Rashid Usman - Academia.edu (original) (raw)

Papers by Rashid Usman

Research paper thumbnail of Evaluation, Surgical Management and Outcome of Traumatic Extremity Vascular Injuries: A 5-year Level-1 Trauma Centres Experience

Objective: We aim to share our experience regarding the surgical management and outcome of extrem... more Objective: We aim to share our experience regarding the surgical management and outcome of extremity vascular trauma in level-1 trauma centres in Pakistan. Patients and methods: All consecutive patients with traumatic extremity vascular injury (TEVI) fulfilling the inclusion criteria; between June 2012 and June 2017 were included. The demographics, clinical presentation, management, and outcome measures were recorded. Results: The study included 81 patients. The mean age±standard deviation was 28.6±14.5 years and 81.5% (n=66) of the patients were males. Blunt TEVI was found in 65.4% (n=53) of the cases. Partial laceration was the most common type of arterial injury (64.2%, n=52) and autologous interposition venous grafting was the most common repair performed (60.5%, n=49). Fasciotomy was performed in 67.9% (n=55) of the patients. The limb salvage rate was 82.7%. The amputation rate was higher in the blunt trauma group when compared with that of the penetrating trauma group. The len...

Research paper thumbnail of Tuberculous Abdominal Aortic Aneurysm – an Uncommon Association with Vertebral Tuberculosis

Tuberculosis of aortic aneurysm was first 1 reported in 1882 . It usually results from direct ext... more Tuberculosis of aortic aneurysm was first 1 reported in 1882 . It usually results from direct extension of the disease from the contagious tuberculous spines and clinically present with backache, low grade fever, weight loss and abdominal pain. . Early diagnosis and a combination of surgical intervention (aortic reconstruction and extensive excision of the infected field) and prolonged anti tuberculosis drug therapy provide good results. All of our six cases were treated with surgical debridement, aortic restoration with graft or synthetic patch and long term anti tuberculosis therapy. Five patients had an uneventful recovery. One patient with suprarenal aortic aneurysm died 6 hours after the surgery.

Research paper thumbnail of Comparison of Antibiotic treatment and Appendectomy for non-complicated Acute Appendicitis during Covid-19 pandemic

Pakistan Journal of Medical and Health Sciences

Aim: To evaluate the efficacy of antibiotic treatment as the primary option for non-complicated a... more Aim: To evaluate the efficacy of antibiotic treatment as the primary option for non-complicated acute appendicitis in pandemic situation. Study Design: Prospective interventional study. Setting & Duration of Study: CMH Lahore, a 700 bedded tertiary care hospital, for 4 months from 15th April 2020 to 15th august 2020. Methodology: A total of 110 cases meeting inclusion criteria, aged 13-65 years of both genders with suspicion of non-complicated appendicitis were included in the study, using probability sampling. They were divided in two groups on randomization basis. Group A for antibiotic therapy and Group B for appendectomy. Group A patients admitted in the ward 48 hours for IV antibiotics, were re-evaluated after 24 hours. If condition improves, the patient was discharged on oral antibiotics for next 10 days & if condition does not improve, antibiotics were prolonged for 48 hours. If deteriorating or patient. .chooses to change group, they underwent appendectomy. If condition impr...

Research paper thumbnail of Outcome of Sclerotherapy in Thetreatment of Non-Healing Varicose Ulcers Under Ultrasound Control

Journal of University Medical & Dental College

BACKGROUND & OBJECTIVE: Varicose veins are the commonest vascular problem both in men and women ... more BACKGROUND & OBJECTIVE: Varicose veins are the commonest vascular problem both in men and women worldwide. Lack of timely management, inadequate treatment, and maltreatment of varicose veins can lead to the development of nonhealing ulcers and affects the quality of life in terms of health. Surgery, heat therapy, chemical therapy, and endoscopic treatment are the options of treatment. Foam sclerotherapy is relatively a new technique being practiced all over the world and has promising results.The objective was to determine the outcomes of foam sclerotherapy in the treatment of non-healing varicose ulcers. METHODOLOGY:In this descriptive study, 240 patients with chronic leg ulcers with varicose veins had been managed with foam sclerotherapy under ultrasound and compression bandage. All patients were reviewed at 7 days, 1month, 3 months, 6 months, 1 year, and 18 months both clinically and radiologically with a doppler ultrasound to assess the ulcer healing rates. RESULTS:The overall ...

