Sadaf Nasir | Liaquat National Medical college (original) (raw)

Papers by Sadaf Nasir

Journal of advances in medicine and medical research, Apr 3, 2024

To examine the association between positive facet fluid on T2-weighted MRI of lumbosacral spine a... more To examine the association between positive facet fluid on T2-weighted MRI of lumbosacral spine and the presence of instability on lateral flexion/extension radiographs, and to determine whether a correlation exists between the quantity of facet fluid on axial MRI and the degree of spinal instability on lateral standing flexion/extension radiographs. Overview of literature: The presence of increased facet fluid on axial T2-weighted magnetic resonance imaging (MRI) has been proposed as a potential marker for motion segment instability in the lumbar spine. Both facet fluid on MRI and spinal instability on dynamic x-rays are crucial in diagnosing and managing low back pain, guiding decisions on surgical interventions. Methods: We analyzed the prospectively collected data from patients meeting the inclusion criteria. Facet fluid measurements were made according to Schinnerer's criteria on axial T2weighted images and anterior translation as a marker of instability was evaluated on dynamic radiographs for all eligible patients. Statistical analysis was performed using IBM SPSS version 23, employing cross-tabulations, chi-square tests, and Pearson correlation. The study utilized a null hypothesis to evaluate the association between facet fluid and spinal instability. Results: Our findings demonstrated a statistically significant association between positive facet fluid on MRI and the occurrence of instability on lateral flexion/extension radiographs. Moreover, we found a strong positive correlation between the volume of facet fluid on axial MRI and the level of spinal instability on standing flexion/extension radiographs. Conclusion: Based upon these outcomes, we propose that standing lateral flexion-extension radiographs should be routinely administered to patients exhibiting increased facet fluid signals on MRI, as they may provide valuable information regarding potential spinal instability. Further research will help establish the clinical utility of this approach in managing degenerative lumbar diseases.

International journal of innovative research in medical science, Feb 18, 2024

The Professional Medical Journal

Objective: To assess the prevalence of alpha hemolytic streptococcal (AHS) infections and related... more Objective: To assess the prevalence of alpha hemolytic streptococcal (AHS) infections and related risk factors in patients with newly diagnosed acute myeloid leukemia (AML) undergoing consistent treatment. Study Design: Prospective study. Setting: Jinnah Teaching Hospital and DHQ Charsadda undergoing treatment from Hayatabad Medical Complex Peshawar. Period: June 2022 to February 2023. Material & Methods: AML patients were recruited and algorithmically followed for AHS infections. Core symptoms, diagnostic workups, differential diagnoses, and relevant treatments were assessed in this manner. Results: AHS caused 22% of bacteremic infections in 22% of patients, mostly by blood transmission (87%). After treatment, 32% recurred. AHS had a 60% mortality rate (P < 0.002). Age, precise induction timing, and high-dose cytarabine significantly enhanced AHS incidence (OR 2.0, 1.8–1.9, and 3.8, respectively). AHS infections increased hospital stays (P < 0.0002) and decreased long-term su...

PubMed, Mar 1, 2010

A 50 years old male was admitted with sub-arachnoid haemorrhage. Angiographic examination reveale... more A 50 years old male was admitted with sub-arachnoid haemorrhage. Angiographic examination revealed an abnormal origin of the right vertebral artery from the right external carotid artery. Multiple variations in the origin of right vertebral artery have been reported in literatures. Anomalous origin of the right vertebral artery from the right external carotid artery has not been reported earlier.

