Ali Akbar | Universitas Islam Negeri Sultan Syarif Qasim Riau (original) (raw)

Papers by Ali Akbar

Research paper thumbnail of Makalah Sensor Kelembapan

Ali Akbar, 2016

Puji syukur penulis ucapkan kehadirat Allah SWT, yang mana Ia telah memberikan penulis kesehatan,... more Puji syukur penulis ucapkan kehadirat Allah SWT, yang mana Ia telah memberikan penulis kesehatan, kesempatan bahkan petunjuk dan inspirasi sehingga penulis dapat menyelesaikan makalah ini. Shalawat beriring salam tak lupa penulis sampaikan kepada Nabi Muhammad SAW yang telah membawa umatnya dari zaman kegelapan menuju zaman yang penuh dengan ilmu pengetahuan ini.

Research paper thumbnail of Makalah sensor kelembapan

Research paper thumbnail of Exact solutions of the (2+1)-dimensional cubic Klein-Gordon equation and the (3+1)-dimensional Zakharov-Kuznetsov equation using the modified simple equation method

Research paper thumbnail of SET: Session Layer-Assisted Efficient TCP Management Architecture for 6LoWPAN with Multiple Gateways

6LoWPAN (IPv6 based Low-Power Personal Area Network) is a protocol specification that facilitates... more 6LoWPAN (IPv6 based Low-Power Personal Area Network) is a protocol specification that facilitates communication of IPv6 packets on top of IEEE 802.15.4 so that Internet and wireless sensor networks can be inter-connected. This interconnection is especially required in commercial and enterprise applications of sensor networks where reliable and timely data transfers such as multiple code updates are needed from Internet nodes to sensor nodes. For this type of inbound traffic which is mostly bulk, TCP as transport layer protocol is essential, resulting in end-to-end TCP session through a default gateway. In this scenario, a single gateway tends to become the bottleneck because of non-uniform connectivity to all the sensor nodes besides being vulnerable to buffer overflow. We propose SET; a management architecture for multiple split-TCP sessions across a number of serving gateways. SET implements striping and multiple TCP session management through a shim at session layer. Through analytical modeling and ns2 simulations, we show that our proposed architecture optimizes communication for ingress bulk data transfer while providing associated load balancing services. We conclude that multiple split-TCP sessions managed in parallel across a number of gateways result in reduced latency for bulk data transfer and provide robustness against gateway failures. research challenges for commercial WSNs are support for multiple applications, several service providers sharing a single-sensor network, WSN and the Internet connectivity, and reliable, timely, and multiple code updates thereof.

Research paper thumbnail of An Investigation into the Effect of Cooperative Learning with Focus on Jigsaw Technique on the Academic achievement of 2 nd -Grade Middle School Students

This study aims to investigate and compare the effect of cooperative learning with an emphasis on... more This study aims to investigate and compare the effect of cooperative learning with an emphasis on Jigsaw technique on the academic achievement of 2 nd -grade middle school student in district 1 of Bandar Abbas city. It is considered a semi-experimental study and the method is pre-test post-test with a control group. The sampling is multi-stage and the sample size includes 153 students. The tool used in this study is Teacher's Academic achievement. It uses the statistical method of analysis of covariance (ANCOVA). The findings of the study indicate that a cooperative learning method that focuses on Jigsaw technique has significant effect on students' academic achievement. INTRODUCTION The old longing of any society is the progress and elevation of its members and to have wise and intellectual students. It is obvious that any kind of progress in different areas such as culture, economy, society, politics and the like require having sensible, creative, and critical people who c...

