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Hussain M, Zafar N, Bux A, Sultan S, Hashmi A, Hussain Z, Hafiz S, Naqvi A, Rizvi A. Pharmacokinetics of cyclosporine microemulsion in Pakistani renal allograft recipients: correlation of trough peak levels with 7-point and 3-point AUC. Transplant Proc 1998; 30:3555. [PMID: 9838556 DOI: 10.1016/s0041-1345(98)01133-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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77
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Akhtar F, Rana TA, Kazi J, Zafar N, Hashmi A, Bhatti S, Naqvi R, Mohsin R, Naqvi A, Rizvi A. Correlation between biopsies and noninvasive assessment of acute graft dysfunction. Transplant Proc 1998; 30:3069. [PMID: 9838352 DOI: 10.1016/s0041-1345(98)00933-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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78
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Abu-Sulaiman RM, Hashmi A, McCrindle BW, Williams WG, Freedom RM. Anomalous origin of one pulmonary artery from the ascending aorta: 36 years' experience from one centre. Cardiol Young 1998; 8:449-54. [PMID: 9855098 DOI: 10.1017/s1047951100007101] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
UNLABELLED Anomalous origin of one pulmonary artery from the ascending aorta is an uncommon lesion with an uncertain outcome. We reviewed 16 consecutive children (9 males) presenting with this lesion over a 36 year period at a single institution. Median age at presentation was 2 days (range, birth to 3.2 years). The anomalous pulmonary was the right in 12 and the left in 4, all originating from the proximal ascending aorta, with no patient having stenosis at the origin of the anomalous pulmonary artery. Associated cardiac anomalies were noted in 9 patients. No intervention was attempted in 2 patients: one was deemed inoperable due to complex associated lesions and pulmonary vascular obstructive disease, while the other one died before repair. Surgical intervention was attempted in 14 patients, with 3 intraoperative deaths (21%). Of 11 operative survivors, 8 developed pulmonary arterial stenosis graded severe in 2, moderate in 1 and mild in 5. Patients with severe stenosis required surgical angioplasty, 1 after unsuccessful dilation combined with placement of an endovascular stent. One patient with moderate, and one with mild, stenosis underwent successful transcatheter balloon dilation. The remaining 4 patients with mild stenosis remain unchanged during follow-up. One patient had biopsy evidence of pulmonary vascular obstructive disease at 3.3 years of age. There were no late deaths, giving a total mortality of 25% (4/16). CONCLUSION While early diagnosis and repair of anomalous origin of one pulmonary artery from the ascending aorta is necessary, restenosis of the site of repair is common.
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Freedom RM, Hashmi A. Total anomalous pulmonary venous connections and consideration of the Fontan or one-ventricle repair. Ann Thorac Surg 1998; 66:681-2. [PMID: 9725453 DOI: 10.1016/s0003-4975(98)00617-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There is now a considerable literature that babies with right atrial isomerism have a poor outcome. The reasons for this are complex and multifactorial, but may be related at least in part to intrinsically small and abnormal pulmonary veins. We reviewed a series of consecutive patients seen at a single institution and found that babies with right atrial isomerism, severe pulmonary outflow tract obstruction or atresia, and total anomalous obstructed pulmonary veins had a grim outlook, especially those requiring operation in the neonatal period. Others have reported a similarly concerning outcome.
