Syed Rizvi | Ziauddin Medical University (original) (raw)

Papers by Syed Rizvi

"Asthma is a disease characterized by wide variations in pathogenesis that cause... more "Asthma is a disease characterized by wide variations in pathogenesis that cause resistance to flow in intrapulmonary airways. The dramatic changes in the architecture of the airway walls are usually connected to allergic reaction or other forms of hyper sensitivity, causing marked spasms that lead to difficulty in breathing. It is possible to relieve or remove the symptoms in the majority of patients by adopting the clinical guidelines for pharmacotherapy of asthma which include inhaled corticosteroids, long and short acting beta agonists, muscarinic antagonists, leukotriene modifiers, xanthine drugs and some allergy medicines. The proper use of these agents can aid in reducing or reversing many symptoms of asthma. Certain methods of using medicines, for example the correct use of the inhaler for relief and maintenance therapy, are also associated with a significant reduction in symptoms. This can be achieved by a pharmacist’s intervention that can provide a detailed understanding of the current rational drug choices and proper medication use to the patient. Nowadays massive resources are being ploughed into research in a concerted effort to halt the progress of this illness that can strike in all ages."

Tuberculosis (TB) is the most important community health dilemma in Pakistan. TB has been prevale... more Tuberculosis (TB) is the most important community health dilemma in Pakistan. TB has been prevalent in Pakistan since last 10 years and unfortunately it has been one of the neglected and mistreated health diseases in the past. Globally, Pakistan ranks 7th amongst the countries with highest load of TB in the world. Pakistan contributes about 44% of tuberculosis problems in the Eastern Mediterranean Region. the World Health Organization (WHO), reported that incidence of sputum positive TB cases in Pakistan is 80/100000 per year and for all types it is 177/100000.The objective of this study was to determine the level of knowledge about tuberculosis among patients in Karachi. The campaign regarding the DOTS strategy by WHO and implementation of the strategy in TB control programs has led an up to 95% cure rate in some countries. A considerable decline in the prevalence of drug resistance amongst TB patients has observed. The most controlling weapon for controlling and preventing TB are ...

Overweight and obesity is one of the major health problems in the UK and worldwide. Approximately... more Overweight and obesity is one of the major health problems in the UK and worldwide. Approximately two-thirds of the population in the UK is either overweight or obese. Overweight and obesity is an important issue that causes distress to most women. Health promotion is the best method to educate overweight and obese women. It is defined as the process enabling people to increase control over and to improve their health by Ottawa Charter for Health Promotion. It is aimed to enhance the well-being of the individuals and their positive attitudes towards prevention of various diseases. In order to make any improvement to the health promotion for overweight and obesity, the risk factors and the opinions from the public should first be identified and addressed. Cross-sectional survey design was selected with a questionnaire that consisted of 20 open and close ended questions. A sample size of 196 was determined. The data thus gathered was analyzed using SPSS V20 (Statistical Package for So...

Urology journal, 2011

To determine the value of color Doppler ultrasonography (CDUS) as a routine investigational metho... more To determine the value of color Doppler ultrasonography (CDUS) as a routine investigational method for diagnosis of scrotal pathologies. This prospective observational study (case series) was carried out over a period of 16 months on 122 patients in the age range of 13 to 70 years old, who presented with scrotal swellings. After adequate history taking and examination, CDUS was performed. The diagnosis of the surgeon and that of radiologist were compared with final outcome, which was based on course and outcome of the disease, fine needle aspiration cytology results, and operative findings. The final diagnoses were epididymitis or epididymo-orchitis (46), hydrocele (26), varicocele (16), testicular malignancy (16), orchitis (6), testicular torsion (4), spermatic cord injury (2), hematocele (2), and pyocele (2). Color Doppler ultrasonography accurately diagnosed all cases of epididymitis or epididymo-orchitis, spermatic cord injury, testicular torsion, varicocele, and hydrocele (sens...

Pain management, 2012

SUMMARY Pain is a complex behavior process, the anatomy and physiology of which is not completely... more SUMMARY Pain is a complex behavior process, the anatomy and physiology of which is not completely understood, and is subject to continuous exploration and research. Following on the heels of Melzack and Wall's gate control theory of pain (1965), Shealey et al., in 1967, were the first to implant stimulation electrodes over the dorsal columns in an attempt to provide relief for patients with chronic, intractable pain. Since then, significant strides in both the technological and therapeutic sides have facilitated the evolution of spinal cord stimulation (SCS) in the management of a variety of pain pathologies. High-quality evidence attests to the efficacy and cost-effectiveness of this modality. In contrast to conventional medical management, SCS offers long-lasting symptom relief, improved quality of life and functional capability, often achieving these goals at a reduced cost. This article illustrates the present status, challenges and future of SCS.

