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Rehman A, Baloch NUA, Morrow JP, Pacher P, Haskó G. Targeting of G-protein coupled receptors in sepsis. Pharmacol Ther 2020; 211:107529. [PMID: 32197794 PMCID: PMC7388546 DOI: 10.1016/j.pharmthera.2020.107529] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 03/11/2020] [Accepted: 03/11/2020] [Indexed: 12/11/2022]
Abstract
The Third International Consensus Definitions (Sepsis-3) define sepsis as life-threatening multi-organ dysfunction caused by a dysregulated host response to infection. Sepsis can progress to septic shock-an even more lethal condition associated with profound circulatory, cellular and metabolic abnormalities. Septic shock remains a leading cause of death in intensive care units and carries a mortality of almost 25%. Despite significant advances in our understanding of the pathobiology of sepsis, therapeutic interventions have not translated into tangible differences in the overall outcome for patients. Clinical trials of antagonists of various pro-inflammatory mediators in sepsis have been largely unsuccessful in the past. Given the diverse physiologic roles played by G-protein coupled receptors (GPCR), modulation of GPCR signaling for the treatment of sepsis has also been explored. Traditional pharmacologic approaches have mainly focused on ligands targeting the extracellular domains of GPCR. However, novel techniques aimed at modulating GPCR intracellularly through aptamers, pepducins and intrabodies have opened a fresh avenue of therapeutic possibilities. In this review, we summarize the diverse roles played by various subfamilies of GPCR in the pathogenesis of sepsis and identify potential targets for pharmacotherapy through these novel approaches.
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Affiliation(s)
- Abdul Rehman
- Department of Medicine, Rutgers-New Jersey Medical School, Newark, NJ, United States
| | - Noor Ul-Ain Baloch
- Department of Medicine, Rutgers-New Jersey Medical School, Newark, NJ, United States
| | - John P Morrow
- Department of Medicine, Columbia University, New York City, NY, United States
| | - Pál Pacher
- Laboratory of Cardiovascular Physiology and Tissue Injury, National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States
| | - György Haskó
- Department of Anesthesiology, Columbia University, New York City, NY, United States.
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Awais M, Rehman A, Baloch NUA. Use of portable gadgets in radiology clinical and academic activities: A questionnaire-based, cross-sectional study. J PAK MED ASSOC 2019; 69:864-868. [PMID: 31201393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To assess knowledge, attitudes, practices and perceptions of healthcare professionals regarding use of portable gadgets in daily clinical practice and for academic purposes. METHODS The questionnaire-based, cross-sectional study was performed at Aga Khan University Hospital, Karachi, from February to March, 2015, and comprised healthcare professionals recruited using convenience-based sampling. A self-administered questionnaire was used for data collection. Items in the instrument pertained to use of portable gadgets, knowledge of radiology applications and perceptions regarding benefits/drawbacks of such gadgets. 'Portable gadgets' referred to any handheld electronic device, such as mobile phones, tablet or personal digital assistants. SPSS 20 was used for data analysis. RESULTS Of the 100 subjects, 38(38%) were radiology residents, 34(34%) consultant radiologists 28(28%) were radiographers. The overall mean age was 32.7}8.66 years. Overall, 80 (80%) subjects possessed a portable gadget. Although 64(64%) participants commonly used the gadgets for clinical and academic activities, only 46(46%) had heard of radiology smartphone applications. Majority 80(80%) preferred hardcopies for studying books as opposed to digital formats. However, 78(78%) believed that portable gadgets had a positive impact on their clinical practice. CONCLUSIONS Portable gadgets were being used by a substantial proportion of healthcare professionals for clinical and academic activities.
