Iqbal Ahmed Memon

Dow University of Health Sciences, Kurrachee, Sindh, Pakistan

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Publications (12)2.16 Total impact

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    ABSTRACT: Objective: To compare the results of conventional open with laparoscopic cholecystectomy regarding their operative time and postoperative parameters. Methodology: This is a comparative study of 400 patients of cholelithiasis operated for either open or Laparoscopic cholecystectomy during five years from January 2004 to December 2008. The cases were compared for operative time and various postoperative parameters in order to assess the advantages and disadvantages of each procedure. The patients were divided into two groups, group OC for open and group LC for laparoscopic cholecystectomy, each comprising of 200 cases. Results: The operative time was longer in OC than LC patients with mean operative time of 54.16± 11.94 minutes in OC and 46.89±14.83 minutes in LC group (P<0.001). The overall frequency of postoperative complications was relatively high in OC group 50.5% as compared to LC (37%) including all minor and major problems with combined morbidity of 43.75% (P<0.001). The mean hospital stay was shorter in LC group as compared to OC group i.e. 3.02±1.75 (range 1-5) days versus 5.56±9.8 (range 4-10) days respectively. Return to normal work was also significantly shorter in LC group i.e. 18.06±5.16 days (range 1-4 weeks) as compared to 31.61±7.6 days (range 3-6 weeks) in OC group with p value <0.001. Conclusions: The laparoscopic cholecystectomy is superior to open cholecystectomy due to short operative time, early mobilization and fast recovery, less postoperative pain and complications, short hospital stay and early return to work. Comparative study of conventional open versus laparoscopic cholecystectomy for symptomatic cholelithiasis. Pak J Med Sci 2011;27(1):33-37 1.
    Pak J Med Sci Sci January -March. 01/2011; 27(1):33-37.
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    ABSTRACT: To analyze the frequency and causes of anaemia in systemic lupus erythematosus (SLE) patients attending in department of medicine at tertiary care hospitals. This retrospective, descriptive and analytical study was planned to analyze the frequency and causes of anaemia in SLE patients attending the department of medicine at (MMC) and (LUMHS) hospitals during the period of Jan 2006 to Nov 2008. The criteria used in this study were from the American College of Rheumatology. Investigations recorded were blood complete picture, absolute values, peripheral smear, and reticulocyte count in all patients of anaemia. These investigations were necessary to analyse the cases of anaemia in SLE. All investigations were not done in all cases. Patients with hypochromic microcytic anaemia were advised to have serum iron and ferritin levels, seven patients with macrocytic anaemia were advised to have direct and indirect coomb's test, LFTs, serum LDH, serum B12 and folate levels. Patients with normochromic and normocytic anaemia were considered to have anaemia of chronic disease. Bone marrow aspiration and Hb electrophoresis were done in two patients with anaemia of chronic disease. Thirty adult patients were included in this study. Special proforma were prepared to record the information from case sheets of patients including basic information, symptomatology and laboratory investigations. Severity and various types of anaemias were recorded. Anaemia was graded according to severity, as mild (Hb 10-12 G/dl), Moderate (Hb 8-10 G/dl) and severe (Hb < 8 G/dl). Haemoglobinopathies and other types of anaemias were excluded from study. Thirty adult diagnosed patients of SLE, were included. Their ages ranged from twenty years to fifty years at time of presentation. The mean age +/- SD (range) was 28 +/- 6.22 (20-50) years and median age was 31 years. Out of thirty patients, twenty seven (90%) were females and three (10%) were males. Twenty eight (93.33%) patients presented with anaemia, 14 (46.66%) patients were of mild anaemia, 8 (26.66%) patients were of moderate grade anaemia and 6 (20%) patients had severe anaemia. Iron deficiency anaemia was found in 9 (30%) patients, 12 (40%) patients had anaemia of chronic disease and 7 (23.33%) patients had haemolytic anaemia, out of theses 7 patients, 5 (16.66%) patients had Coomb's positive haemolytic anaemia. All thirty patients had ANA positive titres > 1:80; and nineteen (63.33%) patients had anti ds DNA positive, titres > 1:10. Haematologic abnormalities are common manifestations in patients with SLE. Most patients exhibit anaemia at some point during their disease course.