Pakistan Journal of Neurological Sciences, 2016

Background: The presence of cranial autonomic symptoms often leads to a misdiagnosis of sinus hea... more Background: The presence of cranial autonomic symptoms often leads to a misdiagnosis of sinus headache or ocular problems in adult migraineurs, leading to unnecessary investigations &delaying treatment.Objective: This study was done todetermine the frequency of cranial autonomic symptoms (CAS) among migraine patients presenting to neurology ward of tertiary care hospital in Karachi.METHODS: This descriptive cross sectional studywas conducted in duration of one year in Neurology Ward Jinnah Postgraduate Medical Center, Karachi. Total 105 patients of age 18-65 years, either gender, diagnosed cases of migraine of >1 year duration were consecutively selected.RESULTS: Mean ± SD age was 35.08 ± 10.18 years. Mean ± SD duration of migraine at was 3.68 ± 1.42 years. Majority of patients were females i-e; 59% (n=62). Frequency of CAS was more (75.8%) in patients of 21-40 years age compared to elder and very younger age patients (P value = 0.303). Female patients had very higher incidence of CAS (77.4%) compared to their male (P value < 0.049). Frequency of CAS was 58.82% with history of up to 1 year of migraine, 68.18% with history of 2-3 years & 74.24% with 4-5 years history of migraine. (P value 0.002).CONCLUSION: The CAS in migraine patients are very frequently present. All migraine patients should be evaluated for cranial autonomic symptoms from the day one of their diagnosis.

Pakistan Journal of Neurological Sciences, 2017

Background: Miller fisher syndrome is generally considered a rare but important variant of Guilla... more Background: Miller fisher syndrome is generally considered a rare but important variant of Guillain Barré Syndrome (GBS) having geographically variable incidence. Patients with this clinical syndrome are often misdiagnosed and mismanaged due to lack of awareness on the part of physician. Objective: To determine frequency of Miller fisher syndrome (MFS), variant of GBS in patients presenting to a tertiary care hospital in Karachi. Methods: This descriptive cross sectional study was conducted in the Department of Neurology, Jinnah Postgraduate Medical Centre (JPMC), Karachi. The duration was from April, 2014 to April, 2016 (two years). A total of 100 patients were included in this study. Patients were classified into GBS, MFS and GBS/MFS overlap according to their clinical presentation, CSF analysis and electrophysiological findings. Data was collected on a predesigned proforma. Results: Out of 100 cases, 62 (62%) were males and 38 (38%) were females. Frequency of Miller fisher syndro...

BMJ, 2006

Objective To assess the accuracy of preoperative staging of rectal cancer with magnetic resonance... more Objective To assess the accuracy of preoperative staging of rectal cancer with magnetic resonance imaging to predict surgical circumferential resection margins. Design Prospective observational study of rectal cancers treated by colorectal multidisciplinary teams between January 2002 and October 2003. Setting 11 colorectal units in four European countries. Participants 408 consecutive patients presenting with all stages of rectal cancer and undergoing magnetic resonance imaging before total mesorectal excision surgery and histopathological assessment of the surgical specimen. Main outcome measures Accuracy of magnetic resonance imaging in predicting a curative resection based on the histological yardstick of presence or absence of tumour at the margins of the specimen. Results 354 of the 408 patients had a clear circumferential resection margin (87%, 95% confidence interval 83% to 90%). Specificity for prediction of a clear margin by magnetic resonance imaging was 92% (327/354, 90% to 95%). High resolution scans were technically satisfactory in 93% (379/408). Surgical specimens were histopathologically graded as complete or moderate in 80% (328/408), and the median lymph node harvest was 12 (range 0-49). Magnetic resonance imaging predicted clear margins in 349 patients. At surgery 327 had clear margins (94%, 91% to 96%). Conclusion High resolution magnetic resonance imaging accurately predicts whether the surgical resection margins will be clear or affected by tumour. This technique can be reproduced accurately in multiple centres to predict curative resection and warns the multidisciplinary team of potential failure of surgery, thus enabling selection of patients for preoperative treatment. A list of the members of the MERCURY Study Group, details of imaging sequences, and a copy of the proforma can be found on bmj.com.