Research paper thumbnail of Synthesis of Biopolymeric α-Lactalbumin Protein Nanoparticles and Nanospheres as Green Nanofluids Using in Drug Delivery and Food Technology

Journal of Nano Research, 2012

New nanofluids carrier containing fine homogeneous whey protein α-lactalbumin spherical nanoparti... more New nanofluids carrier containing fine homogeneous whey protein α-lactalbumin spherical nanoparticles and nanospheres have been synthesized by three methods in this research. Biochemical enzymatic catalysis by V8-protease, chemical hydrolysis (sol-gel assisted self assembly method) using cationic templates and metal ions ligand forming, and also by direct acidic titration method with applying various ethylene glycol derivatives containg alcohol solvents. Repeatability and stability of synthetic nanoparticles and nanospheres milk protein structures in clear and crystalline green water-based nanofluids was confirmed by dynamic light scattering (DLS) analysis and TEM images (2-5nm) even after a one year period of preparation. Fabrication of non-toxic nanosolutions-nanofluids including nonionic and cationic surfactants, cosurfactants and suitable solvents, besides proper incubation temperatures (37-50˚C), adjusted aging times and doped of divalent ions-bridging (Ca2+, Mn2+ and Zn2+ ) between specific amino acids and carboxyl groups, are so vital factors in kinetically controlled self-assembly phenomenon of the natural protein building blocks to form high resistant and homogeneous nanoparticles and nanospheres in transparent and clear green nanofluids. Such nanofluids can have many applications in food and pharmaceutical industries for example in formulate foods with high nutritional value in oral and digestive (ingestion) routes, and drug delivery. Interesting textures of SEM images have also shown these new nanobiostructures of natural milk protein morphologies.

Research paper thumbnail of Long-term pulmonary complications in combatants exposed to mustard gas: a historical cohort study

International Journal of Epidemiology, 2004

Background Sulphur mustard (mustard gas), the most widely used chemical agent in the Iran-Iraq wa... more Background Sulphur mustard (mustard gas), the most widely used chemical agent in the Iran-Iraq war, affects many organs including the skin, the gastrointestinal and respiratory tracts, and the central nervous system. The aim of this study was to assess the cumulative incidence rate and annual incidence rate of pulmonary complications, and the rate ratio of related factors.

Research paper thumbnail of Can induction chemotherapy before concurrent chemoradiation impact circumferential resection margin positivity and survival in low rectal cancers?

Asian Pacific journal of cancer prevention : APJCP, 2015

Distance from anal verge and abdominoperineal resection are risk factors for circumferential rese... more Distance from anal verge and abdominoperineal resection are risk factors for circumferential resection margin (CRM) positivity in rectal cancer. Induction chemotherapy (IC) before concurrent chemoradiation (CRT) has emerged as a new treatment modification. Impact of IC before concurrent CRT on CRM positivity in low rectal cancer remains to be independently studied. The objective of this study was to determine CRM positivity in low rectal cancer, with and without prior IC, and to identify predictors of disease free and overall survival. Patients who underwent surgery for rectal cancer between 2005 and 2011 were retrospectively reviewed and divided into two groups. Group 1 received IC before CRT and Group 2 did not. Demographics, clinicopathological variables and CRM status were compared. Actuarial 5 year disease free survival (DFS), overall survival (OS) and independent predictors of survival were determined. Patients in the IC group presented with advanced stage (Stage 3=89.2% versu...

Research paper thumbnail of Outcome of rectal cancer in patients aged 30 years or less in the Pakistani population

Asian Pacific journal of cancer prevention : APJCP, 2014

The incidence of rectal cancer is increasing in younger age groups. Limited data is available reg... more The incidence of rectal cancer is increasing in younger age groups. Limited data is available regarding survival outcome in younger patients with conflicting results from western world. The goal of this study was to determine survival in patients with rectal cancer<30 years of age and compare it with their older counterparts in the Pakistani population. A retrospective chart review of patients operated for rectal adenocarcinoma between January 2005 and December 2010 was performed. Patients were divided into two groups, Group 1 aged ≤30 years and Group 2 aged…

Research paper thumbnail of Impact of lymph node ratio and number on survival in patients with rectal adenocarcinoma after preoperative chemo radiation

International Journal of Surgery, 2015

Background: Retrieval of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp... more Background: Retrieval of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;12 lymph nodes after proctectomy and preoperative chemoradiation (C-XRT) may improve survival in good risk patients. The objective of this study was to determine impact of…

Research paper thumbnail of Impact of acellular mucin pools on survival in patients with complete pathological response to neoadjuvant treatment in rectal cancer