    Journal of the Pakistan Medical Association 10/2010; 60(10):822-5. · 0.40 Impact Factor
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    ABSTRACT: Various autoimmune diseases have association with each other but it is very rare to see multiple autoimmune diseases in one patient. Presence of more than two autoimmune diseases in one patient is known as multiple autoimmune syndrome (MAS). We report the case of an 11 years old girl who presented with history of swelling in front of the neck along with constipation, anorexia, weight gain and increasing pallor over a period of six months. Additionally she had an episodic history of joint pains and abdominal pain with no specific relation to diet, time, other gastrointestinal or genitourinary symptom. Hypothyroid goiter (Autoimmune thyroiditis, Hashimoto's thyroidits) was diagnosed by raised thyroid stimulating hormone (TSH), low T4 and presence of thyroid specific antibodies in blood. Patient was discharged on tablet Levothyroxine to which she responded well with reduction in size of the swelling and relief of the symptoms except for the joint pains and abdominal pain. To evaluate the persistent symptoms she was investigated further for other autoimmune diseases and was diagnosed to be having systemic lupus erythematosus (SLE) and Coeliac disease also. The final diagnosis was multiple autoimmune syndrome (Hashimoto's thyroiditis, Coeliac disease and SLE).
    Journal of the Pakistan Medical Association 10/2010; 60(10):863-5. · 0.40 Impact Factor
  • Journal of the Pakistan Medical Association 01/2010; 60(10):863-5. · 0.40 Impact Factor
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    ABSTRACT: To assess serum zinc and magnesium level in type-2 diabetic patients and the effect of age, gender, glycemic control and duration of diabetes on these trace elements in comparison with those of control subjects. Non-interventional case control study. Department of Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, Hyderabad, from October 2007 to March 2008. There were 42 diabetic patients and 42 age matched non-diabetic (control) subjects included in this study. Serum zinc, serum magnesium and fasting blood sugar measured among the diabetic and control groups and association of both trace elements were assessed with glycemic status, age, gender and duration of diabetes using SPSS version 16.0 for analysis. Serum zinc level was significantly lower (mean 2.03 +/- 0.39 mg/dL) in diabetic patients as compared to control subjects (4.84 +/- 4.217 mg/dL, p = < 0.001). No significant difference was found in serum magnesium level with mean of 22.67 +/- 24.5 mg/dL in diabetic patients as compared to controls (18.3 +/- 3.4 mg/dL, p = 0.26). Serum zinc level was significantly lower in type-2 diabetics, whereas no significant difference was found in serum magnesium level when compared with control subjects. There was no association of age, gender, glycemic status and duration of diabetes on the serum concentration of these trace elements in type-2 diabetic patients.
