I am a surgeon by profession .working as Associate Professor at Dow University of health sciences Karachi,Pakistan.professional Qualification:MBBS.FCPS
Abstract:
Background: It had generally been thought that male gender is associated with diffi cul... more Abstract: Background: It had generally been thought that male gender is associated with diffi cult cholecystectomies. Laparoscopic Cholecystectomy has been considered as a standard of care for treating patients with gall stone disease. However increased diffi culties are encountered when males undergo surgery with increased conversion rates to open procedures. Objective: Th e objective of our study was to analyze gender as predictor of conversion of laparoscopic to open cholecystectomy and to also fi nd out other factors predicting conversion of laparoscopic to open cholecystectomy. Material and methods: We conducted Retrospective Cohort Study at Surgical Unit IV Civil Hospital Karachi. Record of all the patients who had undergone Laparoscopic Cholecystectomy from Jan 2013 to Dec 2013 were retrieved and reviewed. Patients were divided into two sub groups based upon their gender. Exposed group included male patients with gall stones disease and control group included female patients with gall stone disease. Results: A total of 123 Laparoscopic Cholecystectomies were performed in the above mentioned period. 24%(30) of the participants were males while seventy six percent of the participants (93) were females. Mean age of the participants was 40 +/- 11.8 years. Mean age of males was 45 +/- 14.5 years while that of females was 38.6 +/- 10.5 years, p value 0.028. 12 (9.8%) patients required conversion of the laparoscopic to open procedure. Th e risk of conversation of laparoscopic cholecystectomy to open procedure in male patients was 4.34 times those of female patients which when adjusted for covariates including age and cholecystitis reduced to 2.95 and did not achieve statistical signifi cance. For male patients, adjusted relative risk for operating surgeon to encounter diffi culty during operation turned out to be 1.86 times than those for female patients but this did not achieve statistical signifi cance. Conclusion: Male gender does exhibit increased diffi culty and conversion to open procedures while performing laparoscopic cholecystectomy however in our study they did not achieve statistical signifi cance. Whether gender is an important risk factor to encounter diffi culties and increased conversions to open procedures still needs to be studied in prospective setting
Identifying patients who are at risk for conversion from laparoscopic (LC) to open cholecystectom... more Identifying patients who are at risk for conversion from laparoscopic (LC) to open cholecystectomy (OC) has proven to be difficult. The purpose of this review was to identify factors that may be predictive of cases which will require conversion to laparotomy for completion of cholecystectomy. We reviewed 581 LCs initiated between July 1990 and August 1993 at a university medical center and recorded reasons for conversion to OC. Statistical analysis was then performed to identify factors predictive of increased risk for conversion. Of the 581 LC initiated, 45 (8%) required OC for completion. Reasons for conversion included technical and mandatory reasons and equipment failure. By multivariate analysis, statistically significant risk factors for conversion included increasing age, acute cholecystitis, a history of previous upper abdominal surgery, and being a patient at the Veterans Affairs Medical Center (VAMC). Factors not increasing risk of conversion included gender and operating surgeon. We conclude that no factor alone can reliably predict unsuccessful LC, but that combinations of increasing age, acute cholecystitis, previous upper abdominal surgery, and VAMC patient result in high conversion rates. Patients with the defined risk factors may be counseled on the increased likelihood of conversion. However, LC can be safely initiated for gallbladder removal with no excess morbidity or mortality should conversion be required.
Objective: To determine the frequency of early breast cancer in women presenting with palpable b... more Objective: To determine the frequency of early breast cancer in women presenting with palpable breast lumps. Study design: Prospective cohort study. Place & Duration of study: Surgical Unit - IV Civil Hospital Karachi, from December 2011 to June 2012. Methodology: All female patients 13 year and above with palpable breast lumps were recruited in this study after seeking their consent. Triple assessment was carried out and core biopsies taken. Histopathology reports were recorded. To determine the frequency of early breast cancer in women presenting with palpable breast lumps. Results: Two hundred and eighty two females between 15 to 80 year (mean= 36.5 year) presented with breast lumps. Of the total 72% (n=199) lumps were benign on histopathology while 29 % (n=83) showed malignancy. There were 19 (7%) cases of breast abscess. Conclusion: The frequency of breast cancer was 29% in present group of patients presenting with breast lumps.