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80
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Naqvi A, Aziz T, Hussain M, Zafar N, Muzaffar R, Kazi J, Akhtar F, Ahmad E, Hashmi A, Hussain Z, Rizvi A. Outcome of living-related donor renal allografts in hepatitis C antibody-positive recipients. Transplant Proc 1998; 30:793. [PMID: 9595101 DOI: 10.1016/s0041-1345(98)00051-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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81
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Rizvi A, Naqvi A, Hussain Z, Hafiz S, Hashmi A, Zafar N, Akhtar F, Ahmed E, Hussain M, Askari A. Factors influencing graft survival in living-related donor kidney transplantation at a single center. Transplant Proc 1998; 30:712-6. [PMID: 9595069 DOI: 10.1016/s0041-1345(98)00019-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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82
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Lal M, Alamdar S, Ali B, Hussain M, Hashmi A, Hussain Z, Naqvi A, Rizvi A. Postrenal transplant malignancies in a living-related donor program. Transplant Proc 1998; 30:822-3. [PMID: 9595113 DOI: 10.1016/s0041-1345(98)00063-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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83
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Hashmi A, Abu-Sulaiman R, McCrindle BW, Smallhorn JF, Williams WG, Freedom RM. Management and outcomes of right atrial isomerism: a 26-year experience. J Am Coll Cardiol 1998; 31:1120-6. [PMID: 9562017 DOI: 10.1016/s0735-1097(98)00062-x] [Citation(s) in RCA: 143] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES We sought to determine, in a large series of patients with right atrial isomerism, factors associated with mortality. BACKGROUND Right atrial isomerism is associated with complex congenital heart disease and high morbidity and mortality. METHOD All data from patients diagnosed with right atrial isomerism between January 1970 and March 1996 were reviewed. RESULTS A total of 91 consecutive patients (54 male) were identified. Most patients (89%) presented within the first month of life, 62% at birth. Cardiac abnormalities included common atrioventricular (AV) valve (81%), ventricular hypoplasia or single ventricle (73%), abnormal ventriculoarterial connections (96%), pulmonary outflow tract obstruction (84%), anomalous pulmonary venous drainage (87%) and pulmonary vein obstruction (30%). The overall mortality rate was 69%. No interventions were planned or performed in 24%, 95% of whom died. The mortality rate for patients requiring their first cardiovascular operation in the neonatal period was 75% versus 51% for those with later first operations (p < 0.05). The surgical mortality rate for patients undergoing pulmonary vein repair was 95%. Overall survival estimates were 71% at 1 month, 49% at 1 year and 35% at 5 years. Independent risk factors for decreased time to death included the absence of pulmonary outflow obstruction (relative risk [RR] 2.23, p < 0.03), presence of major AV valve anomaly (RR 5.23, p < 0.03) and obstructed pulmonary veins (RR 5.43, p < 0.0001). CONCLUSIONS Right atrial isomerism continues to have an associated high mortality despite surgical innovations. Management of pulmonary vein obstruction remains a serious problem and is associated with high mortality.
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Amin F, Hashmi A, Stroe AE, Adebogun O, Densmore D, Knott PJ. Reproducibility of plasma catecholamine metabolites in normal subjects. Biol Psychiatry 1998; 43:233-5. [PMID: 9494706 DOI: 10.1016/s0006-3223(97)00378-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Plasma homovanillic acid (HVA) and methoxy-hydroxy-phenylglycol (MHPG) are often used in repeated measurement designs to assess dopamine and norepinephrine metabolism in clinical research. However, only limited data on the reproducibility of these metabolites are currently available. METHODS Plasma HVA and MHPG were measured in normal volunteers on five nonconsecutive mornings under fasting conditions and restricted smoking and physical activity. RESULTS Intraclass correlation coefficients (ICC) for plasma HVA and MHPG across 5 days were determined to be 0.85 and 0.79, respectively. ICC improved to 0.90 for HVA and 0.91 for MHPG when the average of the first 2 days was examined against the average of the last 2 days. CONCLUSIONS Results suggested that under controlled conditions plasma HVA and MHPG measurements have good reproducibility.
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Hashmi A, Hosking M, Teixeira O, Cornel G, Duncan W. Transoesophageal echocardiographic assessment of obstruction to the pulmonary venous pathway in children with Mustard or Senning repair. Cardiol Young 1998; 8:79-85. [PMID: 9680275 DOI: 10.1017/s1047951100004674] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The morphology and mechanism of obstruction to the pulmonary venous pathway in patients following either Mustard or Senning repair of complete transposition was assessed using transoesophageal echocardiography. Seven patients underwent catheterization and complete transoesophageal study in both transverse and longitudinal planes, followed by balloon dilation of the obstructed venous pathway in five of seven under transoesophageal echocardiography guidance. A complete scan of both systemic and venous pathway was obtained in all patients. Four patients with a Mustard repair were found to have a 'tubular' baffle, with stenosis resulting from a discrete wedge of tissue arising from the atrial free wall in association with fibrous adhesions to the baffle. In the three patients with a Senning repair the intra-atrial baffle showed a characteristic 'peaked' appearance, with stenosis of the venous pathway stenosis related directly to contracture of the patch used to augment the atrial free wall. The mechanism of obstruction appears to be inherent to the different surgical techniques. Indwelling transoesophageal echocardiography provided immediate haemodynamic and morphologic assessment of the efficacy of dilation of the obstructed venous pathway.
