Publications by authors named "Ahmed Siddique Ammar"

6 Publications

  • Page 1 of 1

A rare case report of short bowel anastomosis after acute mesenteric ischaemia in Covid-19 postive patient.

J Pak Med Assoc 2022 Jun;72(6):1222-1224

Department of General Surgery, Mayo Hospital, Lahore, Pakistan.

Acute mesenteric ischaemia is one of the serious abdominal surgical emergency, which has got very high morbidity and mortality. During the pandemic of COVID-19, besides respiratory complications, the virus was causing venous and arterial thromboembolism that can lead to acute mesenteric ischaemia in otherwise healthy individuals. Early diagnosis and suitable surgical procedures are the key to the better outcome of this disease. Surgical resection of gangrenous gut, leaving healthy gut is an important step of this operation. Leaving less than 200 cm of small intestine leads to short bowel syndrome which has got its own complication. This case report is on a healthy COVID-19 positive patient who presented with acute mesenteric ischaemia. After surgical resection only 1.5 feet small bowel (60 cm) was left behind and anastomosis was done with healthy transverse colon. He was later managed for complications of small bowel syndrome and was discharged successfully with dietary modifications.
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http://dx.doi.org/10.47391/JPMA.3961DOI Listing
June 2022

A rare case of acute mesenteric ischaemia and duodenal ulcer perforation together in a single patient in a tertiary care hospital.

J Pak Med Assoc 2022 Apr;72(4):755-757

Department of Surgery, Mayo Hospital, Lahore, Pakistan.

A 57 years old male presented in the emergency department of EAST Surgical Ward, MAYO Hospital Lahore in February 2021 with complaints of abdominal distension, pain and vomiting. He was a chronic smoker and diagnosed hypertensive for the last 14 years but was non-compliant with oral antihypertensive medications. He was a factory worker and took NSAIDs off and on for pain in the knee joint for the last five years. On examination, his abdomen was tense and tender with resonant percussion notes in the right hypogastrium and epigastrium. His chest x-ray showed free gas under the right diaphragm. Diagnosis of a perforated duodenal ulcer was made and exploratory laparotomy was done. Examination revealed a perforated ulcer in the first part of the duodenum with greenish gangrenous patches on the next 3 feet of the small gut. Graham's patch repair and resection of the diseased small gut was done and a jejuno ileostomy was performed. Unfortunately, the patient expired on 2nd postoperative day due to sudden cardiopulmonary arrest.
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http://dx.doi.org/10.47391/JPMA.3716DOI Listing
April 2022

A case report of abdominal sponge in ileum in a patient with intestinal obstruction.

J Pak Med Assoc 2021 Jan;71(1(B)):373-375

Department of General Surgery, East Surgical Ward, Mayo Hospital, Lahore, Pakistan.

A 36-year-old woman presented in the emergency department of East Surgical Ward of MAYO Hospital Lahore, Pakistan, in August 2019 with complaint of abdominal pain and vomiting for the past five days. The patient had a history of three Caesarean sections, the last one three years back. Off and on, she experienced abdominal pain and distension which was relieved after taking local medicines. She had no comorbid conditions and her baseline investigations were normal. On examination she had tachycardia with pulse 110/min and her whole abdomen was tender with exaggerated bowel sounds. X-ray of the abdomen showed multiple air fluid levels in the small intestine. Exploration plan was made; a distended segment of ileum was later found to have an abdominal sponge inside its lumen. There was a perforation in the ileum through which the sponge was retrieved and resection and end-to-end anastomosis was done. The patient was discharged on third post operation day.
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http://dx.doi.org/10.47391/JPMA.1284DOI Listing
January 2021

Predictors of lower limb amputations in patients with diabetic foot ulcers presenting to a tertiary care hospital of Pakistan.

J Pak Med Assoc 2021 Sep;71(9):2163-2166

Department of Biochemistry, King Edward Medical University, Lahore, Pakistan.