Neuromodulation: Technology at the Neural Interface, 2014

Objectives: This study aims to review the current state of spinal cord stimulation for the treatm... more Objectives: This study aims to review the current state of spinal cord stimulation for the treatment of chronic pain associated with failed back surgery syndrome (FBSS) and complex regional pain syndrome (CRPS) and to describe intraspinal targets and stimulation parameters, patient selection, therapy cost-effectiveness, and strategies to improve outcomes.

Comprehensive Treatment of Chronic Pain by Medical, Interventional, and Integrative Approaches, 2012

Pain Medicine, 2013

Objective. To evaluate the cost-effectiveness of spinal cord stimulation (SCS) and conventional m... more Objective. To evaluate the cost-effectiveness of spinal cord stimulation (SCS) and conventional medical management (CMM) compared with CMM alone for patients with failed back surgery syndrome (FBSS), complex regional pain syndrome (CRPS), peripheral arterial disease (PAD), and refractory angina pectoris (RAP).

The Clinical Journal of Pain, 2013

Objective: To evaluate the cost effectiveness of intrathecal drug therapy (IDT) compared with con... more Objective: To evaluate the cost effectiveness of intrathecal drug therapy (IDT) compared with conventional medical management (CMM) for patients with refractory chronic noncancer pain.

Urologic Oncology: Seminars and Original Investigations, 2016

The Glutathione S-transferases (GSTs) genes deletion polymorphisms have been associated with the ... more The Glutathione S-transferases (GSTs) genes deletion polymorphisms have been associated with the progression of several cancers. The association studies between the 2 GSTs (GSTM1 and GSTT1) null polymorphisms with the susceptibility to renal cell carcinoma (RCC) have been inconclusive. Therefore, with the inclusion of our own data, we performed a comprehensive meta-analysis to assess the association between these 2 polymorphisms and the risk of RCC. A systematic literature search was carried out for studies published in the PubMed, EMBASE, Cochrane library, and Google Scholar from 1997 to December 2014. Results were stated as pooled odds ratios (ORs) for nonparametric data after heterogeneity analysis with 95% CI using fixed effect or random effect model. We systematically selected 13 relevant studies after thorough searches from the databases. Data showed no association between the GSTM1 and the GSTT1 null genotypes and the risk of RCC (OR = 1.01; CI: 0.92-1.11; P = 0.89 for GSTM1 and OR = 1.14; CI: 0.91-1.42; P = 0.25 for GSTT1). No association was found when the data were stratified according to the geographical/ethnic basis, source of control, and the risk factor evaluation. Subgroup analysis of occupational exposure to pesticides showed an inverse association of the active genotypes of both GSTM1 and GSTT1 polymorphisms with the exposed group of RCC (P<0.00001 and P<0.00001, respectively). The combined null genotype of the GSTM1/GSTT1 significantly increased the susceptibility to RCC by 1.4-fold (P = 0.001). This association remained significant for the Asian populations in subgroup analysis (OR = 1.8; CI: 1.30-2.49; P = 0.0004). In conclusion, this meta-analysis suggests that the 2 GSTs deletion polymorphisms independently have no association with the risk of RCC. However, combination of both deletions increases the risk of developing the RCC.

Clinical Transplantation, 2015

Acute rejections (ARs) with plasma cell-rich infiltrates (PCARs) are associated with poor outcome... more Acute rejections (ARs) with plasma cell-rich infiltrates (PCARs) are associated with poor outcomes. Between February 2012 and December 2013, 1630 dysfunctional renal graft biopsies were performed. Of these, 50 (3%) showed PCAR. ARs with >10% plasma cells were defined as PCAR. Human leukocyte antigen (HLA) antibodies were tested in historic sera and at the time of PCAR. Treatment for PCAR comprised methylprednisolone, antithymocyte globulin, plasmapheresis, and anti-CD20 antibody. Of the 1630 dysfunctional biopsies, 50 (3%) had PCAR which occurred 3.1 ± 2.55 yr after transplant. The percentage of plasma cells was 28.8 ± 11.7, and CD138, 29.0 ± 12.4. Donor-specific antibodies (DSAs) were found in 32 (64%) overall, Class I in 15% and Class II in 65%. Post-treatment serum creatinine improved from 3.80 ± 2.59 to 2.66 ± 1.59 mg/dL in DSA positive (p < 0.003) and from 2.59 ± 1.09 to 2.08 ± 0.86 mg/dL in DSA negative (p < 0.008). One- and two-yr graft survival after PCAR was 72%, 42% in the DSA-positive vs. 89%, 82% in the DSA-negative group, respectively (p = 0.071). Our results show that PCAR occurs late after transplant and in many cases is associated with DSAs. Graft outcome was poor when PCAR was associated with DSAs.