Research paper thumbnail of Surgical Excision of Carotid Body Tumor at an Early Stage Has Best Outcome: Result of 22 Cases along with Literature Review

Annals of Vascular Diseases

The objective of this study is to share our experience of early surgical excision of highly vascu... more The objective of this study is to share our experience of early surgical excision of highly vascular carotid body tumor (CBT) and to correlate it with current literature. Materials and Methods: Data of all consecutive patients diagnosed with CBT from September 2011 to September 2018, who underwent surgical excision, was analyzed. Results: Of the 22 cases with mean age of 42±standard deviation (SD) 6 years and female to male ratio of 1.2 : 1, 68.1% (n=15) of the tumors were on the right side. There were 13.6% (n=3) Shamblin I, 77.2% (n=17) Shamblin II, and 9% (n=2) Shamblin III tumors. Complete excision without vascular reconstruction was achieved in 63.6% (n=14), while patch plasty with Dacron graft was noted in 29.4% (n=5) and interposition Dacron grafting 13.6% (n=3). Peroperative vascular shunt was deployed in 13.6% (n=3) of cases. Transient neuropraxia of the hypoglossal nerve was noted in 13.6% (n=3) of cases, while permanent drooping of the lower lip was noted in 4.5% (n=1). There was no ischemic stroke. The mortality rate was zero, and no recurrence was recorded in mean follow-up of 24±SD 3 months. Conclusion: Complete surgical excision of CBT at an early stage, regardless of size, is associated with the best outcome.

Research paper thumbnail of Optical Trocar Causing Aortic Injury: A Potentially Fatal Complication of Minimal Access Surgery

Journal of the College of Physicians and Surgeons Pakistan

Research paper thumbnail of Iatrogenic Arterial Injuries in Neonates Secondary To Venepuncture Presentation Management and Outcome

Journal of the Dow University of Health Sciences

Research paper thumbnail of True Aneurysm of the Uterine Artery in a Young Nulliparous Female: An Extremely Rare Vascular Entity

Annals of Vascular Diseases

We present the first case of a large true uterine artery aneurysm, with a 5-cm diameter, in a 35-... more We present the first case of a large true uterine artery aneurysm, with a 5-cm diameter, in a 35-year-old nulliparous woman who presented with lower abdominal pain and dyspareunia. She underwent successful ligation and excision of the aneurysm using the Pfannenstiel approach. The diagnostic modalities and treatment option for such a case is discussed herein.

Research paper thumbnail of Proximal Arterio Venous Fistula Creation - A Gold Standard In Chronic Renal Failure Patients With Multiple Comorbidities

Journal of Ayub Medical College, Abbottabad : JAMC

Patients with end stage renal disease need an accurate and effective vascular access for haemodia... more Patients with end stage renal disease need an accurate and effective vascular access for haemodialysis. This study was conducted to postulate a hypothesis that proximal arterio venous fistula (AVF) creation should be a gold standard in Chronic Renal Failure (CRF) patients with multiple co morbidities.. A total of 230 patients reporting to Vascular Surgery Clinic in Combined Military Hospital Lahore and Peshawar from January 2014 to January 2016 for AVF creation, were included and equally divided into two groups by random draw method. Distal AVF created in Group A and proximal AVFs at elbow in Group B. The data regarding age, gender, atherosclerotic risk factors, body mass index (BMI) was recorded. The groups were compared for functional maturation of AVF and their patency at 6 and 12 months. Mean age was 30±SD 6.5 years (31±SD 5.1 in Group A, 30±SD 6.9 in Group B) with a male to female ratio of 5.4:1. In terms of age (p-value 0.529), gender (p-value 0.716), diabetes (p-value 0.682),...

