Saulat Hasnain Fatimi

Aga Khan University, Pakistan, Kurrachee, Sindh, Pakistan

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Publications (88)98.27 Total impact

  • ANZ Journal of Surgery 03/2015; DOI:10.1111/ans.12996 · 1.50 Impact Factor
  • Saulat Hasnain Fatimi, Taimur Asif Ali, Zain Majid, Ranish Deedar Ali
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    ABSTRACT: We present the case of a 3.5-year-old child who presented with recurrent chest infections and fever since birth. Antenatal ultrasonography had shown that she had a congenital cystic malformation of the left lower lobe of her lung. She was initially managed conservatively, and after a couple of years, underwent an uneventful left lower lobectomy via a posterolateral thoracotomy. She did very well after the procedure and her symptoms resolved significantly. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
    Asian cardiovascular & thoracic annals 12/2014; DOI:10.1177/0218492314563774
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    ABSTRACT: A 70 years old male underwent Coronary Artery Bypass and Graft (CABG) surgery. After induction, a Pulmonary Artery Catheter (PAC) was inserted via right IJV with some difficulty in achieving PA tracing. During distal RCA anastomosis, surgeon noticed PAC tip coming out of Right Ventricular (RV) surface. Resistance was felt on trying to pull PAC, so it was left there. Cardiac surgeon then opened the Right Atrium (RA) and pulled out the catheter. Multiple attempts during insertion of PA catheter should always raise the suspicion of PAC tip slipping back into the RV. It should be closely monitored during surgery and communicated to the surgeon.
    Journal of the College of Physicians and Surgeons--Pakistan: JCPSP 11/2014; 24(11):S166-S168. · 0.32 Impact Factor
  • Therapeutic advances in endocrinology and metabolism 12/2013; 4(6):173-175. DOI:10.1177/2042018813512361
  • Saulat Hasnain Fatimi, Ranish Deedar Ali Khawaja, Zain Majid
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    ABSTRACT: We present the case of a 13-year-old girl who had a large swelling in her left breast with a history of weight loss, low-grade fever, and cold sweats. Computed tomography showed a large mass encroaching on the mediastinum and heart, with erosion of the adjacent ribs. Resection of the mass along with a pneumonectomy were performed. Postoperative tests showed no sign of metastases.
    Asian cardiovascular & thoracic annals 10/2013; DOI:10.1177/0218492313498089
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    ABSTRACT: Inflammatory endobronchial polyps are rarely encountered. We report a case of a 14 years old girl with a benign granulomatous polyp originating in the bronchus. Computed tomography scan showed an intraluminal soft tissue opacity while fiberoptic bronchoscopy revealed a large soft tissue mass completely occluding the left lower lobe. Rigid bronchoscopy under general anaesthesia identified a fleshy mass in the left main stem bronchus which was excised via bronchoscopy. The histopathology showed benign polyp with non-specific inflammation. The patient's symptoms improved subsequently and no recurrence was reported till two years of follow-up.
    Journal of the College of Physicians and Surgeons--Pakistan: JCPSP 07/2013; 23(7):519-21. · 0.32 Impact Factor
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    ABSTRACT: Inflammatory endobronchial polyps are rarely encountered. We report a case of a 14 years old girl with a benign granulomatous polyp originating in the bronchus. Computed tomography scan showed an intraluminal soft tissue opacity while fiberoptic bronchoscopy revealed a large soft tissue mass completely occluding the left lower lobe. Rigid bronchoscopy under general anaesthesia identified a fleshy mass in the left main stem bronchus which was excised via bronchoscopy. The histopathology showed benign polyp with non-specific inflammation. The patient's symptoms improved subsequently and no recurrence was reported till two years of follow-up.
    07/2013; 23(7):519-21.
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    ABSTRACT: Aortoesophageal fistula (AEF) is an atypical cause of massive hematemesis proving to be lethal if left untreated. We report a case of a 56-year-old man who presented with chest pain and hematemesis. He was diagnosed with pseudoaneurysm of the descending aorta and underwent open surgery for primary repair.
    Indian Journal of Surgery 06/2013; 75(1). DOI:10.1007/s12262-013-0839-y · 0.27 Impact Factor
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    ABSTRACT: Objective: Increased body mass index has been associated with increased postoperative morbidity. We studied the effect of body mass index in our population, using a modified scale suggested by the World Health Organization. Methods: From January 2006 to December 2008, 1019 patients undergoing first-time isolated elective coronary artery bypass grafting were selected from our cardiac surgery database. Data were analyzed by univariate and multivariate analyses. Results: Of the 1019 elective coronary artery bypass patients, 168 (15.8%) had a normal body mass index (18.5-22.9 kg·m(-2)) and 894 (84.2%) had a high body mass index (≥23.0 kg·m(-2)). There were 921 (86.7%) patients with 3-vessel disease, and 1012 (95.3%) had internal mammary artery grafts. The 30-day mortality was 0.8%. Multivariate analysis revealed age, hospital stay, perfusion time, and renal failure were significantly associated with hospital complications. High body mass index was not significantly associated with morbidity or mortality. The model had an adequate fit at p = 0.708 by the Hosmer and Lemeshow test. Conclusion: Increased body mass index alone is not a predictor of increased mortality and morbidity. In fact, these outcomes were associated with advanced age, hospital stay, perfusion time, and renal failure.