Journal of surgical case reports, 2010

Sebaceous gland carcinomas (SGC) are highly malignant lid tumors which originate from meibomian g... more Sebaceous gland carcinomas (SGC) are highly malignant lid tumors which originate from meibomian glands and rarely from the gland of Zeis, sebaceous gland of caruncle, eyebrows and periocular skin. In many cases correct diagnosis of SGC is delayed because of its ability to masquerade as a variety of other ocular conditions. A forty year old male presented with a left upper eyelid swelling with an ulcerated wound on its nasal aspect. A differential diagnosis of sebaceous gland carcinoma or preseptal cellulitis was made. Contrast enhanced computed tomography showed an ill defined soft tissue density mass in the left orbit encasing the whole of the optic nerve. A total exentration was performed. A diagnosis of meibomian gland carcinoma was confirmed on histopathology. This is a report of an advanced sebaceous gland carcinoma with deep orbital extension. An early diagnosis and appropriate treatment may decrease the long term morbidity and extend the survival rate of such patients.

Neuromodulation : journal of the International Neuromodulation Society, 2014

The Neuromodulation Appropriateness Consensus Committee (NACC) of the International Neuromodulati... more The Neuromodulation Appropriateness Consensus Committee (NACC) of the International Neuromodulation Society (INS) evaluated evidence regarding the safety and efficacy of neurostimulation to treat chronic pain, chronic critical limb ischemia, and refractory angina and recommended appropriate clinical applications. The NACC used literature reviews, expert opinion, clinical experience, and individual research. Authors consulted the Practice Parameters for the Use of Spinal Cord Stimulation in the Treatment of Neuropathic Pain (2006), systematic reviews (1984 to 2013), and prospective and randomized controlled trials (2005 to 2013) identified through PubMed, EMBASE, and Google Scholar. Neurostimulation is relatively safe because of its minimally invasive and reversible characteristics. Comparison with medical management is difficult, as patients considered for neurostimulation have failed conservative management. Unlike alternative therapies, neurostimulation is not associated with medi...

Mutation Research/Fundamental and Molecular Mechanisms of Mutagenesis, 2014

"Asthma is a disease characterized by wide variations in pathogenesis that cause... more "Asthma is a disease characterized by wide variations in pathogenesis that cause resistance to flow in intrapulmonary airways. The dramatic changes in the architecture of the airway walls are usually connected to allergic reaction or other forms of hyper sensitivity, causing marked spasms that lead to difficulty in breathing. It is possible to relieve or remove the symptoms in the majority of patients by adopting the clinical guidelines for pharmacotherapy of asthma which include inhaled corticosteroids, long and short acting beta agonists, muscarinic antagonists, leukotriene modifiers, xanthine drugs and some allergy medicines. The proper use of these agents can aid in reducing or reversing many symptoms of asthma. Certain methods of using medicines, for example the correct use of the inhaler for relief and maintenance therapy, are also associated with a significant reduction in symptoms. This can be achieved by a pharmacist’s intervention that can provide a detailed understanding of the current rational drug choices and proper medication use to the patient. Nowadays massive resources are being ploughed into research in a concerted effort to halt the progress of this illness that can strike in all ages."

Tuberculosis (TB) is the most important community health dilemma in Pakistan. TB has been prevale... more Tuberculosis (TB) is the most important community health dilemma in Pakistan. TB has been prevalent in Pakistan since last 10 years and unfortunately it has been one of the neglected and mistreated health diseases in the past. Globally, Pakistan ranks 7th amongst the countries with highest load of TB in the world. Pakistan contributes about 44% of tuberculosis problems in the Eastern Mediterranean Region. the World Health Organization (WHO), reported that incidence of sputum positive TB cases in Pakistan is 80/100000 per year and for all types it is 177/100000.The objective of this study was to determine the level of knowledge about tuberculosis among patients in Karachi. The campaign regarding the DOTS strategy by WHO and implementation of the strategy in TB control programs has led an up to 95% cure rate in some countries. A considerable decline in the prevalence of drug resistance amongst TB patients has observed. The most controlling weapon for controlling and preventing TB are ...