International Journal of Surgery, 2014

Rarely, patients with pathological complete response (PCR) after neoadjuvant chemoradiotherapy de... more Rarely, patients with pathological complete response (PCR) after neoadjuvant chemoradiotherapy demonstrate acellular mucin pools. The prognostic significance of this finding is controversial. The objective of this study was to determine impact of acellular mucin pools on disease free and overall survival in patients with complete pathological response to neoadjuvant chemoradiotherapy in rectal cancer. One hundred and seventy two patients received neoadjuvant chemoradiotherapy for rectal cancer and underwent surgery. Patients were divided into two groups based on presence of acellular mucin pools. Locoregional failures, distant failures and deaths were compared. Expected 5 year disease free and overall survival was calculated. Median follow-up was 36(4-94) months. Complete pathological response was identified in 35(20.3%) patients. Of these, 12(34.2%) had acellular mucin pools in resected specimen. Majority of mucin negative tumors were moderately differentiated (78% vs 25%) (P = 0.005). Median overall survival for mucin positive and mucin negative tumors was 4(1.3-5.7) and 3.3(0.1-6.3) years respectively. Expected 5 year disease free and overall survival for mucin positive and mucin negative tumors was 73% and 89% (P = 0.1) and 75% and 87% (P = 0.4). Acellular mucin pools in rectal cancer following a PCR to neoadjuvant treatment do not impact survival.

Research paper thumbnail of Using telemedicine as an enabler for antenatal care in Pakistan

Pakistan is a developing country with more than 60% of its population residing in rural areas wit... more Pakistan is a developing country with more than 60% of its population residing in rural areas with insufficient health care facilities. The recent advancements in telemedicine provide a significant opportunity to the developing countries to develop a health infrastructure that addresses the needs of the rural population. In this paper, we discuss our model of a remote patient monitoring system (RPMS) that aims to provide a cost efficient yet effective health care system to the patients residing in the remote areas of Pakistan. In particular, we have initially selected the domain of antenatal care because of an alarming mother mortality rate of Pakistan. This system will augment the existing health care infrastructure.

Research paper thumbnail of Endoscopic Ultrasound-Guided Biliary Drainage: A Systematic Review and Meta-Analysis

Digestive diseases and sciences, Jan 30, 2015

Variable success and adverse event rates have been reported for endoscopic ultrasound-guided bili... more Variable success and adverse event rates have been reported for endoscopic ultrasound-guided biliary drainage (EUS-BD) utilizing either extrahepatic or intrahepatic approach. We aimed to conduct a proportion meta-analysis to evaluate the cumulative efficacy and safety of EUS-BD and to compare the two approaches and transluminal methods of EUS-BD. We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, ISI Web of Science, and Scopus from January 2001 through January 5, 2015, to identify studies reporting technical success and adverse events of EUS-BD. A sample size of more than 20 patients was a further criterion. Weighted pooled rate (WPR) for technical success and post-procedure complications was calculated for overall studies and predefined subgroups. Pooled odds ratios were calculated for technical success and adverse events for two approaches and transluminal methods of EUS-BD for distal common bile duct (CBD) strictures. The WPR with 95 % confidence interva...

Research paper thumbnail of Myelography in spinal disorders--experience of 1400 cases

JPMA. The Journal of the Pakistan Medical Association, 2004

To evaluate the diagnostic importance of myelography in spinal disorders, in correlation with cli... more To evaluate the diagnostic importance of myelography in spinal disorders, in correlation with clinical presentation of the patients. Patients selected for myelography had presented with history of various spinal disorders such as low backache, neurogenic claudication, paraparesis or paraplegia, quadriparesis or quadriplegia, trauma to spinal region and infective spondylitis. Patients excluded were those with history of allergies to iodinated contrast agents, seizures coagulopathy and pregnant women. Contrast agent was water soluble non ionic agent--lohexol. Spinal Needles used were of 20,22 and 25 gauge. X-Ray machine with tiltable table was used for myelography. There were 1400 patients of whom 935 were males and 465 females with male to female ratio of 2.1. Age range was 8 to 65 years. Spinal disorders diagnosed on myelography were lumbar disc prolapse 866 (60%) cases, lumbar canal stenosis 113 (8%), thoracic disc protrusions 15 (1%), infective spondylitis 53 (4%) cases, spinal tu...