Research paper thumbnail of Evaluation, Surgical Management and Outcome of Traumatic Extremity Vascular Injuries: A 5-year Level-1 Trauma Centres Experience

Annals of vascular diseases, Jan 25, 2018

Research paper thumbnail of Neurocognitive Improvement in Patients Undergoing Carotid Endarterectomy for Atherosclerotic Occlusive Carotid Artery Disease

Annals of Vascular Diseases, 2016

To assess the improvement in neurocognitive functions after carotid endarterectomy (CEA) under lo... more To assess the improvement in neurocognitive functions after carotid endarterectomy (CEA) under local anesthesia (LA) in patients with carotid bifurcation occlusive disease.

Research paper thumbnail of Advantages of Selective Use of Intraluminal Shunt in Carotid Endarterectomy: a Study of 122 Cases

Annals of Vascular Diseases, 2016

To assess the advantage of selective use of shunt in carotid endarterectomy (CEA) under local ane... more To assess the advantage of selective use of shunt in carotid endarterectomy (CEA) under local anesthesia. Materials and Methods: A total of 122 consecutive patients fulfilling international guidelines were included. Shunt was used selectively only in cases of bilateral severe carotid artery occlusive disease or in those patients who developed neurological symptoms on clamping of carotid artery. Follow up was done weekly for one month; then every month for 3 months; and then every 3 months for a year. Results: Shunt was used only in 5% (n = 6) patients. Of these, 2.5% (n = 3) patients were those who developed neurological symptoms on clamping the internal carotid and deployment of shunt resulted in complete resolution of symptoms. 2.5% (n = 3) had severe bilateral carotid stenosis and shunt was deployed. One of these patients developed stroke which was permanent. There was no mortality. The mean procedure time was 170 min in patients in whom shunt was used, when compared with 100 min in patients without shunt (P = 0.003). Conclusion: Use of shunt in carotid endarterectomy under local anesthesia as selective policy has an advantage in terms of cost effectiveness, operation time and prevention of potential complications.

Research paper thumbnail of Predictive Parameters for Successful Functional Maturation of Native Arteriovenous Fistula

Journal of Ayub Medical College, Abbottabad : JAMC

Successful arteriovenous fistula (AVF) significantly reduces both the morbidity as well as mortal... more Successful arteriovenous fistula (AVF) significantly reduces both the morbidity as well as mortality of the patients who have end stage renal disease, and significantly improve their survival rate. The objective of the study was to high light the role of various parameters in the functional maturation of arteriovenous fistula (AVF). This descriptive analytical study conducted at Department of Vascular Surgery, Combined Military Hospital Lahore from January 2014 to January 2015. All consecutive patients who underwent creation of AVF and had pre and post-operative Duplex scan to assess the arteries and veins of the upper limbs, were included. The AVFs were created at wrist, forearm and arm under local anaesthesia. The data was collected from radiology department and dialysis centre and correlated with the data from operation theatre. A total of 127 patients (89 males and 38 females) were included in this study. Only 57.5% (n = 73) patients showed functional maturation of their AVFs. O...

Research paper thumbnail of Abdominal Aorta Injury - a Fatal Complication of Laparoscopic Cholecystectomy

Journal of Ayub Medical College, Abbottabad : JAMC

Laparoscopic cholecystectomy (LC) has many advantages over open cholecystectomy, but sometimes, i... more Laparoscopic cholecystectomy (LC) has many advantages over open cholecystectomy, but sometimes, it can cause life threatening complications. Abdominal aortic injuries are rare but if occur, usually prove fatal if not diagnosed and treated promptly. We report a case of abdominal aortic injury which occurred during laparoscopic cholecystectomy. To the best of our knowledge this would be the first ever case reported in Pakistan.

Research paper thumbnail of Successful Repair of a Pseudoaneurysm of Renal Allograft Artery

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2015

Aneurysm of renal artery is a rare vascular complication after renal transplantation. A60 years m... more Aneurysm of renal artery is a rare vascular complication after renal transplantation. A60 years man showed an aneurysm of the renal artery in the transplanted kidney was an incidental finding on routine abdominal ultrasound. The function of the allograft was stable. Amagnetic resonance angiogram confirmed the diagnosis. Considering a very high risk of rupture due to its size (6.0 x 4.9 x 4.7 cm), and the organ being his only functional kidney, it was decided to perform an open surgical repair. Midline laparotomy was performed, allograft was mobilised, the aneurysm was resected and dacron patch arterioplasty was done. The patient had an uneventful recovery and his renal function returned to pre-operative levels by the fifth postoperative day. The patient was discharged home with regular monthly follow-up for 6 months.