    Asian cardiovascular & thoracic annals 04/2013; 21(2):176-80. DOI:10.1177/0218492312451165
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    ABSTRACT: Bronchial carcinoid tumours is a rare group of pulmonary malignant neoplasm that is derived from neuroendocrine system. Bronchial carcinoid usually present with hilar masses, atelactasis, bronchiectasis, or post-obstructive pneumonia. This case describes a very unusual presentation of bronchial carcinoid tumour with multiple lung abscesses involving the whole lung. This report is of an adult lady who presented with multiple lung abscesses involving her whole of the right lung. She was found to have an endo-bronchial lesion in her right main bronchus which eventually turned out to be carcinoid tumour. She responded to resection and antibiotic therapy.
    03/2013; 23(3):229-30.
  • Taimur A Ali, Saulat H Fatimi, Babar S Hasan
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    ABSTRACT: A relatively rare occurrence, the incidence of ventricular septal defect (VSD) complicating penetrating cardiac trauma has been reported at 4.5%. Closing such defects may be challenging especially in an unstable patient where cardiopulmonary bypass may exponentially increase the surgical risk. In such patients, catheter based device closure is a reliable and effective alternative. We describe case of a 30 year old man who presented with a stab wound to his anterior mediastinum. His injuries involved laceration to right and left ventricles and a VSD. His lacerations were repaired on a beating heart and the VSD was not addressed due to patient hemodynamic instability. The VSD was semi-electively closed using a 24 mm Amplatzer TM device as the patient demonstrated significant left to right shunt. Post device closure, the patient developed hemolysis attributed to an intra- device residual leak. The hemolysis resolved without any complications by conservative medical management. At latest follow-up the patient is in NYHA functional class I-II. © 2012 Wiley Periodicals, Inc.
    Catheterization and Cardiovascular Interventions 03/2013; 82(4). DOI:10.1002/ccd.24739 · 2.51 Impact Factor
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    ABSTRACT: Tracheal stenosis refers to a reduction in the size of the tracheal lumen and can be due to a myriad of reasons, but the most common remains trauma. In iatrogenic situations, internal trauma is the most likely culprit, resulting from prolonged intubation. Our case reviews a patient who developed severe tracheal stenosis (90% reduction in lumen size) within a month of a threeday- long intubation, and presented to the emergency room with dyspnea, orthopnea, and stridor. Tracheal reconstruction with resection of the stenosed segment and end-to-end anastomosis was done. The patient returned a month later with re-stenosis, and underwent tracheal dilatation. Subsequently, he was discharged with a tracheostomy with no problems thereafter.
    01/2013; 2(2):57–59. DOI:10.1016/S2049-0801(13)70038-4
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    ABSTRACT: Thymomas are rare malignant epithelial growths, constituting 20% of mediastinal tumours. Resection followed by irradiation may be employed in all thymomas except for stage 1 thymomas. Mediastinal irradiation is associated with coronary artery disease. The mean duration of presentation of post-irradiation coronary artery disease is 16 years (range 3-29 years). In our patient coronary artery disease was found only a year post irradiation. A 55 year old male who presented with complaints of dyspnoea, retrosternal chest pain and heaviness since one year underwent resection for malignant thymoma followed by radiotherapy. He presented with coronary artery disease a year after undergoing mediastinal irradiation. On follow-up, patient was treated successfully by coronary artery bypass graft. This case is an unusual occurrence and suggests that mediastinal irradiation may result in significant coronary artery disease as early as within one year.
    Journal of the Pakistan Medical Association 11/2012; 62(11):1248-50. · 0.40 Impact Factor
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    Journal of the Pakistan Medical Association 11/2012; 62(11):1248-50. · 0.40 Impact Factor
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    ABSTRACT: Seventy-five percent of all trauma-related deaths are related to thoracic trauma. Very few penetrating cardiac trauma patients arrive to the hospital alive. Due to its high prevalence, an understanding of the pathogenesis, manifestations and management of cardiac trauma by the medical personnel is becoming increasingly important. We retrospectively reviewed the files of 169 patients with a preoperative diagnosis of vascular injury who underwent management at the Aga Khan University Hospital from 2001 to 2006. Of these patients, 13 had cardiovascular and cardiac injuries. 23% (n=3) had cardiac injuries; 2 had right ventricle injuries and 1 had injury to both ventricles. Great vessel injuries included: pulmonary artery (n=2), inferior vena cava (n=1), left carotid artery (n=1), left subclavian artery (n=2), and right subclavian artery (n=3). 53.8% of the patients suffered from postoperative complications. The overall mortality of patients with major thoracic vessel and cardiac trauma was found to be 15.4%. We believe that, in the past, the inevitable delay in diagnosis led to unsuccessful thoracotomies, late transfers to the operating room and physiological deterioration of the patient. As the incidence of trauma is increasing worldwide, it is essential for surgeons to be prepared to handle cardiovascular and cardiac trauma injuries immediately, as delay can adversely affect the outcome in terms of both morbidity and mortality. All patients presenting with trauma to the chest should be assessed with a high index of suspicion for major cardiovascular injuries. Early diagnosis, prompt transfer to the operating room and speedy and perfect surgery influence a favorable outcome.
    Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery: TJTES 11/2012; 18(6):490-4. DOI:10.5505/tjtes.2012.39225 · 0.38 Impact Factor
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    ABSTRACT: Subclavian steal syndrome (SSS) is a rare condition. It results from subclavian artery (SA) stenosis proximal to the origin of the vertebral artery. It is characterized by cerebral ischaemia with associated symptoms of vertebrobasilar hypoperfusion and/or symptoms of brainstem or arm ischaemia. We describe a case of a 35 year old male who presented with persistent vertigo for two months, blue discoloration and pain in the left fingers for two weeks. A diagnosis of SSS was made and patient was treated with a gortex graft from the arch of the aorta to the second portion of the left subclavian artery. Treatment is aimed at restoring permanent antegrade blood flow to the affected vertebral artery. This abolishes vertebral basilar symptoms and other manifestations of SSS. Several modalities exist, however surgical correction is the treatment of choice.
    Journal of the Pakistan Medical Association 10/2012; 62(10):1118-20. · 0.40 Impact Factor
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    ABSTRACT: To: determine the outcome of patients having undergone Video Assisted Thoracoscopic Surgery (VATS) for spontaneous pneumothrox in terms of hospital stay, complications and recurrence. The netrospective study included the review of 39 cases who had presented with spontaneous pneumothorax at the Aga Khan University Hospital, Karachi, Pakistan, between January 2001 to November 2008 and had undergone video assisted thoracoscopic surgery (VATS). The duration of hospital stay (had a range of 3 to 9 days), and the length of chest tube in place (a range of 2 to 8 days), 2 (5.1%) patients developed recurrence after VATS while 3 (7.6%) patients developed bleeding post operatively requiring transfusion and 2 (5.1%) patients developed atelectasis requiring bronchoscopy. Compared with figures for thoracotomy data from other studies, it was seen that the length of hospital stay and chest tube placement with VATS was less than that for thoracotomy, and the overall cost as well as post-operative pain was also low. The rate of recurrence was however comparable to that after thoracotomy.
    Journal of the Pakistan Medical Association 10/2012; 62(10):1041-5. · 0.40 Impact Factor
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    ABSTRACT: A 50-year-old woman presented with fever, cough, shortness of breath, and left-sided chest pain. Computed tomography with contrast showed a pseudoaneurysm occupying the upper half of the left hemithorax. Surgical repair with a Dacron patch was performed after considering the risk of pseudoaneurysmal rupture.
    Asian cardiovascular & thoracic annals 06/2012; 20(3):330-2. DOI:10.1177/0218492311423155
  • Saulat Hasnain Fatimi, Roheena Zainab Panni, Awais Ashfaq
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    ABSTRACT: The prevalence of aortic aneurysms is 3-4% in individuals more than 65 years. Age and haemodynamic factors play an important role in the development of aortic aneurysms. Most patients with aortic aneurysms are asymptomatic at the time of discovery. Thoracic aneurysms are usually found incidentally after chest radiographs or other imaging studies. The most common complications of thoracic aortic aneurysms are acute rupture or dissection. Some patients present with tender or painful nonruptured aneurysms. Patients are thought to be at increased risk for rupture and should undergo surgical repair on an emergent basis We document a case of a 66-year-old man who presented with shortness of breath. On evaluation, he was found to have severe aortic regurgitation and large aortic root aneurysm. Patient underwent successful open heart surgery. Aortic root and aortic valve were replaced with valve conduit and coronary arteries were re-implanted. Patient had an uneventful recovery.
    Journal of the Pakistan Medical Association 06/2012; 62(6):617-9. · 0.40 Impact Factor
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    ABSTRACT: Following percutaneous intervention (PCI), restenosis, progression of disease and multi-vessel involvement may require further intervention in the form of surgical revascularization. Patients with coronary artery bypass grafting (CABG) done after PCI were evaluated to find out the reason for the need of surgical revascularization. Over a period of 12 months, 610 patients underwent CABG. Out of them, 34 patients had previous PCI/stenting. Coronary risk factors including hypertension in 85%, diabetes mellitus in 60%, dyslipidemia in 60%, tobacco use in 50% and a positive family history was present in 53% of the patients. All patients were symptomatic. Multi-vessel disease was present in 67% and single vessel in 4.7%. The extent of disease and stenosis of stents were responsible for reintervention. Careful selection of patients is required in presence of multiple risk factors for coronary artery disease to provide maximum benefit by either PCI or CABG.
    05/2012; 22(5):340-1.