Saad Niaz - Academia.edu (original) (raw)
Papers by Saad Niaz
Saudi Journal of Gastroenterology, 2010
The Saudi Journal of Gastroenterology and mortality. [5] Endoscopic treatment has demonstrated re... more The Saudi Journal of Gastroenterology and mortality. [5] Endoscopic treatment has demonstrated results comparable to those achieved with surgery, with lower morbidity and mortality. [6,7] This retrospective work presents the experience of Mansoura Gastroenterology Center in endoscopic management of postoperative biliary leaks or strictures during a period of 14 years. PATIENTS AND METHODS The endoscopy database of Mansoura Gastroenterology Center, a tertiary referral university-affiliated center specialized in endoscopic and surgical management of gastrointestinal disorders was reviewed to identify all patients referred for endoscopic retrograde cholangiopancreatography (ERCP) because of suspected POBDI. Data collected included clinical presentation, time interval between surgery and ERCP, preoperative workup (clinical evaluation, biochemical and Bile duct injuries (BDI) can occur after many abdominal operations, e.g. liver surgery, gastrectomy, common bile duct (CBD) exploration. However, the majority of postoperative bile duct injuries (POBDI) occur during open or laparoscopic cholecystectomy. The incidence of injury has risen with the advent of LC (0.1-0.2% for open to 0.4-0.6% for laparoscopy) [1] Despite increasing experience with laparoscopy, a review of 1.6 million cholecystectomies demonstrated an unchanging 0.5% incidence of bile duct injury, report after many days post operation, of abdominal pain, bile leak, jaundice or cholangitis. Only 30% of injuries are recognized at the time of operation. [3] Bile duct injuries, particularly strictures, have traditionally been managed by surgical reconstruction (Roux-en-Y hepaticojejunostomy). The reported occurrence of symptomatic anastomotic strictures after long-term follow-up of surgical reconstruction ranges from 9-25 %. [4] Surgery is definitely associated with significant morbidity
Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2016
OBJECTIVE To evaluate the complications, technical success, diagnostic evaluation and various end... more OBJECTIVE To evaluate the complications, technical success, diagnostic evaluation and various endoscopic management options in patients with pancreas divisum. STUDY DESIGN Descriptive study. PLACE AND DURATION OF STUDY Endoscopy Suite, Surgical Unit 4, Civil Hospital, Karachi, from January 2007 to December 2013. METHODOLOGY All Endoscopic Retrograde Cholangio-pancreatography (ERCPs) procedure performed in patients with pancreas divisum were analyzed. Success was defined as having authentic diagnostic information or a successful endoscopic therapy for the condition. RESULTS During the study period, 3600 patients underwent 4500 ERCPprocedures. Pancreas divisum was found in 17 patients (0.47%); 7 ERCPs (41.2%) were performed for diagnostic and 10 (58.8%) for therapeutic purposes. Sixteen (94.1%) had complete PD and one (5.9%) had incomplete PD. Male and Female ratio was 1:1.83 with a mean age of 26.3 years and median symptom duration of 11 months. Atotal of 23 procedures were performed...
Asian Journal of Medical Sciences, 2021
Background: The emergence of SARS-COVID2 has completely reshaped the way we go about our daily bu... more Background: The emergence of SARS-COVID2 has completely reshaped the way we go about our daily business. Apart from other services, this has also impacted healthcare services and the way they are delivered. As endoscopy is an Aerosol generating procedure (AGP) with high risk of transmission, multiple endoscopy societies at the peak of the pandemic published guidelines on prioritizing of endoscopy services according to the urgency, highlighting the clinical indications which could be deferred until a more comprehensive plan is put out to safely perform endoscopy procedures or the infection rates drop down. Aims and Objectives: We give an example of how our unit in a low Human development Index country, worked through the peak of pandemic providing service to patients in a safe manner which can be continued forward until the pandemic runs its course. Materials and Methods: This prospective study was performed at Dr. Ziauddin University Hospital, Karachi. The ethical endorsement was ta...
JPMA. The Journal of …, 2010
Many diseases can cause esophageal stricture formation. These include acid peptic, autoimmune, in... more Many diseases can cause esophageal stricture formation. These include acid peptic, autoimmune, infectious, caustic, congenital, iatrogenic, medication-induced, radiation-induced, malignant, and idiopathic disease processes. Gastroesophageal reflux ...
JPMA. The Journal of the Pakistan Medical Association, 2015
Gastroesophageal reflux disease (GERD) is the most common acid-related disorder encountered durin... more Gastroesophageal reflux disease (GERD) is the most common acid-related disorder encountered during clinical practice in Pakistan and is associated with significant impairment of health-related quality of life. A number of guidelines and recommendations for the diagnosis and management of GERD have been published in different countries, but a Pakistani accepted directive by the standards of evidence-based medicine is still lacking. Our aim was to create an understanding of the natural history and presentations of reflux disease; evaluating possible treatment options available for the patients with complex and uncomplicated reflux ailments with the development of current and up to date evidence based endorsement, relevant to the needs of Pakistani health care providers in order to treat oesophageal manifestations of GERD. In order to make such guidelines, a comprehensive literature search was conducted with pertinent evidence reviewed, and quality of relevant data assessed. The result...