Research paper thumbnail of Management of Arterial Injury in Children with Supracondylar Fracture of the Humerus and a Pulseless Hand

Annals of vascular diseases, Jan 25, 2017

This article is distributed under the terms of the Creative Commons Attribution License, which pe... more This article is distributed under the terms of the Creative Commons Attribution License, which permits use, distribution, and reproduction in any medium, provided the credit of the original work, a link to the license, and indication of any change are properly given, and the original work is not used for commercial purposes. Remixed or transformed contributions must be distributed under the same license as the original.

Research paper thumbnail of 503-1383-1-PB.pdf

Objective: To share collective operative experience in management of iatrogenic arterial injuries... more Objective: To share collective operative experience in management of iatrogenic arterial injuries secondary
to venepuncture in terms of demographics, clinical presentation, treatment and outcome; along with review of
current relevant literature.
Materials & Methods: A prospective review of database at tertiary care military hospitals of all iatrogenic
paediatric arterial injuries from March 2006 to March 2016 was performed. The data was analysed in terms
of demographics, presentation, treatment and outcome.
Results: A total of 28 patients were referred from various hospitals with iatrogenic arterial injuries during
venepuncture. The mean age was 13 ± SD 4 days and weight was 2.6 ± SD 0.8 Kgs. Of the 28; 71.4% (n=20)
had acute limb ischemia (ALI), 21.4% (n=6) dry gangrene and 7.1% (n=2) had pseudo-aneurysm. All patients
with ALI underwent thrombo-embolectomy, amputations were done for dry gangrene and pseudo-aneurysms
were resected with reverse venous bypass grafting. Mean follow up of 12 months was uneventful.
Conclusion: Iatrogenic neonatal arterial injuries secondary to venepuncture are rare but may cause limb and
even life threatening complications. Early diagnosis and surgical intervention using microsurgical techniques
is limb saving and prevents long term complications.
Key wards: Arterial, iatrogenic, injury, neonates, venepuncture.

Research paper thumbnail of Evaluation, Surgical Management and Outcome of Traumatic Extremity Vascular Injuries: A 5-year Level-1 Trauma Centres Experience

Objective: We aim to share our experience regarding the surgical management and outcome of extrem... more Objective: We aim to share our experience regarding the surgical management and outcome of extremity vascular trauma in level-1 trauma centres in Pakistan. Patients and methods: All consecutive patients with traumatic extremity vascular injury (TEVI) fulfilling the inclusion criteria; between June 2012 and June 2017 were included. The demographics, clinical presentation, management, and outcome measures were recorded. Results: The study included 81 patients. The mean age±standard deviation was 28.6±14.5 years and 81.5% (n=66) of the patients were males. Blunt TEVI was found in 65.4% (n=53) of the cases. Partial laceration was the most common type of arterial injury (64.2%, n=52) and autologous interposition venous grafting was the most common repair performed (60.5%, n=49). Fasciotomy was performed in 67.9% (n=55) of the patients. The limb salvage rate was 82.7%. The amputation rate was higher in the blunt trauma group when compared with that of the penetrating trauma group. The len...

Research paper thumbnail of Tuberculous Abdominal Aortic Aneurysm – an Uncommon Association with Vertebral Tuberculosis

Tuberculosis of aortic aneurysm was first 1 reported in 1882 . It usually results from direct ext... more Tuberculosis of aortic aneurysm was first 1 reported in 1882 . It usually results from direct extension of the disease from the contagious tuberculous spines and clinically present with backache, low grade fever, weight loss and abdominal pain. . Early diagnosis and a combination of surgical intervention (aortic reconstruction and extensive excision of the infected field) and prolonged anti tuberculosis drug therapy provide good results. All of our six cases were treated with surgical debridement, aortic restoration with graft or synthetic patch and long term anti tuberculosis therapy. Five patients had an uneventful recovery. One patient with suprarenal aortic aneurysm died 6 hours after the surgery.

