Publications by authors named "Khursheed Ahmed Samo"

8 Publications

  • Page 1 of 1

Factors affecting delay in diagnosis of colorectal cancer: A cross-sectional study from a tertiary care hospital of Karachi, Pakistan.

Int J Clin Pract 2021 Jun 15:e14529. Epub 2021 Jun 15.

Surgical Unit 3, Dr. Ruth K.M Pfau Civil Hospital, Dow University of Health Sciences, Karachi, Pakistan.

Background: Colorectal cancer (CRC) incidence is increasing in our region. There is no specific CRC control programme or national cancer registry in Pakistan. Previously, no data have been published on presentation delay and diagnosis delay of CRC in our region. This study is conducted to determine the factors affecting delay in presentation and diagnosis and to provide baseline information to launch a CRC control programme. The primary objective is to determine factors causing delay in diagnosis of CRC. The secondary objective is to evaluate the relationship between tumour site and stage of CRC with presenting symptoms and symptom duration.

Methods: This project is a prospective cross-sectional study on 113 biopsy-proven CRC patients admitted to the surgical ward of Civil Hospital Karachi.

Results: The total number of participants was 113. Presentation delay was observed in 83.2% of patients. The main reasons for a reported delay in the presentation were lack of patients' knowledge that these symptoms may be cancer (60.4%), the wrong diagnosis by the primary physician (34.6%) or the patient did not want to visit the doctor (0.04%). Most tumours (95%) originated from the sigmoid and rectum; 44.2% and 38.9% of the patients were diagnosed at Stages 3 and 4, respectively.

Conclusions: This study revealed that CRC patients in Pakistan are facing delays in presentation and diagnosis. This is the reason behind diagnosis at the advanced stage with a poor prognosis. On the basis of this study findings, CRC control programme should be introduced to detect CRC at an early stage.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/ijcp.14529DOI Listing
June 2021

Jejunal Adenocarcinoma as a Rare Cause of Small Bowel Obstruction: A Case Report.

Cureus 2020 Oct 2;12(10):e10763. Epub 2020 Oct 2.

Surgery, Dow Medical College, Dr. Ruth K. M. Pfau Civil Hospital, Karachi, PAK.

Jejunal adenocarcinoma, a small bowel adenocarcinoma (SBA), is a rare cause of small bowel obstruction. Jejunal adenocarcinoma classically presents with vague clinical symptoms, i.e., abdominal pain, discomfort, and weight loss, making timely diagnosis challenging. Owing to its diagnosis at a late stage, the prognosis of jejunal adenocarcinoma is poor. Curative resection of the tumor at the early stages remains a treatment of choice. Here, we report a case of a 55-year-old man presenting with symptoms of nausea, vomiting, abdominal pain, abdominal distension, and relative constipation. Computed tomography (CT) scan showed dilated small bowel loops. Exploratory laparotomy was performed, which revealed a jejunal stricture and dilated small bowel loops proximal to it. Suspicious stricture, along with the diseased portion of the intestine, was removed through en-bloc resection. Histopathology and metastatic workup revealed moderately differentiated adenocarcinoma with stage IIB (T4aN0M0). We conclude that, although rare, jejunal adenocarcinoma should be kept in mind when dealing with a patient presenting with symptoms indicating small bowel obstruction. Our purpose is to emphasize laparotomy as both a diagnostic and surgical modality for SBAs in early stages, especially in setups of low economic countries where advanced imaging techniques are relatively inaccessible.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7759/cureus.10763DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7606176PMC
October 2020

Spontaneous Axillary Cystic Hygroma: A Rare Entity in Adults.

J Coll Physicians Surg Pak 2020 Jul;30(7):769-770

General Surgical Unit 3, Dr Ruth KM Pfau, Civil Hospital Karachi, Pakistan.

Null.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.29271/jcpsp.2020.07.769DOI Listing
July 2020

Primary Rectal Amelanotic Malignant Melanoma: A Rare Case Report.

Cureus 2020 May 14;12(5):e8115. Epub 2020 May 14.

Surgery, Dow University of Health Sciences, Civil Hospital Karachi, Karachi, PAK.