$Research paper thumbnail of Traumatic L5/S1 bilateral locked facets with bilateral pars fractures – A case report$

Surgical Neurology International

Background: Although rare, traumatic lumbosacral (L/S) Grade I spondylolisthesis (i.e., Lumbar lo... more Background: Although rare, traumatic lumbosacral (L/S) Grade I spondylolisthesis (i.e., Lumbar locked facet syndrome) is characterized by unilateral or bilateral facet dislocations. Case Description: A 25-year-old male presented following a high velocity road traffic accident with back pain and tenderness at the L/S junction. His radiologic images showed bilateral locked facets at the L5/S1 level with Grade 1 spondylolisthesis, bilateral pars fractures, acute traumatic L5/S1 disc herniation, and disruption of the anterior and posterior longitudinal ligaments. After undergoing a L4-S1 laminectomy with pedicle screw fixation, he became asymptomatic and remained neurologically stable. Conclusion: L5/S1 facet dislocation whether unilateral or bilateral needs to be diagnosed early and treated with realignment and instrumented stabilization.

This is a case of 35 years old female with endometrioid adenocarcinoma in uterine polyp. However,... more This is a case of 35 years old female with endometrioid adenocarcinoma in uterine polyp. However, no disease was found in uterus after polypectomy but her irregular per vaginal bleeding persisted even after six months. Hence her completion surgery was done.

Purpose: The objective of our study was to determine the change in management brought about by ma... more Purpose: The objective of our study was to determine the change in management brought about by magnetic resonance imaging (MRI) of the cervical spine in alert and awake patients with facet dislocation and spinal cord injury presenting within 4 hours after injury. Overview of Literature: Spinal cord injury is a common clinical entity. The role of MRI is well established in evaluating spinal trauma. However, the time at which MRI should be used is still controversial. Methods: Retrospective data from 2002-2010 was evaluated. All of the alert and awake patients with spinal cord injury, based on clinical examination with facet dislocation diagnosed on lateral cervical spine X-rays, were included. A questionnaire was also conducted, the data of which consisted of demographic details including age and sex, the mechanism of injury, clinical examination, X-ray findings, MRI findings, whether or not surgery was performed and the time elapsed since injury. Data was analyzed using SPSS ver. 17...

Chinese journal of traumatology = Zhonghua chuang shang za zhi, 2011

OBJECTIVE To determine the frequency of altered findings on repeat cranial tomography (CT) in pat... more OBJECTIVE To determine the frequency of altered findings on repeat cranial tomography (CT) in patients with mild head injury along with stable neurological examination at tertiary care hospital. METHODS Cross-sectional study was done in the Department of Radiology, Liaquat National Hospital, Karachi from January 2008 to September 2010. All patients with mild head injury in terms of Glasgow Coma Scale (GCS) who underwent repeat scan without clinical or neurological deterioration in the emergency department of a tertiary care centre were included. The collected data were accordingly entered and analyzed by the principal investigator using Statistical Package for Social Sciences (SPSS) version 16.0. RESULTS In all 275 patients, only 17 (6%) of the patients were found worseing on repeat CT, 120 (43.63%) scans improved, 138 (50.18%) unchanged and 17 (6.18%) worsened. None of these patients showed signs of clinical deterioration. CONCLUSION Our results suggest that for patients with mild ...

Background Blunt abdominal injuries are very common and usually result from motor vehicle collisi... more Background Blunt abdominal injuries are very common and usually result from motor vehicle collisions, recreational accidents or falls. The appropriate next step investigation plays a very vital role in management of such patients who otherwise face increase morbidity or even mortality. MDCT scans are currently the gold standard for evaluation of posttraumatic patients for evaluation of abdominal injuries. Objectives To evaluate patterns of various injuries in blunt abdominal trauma patients presented to a tertiary care hospital based on CT scan Materials and Methods A retrospective cross sectional study was performed on data collected from records of Liaquat National Hospital Radiology department of abdominal trauma patients from 1 st July 2015 to 31 st December 2016. Patients who were hemodynamically stable, with high clinical suspicion of intra-abdominal injury and those with positive ultrasound fast after blunt abdominal injury secondary to RTA or fall were included. Results A to...