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Affiliation(s)
| | - Abdul Rehman
- Department of Biological & Biomedical Sciences, Aga Khan University, Pakistan
| | - Noor Ul-Ain Baloch
- Department of Biological & Biomedical Sciences, Aga Khan University, Pakistan
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Awais M, Rehman A, Baloch NUA. Gastric-type Enteric Duplication Cyst in the Tail of a Bifid Pancreas in Association with Complete Intestinal Malrotation. J Coll Physicians Surg Pak 2019; 29:489-490. [PMID: 31036128 DOI: 10.29271/jcpsp.2019.05.489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 11/07/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Muhammad Awais
- Department of Radiology, Dow University of Health Sciences, Ojha Campus, Karachi 75270, Pakistan
| | - Abdul Rehman
- Department of Biological and Biomedical Sciences, The Aga Khan University Hospital, Karachi 74800, Pakistan
| | - Noor Ul-Ain Baloch
- Department of Biological and Biomedical Sciences, The Aga Khan University Hospital, Karachi 74800, Pakistan
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Baloch NUA, Ibeabuchi AN. Hydralazine-induced MPO-ANCA Renal-Limited Vasculitis Masquerading as Lupus Nephritis. J Coll Physicians Surg Pak 2019; 28:896-897. [PMID: 30369391 DOI: 10.29271/jcpsp.2018.11.896] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Accepted: 08/02/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Noor Ul-Ain Baloch
- Department of Medicine, Rutgers - New Jersey Medical School, University Hospital, 150 Bergen St, Newark, NJ 07103, United States
| | - Adaeze N Ibeabuchi
- Department of Medicine, Hackensack University Medical Center, 30 Prospect Ave, Hackensack, NJ 07601, United States
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Rahman AJ, Hanif S, Baloch NUA, Rehman A, Sheikh T, Ladhani MI. Spectrum, management and outcomes of structural and functional uropathies in children attending a tertiary care center in Karachi; Pakistan. J PAK MED ASSOC 2018; 68:1699-1704. [PMID: 30410153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Causes and outcomes of children diagnosed with hydronephrosis in resource-limited countries with a low utilization of antenatal ultrasonography remain unexplored. We performed a retrospective, crosssectional study of all paediatric patients diagnosed with hydronephrosis and managed at a tertiary care center in Karachi, Pakistan between 2005 and 2010. Data relating to demographics, clinical features, etiologies and treatment modalities were systematically collected. Of a total of 234 cases (74.4% male), 83 (35.5%) and 42 (17.9%) were neonates and infants respectively. Congenital urinary tract pathologies were noted in 192(72.2%) patients, of which only 96(50%) had undergone foetal ultrasonography and 77(40.1%) first presented after the age of 1 year. At a median follow-up of 4 years, 24(12.5%) of these patients had evidence of renal dysfunction. Worse urologic outcomes in this study were most likely attributable to delayed diagnosis of congenital urinary tract abnormalities.
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Affiliation(s)
| | - Saima Hanif
- Medical College, Aga Khan University, Karachi
| | | | - Abdul Rehman
- Internal Medicine Section, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
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Azeemuddin M, Awais M, Mubarak F, Rehman A, Baloch NUA. Prevalence of subarachnoid haemorrhage among patients with cranial venous sinus thrombosis in the presence and absence of venous infarcts. Neuroradiol J 2018; 31:496-503. [PMID: 29890915 DOI: 10.1177/1971400918783060] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Introduction In patients with cranial venous sinus thrombosis, the occurrence of subarachnoid haemorrhage in association with haemorrhagic venous infarcts is a well described phenomenon. However, the presence of subarachnoid haemorrhage in patients with cranial venous sinus thrombosis in the absence of a haemorrhagic venous infarct is exceedingly rare. Methods We retrospectively reviewed charts and scans of all patients who had cranial venous sinus thrombosis confirmed by magnetic resonance venography at our hospital between September 2004 and May 2015. The presence of subarachnoid haemorrhage was ascertained on fluid-attenuated inversion recovery, susceptibility-weighted imaging and/or unenhanced computed tomography scans by a single experienced neuroradiologist. Statistical analysis was performed using the Statistical Package for Social Sciences version 20. Differences in the proportion of haemorrhagic venous infarcts among patients with subarachnoid haemorrhage versus those without subarachnoid haemorrhage were compared using the chi-square test. A P value of less than 0.05 was considered significant. Results A total of 138 patients who had cranial venous sinus thrombosis were included in the study. Seventy-three (52.9%) were women and the median age of subjects was 35 (interquartile range 22-47) years. Venous infarcts and haemorrhagic venous infarcts were noted in 20/138 (14.5%) and 62/138 (44.9%) cases, respectively. Subarachnoid haemorrhage was present in 15/138 (10.9%) cases and, in three cases, subarachnoid haemorrhage occurred in the absence of a venous infarct. Haemorrhagic venous infarcts were more prevalent ( P = 0.021) among patients with subarachnoid haemorrhage (11/15) than in those without subarachnoid haemorrhage (51/123). Conclusion In patients with cranial venous sinus thrombosis, subarachnoid haemorrhage can occur even in the absence of a haemorrhagic venous infarct. The recognition of cranial venous sinus thrombosis as the underlying cause of subarachnoid haemorrhage is important to avoid misdiagnosis and inappropriate management.