Overweight and obesity is one of the major health problems in the UK and worldwide. Approximately... more Overweight and obesity is one of the major health problems in the UK and worldwide. Approximately two-thirds of the population in the UK is either overweight or obese. Overweight and obesity is an important issue that causes distress to most women. Health promotion is the best method to educate overweight and obese women. It is defined as the process enabling people to increase control over and to improve their health by Ottawa Charter for Health Promotion. It is aimed to enhance the well-being of the individuals and their positive attitudes towards prevention of various diseases. In order to make any improvement to the health promotion for overweight and obesity, the risk factors and the opinions from the public should first be identified and addressed. Cross-sectional survey design was selected with a questionnaire that consisted of 20 open and close ended questions. A sample size of 196 was determined. The data thus gathered was analyzed using SPSS V20 (Statistical Package for So...

Urology journal, 2011

To determine the value of color Doppler ultrasonography (CDUS) as a routine investigational metho... more To determine the value of color Doppler ultrasonography (CDUS) as a routine investigational method for diagnosis of scrotal pathologies. This prospective observational study (case series) was carried out over a period of 16 months on 122 patients in the age range of 13 to 70 years old, who presented with scrotal swellings. After adequate history taking and examination, CDUS was performed. The diagnosis of the surgeon and that of radiologist were compared with final outcome, which was based on course and outcome of the disease, fine needle aspiration cytology results, and operative findings. The final diagnoses were epididymitis or epididymo-orchitis (46), hydrocele (26), varicocele (16), testicular malignancy (16), orchitis (6), testicular torsion (4), spermatic cord injury (2), hematocele (2), and pyocele (2). Color Doppler ultrasonography accurately diagnosed all cases of epididymitis or epididymo-orchitis, spermatic cord injury, testicular torsion, varicocele, and hydrocele (sens...

Pain management, 2012

SUMMARY Pain is a complex behavior process, the anatomy and physiology of which is not completely... more SUMMARY Pain is a complex behavior process, the anatomy and physiology of which is not completely understood, and is subject to continuous exploration and research. Following on the heels of Melzack and Wall's gate control theory of pain (1965), Shealey et al., in 1967, were the first to implant stimulation electrodes over the dorsal columns in an attempt to provide relief for patients with chronic, intractable pain. Since then, significant strides in both the technological and therapeutic sides have facilitated the evolution of spinal cord stimulation (SCS) in the management of a variety of pain pathologies. High-quality evidence attests to the efficacy and cost-effectiveness of this modality. In contrast to conventional medical management, SCS offers long-lasting symptom relief, improved quality of life and functional capability, often achieving these goals at a reduced cost. This article illustrates the present status, challenges and future of SCS.

Neuromodulation: Technology at the Neural Interface, 2014

Objectives: This study aims to review the current state of spinal cord stimulation for the treatm... more Objectives: This study aims to review the current state of spinal cord stimulation for the treatment of chronic pain associated with failed back surgery syndrome (FBSS) and complex regional pain syndrome (CRPS) and to describe intraspinal targets and stimulation parameters, patient selection, therapy cost-effectiveness, and strategies to improve outcomes.

Comprehensive Treatment of Chronic Pain by Medical, Interventional, and Integrative Approaches, 2012

Pain Medicine, 2013

Objective. To evaluate the cost-effectiveness of spinal cord stimulation (SCS) and conventional m... more Objective. To evaluate the cost-effectiveness of spinal cord stimulation (SCS) and conventional medical management (CMM) compared with CMM alone for patients with failed back surgery syndrome (FBSS), complex regional pain syndrome (CRPS), peripheral arterial disease (PAD), and refractory angina pectoris (RAP).

The Clinical Journal of Pain, 2013

Objective: To evaluate the cost effectiveness of intrathecal drug therapy (IDT) compared with con... more Objective: To evaluate the cost effectiveness of intrathecal drug therapy (IDT) compared with conventional medical management (CMM) for patients with refractory chronic noncancer pain.