Abstract:
Background: It had generally been thought that male gender is associated with diffi cul... more Abstract: Background: It had generally been thought that male gender is associated with diffi cult cholecystectomies. Laparoscopic Cholecystectomy has been considered as a standard of care for treating patients with gall stone disease. However increased diffi culties are encountered when males undergo surgery with increased conversion rates to open procedures. Objective: Th e objective of our study was to analyze gender as predictor of conversion of laparoscopic to open cholecystectomy and to also fi nd out other factors predicting conversion of laparoscopic to open cholecystectomy. Material and methods: We conducted Retrospective Cohort Study at Surgical Unit IV Civil Hospital Karachi. Record of all the patients who had undergone Laparoscopic Cholecystectomy from Jan 2013 to Dec 2013 were retrieved and reviewed. Patients were divided into two sub groups based upon their gender. Exposed group included male patients with gall stones disease and control group included female patients with gall stone disease. Results: A total of 123 Laparoscopic Cholecystectomies were performed in the above mentioned period. 24%(30) of the participants were males while seventy six percent of the participants (93) were females. Mean age of the participants was 40 +/- 11.8 years. Mean age of males was 45 +/- 14.5 years while that of females was 38.6 +/- 10.5 years, p value 0.028. 12 (9.8%) patients required conversion of the laparoscopic to open procedure. Th e risk of conversation of laparoscopic cholecystectomy to open procedure in male patients was 4.34 times those of female patients which when adjusted for covariates including age and cholecystitis reduced to 2.95 and did not achieve statistical signifi cance. For male patients, adjusted relative risk for operating surgeon to encounter diffi culty during operation turned out to be 1.86 times than those for female patients but this did not achieve statistical signifi cance. Conclusion: Male gender does exhibit increased diffi culty and conversion to open procedures while performing laparoscopic cholecystectomy however in our study they did not achieve statistical signifi cance. Whether gender is an important risk factor to encounter diffi culties and increased conversions to open procedures still needs to be studied in prospective setting
Identifying patients who are at risk for conversion from laparoscopic (LC) to open cholecystectom... more Identifying patients who are at risk for conversion from laparoscopic (LC) to open cholecystectomy (OC) has proven to be difficult. The purpose of this review was to identify factors that may be predictive of cases which will require conversion to laparotomy for completion of cholecystectomy. We reviewed 581 LCs initiated between July 1990 and August 1993 at a university medical center and recorded reasons for conversion to OC. Statistical analysis was then performed to identify factors predictive of increased risk for conversion. Of the 581 LC initiated, 45 (8%) required OC for completion. Reasons for conversion included technical and mandatory reasons and equipment failure. By multivariate analysis, statistically significant risk factors for conversion included increasing age, acute cholecystitis, a history of previous upper abdominal surgery, and being a patient at the Veterans Affairs Medical Center (VAMC). Factors not increasing risk of conversion included gender and operating surgeon. We conclude that no factor alone can reliably predict unsuccessful LC, but that combinations of increasing age, acute cholecystitis, previous upper abdominal surgery, and VAMC patient result in high conversion rates. Patients with the defined risk factors may be counseled on the increased likelihood of conversion. However, LC can be safely initiated for gallbladder removal with no excess morbidity or mortality should conversion be required.
Objective: To determine the frequency of early breast cancer in women presenting with palpable b... more Objective: To determine the frequency of early breast cancer in women presenting with palpable breast lumps. Study design: Prospective cohort study. Place & Duration of study: Surgical Unit - IV Civil Hospital Karachi, from December 2011 to June 2012. Methodology: All female patients 13 year and above with palpable breast lumps were recruited in this study after seeking their consent. Triple assessment was carried out and core biopsies taken. Histopathology reports were recorded. To determine the frequency of early breast cancer in women presenting with palpable breast lumps. Results: Two hundred and eighty two females between 15 to 80 year (mean= 36.5 year) presented with breast lumps. Of the total 72% (n=199) lumps were benign on histopathology while 29 % (n=83) showed malignancy. There were 19 (7%) cases of breast abscess. Conclusion: The frequency of breast cancer was 29% in present group of patients presenting with breast lumps.
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Background: It had generally been thought that male gender is associated with diffi cult cholecystectomies.
Laparoscopic Cholecystectomy has been considered as a standard of care for
treating patients with gall stone disease. However increased diffi culties are encountered when
males undergo surgery with increased conversion rates to open procedures.
Objective: Th e objective of our study was to analyze gender as predictor of conversion of
laparoscopic to open cholecystectomy and to also fi nd out other factors predicting conversion
of laparoscopic to open cholecystectomy.
Material and methods: We conducted Retrospective Cohort Study at Surgical Unit IV Civil
Hospital Karachi. Record of all the patients who had undergone Laparoscopic Cholecystectomy
from Jan 2013 to Dec 2013 were retrieved and reviewed. Patients were divided into two
sub groups based upon their gender. Exposed group included male patients with gall stones
disease and control group included female patients with gall stone disease.
