Mukhtar Ansari - Academia.edu (original) (raw)

Papers by Mukhtar Ansari

Research paper thumbnail of Reference values for Doppler indices of the umbilical and fetal middle cerebral arteries in uncomplicated third trimester pregnancy

Journal of Institute of Medicine, 2011

Introduction: The purpose of this study was to categorize new reference ranges for measurements o... more Introduction: The purpose of this study was to categorize new reference ranges for measurements of commonly used umbilical artery and fetal middle cerebral artery Doppler indices (Pulsatility Index, Resistance Index, and Systolic: Diastolic ratio) in uncomplicated third trimester pregnancy. Methods: This was a prospective cross sectional study involving 101 singleton uncomplicated pregnancies of 30 to 37 weeks of gestation. Umbilical artery indices were obtained from free floating loop and middle cerebral Doppler indices were obtained from the proximal third of the artery with flow towards the probe. Regression equations were used to categorize reference ranges and percentile fitted Normograms were obtained for all the parameters. Results: Among 101 singleton pregnancies between 30 and 37 weeks of gestation, 65 (64.35%) were primigravida women and 36 (34.65%) were multigravida. Mean maternal age was 23.12years (range 16 to 35 years). Maximum number of pregnancies (18.81%) was at 34 weeks of gestation. The established percentiles of Doppler indices showed a continuous reduction of all the measured indices as pregnancy increases (p<0.0001). Conclusions: Reference ranges were obtained for the middle cerebral artery and umbilical artery Doppler indices. These ranges are consistent with similar studies done by other authors.

Research paper thumbnail of Coincidence of Congenital Diaphragmatic Hernia and Arnold Chiari II Malformation: A Case Report

Nepalese Journal of Radiology, 2012

Congenital diaphragmatic hernia is the developmental abnormality in which abdominal viscera herni... more Congenital diaphragmatic hernia is the developmental abnormality in which abdominal viscera herniate into the thoracic cavity through defect in the diaphragm. Almost 10% of congenital diaphragmatic hernia has associated central nervous system malformation including anencephaly, myelomeningocele and hydrocephalus. The Arnold-Chiari malformation is a congenital abnormality of Central Nervous System (CNS), characterized by downward displacement of the parts of the cerebellum, fourth ventricle, pons and medulla oblongata into the spinal canal. Here we present an extremely rare case with coexistent congenital diaphragmatic hernia and Arnold Chiari II malformation occurring in a viable fetus of 20 weeks gestational age. NJR I VOL 2 I ISSUE 1 46-49 Jan-June, 2012 DOI: http://dx.doi.org/10.3126/njr.v2i1.6981

Research paper thumbnail of Carotico-Cavernous Fistula Presenting with Proptosis of Contralateral Eye: A Case Report

Nepalese Journal of Radiology, 2012

Spontaneous carotico-cavernous fistula occurring post partum is a rare entity. We report a rare c... more Spontaneous carotico-cavernous fistula occurring post partum is a rare entity. We report a rare case of post partum spontaneous carotico-cavernous fistula with paradoxical proptosis of contralateral eye confirmed by computed tomography and cerebral angiography. NJR I VOL 2 I ISSUE 1 54-56 Jan-June, 2012 DOI: http://dx.doi.org/10.3126/njr.v2i1.6983

Research paper thumbnail of MR imaging features and contrast enhancement characteristics in benign and malignant breast lesions

Journal of Institute of Medicine, 2013

Introduction: Breast cancer is the commonest female malignancy in Malaysia and other countries th... more Introduction: Breast cancer is the commonest female malignancy in Malaysia and other countries the world. All races are affected in Malaysia and breast cancer comprised 30.4% of all newly diagnosed cancer cases. A women in Malaysia has a 1 in 19 chances of getting breast cancer in her lifetime. The Age Standardized Rate (ASR) of female breast cancer in Malaysia is 52.8 per 100,000 people and is higher than that in Singapore, Hong Kong and Shanghai, but it is lower than that in Australia and the UK. Out of the 4,337 new cases of female breast cancer cases reported to the National Cancer Registry of Malaysia in 2002, 52.3% were for women less than 50 years old. Genetic risk factors have not been studies thoroughly in Malaysia. Methods: We prospectively studied 55 patients with breast lumps in whom MR imaging was performed. The T1-and T2-weighted, axial STIR, fat-suppression contrast enhanced fast spin echo and two dimensional dynamic enhanced fast spoiled gradient-echo images were obtained. The tumour margins and shape, enhancement pattern and time-signal intensity curves were analysed. Results: A total of 37 patients fulfilled the study criteria with the mean age of 43.46 ±11.99 years (age ranged 21-70). There were 23 benign and 14 malignant lesions. The MR imaging criteria suggestive of malignancy were poorly defined and spiculated margins, irregular shape, heterogeneous and rim enhancement as well as type II and III curves. On the other hand, the criteria for a benign breast lesions were well-defined margin, regular and lobulated shape, none or homogeneous enhancement and type I curve. Only the malignant lesions are characterised by skin, retroareolar, nipple and pectoralis muscle involvement. Conclusion: MR imaging is a valuable complementary breast imaging tool to further evaluate equivocal findings on conventional x-ray mammography. A combination of lesion morphology and enhancement characteristics is useful in distinguishing benign from malignant lesions.