Malignant melanoma of the rectum comprises 0.5%-4% of all anorectal cancers. Malignant melanoma of the rectum is exceptionally a rare disease. It commonly affects the fifth or sixth decade, with nonspecific symptoms such as rectal bleeding or anal pain. After skin and retina, anorectum is the third common site for malignant melanoma. Proper diagnosis is difficult in the majority of cases due to lack of pigmentation and amelanotic histological appearance. Prognosis is very poor with a median survival of 24 months and five-year survival of 10%-15%. Anorectal malignant melanomas disseminate along the submucosal planes, therefore complete resection at the time of diagnosis is usually not possible.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7759/cureus.8115DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7292714PMC
May 2020

Use of Abdominal Binders after a Major Abdominal Surgery: A Randomized Controlled Trial.

Cureus 2019 Oct 3;11(10):e5832. Epub 2019 Oct 3.

Surgery, Fazaia Ruth Pfau Medical College (FRPMC), Karachi, PAK.

Objective To compare the effect of abdominal binder versus no binder after major abdominal surgery and cesarean section on various post-operative recovery parameters. Materials and methods This is a randomized controlled trial conducted at the Department of General Surgery and Obstetrics, Civil Hospital, Karachi, Pakistan. All those patients aged ≥18 years having abdominal surgery including elective and emergency abdominal surgery and cesarean sections with American Society of Anesthesiologists Class I-III were included in the study. Randomization was done using the sealed envelope method by the principal investigator. The intervention group wore an abdominal binder postoperatively while the control group did not use it. Mobilization and the pain status of both groups were evaluated on the first, fourth, and seventh days after surgery. Results Primary outcome variables were mobility, assessed via 6-minute walk test (6MWT) and postoperative pain, evaluated via visual analogue scale. There was no statistically significant difference in the 6MWT distance before (p = 0.278) and on postoperative day one of the surgery (p = 0.0762). However, the difference was significant on fourth (p < 0.001) and seventh day (p value < 0.001). With regards to the pain status, patients in the binder group reported significantly less postoperative pain on first, fourth, and seventh (p value < 0.001) day compared to the non-binder group. Conclusion The use of abdominal binder postoperatively significantly reduced pain and improved mobility in both obstetric and surgery patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7759/cureus.5832DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6827701PMC
October 2019

Post-Appendectomy Cecal Prolapse.

J Coll Physicians Surg Pak 2017 Jun;27(6):385-386

Department of Surgical Unit III, Civil Hospital, Karachi.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/2646DOI Listing
June 2017

Colorectal cancer in younger population: our experience.

J Pak Med Assoc 2013 Oct;63(10):1275-7

Dow University of Health Sciences, Civil Hospital, Karachi.

Objective: To promote awareness regarding increased occurrence of colorectal cancer in younger population and its clinicopathological features compared to older patients.

Methods: The cross-sectional study was conducted from February 2010 to January 2011 on patients with diagnosis of colorectal carcinoma admitted through emergency or outpatients' departments to Surgical Unit 5, Civil Hospital, Karachi. Data regarding age, gender, presentation, site of tumour, surgery performed and Dukes staging was collected and analysed.

Results: A total of 23 patients were operated during the study period: 13 (56.52%) males and 10 (43.47%) females. Of them 12 (52.17%) were below the age of 40 years, while 3 (13.04%) patients were in the 11-20 age group. In 7 (30.4%) patients, tumour was irresectable at the time of presentation so a palliative procedure (diversion colostomy or ileostomy) was performed.There was a higher proportion of younger patients with metastatic disease at the time of presentation (n = 9; 75%) while 10 out of 12 patients in the younger age group (83.3%) had a tumour of left colon, particularly rectum.

Conclusion: Although colorectal cancer is usually a disease of older patients, it is increasingly becoming more common in younger population. Data suggests a leftward distribution for colorectal carcinoma and that younger patients present with more advanced disease and poorer prognosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
October 2013

Simultaneous duct ectasia of accessory and normally located breast.

J Coll Physicians Surg Pak 2009 Jan;19(1):57-8

Department of Surgery, Unit V, Civil Hospital, Dow University of Health Sciences, Karachi.

Accessory breast and duct ectasia are common clinical problems in their own right. However, their coexistence is a rare entity. Duct ectasia is a dilation in one or more of the larger lactiferous duct filled with a stagnant brown or green secretion, which may or may not discharge through the nipple. This material acts as an irritant and leads to periductal mastitis. Duct ectasia may present with subareolar mass, nipple discharge, nipple retraction, non-cyclical mastalgia or mammary fistula. Surgical options are microdochectomy or cone excision of major ducts. This case report describes the presence of duct ectasia in both accessory breast situated in the axilla and ipsilateral normal breast simultaneously.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/01.2009/JCPSP.5758DOI Listing
January 2009
-->