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Affiliation(s)
| | - Muhammad Awais
- 1 Department of Radiology, Aga Khan University Hospital, Pakistan.,2 Department of Radiology, Dow University of Health Sciences, Pakistan
| | - Fatima Mubarak
- 1 Department of Radiology, Aga Khan University Hospital, Pakistan
| | - Abdul Rehman
- 3 Department of Biological and Biomedical Sciences, Aga Khan University, Pakistan
| | - Noor Ul-Ain Baloch
- 3 Department of Biological and Biomedical Sciences, Aga Khan University, Pakistan
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Abstract
INTRODUCTION Idiopathic systemic capillary leak syndrome (SCLS) is a unique disorder characterized by episodes of massive systemic leak of intravascular fluid leading to volume depletion and shock. A typical attack of SCLS consists of prodromal, leak and post-leak phases. Complications, such as compartment syndrome and pulmonary edema, usually develop during the leak and post-leak phases respectively. Judicious intravenous hydration and early use of vasopressors is the cornerstone of management in such cases. Areas covered: The purpose of the present review is to provide an up-to-date, evidence-based review of our understanding of SCLS and its management in the light of currently available evidence. COMMENTARY Idiopathic SCLS was first described in 1960 and, since then, more than 250 cases have been reported. A large number of cases have been reported over the past one decade, most likely due to improved recognition. In the acute care setting, most patients with SCLS are managed as per the Surviving Sepsis guidelines and receive aggressive volume resuscitation - which is not the optimal management strategy for such patients. There is a need to raise awareness amongst physicians and clinicians in order to improve recognition of this disorder and ensure its appropriate management.
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Affiliation(s)
- Noor Ul-Ain Baloch
- a Resident Physician, Department of Medicine, Rutgers-New Jersey Medical School , University Hospital , Newark , NJ , USA
| | - Marvi Bikak
- b Department of Critical Care Medicine , Indiana University Health Methodist Hospital , Indianapolis , IN , USA
| | - Abdul Rehman
- b Department of Critical Care Medicine , Indiana University Health Methodist Hospital , Indianapolis , IN , USA
| | - Omar Rahman
- b Department of Critical Care Medicine , Indiana University Health Methodist Hospital , Indianapolis , IN , USA
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Awais M, Qamar S, Rehman A, Baloch NUA, Shafqat G. Accuracy of CT chest without oral contrast for ruling out esophageal perforation using fluoroscopic esophagography as reference standard: a retrospective study. Eur J Trauma Emerg Surg 2018; 45:517-525. [PMID: 29484462 DOI: 10.1007/s00068-018-0929-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 02/23/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE Esophageal perforation has a high mortality rate. Fluoroscopic esophagography (FE) is the procedure of choice for diagnosing esophageal perforation. However, FE can be difficult to perform in seriously ill patients. METHODS We retrospectively reviewed charts and scans of all patients who had undergone thoracic CT (TCT) without oral contrast and FE for suspicion of esophageal perforation at our hospital between October, 2010 and December, 2015. Scans were interpreted by a single consultant radiologist having > 5 years of relevant experience. Statistical analysis was performed using SPSS version 20. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of TCT were computed using FE as reference standard. RESULTS Of 122 subjects, 106 (83%) were male and their median age was 42 [inter-quartile range (IQR) 29-53] years. Esophageal perforation was evident on FE in 15 (8%) cases. Sensitivity, specificity, PPV and NPV of TCT for detecting esophageal perforation were 100, 54.6, 23.4 and 100%, respectively. When TCT was negative (n = 107), an alternative diagnosis was evident in 65 cases. CONCLUSION Thoracic computed tomography (TCT) had 100% sensitivity and negative predictive value for excluding esophageal perforation. FE may be omitted in patients who have no evidence of mediastinal collection, pneumomediastinum or esophageal wall defect on TCT. However, in the presence of any of these features, FE is still necessary to confirm or exclude the presence of an esophageal perforation.