Research paper thumbnail of Clinical Investigation of the Protective Effects of Palm Vitamin E Tocotrienols on Brain White Matter

Stroke, 2014

Background and Purpose— Previous cell-based and animal studies showed mixed tocotrienols are neur... more Background and Purpose— Previous cell-based and animal studies showed mixed tocotrienols are neuroprotective, but the effect is yet to be proven in humans. Thus, the present study aimed to evaluate the protective activity of mixed tocotrienols in humans with white matter lesions (WMLs). WMLs are regarded as manifestations of cerebral small vessel disease, reflecting varying degrees of neurodegeneration and tissue damage with potential as a surrogate end point in clinical trials. Methods— A total of 121 volunteers aged ≥35 years with cardiovascular risk factors and MRI-confirmed WMLs were randomized to receive 200 mg mixed tocotrienols or placebo twice a day for 2 years. The WML volumes were measured from MRI images taken at baseline, 1 year, and 2 years using a validated software and were compared. Fasting blood samples were collected for full blood chemistry investigation. Results— According to per-protocol (88 volunteers) and intention-to-treat (121 volunteers) analyses, the mean ...

Research paper thumbnail of Tocotrienols for normalisation of hepatic echogenic response in nonalcoholic fatty liver: a randomised placebo-controlled clinical trial

Nutrition Journal, 2013

Background Nonalcoholic fatty liver disease (NAFLD) is one of the commonest liver disorders. Obes... more Background Nonalcoholic fatty liver disease (NAFLD) is one of the commonest liver disorders. Obesity, insulin resistance, lipid peroxidation and oxidative stress have been identified amongst the possible hits leading to the onset and progression of this disease. Nutritional evaluation of NAFLD patients showed a lower-than-recommended intake of vitamin E. Vitamin E is a family of 8 isoforms, 4 tocopherols and 4 tocotrienols. Alpha-tocopherol has been widely investigated in liver diseases, whereas no previous clinical trial has investigated tocotrienols for NAFLD. Aim of the study was to determine the effects of mixed tocotrienols, in normalising the hepatic echogenic response in hypercholesterolaemic patients with ultrasound-proven NAFLD. Methods Eighty-seven untreated hypercholesterolaemic adults with ultrasound-proven NAFLD were enrolled and randomised into control group (n = 44) and tocotrienols group (n = 43). The treatment, either mixed tocotrienols 200 mg twice daily or placebo...

Research paper thumbnail of Gastroschisis and Omphalocele: A Case report

Nepalese Journal of Radiology, 2012

Fetal gastroschisis and omphalocele are congenital defects of abdominal wall that are often diagn... more Fetal gastroschisis and omphalocele are congenital defects of abdominal wall that are often diagnosed by prenatal ultrasound done for routine screening or for obstetric indications such as evaluating an elevated maternal serum alpha fetoprotein (AFP). Prenatal ultrasound could potentially identify the overwhelming majority of abdominal wall defects and accurately distinguish omphalocele from gastroschisis. Here we report two cases of gastroschisis and omphalocele diagnosed at routine prenatal ultrasound. NJR I VOL 2 I ISSUE 1 42-45 Jan-June, 2012 DOI: http://dx.doi.org/10.3126/njr.v2i1.6980

Research paper thumbnail of Fetal Cardiac Interventricular Septal Thickness at 28–37 Weeks of Gestation in Nepalese Population

Nepalese Journal of Radiology, 2013

Objective: The purpose of this study is to establish a new reference range for fetal interventric... more Objective: The purpose of this study is to establish a new reference range for fetal interventricular septal thickness in uncomplicated pregnancy at 28-37 weeks of gestation. Materials and Methodology: This was a prospective cross sectional study involving 300 singleton pregnancies between 28-37 weeks of gestation without any known risk factors of adverse pregnancy outcome who were referred for routine obstetric examination. The protocol included the prenatal 2-dimensional M-mode echocardiographic measurements of fetal IVST and data were used to construct the normograms and percentile fitted curves for different gestational age. The relationship between the IVSD and IVSS and gestational age were determined. Results: A total of 300 measurements were obtained. The normal values of the IVSD and IVSS according to gestational age were presented as 5th, 50th and 95th percentile ranks. The correlation coefficients (r) between the IVSD and IVSS and gestational age were 0.19 and 0.14, respec...