Saudi Journal of Gastroenterology, 2010
The Saudi Journal of Gastroenterology and mortality. [5] Endoscopic treatment has demonstrated re... more The Saudi Journal of Gastroenterology and mortality. [5] Endoscopic treatment has demonstrated results comparable to those achieved with surgery, with lower morbidity and mortality. [6,7] This retrospective work presents the experience of Mansoura Gastroenterology Center in endoscopic management of postoperative biliary leaks or strictures during a period of 14 years. PATIENTS AND METHODS The endoscopy database of Mansoura Gastroenterology Center, a tertiary referral university-affiliated center specialized in endoscopic and surgical management of gastrointestinal disorders was reviewed to identify all patients referred for endoscopic retrograde cholangiopancreatography (ERCP) because of suspected POBDI. Data collected included clinical presentation, time interval between surgery and ERCP, preoperative workup (clinical evaluation, biochemical and Bile duct injuries (BDI) can occur after many abdominal operations, e.g. liver surgery, gastrectomy, common bile duct (CBD) exploration. However, the majority of postoperative bile duct injuries (POBDI) occur during open or laparoscopic cholecystectomy. The incidence of injury has risen with the advent of LC (0.1-0.2% for open to 0.4-0.6% for laparoscopy) [1] Despite increasing experience with laparoscopy, a review of 1.6 million cholecystectomies demonstrated an unchanging 0.5% incidence of bile duct injury, report after many days post operation, of abdominal pain, bile leak, jaundice or cholangitis. Only 30% of injuries are recognized at the time of operation. [3] Bile duct injuries, particularly strictures, have traditionally been managed by surgical reconstruction (Roux-en-Y hepaticojejunostomy). The reported occurrence of symptomatic anastomotic strictures after long-term follow-up of surgical reconstruction ranges from 9-25 %. [4] Surgery is definitely associated with significant morbidity
Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2016
OBJECTIVE To evaluate the complications, technical success, diagnostic evaluation and various end... more OBJECTIVE To evaluate the complications, technical success, diagnostic evaluation and various endoscopic management options in patients with pancreas divisum. STUDY DESIGN Descriptive study. PLACE AND DURATION OF STUDY Endoscopy Suite, Surgical Unit 4, Civil Hospital, Karachi, from January 2007 to December 2013. METHODOLOGY All Endoscopic Retrograde Cholangio-pancreatography (ERCPs) procedure performed in patients with pancreas divisum were analyzed. Success was defined as having authentic diagnostic information or a successful endoscopic therapy for the condition. RESULTS During the study period, 3600 patients underwent 4500 ERCPprocedures. Pancreas divisum was found in 17 patients (0.47%); 7 ERCPs (41.2%) were performed for diagnostic and 10 (58.8%) for therapeutic purposes. Sixteen (94.1%) had complete PD and one (5.9%) had incomplete PD. Male and Female ratio was 1:1.83 with a mean age of 26.3 years and median symptom duration of 11 months. Atotal of 23 procedures were performed...
Asian Journal of Medical Sciences, 2021
Background: The emergence of SARS-COVID2 has completely reshaped the way we go about our daily bu... more Background: The emergence of SARS-COVID2 has completely reshaped the way we go about our daily business. Apart from other services, this has also impacted healthcare services and the way they are delivered. As endoscopy is an Aerosol generating procedure (AGP) with high risk of transmission, multiple endoscopy societies at the peak of the pandemic published guidelines on prioritizing of endoscopy services according to the urgency, highlighting the clinical indications which could be deferred until a more comprehensive plan is put out to safely perform endoscopy procedures or the infection rates drop down. Aims and Objectives: We give an example of how our unit in a low Human development Index country, worked through the peak of pandemic providing service to patients in a safe manner which can be continued forward until the pandemic runs its course. Materials and Methods: This prospective study was performed at Dr. Ziauddin University Hospital, Karachi. The ethical endorsement was ta...
JPMA. The Journal of …, 2010
Many diseases can cause esophageal stricture formation. These include acid peptic, autoimmune, in... more Many diseases can cause esophageal stricture formation. These include acid peptic, autoimmune, infectious, caustic, congenital, iatrogenic, medication-induced, radiation-induced, malignant, and idiopathic disease processes. Gastroesophageal reflux ...
JPMA. The Journal of the Pakistan Medical Association, 2015
Gastroesophageal reflux disease (GERD) is the most common acid-related disorder encountered durin... more Gastroesophageal reflux disease (GERD) is the most common acid-related disorder encountered during clinical practice in Pakistan and is associated with significant impairment of health-related quality of life. A number of guidelines and recommendations for the diagnosis and management of GERD have been published in different countries, but a Pakistani accepted directive by the standards of evidence-based medicine is still lacking. Our aim was to create an understanding of the natural history and presentations of reflux disease; evaluating possible treatment options available for the patients with complex and uncomplicated reflux ailments with the development of current and up to date evidence based endorsement, relevant to the needs of Pakistani health care providers in order to treat oesophageal manifestations of GERD. In order to make such guidelines, a comprehensive literature search was conducted with pertinent evidence reviewed, and quality of relevant data assessed. The result...