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Affiliation(s)
- Muhammad Awais
- Department of Radiology, The Aga Khan University Hospital, P.O. box 3500, Stadium Road, Karachi, Sindh, 74800, Pakistan. .,Department of Radiology, Dow University of Health Sciences, Ojha Campus, Suparco Road, KDA Scheme 33, Karachi, Sindh, 75270, Pakistan.
| | - Saqib Qamar
- Department of Radiology, The Aga Khan University Hospital, P.O. box 3500, Stadium Road, Karachi, Sindh, 74800, Pakistan
| | - Abdul Rehman
- Department of Radiology, The Aga Khan University Hospital, P.O. box 3500, Stadium Road, Karachi, Sindh, 74800, Pakistan.,Internal Medicine Section, Department of Medicine, Hamad Medical Corporation, P.O. box 3050, Doha, Qatar
| | - Noor Ul-Ain Baloch
- Department of Radiology, The Aga Khan University Hospital, P.O. box 3500, Stadium Road, Karachi, Sindh, 74800, Pakistan.,Department of Medicine, Rutgers-New Jersey Medical School, Newark, NJ, USA
| | - Gulnaz Shafqat
- Department of Radiology, The Aga Khan University Hospital, P.O. box 3500, Stadium Road, Karachi, Sindh, 74800, Pakistan
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9
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Affiliation(s)
- Abdul Rehman
- Section of Internal Medicine, Department of Medicine, Hamad Medical Corporation, Doha, Qatar2Department of Biological and Biomedical Sciences, The Aga Khan University, Karachi, Pakistan
| | - Muhammad Awais
- Department of Radiology, The Aga Khan University Hospital, Karachi, Pakistan
| | - Noor Ul-Ain Baloch
- Department of Biological and Biomedical Sciences, The Aga Khan University, Karachi, Pakistan
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10
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Baloch NUA, Rehman A, Awais M. Occupational Health of Self-Employed Skilled Labourers and Daily-Wage Workers in Pakistan. J Coll Physicians Surg Pak 2016; 26:240-241. [PMID: 26975964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 10/31/2015] [Indexed: 06/05/2023]
Affiliation(s)
- Noor Ul-Ain Baloch
- Department of Biological and Biomedical Sciences, The Aga Khan University, Karachi
| | - Abdul Rehman
- Department of Biological and Biomedical Sciences, The Aga Khan University, Karachi
| | - Muhammad Awais
- Department of Radiology, The Aga Khan University, Karachi
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11
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Abstract
Inferior vena cava (IVC) variants are rare and are usually detected incidentally. Even though, these variants are by themselves asymptomatic, they can have important clinical, radiological, and surgical implications. In this pictorial essay, we sensitize the reader to various IVC variants by presenting reports of actual patients. A succinct description of the embryological development of these anatomic variants is also provided.
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Affiliation(s)
- Muhammad Awais
- Department of Radiology, Aga Khan University Hospital, Karachi, Sindh, Pakistan,
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Awais M, Hilal K, Waheed A, Khattak YJ, Rehman A, Ul-Ain Baloch N. Detection and Communication of Critical Findings Noted on Thoracic CT Scans by Radiology Residents. J Am Coll Radiol 2015; 12:1324-9. [PMID: 26412748 DOI: 10.1016/j.jacr.2015.06.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Revised: 06/19/2015] [Accepted: 06/23/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Muhammad Awais
- Department of Radiology, Aga Khan University Hospital, Karachi, Sindh, Pakistan.
| | - Kiran Hilal
- Department of Radiology, Aga Khan University Hospital, Karachi, Sindh, Pakistan
| | - Adeel Waheed
- Department of Radiology, Aga Khan University Hospital, Karachi, Sindh, Pakistan
| | - Yasir Jamil Khattak
- Department of Radiology, Aga Khan University Hospital, Karachi, Sindh, Pakistan
| | - Abdul Rehman
- Department of Biological & Biomedical Sciences, Aga Khan University, Karachi, Pakistan
| | - Noor Ul-Ain Baloch
- Department of Biological & Biomedical Sciences, Aga Khan University, Karachi, Pakistan
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Awais M, Hafeez S, Rehman A, Baloch NUA. Vibration-induced multifocal carpal osteonecrosis in a 31-year-old man. Occup Environ Med 2015; 72:684. [PMID: 26185127 DOI: 10.1136/oemed-2015-103100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Accepted: 06/28/2015] [Indexed: 11/03/2022]
Affiliation(s)
- Muhammad Awais
- Department of Radiology, Aga Khan University Hospital, Karachi, Sindh, Pakistan
| | - Saima Hafeez
- Department of Radiology, Aga Khan University Hospital, Karachi, Sindh, Pakistan
| | - Abdul Rehman
- Internal Medicine Section, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Noor Ul-Ain Baloch
- Department of Biological & Biomedical Sciences, Aga Khan University, Karachi, Sindh, Pakistan
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Rehman A, Imran S, Hassan M, Akhlaq A, Iqbal S, Beg F, Zahid G, Khalid H, Qadir FS, Murad HF, Baloch NUA, Awais M, Saleem S. Taxi drivers' attitudes toward road safety in Pakistan. Public Health 2015; 129:818-21. [PMID: 25936972 DOI: 10.1016/j.puhe.2015.03.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 02/23/2015] [Accepted: 03/18/2015] [Indexed: 11/28/2022]
Affiliation(s)
- A Rehman
- Medical College, Aga Khan University, Stadium Road, Karachi, Sindh, Pakistan.