Research paper thumbnail of Comparison of Antibiotic treatment and Appendectomy for non-complicated Acute Appendicitis during Covid-19 pandemic

Pakistan Journal of Medical and Health Sciences

Aim: To evaluate the efficacy of antibiotic treatment as the primary option for non-complicated a... more Aim: To evaluate the efficacy of antibiotic treatment as the primary option for non-complicated acute appendicitis in pandemic situation. Study Design: Prospective interventional study. Setting & Duration of Study: CMH Lahore, a 700 bedded tertiary care hospital, for 4 months from 15th April 2020 to 15th august 2020. Methodology: A total of 110 cases meeting inclusion criteria, aged 13-65 years of both genders with suspicion of non-complicated appendicitis were included in the study, using probability sampling. They were divided in two groups on randomization basis. Group A for antibiotic therapy and Group B for appendectomy. Group A patients admitted in the ward 48 hours for IV antibiotics, were re-evaluated after 24 hours. If condition improves, the patient was discharged on oral antibiotics for next 10 days & if condition does not improve, antibiotics were prolonged for 48 hours. If deteriorating or patient. .chooses to change group, they underwent appendectomy. If condition impr...

Research paper thumbnail of Outcome of Sclerotherapy in Thetreatment of Non-Healing Varicose Ulcers Under Ultrasound Control

Journal of University Medical & Dental College

BACKGROUND & OBJECTIVE: Varicose veins are the commonest vascular problem both in men and women ... more BACKGROUND & OBJECTIVE: Varicose veins are the commonest vascular problem both in men and women worldwide. Lack of timely management, inadequate treatment, and maltreatment of varicose veins can lead to the development of nonhealing ulcers and affects the quality of life in terms of health. Surgery, heat therapy, chemical therapy, and endoscopic treatment are the options of treatment. Foam sclerotherapy is relatively a new technique being practiced all over the world and has promising results.The objective was to determine the outcomes of foam sclerotherapy in the treatment of non-healing varicose ulcers. METHODOLOGY:In this descriptive study, 240 patients with chronic leg ulcers with varicose veins had been managed with foam sclerotherapy under ultrasound and compression bandage. All patients were reviewed at 7 days, 1month, 3 months, 6 months, 1 year, and 18 months both clinically and radiologically with a doppler ultrasound to assess the ulcer healing rates. RESULTS:The overall ...

Research paper thumbnail of Surgical Excision of Carotid Body Tumor at an Early Stage Has Best Outcome: Result of 22 Cases along with Literature Review

Annals of Vascular Diseases

The objective of this study is to share our experience of early surgical excision of highly vascu... more The objective of this study is to share our experience of early surgical excision of highly vascular carotid body tumor (CBT) and to correlate it with current literature. Materials and Methods: Data of all consecutive patients diagnosed with CBT from September 2011 to September 2018, who underwent surgical excision, was analyzed. Results: Of the 22 cases with mean age of 42±standard deviation (SD) 6 years and female to male ratio of 1.2 : 1, 68.1% (n=15) of the tumors were on the right side. There were 13.6% (n=3) Shamblin I, 77.2% (n=17) Shamblin II, and 9% (n=2) Shamblin III tumors. Complete excision without vascular reconstruction was achieved in 63.6% (n=14), while patch plasty with Dacron graft was noted in 29.4% (n=5) and interposition Dacron grafting 13.6% (n=3). Peroperative vascular shunt was deployed in 13.6% (n=3) of cases. Transient neuropraxia of the hypoglossal nerve was noted in 13.6% (n=3) of cases, while permanent drooping of the lower lip was noted in 4.5% (n=1). There was no ischemic stroke. The mortality rate was zero, and no recurrence was recorded in mean follow-up of 24±SD 3 months. Conclusion: Complete surgical excision of CBT at an early stage, regardless of size, is associated with the best outcome.

