Publications by authors named "Syed Asghar Naqi"

16 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

Ruptured splenic abscess: A rare case entity.

J Pak Med Assoc 2022 Jan;72(1):168-170

Department of Surgery, Mayo Hospital, Lahore, Pakistan.

Ruptured splenic abscess has been reported as a rare clinical entity in literature. We present the case of a middle aged female with peritonitis due to a ruptured splenic abscess. Emergency splenectomy was done and broad spectrum antibiotic was given postoperatively. However, the patient could not survive and died on the 4th postoperative day. We propose that a ruptured splenic abscess should always be considered in the differential diagnosis of peritonitis, especially in an immuno-compromised individual.
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http://dx.doi.org/10.47391/JPMA.11-2381DOI Listing
January 2022

A cross-sectional study of body mass index and sleep quality as risk factors to severity of acne.

J Pak Med Assoc 2021 Sep;71(9):2148-2150

East Surgical Ward, Mayo Hospital, Lahore, Pakistan.

Objective: To analyse the association of body mass index and sleep quality with severity of acne.

Methods: The cross-sectional study was conducted at the Dermatology Department of Mayo Hospital, Lahore, Pakistan, from January to March 2019, and comprised acne patients of either gender aged 12-45 years. Data was collected using a pre-designed questionnaire. Acne grades 1, 2, 3 and 4 were determined by a consultant dermatologist. Pittsburgh sleep quality index was used to assess sleep quality, while body mass index was calculated as per the standard procedure. Data was analyzed using SPSS 22.

Results: Of the 98 patients, 27(27.6%) were male and 71(72.4%) were female. The overall mean age of the sample was 22.3±4.9 years. There were 36(36.7%) patients with acne grade 3, followed by 25(25.5%) each with grades 1 and 2, and 12(12.2%) with grade 4. The relationship between body mass index and acne severity was not significant (p=0.07), and the same was the case with sleep quality (p=0.09).

Conclusions: Body mass index and sleep quality were not found to be associated with acne severity.
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http://dx.doi.org/10.47391/JPMA.404DOI Listing
September 2021

Adrenal Schwannoma: A Case Report.

Int Med Case Rep J 2021 7;14:617-620. Epub 2021 Sep 7.

Department of Surgery, East Surgical Ward, Mayo Hospital, King Edward Medical University, Lahore, Pakistan.

Schwannoma of the adrenal gland is very rare, comprising 0.2% of adrenal tumors, presenting usually as non-specific abdominal pain. We report such a rare case in a 50-year-old female. Her only complaint was right lumbar pain. Ultrasonography (USG) and computed tomography (CT) both showed a supra renal cystic mass most likely of adrenal origin. Excision of mass was performed. Post-operative course was uneventful. Histopathology showed a benign tumor of Schwann cell origin. Usually, pre-operative imaging including CT and magnetic resonance imaging (MRI) are inconclusive and diagnosis has to be confirmed on histopathology.
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http://dx.doi.org/10.2147/IMCRJ.S311777DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8435475PMC
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

Challenges in providing surgical procedures during the COVID-19 pandemic: Qualitative study among Operating Department Practitioners in Pakistan.

Sci Prog 2021 Apr-Jun;104(2):368504211023282

Institute of Public Health, Charité- Universitätsmedizin Berlin, Berlin, Germany.