Urologic Oncology: Seminars and Original Investigations, 2016

The Glutathione S-transferases (GSTs) genes deletion polymorphisms have been associated with the ... more The Glutathione S-transferases (GSTs) genes deletion polymorphisms have been associated with the progression of several cancers. The association studies between the 2 GSTs (GSTM1 and GSTT1) null polymorphisms with the susceptibility to renal cell carcinoma (RCC) have been inconclusive. Therefore, with the inclusion of our own data, we performed a comprehensive meta-analysis to assess the association between these 2 polymorphisms and the risk of RCC. A systematic literature search was carried out for studies published in the PubMed, EMBASE, Cochrane library, and Google Scholar from 1997 to December 2014. Results were stated as pooled odds ratios (ORs) for nonparametric data after heterogeneity analysis with 95% CI using fixed effect or random effect model. We systematically selected 13 relevant studies after thorough searches from the databases. Data showed no association between the GSTM1 and the GSTT1 null genotypes and the risk of RCC (OR = 1.01; CI: 0.92-1.11; P = 0.89 for GSTM1 and OR = 1.14; CI: 0.91-1.42; P = 0.25 for GSTT1). No association was found when the data were stratified according to the geographical/ethnic basis, source of control, and the risk factor evaluation. Subgroup analysis of occupational exposure to pesticides showed an inverse association of the active genotypes of both GSTM1 and GSTT1 polymorphisms with the exposed group of RCC (P<0.00001 and P<0.00001, respectively). The combined null genotype of the GSTM1/GSTT1 significantly increased the susceptibility to RCC by 1.4-fold (P = 0.001). This association remained significant for the Asian populations in subgroup analysis (OR = 1.8; CI: 1.30-2.49; P = 0.0004). In conclusion, this meta-analysis suggests that the 2 GSTs deletion polymorphisms independently have no association with the risk of RCC. However, combination of both deletions increases the risk of developing the RCC.

Clinical Transplantation, 2015

Acute rejections (ARs) with plasma cell-rich infiltrates (PCARs) are associated with poor outcome... more Acute rejections (ARs) with plasma cell-rich infiltrates (PCARs) are associated with poor outcomes. Between February 2012 and December 2013, 1630 dysfunctional renal graft biopsies were performed. Of these, 50 (3%) showed PCAR. ARs with >10% plasma cells were defined as PCAR. Human leukocyte antigen (HLA) antibodies were tested in historic sera and at the time of PCAR. Treatment for PCAR comprised methylprednisolone, antithymocyte globulin, plasmapheresis, and anti-CD20 antibody. Of the 1630 dysfunctional biopsies, 50 (3%) had PCAR which occurred 3.1 ± 2.55 yr after transplant. The percentage of plasma cells was 28.8 ± 11.7, and CD138, 29.0 ± 12.4. Donor-specific antibodies (DSAs) were found in 32 (64%) overall, Class I in 15% and Class II in 65%. Post-treatment serum creatinine improved from 3.80 ± 2.59 to 2.66 ± 1.59 mg/dL in DSA positive (p < 0.003) and from 2.59 ± 1.09 to 2.08 ± 0.86 mg/dL in DSA negative (p < 0.008). One- and two-yr graft survival after PCAR was 72%, 42% in the DSA-positive vs. 89%, 82% in the DSA-negative group, respectively (p = 0.071). Our results show that PCAR occurs late after transplant and in many cases is associated with DSAs. Graft outcome was poor when PCAR was associated with DSAs.

Journal of surgical case reports, 2010

Sebaceous gland carcinomas (SGC) are highly malignant lid tumors which originate from meibomian g... more Sebaceous gland carcinomas (SGC) are highly malignant lid tumors which originate from meibomian glands and rarely from the gland of Zeis, sebaceous gland of caruncle, eyebrows and periocular skin. In many cases correct diagnosis of SGC is delayed because of its ability to masquerade as a variety of other ocular conditions. A forty year old male presented with a left upper eyelid swelling with an ulcerated wound on its nasal aspect. A differential diagnosis of sebaceous gland carcinoma or preseptal cellulitis was made. Contrast enhanced computed tomography showed an ill defined soft tissue density mass in the left orbit encasing the whole of the optic nerve. A total exentration was performed. A diagnosis of meibomian gland carcinoma was confirmed on histopathology. This is a report of an advanced sebaceous gland carcinoma with deep orbital extension. An early diagnosis and appropriate treatment may decrease the long term morbidity and extend the survival rate of such patients.

Neuromodulation : journal of the International Neuromodulation Society, 2014

The Neuromodulation Appropriateness Consensus Committee (NACC) of the International Neuromodulati... more The Neuromodulation Appropriateness Consensus Committee (NACC) of the International Neuromodulation Society (INS) evaluated evidence regarding the safety and efficacy of neurostimulation to treat chronic pain, chronic critical limb ischemia, and refractory angina and recommended appropriate clinical applications. The NACC used literature reviews, expert opinion, clinical experience, and individual research. Authors consulted the Practice Parameters for the Use of Spinal Cord Stimulation in the Treatment of Neuropathic Pain (2006), systematic reviews (1984 to 2013), and prospective and randomized controlled trials (2005 to 2013) identified through PubMed, EMBASE, and Google Scholar. Neurostimulation is relatively safe because of its minimally invasive and reversible characteristics. Comparison with medical management is difficult, as patients considered for neurostimulation have failed conservative management. Unlike alternative therapies, neurostimulation is not associated with medi...

Mutation Research/Fundamental and Molecular Mechanisms of Mutagenesis, 2014