Research paper thumbnail of Giant cell tumor of patella

Journal of Institute of Medicine, 2013

Giant cell tumor of bone also known as osteoclastoma is a distinct clinical, roentgenographic and... more Giant cell tumor of bone also known as osteoclastoma is a distinct clinical, roentgenographic and pathologic entity with speci•c characteristics. It is a benign but locally aggressive neoplasm of the epiphyseal or metaphyseal-epiphyseal region of long tubular bones extending to the articular surface. It usually occurs after skeletal maturation and is one of the rare bone tumors that more frequently affects women. We report here a case of giant cell tumor originating from the right patella diagnosed on •ne needle aspiration cytology.

Research paper thumbnail of Primary Retroperitoneal Teratoma Presenting As Diabetes Mellitus In A Child

Journal of Clinical and …, 2008

Primary retroperitoneal teratoma is a rare entity which has a distinctive imaging appearance. To ... more Primary retroperitoneal teratoma is a rare entity which has a distinctive imaging appearance. To our knowledge, this is the first reported case of teratoma causing diabetes mellitus in a 9-year old boy who was put on insulin. On clinical examination, there was a large tender mass with a well defined margin, caudally in the epigastrium. Ultrasound of abdomen revealed a huge retroperitoneal multiseptated predominantly cystic mass in the upper abdomen. Plain abdominal computed tomography revealed a large well defined cystic mass in the same region. Contrast enhanced abdominal CT revealed a mass with peripheral rim enhancement. It has multiple septa which also enhanced. Clefts containing fat were present adjacent to the septa. Laparotomy with tumour resection was performed. Pathology of the mass disclosed a retroperitoneal cystic teratoma.

Research paper thumbnail of Reference values for Doppler indices of the umbilical and fetal middle cerebral arteries in uncomplicated third trimester pregnancy

Journal of Institute of Medicine, 2011

Introduction: The purpose of this study was to categorize new reference ranges for measurements o... more Introduction: The purpose of this study was to categorize new reference ranges for measurements of commonly used umbilical artery and fetal middle cerebral artery Doppler indices (Pulsatility Index, Resistance Index, and Systolic: Diastolic ratio) in uncomplicated third trimester pregnancy. Methods: This was a prospective cross sectional study involving 101 singleton uncomplicated pregnancies of 30 to 37 weeks of gestation. Umbilical artery indices were obtained from free floating loop and middle cerebral Doppler indices were obtained from the proximal third of the artery with flow towards the probe. Regression equations were used to categorize reference ranges and percentile fitted Normograms were obtained for all the parameters. Results: Among 101 singleton pregnancies between 30 and 37 weeks of gestation, 65 (64.35%) were primigravida women and 36 (34.65%) were multigravida. Mean maternal age was 23.12years (range 16 to 35 years). Maximum number of pregnancies (18.81%) was at 34 weeks of gestation. The established percentiles of Doppler indices showed a continuous reduction of all the measured indices as pregnancy increases (p<0.0001). Conclusions: Reference ranges were obtained for the middle cerebral artery and umbilical artery Doppler indices. These ranges are consistent with similar studies done by other authors.

Research paper thumbnail of Coincidence of Congenital Diaphragmatic Hernia and Arnold Chiari II Malformation: A Case Report

Nepalese Journal of Radiology, 2012

Congenital diaphragmatic hernia is the developmental abnormality in which abdominal viscera herni... more Congenital diaphragmatic hernia is the developmental abnormality in which abdominal viscera herniate into the thoracic cavity through defect in the diaphragm. Almost 10% of congenital diaphragmatic hernia has associated central nervous system malformation including anencephaly, myelomeningocele and hydrocephalus. The Arnold-Chiari malformation is a congenital abnormality of Central Nervous System (CNS), characterized by downward displacement of the parts of the cerebellum, fourth ventricle, pons and medulla oblongata into the spinal canal. Here we present an extremely rare case with coexistent congenital diaphragmatic hernia and Arnold Chiari II malformation occurring in a viable fetus of 20 weeks gestational age. NJR I VOL 2 I ISSUE 1 46-49 Jan-June, 2012 DOI: http://dx.doi.org/10.3126/njr.v2i1.6981