Research paper thumbnail of Endoscopic treatment of nonstricture-related benign biliary diseases using covered self-expandable metal stents

Endoscopy, Jan 18, 2014

Background and study aims: Nonstricture benign biliary diseases (BBDs) such as leaks, perforation... more Background and study aims: Nonstricture benign biliary diseases (BBDs) such as leaks, perforations, and bleeding, have been traditionally managed by placement of one or more plastic stents. Emerging data support the use of covered, self-expandable, metal stents (CSEMSs). The aim of this study was to assess the outcomes of endoscopic temporary placement of CSEMS in patients with nonstricture BBD. Patients and methods: This was a retrospective study of CSEMS placement for BBD between May 2005 and August 2013 at two tertiary care centers. The main outcome measures were resolution of perforation, bleeding, leak, and adverse events related to CSEMS treatment. Results: A total of 87 patients were included (median age 62 years [range 18 - 86]). Indications for stent placement were bile leaks (n = 35, 40 %), bleeding (n = 27, 31 %), perforation (n = 18, 21 %), and other conditions (n = 7, 8 %). Fully and partially covered 8 - 10-mm diameter CSEMS were placed and subsequently removed in all ...

Research paper thumbnail of Severe Ischemic Pancreatitis Following the Use of Extracorporeal Membrane Oxygenation

Journal of Pediatric Gastroenterology and Nutrition, 2012

Research paper thumbnail of Mo1338 Use of Covered Self Expandable Metal Stents (CSEMS) for Endoscopic Management of Non-Stricture Related Benign Biliary Diseases

Gastrointestinal Endoscopy, 2012

Research paper thumbnail of Use of covered self-expandable metal stents for endoscopic management of benign biliary disease not related to stricture (with video)

Gastrointestinal Endoscopy, 2012

Research paper thumbnail of Placement of fully covered self-expandable metal stents to control entry-related bleeding during transmural drainage of pancreatic fluid collections (with video)

Gastrointestinal Endoscopy, 2012

Research paper thumbnail of Ischemic biliary injury following extra-corporeal membrane oxygenation (ECMO)

Digestive and Liver Disease, 2012

Research paper thumbnail of Makalah Sensor Kelembapan

Ali Akbar, 2016

Puji syukur penulis ucapkan kehadirat Allah SWT, yang mana Ia telah memberikan penulis kesehatan,... more Puji syukur penulis ucapkan kehadirat Allah SWT, yang mana Ia telah memberikan penulis kesehatan, kesempatan bahkan petunjuk dan inspirasi sehingga penulis dapat menyelesaikan makalah ini. Shalawat beriring salam tak lupa penulis sampaikan kepada Nabi Muhammad SAW yang telah membawa umatnya dari zaman kegelapan menuju zaman yang penuh dengan ilmu pengetahuan ini.

Research paper thumbnail of Makalah sensor kelembapan

Research paper thumbnail of Exact solutions of the (2+1)-dimensional cubic Klein-Gordon equation and the (3+1)-dimensional Zakharov-Kuznetsov equation using the modified simple equation method

Research paper thumbnail of SET: Session Layer-Assisted Efficient TCP Management Architecture for 6LoWPAN with Multiple Gateways

6LoWPAN (IPv6 based Low-Power Personal Area Network) is a protocol specification that facilitates... more 6LoWPAN (IPv6 based Low-Power Personal Area Network) is a protocol specification that facilitates communication of IPv6 packets on top of IEEE 802.15.4 so that Internet and wireless sensor networks can be inter-connected. This interconnection is especially required in commercial and enterprise applications of sensor networks where reliable and timely data transfers such as multiple code updates are needed from Internet nodes to sensor nodes. For this type of inbound traffic which is mostly bulk, TCP as transport layer protocol is essential, resulting in end-to-end TCP session through a default gateway. In this scenario, a single gateway tends to become the bottleneck because of non-uniform connectivity to all the sensor nodes besides being vulnerable to buffer overflow. We propose SET; a management architecture for multiple split-TCP sessions across a number of serving gateways. SET implements striping and multiple TCP session management through a shim at session layer. Through analytical modeling and ns2 simulations, we show that our proposed architecture optimizes communication for ingress bulk data transfer while providing associated load balancing services. We conclude that multiple split-TCP sessions managed in parallel across a number of gateways result in reduced latency for bulk data transfer and provide robustness against gateway failures. research challenges for commercial WSNs are support for multiple applications, several service providers sharing a single-sensor network, WSN and the Internet connectivity, and reliable, timely, and multiple code updates thereof.