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Creery WD, Hashmi A, Hutchison JS, Singh RN. Surfactant therapy improves pulmonary function in infants with Pneumocystis carinii pneumonia and acquired immunodeficiency syndrome. Pediatr Pulmonol 1997; 24:370-3. [PMID: 9407571 DOI: 10.1002/(sici)1099-0496(199711)24:5<370::aid-ppul10>3.0.co;2-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Pneumocystis carinii pneumonia (PCP) is an important cause of acute respiratory failure in HIV-infected children. PCP may initiate acute respiratory distress syndrome (ARDS) by adversely affecting surfactant physiology. We report improved pulmonary function following administration of bovine lipid extract surfactant to two infants with AIDS-related PCP/ARDS.
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Weatherdon DE, Molitor BA, Hashmi A, Hosking MC, Duncan WJ. Systolic function of the univentricular heart: comparison of the Simpson's rule with acoustic quantification. Can J Cardiol 1997; 13:1027-32. [PMID: 9413233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Acoustic quantification (AQ) is a new method of obtaining real-time information about systolic ventricular function. This method establishes a ;blood-tissue interface' and computes an intraventricular blood volume in real time to derive a beat to beat instantaneous ejection fraction. AQ assessment of systolic function has been reported previously in patients with normal cardiotypes and varying degrees of myocardial dysfunction. OBJECTIVE To determine the potential utility of AQ in patients with abnormal ventricular morphology, in whom systolic function may be difficult to measure by traditional methods. PATIENTS AND DESIGN Seventeen children (nine females) ranging in age from five days to 18 years (mean 6.9 years) with univentricular left ventricle heart morphology underwent a prospective and comparative echocardiographic study of ventricular function with the use of AQ and manual planimetry (single plane Simpson's rule). Imaging was done during steady state without sedation. Routine scan planes were performed, followed by repeat scanning of the univentricle from the apical four-chamber view in the AQ mode. Subsequently, manual planimetry using Simpson's rule was performed from an online graphical analysis package to measure systolic and diastolic frames from the conventional replay images. These data were used to calculate ejection fraction using standards previously established. The results were then compared with real-time AQ results. SETTING Tertiary care referral center. RESULTS Scan time for the combined standard and AQ imaging averaged 45 mins (range 35 to 65 mins). Measured ejection fraction by AQ and manual planimetry were 44 +/- 11% and 46 +/- 10%, respectively. Statistical analysis by repeated measures ANOVA with Bonferroni/Dunn correction (F = 0.6, df = 1,32, P = 0.44) demonstrated significant agreement between AQ and manual planimetry with an intraclass correlation coefficient of 0.93. Bland-Altman analysis was used to provide a graphic display of the clinical significance of differences in the comparison of the two methods of measurement. CONCLUSIONS These findings support the use of AQ for continuous online determination of indexes of systolic function for patients with univentricular left ventricle morphology. The variability in the morphology inherently present within this group of patients results in a wider variability of determined ejection fraction. Particular attention must be directed to the technical aspects of image acquisition and AQ application to ensure accuracy.
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Hashmi A, Hussain M, Hussain Z, Ahmed E, Shamsi T, Naqvi R, Ali B, Mehdi H, Mohsin R, Naqvi A, Rizvi A. Use of rHu GM-CSF in renal-transplant patients developing leukopenia. Transplant Proc 1997; 29:3053. [PMID: 9365663 DOI: 10.1016/s0041-1345(97)00779-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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89
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Lemmon D, Shiang TY, Hashmi A, Ulbrecht JS, Cavanagh PR. The effect of insoles in therapeutic footwear--a finite element approach. J Biomech 1997; 30:615-20. [PMID: 9165395 DOI: 10.1016/s0021-9290(97)00006-7] [Citation(s) in RCA: 131] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Current practice in the prevention of recurrence of neuropathic foot ulcers is to prescribe accommodative in-shoe orthoses or insoles which reduce plantar pressure levels at locations of bony prominences, particularly under the metatarsal heads. To date, design of these orthoses has largely been a trial and error process. There is little quantitative information available regarding the effects of thickness and the influence of soft tissue characteristics on the cushioning effect of such interventions. The current paper investigated alterations in pressure under the second metatarsal head as a function of insole thickness and tissue thickness. Both experimental and quasi-static plane strain finite element approaches were employed. The orthoses chosen reduced plantar pressure by a maximum of approximately 30% and were more effective (on a percentage basis) in the setting of reduced sub-metatarsal tissue thickness. Peak normal stresses predicted by the FE models were, on average, within 5.9% of experimentally measured values for the normal tissue case and 8.1% for the reduced tissue case. The techniques presented represent a promising approach to understanding plantar cushioning and the principles involved in the design of therapeutic footwear for insensate feet.