Research paper thumbnail of Optical Trocar Causing Aortic Injury: A Potentially Fatal Complication of Minimal Access Surgery

Journal of the College of Physicians and Surgeons Pakistan

Research paper thumbnail of Iatrogenic Arterial Injuries in Neonates Secondary To Venepuncture Presentation Management and Outcome

Journal of the Dow University of Health Sciences

Research paper thumbnail of True Aneurysm of the Uterine Artery in a Young Nulliparous Female: An Extremely Rare Vascular Entity

Annals of Vascular Diseases

We present the first case of a large true uterine artery aneurysm, with a 5-cm diameter, in a 35-... more We present the first case of a large true uterine artery aneurysm, with a 5-cm diameter, in a 35-year-old nulliparous woman who presented with lower abdominal pain and dyspareunia. She underwent successful ligation and excision of the aneurysm using the Pfannenstiel approach. The diagnostic modalities and treatment option for such a case is discussed herein.

Research paper thumbnail of Proximal Arterio Venous Fistula Creation - A Gold Standard In Chronic Renal Failure Patients With Multiple Comorbidities

Journal of Ayub Medical College, Abbottabad : JAMC

Patients with end stage renal disease need an accurate and effective vascular access for haemodia... more Patients with end stage renal disease need an accurate and effective vascular access for haemodialysis. This study was conducted to postulate a hypothesis that proximal arterio venous fistula (AVF) creation should be a gold standard in Chronic Renal Failure (CRF) patients with multiple co morbidities.. A total of 230 patients reporting to Vascular Surgery Clinic in Combined Military Hospital Lahore and Peshawar from January 2014 to January 2016 for AVF creation, were included and equally divided into two groups by random draw method. Distal AVF created in Group A and proximal AVFs at elbow in Group B. The data regarding age, gender, atherosclerotic risk factors, body mass index (BMI) was recorded. The groups were compared for functional maturation of AVF and their patency at 6 and 12 months. Mean age was 30±SD 6.5 years (31±SD 5.1 in Group A, 30±SD 6.9 in Group B) with a male to female ratio of 5.4:1. In terms of age (p-value 0.529), gender (p-value 0.716), diabetes (p-value 0.682),...

Research paper thumbnail of Evaluation, Surgical Management and Outcome of Traumatic Extremity Vascular Injuries: A 5-year Level-1 Trauma Centres Experience

Annals of vascular diseases, Jan 25, 2018

Research paper thumbnail of Neurocognitive Improvement in Patients Undergoing Carotid Endarterectomy for Atherosclerotic Occlusive Carotid Artery Disease

Annals of Vascular Diseases, 2016

To assess the improvement in neurocognitive functions after carotid endarterectomy (CEA) under lo... more To assess the improvement in neurocognitive functions after carotid endarterectomy (CEA) under local anesthesia (LA) in patients with carotid bifurcation occlusive disease.

Research paper thumbnail of Advantages of Selective Use of Intraluminal Shunt in Carotid Endarterectomy: a Study of 122 Cases

Annals of Vascular Diseases, 2016

To assess the advantage of selective use of shunt in carotid endarterectomy (CEA) under local ane... more To assess the advantage of selective use of shunt in carotid endarterectomy (CEA) under local anesthesia. Materials and Methods: A total of 122 consecutive patients fulfilling international guidelines were included. Shunt was used selectively only in cases of bilateral severe carotid artery occlusive disease or in those patients who developed neurological symptoms on clamping of carotid artery. Follow up was done weekly for one month; then every month for 3 months; and then every 3 months for a year. Results: Shunt was used only in 5% (n = 6) patients. Of these, 2.5% (n = 3) patients were those who developed neurological symptoms on clamping the internal carotid and deployment of shunt resulted in complete resolution of symptoms. 2.5% (n = 3) had severe bilateral carotid stenosis and shunt was deployed. One of these patients developed stroke which was permanent. There was no mortality. The mean procedure time was 170 min in patients in whom shunt was used, when compared with 100 min in patients without shunt (P = 0.003). Conclusion: Use of shunt in carotid endarterectomy under local anesthesia as selective policy has an advantage in terms of cost effectiveness, operation time and prevention of potential complications.