Research paper thumbnail of An Investigation into the Effect of Cooperative Learning with Focus on Jigsaw Technique on the Academic achievement of 2 nd -Grade Middle School Students

This study aims to investigate and compare the effect of cooperative learning with an emphasis on... more This study aims to investigate and compare the effect of cooperative learning with an emphasis on Jigsaw technique on the academic achievement of 2 nd -grade middle school student in district 1 of Bandar Abbas city. It is considered a semi-experimental study and the method is pre-test post-test with a control group. The sampling is multi-stage and the sample size includes 153 students. The tool used in this study is Teacher's Academic achievement. It uses the statistical method of analysis of covariance (ANCOVA). The findings of the study indicate that a cooperative learning method that focuses on Jigsaw technique has significant effect on students' academic achievement. INTRODUCTION The old longing of any society is the progress and elevation of its members and to have wise and intellectual students. It is obvious that any kind of progress in different areas such as culture, economy, society, politics and the like require having sensible, creative, and critical people who c...

Research paper thumbnail of Synthesis of Biopolymeric α-Lactalbumin Protein Nanoparticles and Nanospheres as Green Nanofluids Using in Drug Delivery and Food Technology

Journal of Nano Research, 2012

New nanofluids carrier containing fine homogeneous whey protein α-lactalbumin spherical nanoparti... more New nanofluids carrier containing fine homogeneous whey protein α-lactalbumin spherical nanoparticles and nanospheres have been synthesized by three methods in this research. Biochemical enzymatic catalysis by V8-protease, chemical hydrolysis (sol-gel assisted self assembly method) using cationic templates and metal ions ligand forming, and also by direct acidic titration method with applying various ethylene glycol derivatives containg alcohol solvents. Repeatability and stability of synthetic nanoparticles and nanospheres milk protein structures in clear and crystalline green water-based nanofluids was confirmed by dynamic light scattering (DLS) analysis and TEM images (2-5nm) even after a one year period of preparation. Fabrication of non-toxic nanosolutions-nanofluids including nonionic and cationic surfactants, cosurfactants and suitable solvents, besides proper incubation temperatures (37-50˚C), adjusted aging times and doped of divalent ions-bridging (Ca2+, Mn2+ and Zn2+ ) between specific amino acids and carboxyl groups, are so vital factors in kinetically controlled self-assembly phenomenon of the natural protein building blocks to form high resistant and homogeneous nanoparticles and nanospheres in transparent and clear green nanofluids. Such nanofluids can have many applications in food and pharmaceutical industries for example in formulate foods with high nutritional value in oral and digestive (ingestion) routes, and drug delivery. Interesting textures of SEM images have also shown these new nanobiostructures of natural milk protein morphologies.

Research paper thumbnail of Long-term pulmonary complications in combatants exposed to mustard gas: a historical cohort study

International Journal of Epidemiology, 2004

Background Sulphur mustard (mustard gas), the most widely used chemical agent in the Iran-Iraq wa... more Background Sulphur mustard (mustard gas), the most widely used chemical agent in the Iran-Iraq war, affects many organs including the skin, the gastrointestinal and respiratory tracts, and the central nervous system. The aim of this study was to assess the cumulative incidence rate and annual incidence rate of pulmonary complications, and the rate ratio of related factors.

Research paper thumbnail of Can induction chemotherapy before concurrent chemoradiation impact circumferential resection margin positivity and survival in low rectal cancers?