The surgical theatre is associated with the highest mortality rates since the onslaught of the COVID-19 pandemic. However, Operating Department Practitioners (ODPs) are neglected human resources for health in regards to both professional development and research for patient safety; even though they are key practitioners with respect to infection control during surgeries. Therefore, this study aims to describe challenges faced by ODPs during the pandemic. The secondary aim is to use empirical evidence to inform the public health sector management about both ODP professional development and improvement in surgical procedures, with a specific focus on pandemics. A qualitative study has been conducted. Data collection was based on an interview guide with open-ended questions. Interviews with 39 ODPs in public sector teaching hospitals of Pakistan who have been working during the COVID-19 pandemic were part of the analysis. Content analysis was used to generate themes. Ten themes related to challenges faced by ODPs in delivering services during the pandemic for securing patient safety were identified: (i) Disparity in training for prevention of COVID-19; (ii) Shortcomings in COVID-19 testing; (iii) Supply shortages of personal protective equipment; (iv) Challenges in maintaining physical distance and prevention protocols; (v) Human resource shortages and role burden; (vi) Problems with hospital administration; (vii) Exclusion and hierarchy; (viii) Teamwork limitations and other communication issues; (ix) Error Management; and (x) Anxiety and fear. The public health sector, in Pakistan and other developing regions, needs to invest in the professional development of ODPs and improve resources and structures for surgical procedures, during pandemics and otherwise.
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http://dx.doi.org/10.1177/00368504211023282DOI Listing
July 2021

Left sided appendicitis - a surgical dilemma: Case report.

J Pak Med Assoc 2021 May;71(5):1483-1485

Department of East Surgical Ward, Mayo Hospital, King Edward Medical University, Lahore, Pakistan.

Left-sided abdominal pain is an uncommon presentation of acute appendicitis. When a patient presents with this complaint, appendicitis can be difficult to diagnose, thus resulting in delayed definitive therapy and increased morbidity and mortality. In this report we discuss the case of a middle-aged man, who presented with left-sided abdominal pain, and was diagnosed to be suffering from acute appendicitis along with asymptomatic midgut malrotation.
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http://dx.doi.org/10.47391/JPMA.09-1108DOI Listing
May 2021

Intravenous drug abusers presenting with pseudoaneurysm and other surgical complications in Pakistan.

J Pak Med Assoc 2021 02;71(2(A)):556-558

King Edward Medical University, Lahore, Pakistan.

People who inject drugs (PWIDs) reuse injection equipment and other paraphernalia, which is a major source of transmission of human immunodeficiency (HIV) and hepatitis C virus (HCV) infections. PWIDs who use infected injections develop many surgical complications which are life- threatening. The most common complication is infected pseudoaneurysm. To assess complications requiring surgery in drug abusers, a study was conducted in the East Surgical Ward of Mayo Hospital Lahore, Pakistan from Jan 2017 to Jan 2019. A total of 48 PWIDs presented to the surgical department, out of which 39 (81%) were HIV positive, and 31 (64%) were HCV positive. Of the 52% who had pseudoaneurysm, 92% had femoral and popliteal aneurysm and 8% had brachial aneurysm. After ligation and excision of pseudoaneurysm only 8% required major amputation. Mortality rate was 0%. Ligation and excision is a safe option in pseudoaneurysm. Most common site for pseudoaneurysm was left femoral artery.
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http://dx.doi.org/10.47391/JPMA.644DOI Listing
February 2021

Comparison of the outcome of mesh hernioplasty under local anaesthesia in patients with age less than 60 years VS more than 60 years in terms of wound complications and urinary retention.

J Pak Med Assoc 2020 Nov;70(11):1962-1965

Department of Peadiatrics, Allied Hospital, Faisalabad, Pakistan.

Objective: To compare the outcome of mesh hernioplasty performed under local anaesthesia in relatively young and older patients regarding wound complications and urinary retention.

Methods: This comparative study was conducted at Mayo Hospital, Lahore, Pakistan, from 17th Feb 2017 to 17th feb 2018, and comprised patients who underwent mesh hernioplasty. Demographic profile was noted and the patients were divided into <60 and >60 age groups. Surgical method used was Lichtenstein mesh repair under local anaesthesia. Outcome was documented in terms of urinary retention at 8 hours post-operation, wound seroma and haematoma at 24 hours and wound infection after 5 days of surgery. Data was analysed using SPSS 20.

Results: Of the 102 patients, there were 51(50%) in each of the two age groups. Among patients <60 years, urinary retention developed in 4(7.8%) compared to 6(11.8%) in the other group. Frequency of the wound complications, including wound haematoma, seroma and wound infection, were seen in 3(5.9%), 2(3.92%) and none respectively in the younger group compared to 2(3.92%), 2(3.92%) and none respectively in patients aged >60 years.