    Journal of the College of Physicians and Surgeons--Pakistan: JCPSP 09/2009; 19(8):483-6. · 0.32 Impact Factor
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    ABSTRACT: To determine the frequency and clinical presentation of amoebic diarrhea in children and its effect on the nutritional status of the affected children. Descriptive. Department of Diarrhea Treatment Unit (DTU), Dow Medical College and Civil Hospital, Karachi, from November 1998 to April 2001. Paediatric patients between the ages of > 1 month to 15 years were included, who visited the DTU of the department with diarrhea. Stool samples of all these patients were checked under microscope for the vegetative forms of Entamoeba Histolytica (E.H.). Patients who were positive for E.H. were evaluated for the symtomatology including the type of diarrhea {acute watery diarrhea (AWD) or dysentery}, abdominal pain, tenesmus and nausea/vomiting. Examination carried out was assessed for state of hydration, fever and anaemia and nutritional status of those less than 5 years of age. The patients were divided into three age groups to assess the association of the age with severity and type of clinical presentation. Chi- square test was applied to calculate the p-values. P-values of 0.05 or less were considered statistically significant. The stool samples of 3870 patients with diarrhea were examined under microscope. Three hundred and twenty eight (8.47%) of these samples were positive for E.H. The difference between the number of patients presenting with acute watery diarrhea n=157, 47.86% and with dysentery n=171, 52.13% was found to be statistically non-significant (p=0.364). Two hundred and seventy seven (84.45%) patients had tenesmus, while abdominal pain was present in 287 (87.5%). Fever and malnutrition were present in 169 (51.52%) patients each. Malnutrition was significantly most frequent in 1-5 years of age groups (n=98, 57.98%, p=0.026). The nutritional evaluation of the 272 under-5 children with amoebic diarrhea showed a significantly normal status in 123 (45.55%, p-value < 0.001). All the signs and symptoms followed a similar trend with 1-5 years age group being the most affected group. However, the frequency of blood in stools increased in direct proportion to the increasing age. Although dysentery was the more common presenting complaint, almost half of the patients presented with watery diarrhea. Most of the patients with dysentery were under the age of 5 years. Fever was present in a high number of patients. The age group most affected by amoebiasis and malnutrition was 1-5 years.
    Journal of the College of Physicians and Surgeons--Pakistan: JCPSP 08/2009; 19(7):440-3. · 0.32 Impact Factor
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    ABSTRACT: The objective of this study was to assess the frequency of thyroid dysfunction in response to combination of interferon and ribavirin therapy in chronic hepatitis C (CHC) patients and HCV outcome. Descriptive study. Place and Duration of Study: This study was conducted at Outpatient Department of Liaquat University of Medical and Health Sciences, Jamshoro, Hyderabad from September 2005 to September 2007. One hundred cases of CHC, proven by anti-HCV and HCV RNA-positive with baseline TSH, FT4 and FT3 within the normal reference range, who were treated with interferon alpha-2b (3 million unit subcutaneously three times per week) and oral ribavirin (1000-1200 mg per day) were included in this study. All patients were assessed for TSH, FT4, FT3 levels at 12 weeks and 24 weeks during therapy. Among the 100 patients, overt thyroid disease developed in 13 (13%) and sub-clinical thyroid disease in 5 (5%). Out of 13 patients of overt thyroid disorders, 11 (84.6%) had hypothyroidism and 02 (15.3%) hyperthyroidism. Four (80%) patients were of sub-clinical hypothyroidism and 01 (20%) patient was of sub-clinical hyperthyroidism. Overall, thyroid disorders developed in 18 (18%) both as overt and sub-clinical thyroid disorders. Ninety one (91%) patients became negative by HCV RNA. Treatment of HCV with IFN-alpha and ribavirin can be safely continued in patients with over and sub clinical hypothyroidism because thyroid disease responds well to treatment.
    Journal of the College of Physicians and Surgeons--Pakistan: JCPSP 07/2008; 18(6):347-51. · 0.32 Impact Factor
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    ABSTRACT: Objective: To evaluate freguency of acute pancreatits in pregnancy and its associated maternal and foetal complications. Study Design: Case Series. Setting & Duration: Department of Surgery, Unit III, Civil Hospital, Karachi from June 2001 to January 2008. Methodology: All pregnant females referred with suspicion of acute pancreatits were included and were further reviewed for maternal and foetal outcomes. Result: The frequency of acute pancreatits in pregnancy was 7.83%, the most commonly presenting symptom was epigastric pain and tenderness while biliary pancreatits was the most common aetiology seen in 61.53% of cases. The recurrence rate during the same pregnancy was 15.38% while the total number of maternal deaths were 4(30.76%) and 9(69.23%) patients suffered severe morbidities. A total of 6(46.15%) fetuses suffered morbidities while their were six (46.15%) mortalities. Conclusion: Acute pancreatits in pregnancy though a rare but a dreaded conditon. The associated maternal and foetal complications can be reduced by early diagnosis and thus early referral for apprprite specialist care.