Liaquat National Tumor Board Journal, 2020

Introduction: Pancreatic cancer is a lethal disease. The mortality rate for pancreatic tumor has ... more Introduction: Pancreatic cancer is a lethal disease. The mortality rate for pancreatic tumor has changed over the last 20 years. Early diagnosis of pancreatic carcinoma is very important for therapeutic decisions and surgical planning. Contrast enhance CT facilitated the detection of primary tumor and staging. Objective: This study is to evaluate various presentations of pancreatic carcinomas on their initial MDCT (Multidetector Computed Tomography) and to evaluate its resectability and to compare CT features among resectable and non-resectable tumors. Methodology: All the patients underwent multi-phasic CT scan on a 16-slice MDCT. CT findings were analyzed included tumor location, size, enhancement pattern, nodal disease, duct dilatations, vascular involvement and evidence of metastatic disease. Results: Total 63 records of patients examined during 2017 and 2019 meeting the inclusion criteria were reviewed. The average age at time of MDCT examination was 62.51 ± 13.17 years. The di...

Pakistan journal of medical sciences

To quantify the increase in workload associated with multidisciplinary team meetings for radiolog... more To quantify the increase in workload associated with multidisciplinary team meetings for radiologists in a tertiary care hospital over a period of 15 months. Data was collected prospectively regarding number of multidisciplinary team meetings, number of clinical cases discussed, number of individual imaging studies reviewed, and preparation time of residents, senior registrar and consultants and the delivery time of meeting. Total 223 meetings were held over 15 months (April 2014 to June 2015) for 12 clinical specialty areas. There were 1120 clinical case discussions and a total of 2759 documented individual imaging studies reviewed. Resident's preparation time was 74.6 hours/month, senior registrar's preparation time was 47.93 hours/month, consultant's preparation time was 18.67 hours/month and the total duration time for meetings was 18 hours/month. Multidisciplinary team meetings now represent a significant workload of radiology and has reduced the time for other acad...

Asian Pacific Journal of Health Sciences, 2017

Fibromatosis colli-pseudotumor of infancy of sternocleidomastoid is a fibromatosis of infants tha... more Fibromatosis colli-pseudotumor of infancy of sternocleidomastoid is a fibromatosis of infants that involves the sternocleidomastoid muscle. It usually presents in neonates and/or infants. If diagnosed correctly & on time, undue fears of parents and unnecessary investigations can be avoided. Its management is though Conservative, Physiotherapy is usually advised to speed up the recovery & to minimize the complications like torticollis. Ultrasonography (USG) is the imaging modality of choice for diagnosis. Cross sectional imaging like CT scan or MRI may help to further delineate the disease and to know the extent of muscle involvement. Here, we present a case of an 18-days old baby boy came with complains of right sided neck swelling noticed by parents for a week. The swelling was not present at the time of birth.

Asian Spine Journal, 2011

S St tu ud dy y D De es si ig gn n: : This is a case series. P Pu up po os se e: : We wanted to i... more S St tu ud dy y D De es si ig gn n: : This is a case series. P Pu up po os se e: : We wanted to identify variations in the practice patterns among neurosurgeons and orthopedic surgeons for the management of spinal disorders. O Ov ve er rv vi ie ew w o of f L Li it te er ra at tu ur re e: : Spinal disorders are common in the clinical practice of both neurosurgeons and orthopedic surgeons. It has been observed that despite the availability of various guidelines, there is lack of consensus among surgeons about the management of various disorders. M Me et th ho od ds s: : A questionnaire was distributed, either directly or via e-mail, to the both the neurosurgeons and orthopedic surgeons who worked at 5 tertiary care centers within a single region of Korea. The surgeons were working either in private practice or in academic institutions. The details of the questionnaire included demographic details and the specialty (orthopedic/neurosurgeon). The surgeons were classified according to the level of experience as up to 5 years, 6-10 years and > 10 years. Questions were asked about the approach to lumbar discectomy (fragmentectomy or aggressive disc removal), using steroids for treating discitis, the fusion preference for spondylolisthesis, the role of an orthosis after fusion, the preferred surgical approach for spinal stenosis, the operative approach for spinal trauma (early within 72 hours or late > 72 hours) and the role of surgery in complete spinal cord injury. The data was analyzed using SPSS ver 16. p-values < 0.05 were considered to be significant. R Re es su ul lt ts s: : Of the 30 surgeons who completed the questionnaire, 20 were neurosurgeons and 10 were orthopedic surgeons. Statistically significant differences were observed for the management of spinal stenosis, spondylolisthesis, using an orthosis after fusion, the type of lumbar discectomy and the value of surgical intervention after complete spinal cord injury. C Co on nc cl lu us si io on ns s: : Our results suggest that there continues to exist a statistically significant lack of consensus among neurosurgeons and orthopedic spine surgeons when considering using an orthosis after fusion, the type of discectomy and the value of intervention after complete spinal injury.