Conclusions: The results in patients aged <60 years and >60 years were comparable in terms of urinary retention and wound complications.
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http://dx.doi.org/10.5455/JPMA.39669DOI Listing
November 2020

Quality of Sleep and Academic Performance among Medical University Students.

J Coll Physicians Surg Pak 2020 Aug;30(8):844-848

Department of East Surgical Ward, King Edward Medical University, Lahore, Pakistan.

Objective: To assess the effect of sleep quality on academic performance of medical university students.

Study Design: Descriptive study.

Place And Duration Of Study: King Edward Medical University, Lahore, from December 2017 to April 2018.

Methodology: Second to final year Medical and Allied Health Sciences students filled out questionnaires that comprised of three major components. With the help of questionnaire, demographic data about the subjects along with academic scores were collected. Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleeping Scale (ESS) were used to collect the data. Qualitative variables are represented as frequencies and percentages; while, quantitative variables are reported as mean along with standard deviation ± S.D. Chi-square and was applied for statistical significance, and p-value <0.05 was considered.

Results: A total of 810 students, including both MBBS and Allied Health Sciences (AHS), filled out the questionnaire. Among those, 564 (69.6%) were females and 246 (30.4%) were males. Overall, mean age was 21.35 ±1.51 years. Of the total, 418 (51.6%) were from MBBS programme and 392 (48.4%) were from AHS. No significant relationship was found between PSQI and academic scores. However, academic scores had a strong association with ESS scores.

Conclusion: Although the majority of the studied students had poor sleep; but its effect on academic scores was not significant. Key Words: Sleep quality, Medical students, Academic performance.
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http://dx.doi.org/10.29271/jcpsp.2020.08.844DOI Listing
August 2020

Transverse testicular ectopia with persistent Mullerian duct syndrome: an operative eureka.

Int J Surg Case Rep 2020 11;71:338-340. Epub 2020 May 11.

Department of Surgery, King Edward Medical University/Mayo Hospital, Lahore, Pakistan.

Introduction: Transverse Testicular Ectopia (TTE) is a rare entity in which both testes descend on the same side, and can be found in ectopic locations. When present with Persistent Mullerian Duct Syndrome (PMDS), a yet rarer entity, the persistence of Mullerian duct derivatives i.e. fallopian tubes, uterus, cervix and upper two-thirds of vagina occurs alongside testicular ectopia. There have only been about a hundred and fifty reported cases of TTE; a fifth of these accompanied by PMDS.

Presentation Of Case: Two middle-aged male patients presented with two separate complaints of inguinoscrotal swellings. In both patients, ultrasonography showed a hernial defect protruding into the scrotum on one side and the testis absent on the contralateral side. During hernia surgery, Mullerian duct remnants were found. Diagnosis of TTE with PMDS was established. Bilateral orchidectomy was done and Mullerian derivatives were excised.

Discussion: There is controversy over the treatment of TTE with PMDS. Some authors,in addition to hernia repair, advocate the preservation of Mullerian structures because of risk to injury to vas deferens while others advocate resection of these structures due to risk of carcinoma. In pediatric patients, orchidopexy should be done to preserve fertility.However, in the older age group, orchidectomy should be done due to an increased risk of testicular carcinoma.

Conclusion: TTE should be suspected in cases of unilateral inguinal hernia with contralateral undescended testes. Orchidectomy is recommended in patients older than 12 years old, otherwise, orchidopexy should be done. No Mullerian duct remnants should be left in situ.
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http://dx.doi.org/10.1016/j.ijscr.2020.04.035DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7264951PMC
May 2020

Benign idiopathic retroperitoneal cyst: A case series of three patients.

Int J Surg Case Rep 2019 23;61:210-213. Epub 2019 Jul 23.

Mayo Hospital/King Edward Medical University Lahore, Pakistan.

Importance: Retroperitoneal cysts are a rare entity in the field of surgery and their management remains a clinical dilemma for many surgeons. This study addresses the clinical management of three benign retroperitoneal cysts which were presented in our hospital.