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    ABSTRACT: Objective: To evaluate the safety of single layer interrupted extra mucosal intestinal anastomosis in comparison with the double layer conventional methods of intestinal anastomosis. Methodology: All patients requiring intestinal anastomosis were included. They were divided into two groups. In-group A single layer interrupted extra mucosal anastomosis was done with 2/0 vicryl while in-group B conventional double-layered anastomosis with 2/0 vicryl was made. Outcome of the two techniques in terms of morbidity, mortality and cost effectivity was compared. Results: Ninety patients were included in our study (42 in group A and 48 in group B). Mean age for group A was 37.5years and group B 40.2 years respectively. Entero-enterostomy, entero-colostomy and colo-colostomy were done in 30(71.4%), 10(23.8%) and 2(4.7%) patients in-group A and 35(72.9%), 10(20.8%) and 3(6.3%) patients in group B respectively. Two patients (4.7%) in group A and four patients (8.3%) among group B developed anastomotic leakage with overall mortality 0% in group A and 4.1% in group B. Conclusion: A single layer interrupted extra mucosal intestinal anastomosis can be constructed in less time with minimal complication compared with two-layered technique. It can be safely introduced into surgical training programme. Volume 25, Issue 3, 2009 is internationally accepted. 3 The objections against double layered anastomosis is that in most of the cases it fails to oppose clean serosal surfaces and it results in large amount of ischemic tissue within suture line which increases the chances of leakage. Further excessive inversion leads to narrowing of lumen. 4 In contrast single layer anastomosis causes least damage to sub mucosal vascular plexus least chances of narrowing of lumen, incorporates strongest sub mucosal layer and accurate tissue apposition. 5 this prospective comparative study was performed to evaluate the safety of single layer interrupted extra mucosal technique.
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    ABSTRACT: Objective: To study the frequency of breast carcinoma in pregnancy and its outcome in our population. Design: Case series. Setting & Duration: Surgical Unit III, Civil Hospital Karachi from January 2001 to September 2007. Patients: All the patients of proven pregnancy associated Breast cancer were included Methodology: All those patients with pregnancy associated breast cancer proven by histology admitted either through OPD or referred from Gynaecology Department were evaluated. Results: During the study period total number of patients were eight (10.9%) out of 73 total cases of breast carcinoma. Five (62.5%) were under the age of forty years while mean age of menarche was 13.4 years. Three (38%) had parity of four, while almost all of them six (75%) breast fed their babies. Maximum number of patients, three (38%) presented in second trimester, four (50%) were in Stage III when diagnosed as a case of PABC. During the study period four (50%) ended up in termination of pregnancy and 38% of females died during different stages of treatment. Conclusion: Breast Cancer which is the most common malignant condition in pregnent women has through still at a low incidence but is apparently on the rise due to advance age at first pregnancy as well as physiological changes in pregnancy masked features of malignancy necessitate thorough examination and evaluation of breast in early pregnancy. Volume 24, Issue 3, 2008 thrice to those who conceive in late teens. 3 With the tendency to prefer late age pregnancy, the incidence is also on the rise. Micro anatomical and endocrinogical changes occuring in the breast during pregnancy render it more difficult to examine and interpret its examination findings thus making the diagnosis all the more difficult. 4 Scarff Bloom, Richardson grade of Pregnancy associated breast carcinoma appears to be higher than in non-preg-nant patients. 5 For the same reason Mammography and Fine Needle Aspiration Cytology (FNAC) are of limited value in diagnosis during pregnancy and inversely biopsy is of greater value. 6 There is hardly any role of radiotherapy of breast cancer during pregnancy though there are some who advocate chemotherapy in least stages. Modified Radical Mastectomy is the best option. 7 The purpose of this study was to evaluate the frequency of breast carcinoma in pregnancy and its outcome in our population.