Asian Spine Journal, 2012

The objective of our study was to determine the change in management brought about by magnetic re... more The objective of our study was to determine the change in management brought about by magnetic resonance imaging (MRI) of the cervical spine in alert and awake patients with facet dislocation and spinal cord injury presenting within 4 hours after injury. Overview of Literature: Spinal cord injury is a common clinical entity. The role of MRI is well established in evaluating spinal trauma. However, the time at which MRI should be used is still controversial. Methods: Retrospective data from 2002-2010 was evaluated. All of the alert and awake patients with spinal cord injury, based on clinical examination with facet dislocation diagnosed on lateral cervical spine X-rays, were included. A questionnaire was also conducted, the data of which consisted of demographic details including age and sex, the mechanism of injury, clinical examination, X-ray findings, MRI findings, whether or not surgery was performed and the time elapsed since injury. Data was analyzed using SPSS ver. 17.0. Continuous variables such as age were expressed in terms of mean ± standard deviation. Categorical variables such as change in management, X-ray/MRI findings and neurological motor level were assessed in terms of percentage. Results: Fifty patients participated in our study. All these patients had spinal cord injury with defined motor levels. The mean age was 35.5 ± 8.95 years (range, 20 to 52 years). Fifty percent showed a motor level at C6 level. None of the patients required any change in management based on the MRI. Conclusions: MRI of the spine in awake patients within 4 hours after injury does not change the management of patients. However, we can hypothesize that such patients can proceed to traction without waiting for the MRI.

The International Journal of Cardiovascular Imaging, 2006

We present a case of a 63-year-old man who was admitted to the hospital due to an acute coronary ... more We present a case of a 63-year-old man who was admitted to the hospital due to an acute coronary syndrome. Angiographic and magnetic resonance angiography examination showed an abnormal right vertebral artery originating from the ascending aorta, just above the left coronary sinus Valsalva in addition to aberrant retro-esophageal right subclavian artery. The variations and the incidence of various abnormal origins of the right vertebral artery are also reviewed.

Chinese journal of traumatology = Zhonghua chuang shang za zhi, 2012

OBJECTIVE To examine the contribution of flexion and extension radiographs in the evaluation of l... more OBJECTIVE To examine the contribution of flexion and extension radiographs in the evaluation of ligamentous injury in awake adults with acute blunt cervical spine trauma, who show loss of cervical lordosis and neck pain. METHODS All patients who presented to our emergency department following blunt trauma were enrolled in this study, except those with schiwora, neurological deficits or fracture demonstrated on cross-table cervical spine X-rays, and those who were either obtunded or presented after cervical spine surgery. Adequacy of flexion and extension views was checked by the neurosurgery and radiology team members. All these patients underwent cross-table cervical spine view followed by flexion/extension views based on the loss of lordosis on cross-table imaging and the presence of neck pain. RESULTS A total of 200 cases were reviewed, of whom 90 (45%) underwent repeat X-rays because of either inadequate exposure or limited motion. None of the patients with loss of lordosis on c...