Objectives: The objective of this case series is to explore the different clinical presentation of the retroperitoneal cyst (RPC). This study also aims at different tools of investigations especially role of CT scan in the diagnosis of RPC and finally the different treatment options available for RPC.

Methods: This is a single centered case series of three retroperitoneal cysts which were presented in surgical department of our hospital in the year 2016 and 2017. Total three patients were presented in this case series, two of them were females and one was male. Females were 13 years and 23 years age-old, male was 45 years old. Two of them admitted through the Outdoor Patient Clinic and one was presented to the surgical emergency. Informed consent from the patients and guardian (case1) has been taken. Research work has been reported in line with the PROCESS criteria.

Results: They were investigated and treated in our hospital. Two of them were diagnosed with retroperitoneal cysts preoperatively and one was diagnosed pre-operatively. In all three cases, surgery had been carried out and they had been observed in their early postoperative period and then followed up for two years. All biopsies had been followed and turned out to be benign idiopathic cysts. These patients have been followed up for 2 years after completion of their treatment.

Conclusion: Retroperitoneal cysts in adults are an uncommon manifestation of abdominal pathology. Their presentation is quite vague. The rarity catches the surgeon off guard at times. Radiology plays a crucial role in defining these lesions and complete surgical excision remains the cornerstone of treatment for symptomatic and complicated patients.
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http://dx.doi.org/10.1016/j.ijscr.2019.07.050DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6698274PMC
July 2019

Breaking bad news skill of postgraduate residents of tertiary care hospital of Lahore, Pakistan: A cross-sectional survey.

J Pak Med Assoc 2019 May;69(5):695-699

East Surgery, Mayo Hospital Lahore.

Objective: To evaluate the skill of postgraduate residents in breaking bad news to the patients in a tertiary care hospital.

Methods: The cross-sectional study was conducted at King Edward Medical university, Lahore, Pakistan, from January to April 2016, and comprised postgraduate residents of different specialties at Mayo Hospital, Lahore. The subjects were examined in terms of their personal experience in breaking bad news to the patients by means of a specifically-designed questionnaire based on six-step protocol of Setting, Perception, Invitation, Knowledge, Empathy and Summarising model. Data was qualitatively and quantitatively analysed using SPSS 22.

Results: Of the 200 respondents, 141(70.5%) were males and 59(29.5%) were females. Overall mean age of the sample was 23 } 2.55years. Of the total, 94(47%) respondents were only fairly satisfied with their breaking bad news skill, while 130(65%) were eager to get training in this regard. The knowledge regarding breaking bad news protocols was lacking across all comparisons (p>0.05).

Conclusions: Majority of the residents had little satisfaction regarding their breaking bad news skill. It is necessary to plan special training for the residents in this key area.
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May 2019

Peer assisted learning as a formal instructional tool.

Authors:
Syed Asghar Naqi

J Coll Physicians Surg Pak 2014 Mar;24(3):169-72

Department of Surgery, King Edward Medical University, Lahore.

Objective: To explore the utility of peer assisted learning (PAL) in medical schools as a formal instructional tool.

Study Design: Grounded theory approach.

Place And Duration Of Study: King Edward Medical University, Lahore, from July 2011 to December 2011.

Methodology: A study was designed using semi-structured in-depth interviews to collect data from final year medical students (n=6), residents (n=4) and faculty members (n=3), selected on the basis of non-probability purposive sampling. The qualitative data thus generated was first translated in English and transcribed and organized into major categories by using a coding framework. Participants were interviewed two more times to further explore their perceptions and experiences related to emergent categories. An iterative process was employed using grounded theory analysis technique to eventually generate theory.

Results: PAL was perceived as rewarding in terms of fostering higher order thinking, effective teaching skills and in improving self efficacy among learners.

Conclusion: PAL can offer learning opportunity to medical students, residents and faculty members. It can improve depth of their knowledge and skills.
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http://dx.doi.org/03.2014/JCPSP.169172DOI Listing
March 2014
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