review, the various biochemical tests that have been proposed for the prediction of preec... more In this review, the various biochemical tests that have been proposed for the prediction of preeclampsia are described and evaluated. Placenta hormone markers do not predict future disease. They denounce the early placental changes that are part of the evolving disease and only predict the imminent of preeclamptic syndrome. This explains why tests are better predictors when preeclampsia supervenes shortly, and why screening in the first trimester is unlikely to work as well as in the second trimester. The use of multiple markers in the screening should reflect different aspects of the disease process and could increase the specificity and sensitivity of the screening and work on different etiologic factors. The possible use of second-trimester biochemical screening to predict the risk of preeclampsia remains to be investigated in the high-risk population.

Research paper thumbnail of Inferior vena cava thrombosis and recurrent pancreatitis in pregnancy

Journal of Obstetrics & Gynaecology, 2006

Research paper thumbnail of Ectopic Pregnancy Within a Cesarean Section Scar

Journal of Diagnostic Medical Sonography, 2006

Research paper thumbnail of Inpatient bladder retraining: is it beneficial on its own?

International Urogynecology Journal, 2010

Introduction and hypothesis Urinary incontinence is a common problem with serious effect on the q... more Introduction and hypothesis Urinary incontinence is a common problem with serious effect on the quality of life. Bladder training aims to increase the interval between voids, either by a mandatory or self-adjustable schedule, so that incontinence is avoided. This study aimed to assess the effectiveness of inpatient bladder retraining. Methods A retrospective case-note analysis was conducted over a period of 24 months. Outcome measures were decrease in incontinence episode frequency (IEF) and nocturia and increase in interval between voids. Subjective improvement was assessed on a four-point scale.

Research paper thumbnail of Urinary ascites following caesarean section: An unusual presentation of bladder injury

European Journal of Obstetrics & Gynecology and Reproductive Biology, 2009

1. Eur J Obstet Gynecol Reprod Biol. 2009 Dec;147(2):237-8. Epub 2009 Sep 18. Urinary ascites fol... more 1. Eur J Obstet Gynecol Reprod Biol. 2009 Dec;147(2):237-8. Epub 2009 Sep 18. Urinary ascites following caesarean section: an unusual presentation of bladder injury. Hassan I, López C, Gee H, Toozs-Hobson P. PMID: 19766378 [PubMed - indexed for MEDLINE]. ...

Research paper thumbnail of Knowledge and beliefs concerning evidence-based practice amongst complementary and alternative medicine health care practitioners and allied health care professionals: A questionnaire survey

BMC Complementary and Alternative Medicine, 2008

Background: Evidence-based practice (EBP) has become an important competency in many allied and c... more Background: Evidence-based practice (EBP) has become an important competency in many allied and complementary and alternative medicine (CAM) health care practitioners' professional standards of proficiency.

Research paper thumbnail of A sternal stress fracture in a gymnast: A case report and literature review

South African Journal of Sports Medicine, 2010

A 15-year-old male competitive gymnast presented 1 week after rou-tine training. While performing... more A 15-year-old male competitive gymnast presented 1 week after rou-tine training. While performing a floor exercise routine and following a tumble, he experienced central chest pain. As a result he with-held further training and consulted 1 week later, due to ongoing pain. There were ...

Research paper thumbnail of Knotting of a nasogastric feeding tube in a child with head injury: A case report and review of literature

African Journal of Paediatric Surgery, 2014

Nasogastric intubation is one of the most common routine nonoperative procedures available for th... more Nasogastric intubation is one of the most common routine nonoperative procedures available for the hospital care of patients. The insertion and removal of this tube is associated with many complications. The complications include trauma, nasal septal abscess and inadvertent entry into the cranial cavity and trachea, ulceration, bleeding from varices and perforation. Knotting of the nasogastric tube is one of the very rare complications of nasogastric intubation particularly in children. To the best of our knowledge there are very few reported cases in children. The technique used in the patient was the application of a steady tug which allows the lower oesophageal sphincter to open, therefore enabling the removal of the nasogastric tube. The possible predispositions to knotting of a nasogastric tube include small bore tubes, excess tube length and gastric surgery. We postulate that reduced gastric tone is another possible predisposing factor with head injury being the most likely reason in the index patient. We also challenge the fact that the small sized stomach is a risk factor for knotting of a feeding tube if the functional status and tone are normal, because of the rarity in children.