| | - S Imran
- Medical College, Aga Khan University, Stadium Road, Karachi, Sindh, Pakistan
| | - M Hassan
- Medical College, Aga Khan University, Stadium Road, Karachi, Sindh, Pakistan
| | - A Akhlaq
- Medical College, Aga Khan University, Stadium Road, Karachi, Sindh, Pakistan
| | - S Iqbal
- Medical College, Aga Khan University, Stadium Road, Karachi, Sindh, Pakistan
| | - F Beg
- Medical College, Aga Khan University, Stadium Road, Karachi, Sindh, Pakistan
| | - G Zahid
- Medical College, Aga Khan University, Stadium Road, Karachi, Sindh, Pakistan
| | - H Khalid
- Medical College, Aga Khan University, Stadium Road, Karachi, Sindh, Pakistan
| | - F S Qadir
- Medical College, Aga Khan University, Stadium Road, Karachi, Sindh, Pakistan
| | - H F Murad
- Medical College, Aga Khan University, Stadium Road, Karachi, Sindh, Pakistan
| | - N U A Baloch
- Medical College, Aga Khan University, Stadium Road, Karachi, Sindh, Pakistan
| | - M Awais
- Department of Radiology, Aga Khan University Hospital, Stadium Road, Karachi, Sindh, Pakistan
| | - S Saleem
- Department of Community Health Sciences, Aga Khan University, Stadium Road, Karachi, Sindh, Pakistan
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Rehman A, Ul-Ain Baloch N, Awais M. Thyroxine Replacement in Patients on Parenteral Nutrition: A Clinical Conundrum. J Coll Physicians Surg Pak 2015; 25:469. [PMID: 26101008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 02/10/2015] [Indexed: 06/04/2023]
Affiliation(s)
- Abdul Rehman
- Department of Biological and Biomedical Sciences, The Aga Khan University Hospital, Karachi
| | - Noor Ul-Ain Baloch
- Department of Biological and Biomedical Sciences, The Aga Khan University Hospital, Karachi
| | - Muhammad Awais
- Department of Biological and Radiology, The Aga Khan University Hospital, Karachi
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Rehman A, Baloch NUA, Awais M. The artificial divide between biomedical sciences and clinical medicine in undergraduate medical education. J Coll Physicians Surg Pak 2015; 25:157. [PMID: 25703767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 08/25/2014] [Indexed: 06/04/2023]
Affiliation(s)
- Abdul Rehman
- Department of Biological and Biomedical Sciences, The Aga Khan University Hospital, Karachi
| | - Noor Ul-Ain Baloch
- Department of Biological and Biomedical Sciences, The Aga Khan University Hospital, Karachi
| | - Muhammad Awais
- Department of Radiology, The Aga Khan University Hospital, Karachi
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Awais M, Rehman A, Baloch NUA. Fibrodysplasia ossificans progressiva misdiagnosed as cervical exostosis. Intern Med 2015; 54:867-8. [PMID: 25832962 DOI: 10.2169/internalmedicine.54.3858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Muhammad Awais
- Department of Radiology, Aga Khan University Hospital, Pakistan
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Rehman A, Ul-Ain Baloch N, Awais M. Severe ovarian hyperstimulation syndrome complicated by Stenotrophomonas maltophilia peritonitis: a case report and literature review. Intern Med 2015; 54:1149-52. [PMID: 25948367 DOI: 10.2169/internalmedicine.54.3564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic disorder resulting from ovulation induction. Although the occurrence of this disorder is rare, it can be potentially life-threatening in its most severe forms. We herein present the case of a young nulliparous woman who presented with features of abdominal compartment syndrome and was subsequently diagnosed with severe OHSS. All physicians, in particular critical care doctors, must be aware of this rare, but potentially life-threatening iatrogenic disorder.