Research paper thumbnail of Carotico-Cavernous Fistula Presenting with Proptosis of Contralateral Eye: A Case Report

Nepalese Journal of Radiology, 2012

Spontaneous carotico-cavernous fistula occurring post partum is a rare entity. We report a rare c... more Spontaneous carotico-cavernous fistula occurring post partum is a rare entity. We report a rare case of post partum spontaneous carotico-cavernous fistula with paradoxical proptosis of contralateral eye confirmed by computed tomography and cerebral angiography. NJR I VOL 2 I ISSUE 1 54-56 Jan-June, 2012 DOI: http://dx.doi.org/10.3126/njr.v2i1.6983

Research paper thumbnail of MR imaging features and contrast enhancement characteristics in benign and malignant breast lesions

Journal of Institute of Medicine, 2013

Introduction: Breast cancer is the commonest female malignancy in Malaysia and other countries th... more Introduction: Breast cancer is the commonest female malignancy in Malaysia and other countries the world. All races are affected in Malaysia and breast cancer comprised 30.4% of all newly diagnosed cancer cases. A women in Malaysia has a 1 in 19 chances of getting breast cancer in her lifetime. The Age Standardized Rate (ASR) of female breast cancer in Malaysia is 52.8 per 100,000 people and is higher than that in Singapore, Hong Kong and Shanghai, but it is lower than that in Australia and the UK. Out of the 4,337 new cases of female breast cancer cases reported to the National Cancer Registry of Malaysia in 2002, 52.3% were for women less than 50 years old. Genetic risk factors have not been studies thoroughly in Malaysia. Methods: We prospectively studied 55 patients with breast lumps in whom MR imaging was performed. The T1-and T2-weighted, axial STIR, fat-suppression contrast enhanced fast spin echo and two dimensional dynamic enhanced fast spoiled gradient-echo images were obtained. The tumour margins and shape, enhancement pattern and time-signal intensity curves were analysed. Results: A total of 37 patients fulfilled the study criteria with the mean age of 43.46 ±11.99 years (age ranged 21-70). There were 23 benign and 14 malignant lesions. The MR imaging criteria suggestive of malignancy were poorly defined and spiculated margins, irregular shape, heterogeneous and rim enhancement as well as type II and III curves. On the other hand, the criteria for a benign breast lesions were well-defined margin, regular and lobulated shape, none or homogeneous enhancement and type I curve. Only the malignant lesions are characterised by skin, retroareolar, nipple and pectoralis muscle involvement. Conclusion: MR imaging is a valuable complementary breast imaging tool to further evaluate equivocal findings on conventional x-ray mammography. A combination of lesion morphology and enhancement characteristics is useful in distinguishing benign from malignant lesions.

Research paper thumbnail of Clinical Investigation of the Protective Effects of Palm Vitamin E Tocotrienols on Brain White Matter

Stroke, 2014

Background and Purpose— Previous cell-based and animal studies showed mixed tocotrienols are neur... more Background and Purpose— Previous cell-based and animal studies showed mixed tocotrienols are neuroprotective, but the effect is yet to be proven in humans. Thus, the present study aimed to evaluate the protective activity of mixed tocotrienols in humans with white matter lesions (WMLs). WMLs are regarded as manifestations of cerebral small vessel disease, reflecting varying degrees of neurodegeneration and tissue damage with potential as a surrogate end point in clinical trials. Methods— A total of 121 volunteers aged ≥35 years with cardiovascular risk factors and MRI-confirmed WMLs were randomized to receive 200 mg mixed tocotrienols or placebo twice a day for 2 years. The WML volumes were measured from MRI images taken at baseline, 1 year, and 2 years using a validated software and were compared. Fasting blood samples were collected for full blood chemistry investigation. Results— According to per-protocol (88 volunteers) and intention-to-treat (121 volunteers) analyses, the mean ...