Asian Pacific journal of cancer prevention : APJCP, 2015

Distance from anal verge and abdominoperineal resection are risk factors for circumferential rese... more Distance from anal verge and abdominoperineal resection are risk factors for circumferential resection margin (CRM) positivity in rectal cancer. Induction chemotherapy (IC) before concurrent chemoradiation (CRT) has emerged as a new treatment modification. Impact of IC before concurrent CRT on CRM positivity in low rectal cancer remains to be independently studied. The objective of this study was to determine CRM positivity in low rectal cancer, with and without prior IC, and to identify predictors of disease free and overall survival. Patients who underwent surgery for rectal cancer between 2005 and 2011 were retrospectively reviewed and divided into two groups. Group 1 received IC before CRT and Group 2 did not. Demographics, clinicopathological variables and CRM status were compared. Actuarial 5 year disease free survival (DFS), overall survival (OS) and independent predictors of survival were determined. Patients in the IC group presented with advanced stage (Stage 3=89.2% versu...

Research paper thumbnail of Outcome of rectal cancer in patients aged 30 years or less in the Pakistani population

Asian Pacific journal of cancer prevention : APJCP, 2014

The incidence of rectal cancer is increasing in younger age groups. Limited data is available reg... more The incidence of rectal cancer is increasing in younger age groups. Limited data is available regarding survival outcome in younger patients with conflicting results from western world. The goal of this study was to determine survival in patients with rectal cancer<30 years of age and compare it with their older counterparts in the Pakistani population. A retrospective chart review of patients operated for rectal adenocarcinoma between January 2005 and December 2010 was performed. Patients were divided into two groups, Group 1 aged ≤30 years and Group 2 aged…

Research paper thumbnail of Impact of lymph node ratio and number on survival in patients with rectal adenocarcinoma after preoperative chemo radiation

International Journal of Surgery, 2015

Background: Retrieval of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp... more Background: Retrieval of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;12 lymph nodes after proctectomy and preoperative chemoradiation (C-XRT) may improve survival in good risk patients. The objective of this study was to determine impact of…

Research paper thumbnail of Impact of acellular mucin pools on survival in patients with complete pathological response to neoadjuvant treatment in rectal cancer

International Journal of Surgery, 2014

Rarely, patients with pathological complete response (PCR) after neoadjuvant chemoradiotherapy de... more Rarely, patients with pathological complete response (PCR) after neoadjuvant chemoradiotherapy demonstrate acellular mucin pools. The prognostic significance of this finding is controversial. The objective of this study was to determine impact of acellular mucin pools on disease free and overall survival in patients with complete pathological response to neoadjuvant chemoradiotherapy in rectal cancer. One hundred and seventy two patients received neoadjuvant chemoradiotherapy for rectal cancer and underwent surgery. Patients were divided into two groups based on presence of acellular mucin pools. Locoregional failures, distant failures and deaths were compared. Expected 5 year disease free and overall survival was calculated. Median follow-up was 36(4-94) months. Complete pathological response was identified in 35(20.3%) patients. Of these, 12(34.2%) had acellular mucin pools in resected specimen. Majority of mucin negative tumors were moderately differentiated (78% vs 25%) (P = 0.005). Median overall survival for mucin positive and mucin negative tumors was 4(1.3-5.7) and 3.3(0.1-6.3) years respectively. Expected 5 year disease free and overall survival for mucin positive and mucin negative tumors was 73% and 89% (P = 0.1) and 75% and 87% (P = 0.4). Acellular mucin pools in rectal cancer following a PCR to neoadjuvant treatment do not impact survival.

Research paper thumbnail of Using telemedicine as an enabler for antenatal care in Pakistan

Pakistan is a developing country with more than 60% of its population residing in rural areas wit... more Pakistan is a developing country with more than 60% of its population residing in rural areas with insufficient health care facilities. The recent advancements in telemedicine provide a significant opportunity to the developing countries to develop a health infrastructure that addresses the needs of the rural population. In this paper, we discuss our model of a remote patient monitoring system (RPMS) that aims to provide a cost efficient yet effective health care system to the patients residing in the remote areas of Pakistan. In particular, we have initially selected the domain of antenatal care because of an alarming mother mortality rate of Pakistan. This system will augment the existing health care infrastructure.