Objective: To assess the risk factors for lower limb amputations in diabetic patients presenting with foot ulcers.

Methods: The analytical cross-sectional study was conducted at the Mayo Hospital, Lahore, Pakistan, from December 1, 2019, to May 31, 2020, and comprised patients of either gender having type 1 or type 2 diabetes and foot ulcers. The wounds were assessed according to Wagner wound staging and wound sepsis was evaluated in terms of local infection of the wound, leucocytosis and osteomyelitis of the bone. The glycaemic control of these patients was assessed on presentation by measuring glycated haemoglobin levels. Data was analysed using SPSS 26.

Results: Of the 135 patients, 82(60.7%) were males and 53(39.2%) were females. Majority patients 59(43.7%) were aged 50-60 years. All 135(100%) patients underwent some type of amputation. Of all the amputations, 91(67.4%) were done in patients with poor glycaemic control on presentation, and 56(41.5%) in those with stage 4 wound. Local wound infection, increased total leukocyte count and bone showing features of osteomyelitis were significantly associated with increased risk of lower extremity amputations (p<0.05).

Conclusion: With proper glycaemic control and early presentation and treatment, majority of amputations could be avoided in diabetic patients with foot ulcers.
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http://dx.doi.org/10.47391/JPMA.06-932DOI Listing
September 2021

Outcome of abdominal binder in midline abdominal wound Dehiscence in terms of pain, psychological satisfaction and need for reclosure.

Pak J Med Sci 2021 Jul-Aug;37(4):1118-1121

Dr. Ahmed Raza Noumani, MBBS, MS General Surgery Senior Registrar, EAST Surgical Ward, Mayo Hospital, Lahore, Pakistan.

Objective: To assess the role of abdominal binder in patients with midline wound dehiscence after elective or emergency laparotomy in terms of pain, psychological satisfaction and need for reclosure.

Methods: It was a comparative study done at EAST Surgical Ward of Mayo Hospital, Lahore from 1 January 2018 to 31 December 2019. One hundred and sixty-two (162) patients were included in this study with post-operative midline abdominal wound dehiscence and after informed consent by consecutive non probability sampling technique. Patients were divided into two groups by lottery method into eighty-one patients each. Group-A included patients where abdominal binder was applied and Group-B included patients without abdominal binder. In both groups pain score, psychological satisfaction and need for reclosure was assessed and compared.

Results: Patients with abdominal binder shows significantly less pain (P value =0.000) and more psychological satisfaction (P value = 0.000) as compared to the patients where abdominal binder was not used. However, there was no difference in reducing the need for reclosure in patients who use abdominal binder (P value = 0.063).

Conclusion: Although abdominal binder helps in reducing the pain and improving the psychological satisfaction in patients with midline abdominal wound dehiscence yet it doesn't help in healing of wound and reclosure of the dehisced abdominal wound is needed.
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http://dx.doi.org/10.12669/pjms.37.4.3671DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8281147PMC
September 2020

Neck exploration for a huge synovial sarcoma, case report and literature review.

J Pak Med Assoc 2021 Feb;71(2(B)):766-768

Department of Surgery, Mayo Hospital, Lahore, Pakistan.

A 47-year-old woman presented in the outpatient department of EAST Surgical ward of MAYO Hospital Lahore, Pakistan, on February 2019 with complaint of swelling in the front section of the neck since five months which increased gradually in size and had been causing pain since two months. She had no comorbidities and insignificant family history. Examination revealed a 23×20 cm mass on the right side of the posterior triangle of the neck. Fine Needle Aspiration Cytology (FNAC) was inconclusive and CT of the neck showed a huge mass on the right side of the neck with cervical lymph nodes. Exploration was planned, and modified radical neck dissection Type III (Also known as Functional Neck dissection) was performed. The biopsy revealed synovial sarcoma of the neck. The patient's post-operative condition was satisfactory and she was discharged on the fifth post-operative day.
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http://dx.doi.org/10.47391/JPMA.1283DOI Listing
February 2021
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