Results: A total of 123 Laparoscopic Cholecystectomies were performed in the above mentioned
period. 24%(30) of the participants were males while seventy six percent of the participants
(93) were females. Mean age of the participants was 40 +/- 11.8 years. Mean age of males
was 45 +/- 14.5 years while that of females was 38.6 +/- 10.5 years, p value 0.028. 12 (9.8%)
patients required conversion of the laparoscopic to open procedure. Th e risk of conversation
of laparoscopic cholecystectomy to open procedure in male patients was 4.34 times those of
female patients which when adjusted for covariates including age and cholecystitis reduced
to 2.95 and did not achieve statistical signifi cance. For male patients, adjusted relative risk for
operating surgeon to encounter diffi culty during operation turned out to be 1.86 times than
those for female patients but this did not achieve statistical signifi cance.
Conclusion: Male gender does exhibit increased diffi culty and conversion to open procedures
while performing laparoscopic cholecystectomy however in our study they did not achieve statistical
signifi cance. Whether gender is an important risk factor to encounter diffi culties and
increased conversions to open procedures still needs to be studied in prospective setting
Study design: Prospective cohort study.
Place & Duration of study: Surgical Unit - IV Civil Hospital Karachi, from December 2011 to June 2012.
Methodology: All female patients 13 year and above with palpable breast lumps were recruited in this study after seeking their consent. Triple assessment was carried out and core biopsies taken. Histopathology reports were recorded. To determine the frequency of early breast cancer in women presenting with palpable breast lumps.
Results: Two hundred and eighty two females between 15 to 80 year (mean= 36.5 year) presented with breast lumps. Of the total 72% (n=199) lumps were benign on histopathology while 29 % (n=83) showed malignancy. There were 19 (7%) cases of breast abscess.
Conclusion: The frequency of breast cancer was 29% in present group of patients presenting with breast lumps.
Background: It had generally been thought that male gender is associated with diffi cult cholecystectomies.
Laparoscopic Cholecystectomy has been considered as a standard of care for
treating patients with gall stone disease. However increased diffi culties are encountered when
males undergo surgery with increased conversion rates to open procedures.
Objective: Th e objective of our study was to analyze gender as predictor of conversion of
laparoscopic to open cholecystectomy and to also fi nd out other factors predicting conversion
of laparoscopic to open cholecystectomy.
Material and methods: We conducted Retrospective Cohort Study at Surgical Unit IV Civil
Hospital Karachi. Record of all the patients who had undergone Laparoscopic Cholecystectomy
from Jan 2013 to Dec 2013 were retrieved and reviewed. Patients were divided into two
sub groups based upon their gender. Exposed group included male patients with gall stones
disease and control group included female patients with gall stone disease.
Results: A total of 123 Laparoscopic Cholecystectomies were performed in the above mentioned
period. 24%(30) of the participants were males while seventy six percent of the participants
(93) were females. Mean age of the participants was 40 +/- 11.8 years. Mean age of males
was 45 +/- 14.5 years while that of females was 38.6 +/- 10.5 years, p value 0.028. 12 (9.8%)
patients required conversion of the laparoscopic to open procedure. Th e risk of conversation
of laparoscopic cholecystectomy to open procedure in male patients was 4.34 times those of
female patients which when adjusted for covariates including age and cholecystitis reduced
to 2.95 and did not achieve statistical signifi cance. For male patients, adjusted relative risk for
operating surgeon to encounter diffi culty during operation turned out to be 1.86 times than
those for female patients but this did not achieve statistical signifi cance.
Conclusion: Male gender does exhibit increased diffi culty and conversion to open procedures
while performing laparoscopic cholecystectomy however in our study they did not achieve statistical
signifi cance. Whether gender is an important risk factor to encounter diffi culties and
increased conversions to open procedures still needs to be studied in prospective setting
Study design: Prospective cohort study.
Place & Duration of study: Surgical Unit - IV Civil Hospital Karachi, from December 2011 to June 2012.
Methodology: All female patients 13 year and above with palpable breast lumps were recruited in this study after seeking their consent. Triple assessment was carried out and core biopsies taken. Histopathology reports were recorded. To determine the frequency of early breast cancer in women presenting with palpable breast lumps.
Results: Two hundred and eighty two females between 15 to 80 year (mean= 36.5 year) presented with breast lumps. Of the total 72% (n=199) lumps were benign on histopathology while 29 % (n=83) showed malignancy. There were 19 (7%) cases of breast abscess.
Conclusion: The frequency of breast cancer was 29% in present group of patients presenting with breast lumps.