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Affiliation(s)
- Abdul Rehman
- Department of Biological & Biomedical Sciences, Aga Khan University, Pakistan
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Abstract
Simple renal cysts are among the most common cystic lesions of the kidney. Renal cysts most often remain asymptomatic, but rarely these cysts may become huge in size and result in significant symptoms. Giant renal cysts present a technical challenge in terms of surgical management. Although laparoscopic procedures have been performed successfully at experienced centres, intraperitoneal marsupialization via open approach may be a feasible option at less experienced centres. We report a case of a young female with a giant (24 × 18 cm) renal cyst of Bosniak type-II variety. De-roofing and intraperitoneal marsupialization of the cyst was performed. At the 1-year follow-up, she was asymptomatic, with no residual cyst.
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Affiliation(s)
- Abdul Rehman
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Muhammad Awais
- Department of Radiology, Aga Khan University Hospital, Karachi, Pakistan
| | | | - Hammad M Ather
- Section of Urology, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
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Awais M, Rehman A, Baloch NUA, Khan F, Khan N. Evaluation and management of recurrent urinary tract infections in children: state of the art. Expert Rev Anti Infect Ther 2014; 13:209-31. [PMID: 25488064 DOI: 10.1586/14787210.2015.991717] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Urinary tract infections (UTIs) represent an important cause of febrile illness in young children and can lead to renal scarring and kidney failure. However, diagnosis and treatment of recurrent UTI in children is an area of some controversy. Guidelines from the American Academy of Pediatrics, National Institute for Health and Clinical Excellence and European Society of Paediatric Radiology differ from each other in terms of the diagnostic algorithm to be followed. Treatment of vesicoureteral reflux and antibiotic prophylaxis for prevention of recurrent UTI are also areas of considerable debate. In this review, we collate and appraise recently published literature in order to formulate evidence-based guidance for the diagnosis and treatment of recurrent UTI in children.
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Affiliation(s)
- Muhammad Awais
- Department of Radiology, Aga Khan University Hospital, P.O. box 3500, Stadium Road, Karachi 74800, Sindh, Pakistan
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Rehman A, Ul-Ain Baloch N, Awais M. Practice of cupping (Hijama) and the risk of bloodborne infections. Am J Infect Control 2014; 42:1139. [PMID: 25278416 DOI: 10.1016/j.ajic.2014.06.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 06/30/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Abdul Rehman
- Department of Biological & Biomedical Sciences, Aga Khan University, Karachi, Sindh, Pakistan.
| | - Noor Ul-Ain Baloch
- Department of Biological & Biomedical Sciences, Aga Khan University, Karachi, Sindh, Pakistan
| | - Muhammad Awais
- Department of Radiology, Aga Khan University Hospital, Karachi, Sindh, Pakistan
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Rehman A, Baloch NUA, Awais M. Eid-ul-Azha festival in Pakistan: a vulnerable time for Crimean-Congo hemorrhagic fever outbreak. Am J Infect Control 2014; 42:939-40. [PMID: 24913761 DOI: 10.1016/j.ajic.2014.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Accepted: 05/01/2014] [Indexed: 10/25/2022]
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Rehman A, Baloch NUA, Awais M. Gossypiboma diagnosed fifteen years after a cesarean section: A case report. Qatar Med J 2014; 2014:65-9. [PMID: 25745595 PMCID: PMC4344979 DOI: 10.5339/qmj.2014.12] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 09/19/2014] [Indexed: 11/03/2022] Open
Abstract
Gossypiboma, a retained surgical sponge, is a rare complication following any surgical procedure and is primarily a result of human error. Such patients often have vague clinical presentations and the diagnosis often comes as a surprise. We present the case of a 40-year-old woman who had a long-standing history of lower abdominal discomfort. She was diagnosed with a gossypiboma fifteen years after a cesarean section. All general physicians, surgeons and radiologists must be aware of this rare but clinically significant entity.
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Affiliation(s)
- Abdul Rehman
- Department of Biological & Biomedical Sciences, Aga Khan University, Karachi, Sindh, Pakistan
| | - Noor Ul-Ain Baloch
- Department of Biological & Biomedical Sciences, Aga Khan University, Karachi, Sindh, Pakistan
| | - Muhammad Awais
- Department of Radiology, Aga Khan University Hospital, Karachi, Sindh, Pakistan
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