Research paper thumbnail of Predictive Parameters for Successful Functional Maturation of Native Arteriovenous Fistula

Journal of Ayub Medical College, Abbottabad : JAMC

Successful arteriovenous fistula (AVF) significantly reduces both the morbidity as well as mortal... more Successful arteriovenous fistula (AVF) significantly reduces both the morbidity as well as mortality of the patients who have end stage renal disease, and significantly improve their survival rate. The objective of the study was to high light the role of various parameters in the functional maturation of arteriovenous fistula (AVF). This descriptive analytical study conducted at Department of Vascular Surgery, Combined Military Hospital Lahore from January 2014 to January 2015. All consecutive patients who underwent creation of AVF and had pre and post-operative Duplex scan to assess the arteries and veins of the upper limbs, were included. The AVFs were created at wrist, forearm and arm under local anaesthesia. The data was collected from radiology department and dialysis centre and correlated with the data from operation theatre. A total of 127 patients (89 males and 38 females) were included in this study. Only 57.5% (n = 73) patients showed functional maturation of their AVFs. O...

Research paper thumbnail of Abdominal Aorta Injury - a Fatal Complication of Laparoscopic Cholecystectomy

Journal of Ayub Medical College, Abbottabad : JAMC

Laparoscopic cholecystectomy (LC) has many advantages over open cholecystectomy, but sometimes, i... more Laparoscopic cholecystectomy (LC) has many advantages over open cholecystectomy, but sometimes, it can cause life threatening complications. Abdominal aortic injuries are rare but if occur, usually prove fatal if not diagnosed and treated promptly. We report a case of abdominal aortic injury which occurred during laparoscopic cholecystectomy. To the best of our knowledge this would be the first ever case reported in Pakistan.

Research paper thumbnail of Successful Repair of a Pseudoaneurysm of Renal Allograft Artery

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2015

Aneurysm of renal artery is a rare vascular complication after renal transplantation. A60 years m... more Aneurysm of renal artery is a rare vascular complication after renal transplantation. A60 years man showed an aneurysm of the renal artery in the transplanted kidney was an incidental finding on routine abdominal ultrasound. The function of the allograft was stable. Amagnetic resonance angiogram confirmed the diagnosis. Considering a very high risk of rupture due to its size (6.0 x 4.9 x 4.7 cm), and the organ being his only functional kidney, it was decided to perform an open surgical repair. Midline laparotomy was performed, allograft was mobilised, the aneurysm was resected and dacron patch arterioplasty was done. The patient had an uneventful recovery and his renal function returned to pre-operative levels by the fifth postoperative day. The patient was discharged home with regular monthly follow-up for 6 months.

Research paper thumbnail of Management of Arterial Injury in Children with Supracondylar Fracture of the Humerus and a Pulseless Hand

Annals of vascular diseases, Jan 25, 2017

This article is distributed under the terms of the Creative Commons Attribution License, which pe... more This article is distributed under the terms of the Creative Commons Attribution License, which permits use, distribution, and reproduction in any medium, provided the credit of the original work, a link to the license, and indication of any change are properly given, and the original work is not used for commercial purposes. Remixed or transformed contributions must be distributed under the same license as the original.

Research paper thumbnail of 503-1383-1-PB.pdf

Objective: To share collective operative experience in management of iatrogenic arterial injuries... more Objective: To share collective operative experience in management of iatrogenic arterial injuries secondary
to venepuncture in terms of demographics, clinical presentation, treatment and outcome; along with review of
current relevant literature.
Materials & Methods: A prospective review of database at tertiary care military hospitals of all iatrogenic
paediatric arterial injuries from March 2006 to March 2016 was performed. The data was analysed in terms
of demographics, presentation, treatment and outcome.
Results: A total of 28 patients were referred from various hospitals with iatrogenic arterial injuries during
venepuncture. The mean age was 13 ± SD 4 days and weight was 2.6 ± SD 0.8 Kgs. Of the 28; 71.4% (n=20)
had acute limb ischemia (ALI), 21.4% (n=6) dry gangrene and 7.1% (n=2) had pseudo-aneurysm. All patients
with ALI underwent thrombo-embolectomy, amputations were done for dry gangrene and pseudo-aneurysms
were resected with reverse venous bypass grafting. Mean follow up of 12 months was uneventful.
Conclusion: Iatrogenic neonatal arterial injuries secondary to venepuncture are rare but may cause limb and
even life threatening complications. Early diagnosis and surgical intervention using microsurgical techniques
is limb saving and prevents long term complications.
Key wards: Arterial, iatrogenic, injury, neonates, venepuncture.