Research paper thumbnail of Tocotrienols for normalisation of hepatic echogenic response in nonalcoholic fatty liver: a randomised placebo-controlled clinical trial

Nutrition Journal, 2013

Background Nonalcoholic fatty liver disease (NAFLD) is one of the commonest liver disorders. Obes... more Background Nonalcoholic fatty liver disease (NAFLD) is one of the commonest liver disorders. Obesity, insulin resistance, lipid peroxidation and oxidative stress have been identified amongst the possible hits leading to the onset and progression of this disease. Nutritional evaluation of NAFLD patients showed a lower-than-recommended intake of vitamin E. Vitamin E is a family of 8 isoforms, 4 tocopherols and 4 tocotrienols. Alpha-tocopherol has been widely investigated in liver diseases, whereas no previous clinical trial has investigated tocotrienols for NAFLD. Aim of the study was to determine the effects of mixed tocotrienols, in normalising the hepatic echogenic response in hypercholesterolaemic patients with ultrasound-proven NAFLD. Methods Eighty-seven untreated hypercholesterolaemic adults with ultrasound-proven NAFLD were enrolled and randomised into control group (n = 44) and tocotrienols group (n = 43). The treatment, either mixed tocotrienols 200 mg twice daily or placebo...

Research paper thumbnail of Gastroschisis and Omphalocele: A Case report

Nepalese Journal of Radiology, 2012

Fetal gastroschisis and omphalocele are congenital defects of abdominal wall that are often diagn... more Fetal gastroschisis and omphalocele are congenital defects of abdominal wall that are often diagnosed by prenatal ultrasound done for routine screening or for obstetric indications such as evaluating an elevated maternal serum alpha fetoprotein (AFP). Prenatal ultrasound could potentially identify the overwhelming majority of abdominal wall defects and accurately distinguish omphalocele from gastroschisis. Here we report two cases of gastroschisis and omphalocele diagnosed at routine prenatal ultrasound. NJR I VOL 2 I ISSUE 1 42-45 Jan-June, 2012 DOI: http://dx.doi.org/10.3126/njr.v2i1.6980

Research paper thumbnail of Fetal Cardiac Interventricular Septal Thickness at 28–37 Weeks of Gestation in Nepalese Population

Nepalese Journal of Radiology, 2013

Objective: The purpose of this study is to establish a new reference range for fetal interventric... more Objective: The purpose of this study is to establish a new reference range for fetal interventricular septal thickness in uncomplicated pregnancy at 28-37 weeks of gestation. Materials and Methodology: This was a prospective cross sectional study involving 300 singleton pregnancies between 28-37 weeks of gestation without any known risk factors of adverse pregnancy outcome who were referred for routine obstetric examination. The protocol included the prenatal 2-dimensional M-mode echocardiographic measurements of fetal IVST and data were used to construct the normograms and percentile fitted curves for different gestational age. The relationship between the IVSD and IVSS and gestational age were determined. Results: A total of 300 measurements were obtained. The normal values of the IVSD and IVSS according to gestational age were presented as 5th, 50th and 95th percentile ranks. The correlation coefficients (r) between the IVSD and IVSS and gestational age were 0.19 and 0.14, respec...

Research paper thumbnail of Giant cell tumor of patella

Journal of Institute of Medicine, 2013

Giant cell tumor of bone also known as osteoclastoma is a distinct clinical, roentgenographic and... more Giant cell tumor of bone also known as osteoclastoma is a distinct clinical, roentgenographic and pathologic entity with speci•c characteristics. It is a benign but locally aggressive neoplasm of the epiphyseal or metaphyseal-epiphyseal region of long tubular bones extending to the articular surface. It usually occurs after skeletal maturation and is one of the rare bone tumors that more frequently affects women. We report here a case of giant cell tumor originating from the right patella diagnosed on •ne needle aspiration cytology.

Research paper thumbnail of Primary Retroperitoneal Teratoma Presenting As Diabetes Mellitus In A Child

Journal of Clinical and …, 2008

Primary retroperitoneal teratoma is a rare entity which has a distinctive imaging appearance. To ... more Primary retroperitoneal teratoma is a rare entity which has a distinctive imaging appearance. To our knowledge, this is the first reported case of teratoma causing diabetes mellitus in a 9-year old boy who was put on insulin. On clinical examination, there was a large tender mass with a well defined margin, caudally in the epigastrium. Ultrasound of abdomen revealed a huge retroperitoneal multiseptated predominantly cystic mass in the upper abdomen. Plain abdominal computed tomography revealed a large well defined cystic mass in the same region. Contrast enhanced abdominal CT revealed a mass with peripheral rim enhancement. It has multiple septa which also enhanced. Clefts containing fat were present adjacent to the septa. Laparotomy with tumour resection was performed. Pathology of the mass disclosed a retroperitoneal cystic teratoma.