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Stroe AE, Amin F, Hashmi A, Densmore D, Kahn T, Knott PJ. Diurnal variation in plasma homovanillic acid: not a renal phenomenon. Biol Psychiatry 1997; 41:621-3. [PMID: 9046995 DOI: 10.1016/s0006-3223(96)00526-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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91
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Rizvi A, Askari H, Hussain M, Hashmi A, Mohsin R, Hussain Z, Naqvi A. Comparison of extravesical versus internal ureteroneocystostomy in renal transplants. Transplant Proc 1996; 28:1553-4. [PMID: 8658782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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92
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Hussain Z, Naqvi R, Hashmi A, Hafiz S, Naqvi A, Rizvi A. Tuberculosis in renal allograft recipients. Transplant Proc 1996; 28:1516-7. [PMID: 8658766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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93
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Naqvi A, Abbas K, Zafar N, Naqvi R, Askari H, Ahmed E, Hashmi A, Akhtar F, Rizvi A. Factors influencing patient and graft survival in living related renal transplantation at a single centre. Transplant Proc 1996; 28:1574-5. [PMID: 8658790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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94
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Naqvi A, Zafar N, Hashmi A, Akhtar F, Hussain Z, Rizvi A. Two cadaveric renal transplants in Pakistan from non-heart-beating donors from Maastricht. Lancet 1996; 347:477-8. [PMID: 8618518 DOI: 10.1016/s0140-6736(96)90059-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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95
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Hussain Z, Hashmi A, Ather H, Mohsin R, Hussain M, Naqvi A, Rizvi A. Erythrocytosis in renal transplant recipients. Transplant Proc 1995; 27:2736. [PMID: 7482896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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96
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Hashmi A, Naqvi R, Ather H, Sheikh R, Akhtar F, Naqvi A, Rizvi A. CNS infections in renal transplant recipients. Transplant Proc 1995; 27:2735. [PMID: 7482895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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97
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Hashmi A, Klassen T. Correlation between urinalysis and intravenous pyelography in pediatric abdominal trauma. J Emerg Med 1995; 13:255-8. [PMID: 7775802 DOI: 10.1016/0736-4679(94)00152-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Controversy exists surrounding the appropriate indications for intravenous pyelography (IVP) in assessing blunt renal injuries in children. Forty-one consecutive cases of suspected blunt renal injuries, who had an IVP performed between January 1988 and December 1990 at The Children's Hospital of Eastern Ontario, were examined by a retrospective chart review. Eighty percent of the IVPs were normal. Of the eight abnormal IVPs, four were contusions, two lacerations, and two nontraumatic abnormalities. There was no hemodynamic compromise, no requirement for surgical intervention, and no deaths in the study population. In the absence of significant hematuria (> or = 100 rbc/hpf), the probability of detecting a traumatic abnormality on IVP is low (4%). There was no correlation between the mechanism of injury and the IVP findings. We conclude that intravenous pyelography has a low yield in the absence of significant hematuria (> or = 100 rbc/hpf).
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Nawaz H, Hussain M, Hashmi A, Hussain Z, Zafar N, Naqvi A, Rizvi A. Experience with indwelling "J.J" ureteral stents. J PAK MED ASSOC 1993; 43:147-9. [PMID: 8264090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
J.J stents provide free drainage from the kidney to the bladder, reduce or eliminate urine leakage and provide stenting of the ureter. They were used in a total of 200 cases. In 158 to prevent ureteric obstruction before extracorporeal shock wave lithotripsy (ESWL), in 25 to bypass obstruction and in 12 as an adjunct to complicated upper urinary tract surgery. Majority (97%) of the stents were placed endoscopically under local anaesthesia (71.5%). In all the cases stents were successful to provide free drainage. No mortality was attributable to the use of stents but certain complications were encountered. Encrustation of the stents occurred in 21 (10.5%) and migration in 11 (5.5%) cases. Stents were removed easily under local anaesthesia by cystoscope. "J" stents thus provide an effective means to reduce complications and enhance effectiveness specially of ESWL therapy.
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Naqvi SA, Hussain M, Askari H, Hashmi A, Hussain Z, Hussain I, Hafiz S, Yazdani I, Rizvi SA. Is there a place for prophylaxis against tuberculosis following renal transplantation? Transplant Proc 1992; 24:1912. [PMID: 1412909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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100
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Hashmi A, Hussain M, Askari H, Hussain Z, Hafiz S, Hussain I, Yazdani I, Naqvi A, Rizvi SA. Multiple respiratory tract infections with particular reference to immunocompromised patients. Transplant Proc 1992; 24:1927-8. [PMID: 1412914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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