Research paper thumbnail of Endoscopic Ultrasound-Guided Biliary Drainage: A Systematic Review and Meta-Analysis

Digestive diseases and sciences, Jan 30, 2015

Variable success and adverse event rates have been reported for endoscopic ultrasound-guided bili... more Variable success and adverse event rates have been reported for endoscopic ultrasound-guided biliary drainage (EUS-BD) utilizing either extrahepatic or intrahepatic approach. We aimed to conduct a proportion meta-analysis to evaluate the cumulative efficacy and safety of EUS-BD and to compare the two approaches and transluminal methods of EUS-BD. We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, ISI Web of Science, and Scopus from January 2001 through January 5, 2015, to identify studies reporting technical success and adverse events of EUS-BD. A sample size of more than 20 patients was a further criterion. Weighted pooled rate (WPR) for technical success and post-procedure complications was calculated for overall studies and predefined subgroups. Pooled odds ratios were calculated for technical success and adverse events for two approaches and transluminal methods of EUS-BD for distal common bile duct (CBD) strictures. The WPR with 95 % confidence interva...

Research paper thumbnail of Myelography in spinal disorders--experience of 1400 cases

JPMA. The Journal of the Pakistan Medical Association, 2004

To evaluate the diagnostic importance of myelography in spinal disorders, in correlation with cli... more To evaluate the diagnostic importance of myelography in spinal disorders, in correlation with clinical presentation of the patients. Patients selected for myelography had presented with history of various spinal disorders such as low backache, neurogenic claudication, paraparesis or paraplegia, quadriparesis or quadriplegia, trauma to spinal region and infective spondylitis. Patients excluded were those with history of allergies to iodinated contrast agents, seizures coagulopathy and pregnant women. Contrast agent was water soluble non ionic agent--lohexol. Spinal Needles used were of 20,22 and 25 gauge. X-Ray machine with tiltable table was used for myelography. There were 1400 patients of whom 935 were males and 465 females with male to female ratio of 2.1. Age range was 8 to 65 years. Spinal disorders diagnosed on myelography were lumbar disc prolapse 866 (60%) cases, lumbar canal stenosis 113 (8%), thoracic disc protrusions 15 (1%), infective spondylitis 53 (4%) cases, spinal tu...

Research paper thumbnail of Endoscopic treatment of nonstricture-related benign biliary diseases using covered self-expandable metal stents

Endoscopy, Jan 18, 2014

Background and study aims: Nonstricture benign biliary diseases (BBDs) such as leaks, perforation... more Background and study aims: Nonstricture benign biliary diseases (BBDs) such as leaks, perforations, and bleeding, have been traditionally managed by placement of one or more plastic stents. Emerging data support the use of covered, self-expandable, metal stents (CSEMSs). The aim of this study was to assess the outcomes of endoscopic temporary placement of CSEMS in patients with nonstricture BBD. Patients and methods: This was a retrospective study of CSEMS placement for BBD between May 2005 and August 2013 at two tertiary care centers. The main outcome measures were resolution of perforation, bleeding, leak, and adverse events related to CSEMS treatment. Results: A total of 87 patients were included (median age 62 years [range 18 - 86]). Indications for stent placement were bile leaks (n = 35, 40 %), bleeding (n = 27, 31 %), perforation (n = 18, 21 %), and other conditions (n = 7, 8 %). Fully and partially covered 8 - 10-mm diameter CSEMS were placed and subsequently removed in all ...

Research paper thumbnail of Severe Ischemic Pancreatitis Following the Use of Extracorporeal Membrane Oxygenation

Journal of Pediatric Gastroenterology and Nutrition, 2012

Research paper thumbnail of Mo1338 Use of Covered Self Expandable Metal Stents (CSEMS) for Endoscopic Management of Non-Stricture Related Benign Biliary Diseases

Gastrointestinal Endoscopy, 2012

Research paper thumbnail of Use of covered self-expandable metal stents for endoscopic management of benign biliary disease not related to stricture (with video)

Gastrointestinal Endoscopy, 2012

Research paper thumbnail of Placement of fully covered self-expandable metal stents to control entry-related bleeding during transmural drainage of pancreatic fluid collections (with video)

Gastrointestinal Endoscopy, 2012

Research paper thumbnail of Ischemic biliary injury following extra-corporeal membrane oxygenation (ECMO)

Digestive and Liver Disease, 2012