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Biomedical subjects

M Murad

Publications and source records attributed to M Murad.

At least 19 recordsLinked to original sources

Rectal cancer in the Kingdom of Saudi Arabia: the King Faisal Specialist Hospital experience.

BACKGROUND: No survival data have yet been published from the Kingdom of Saudi Arabia for patients with rectal cancer. The present paper reports experience with these patients over an 8-year period. METHODS: All patients referred to the King Faisal Specialist Hospital (KFSH) between March 1990 and February 1998 for the primary management of rectal cancer were entered into a computerized database. Prior to 1993 patients did not receive adjuvant therapy. Kaplan-Meier survival curves and the log-rank test were used to compare outcome data. RESULTS: There were 70 men (average age: 55.6 years) and 75 women (average age: 52.8 years). Twelve per cent of patients admitted a family history of colorectal carcinoma (CRC). Twenty-seven per cent of tumours were circumferential. Most tumours were larger than 4 cm and the lowest edge of the majority of tumours was less than 6 cm from the anal verge. Fifty-four per cent of tumours were fixed; 69% of patients received either pre-operative or postoperative radiotherapy. A total of 106 patients underwent 'curative' surgery. Equal numbers of patients had abdomino-perineal resection (APR) and anterior resection (AR) of the rectum. Thirty-five patients received blood peri-operatively (APR, 34%; AR, 12%). Major anastomotic leakage following AR occurred in two patients. Two patients died within 30 days of surgery. Ten patients were lost to follow-up. Following curative AR, eight patients had a distal resection margin of < 2 cm and two patients (Dukes' C) developed local recurrence (25%); 37 patients had a margin > 2 cm and seven developed local recurrence (18.9%). A total of 48 patients underwent curative APR, and four patients developed local recurrence (8.3%). Overall local recurrence was tumour stage-dependent (Dukes' B, 8.8%; Dukes' C, 29.3%). Recurrence was local in 13 patients. Pre-operative radiotherapy seemed to reduce average tumour size (3.6 vs 4.3 cm). The crude overall 5-year survival rate was 39%. The 5-year survival rate for patients with Dukes' stage C cancers following 'curative' surgery was 25%. CONCLUSION: Curative surgery can be performed with a relatively low requirement for blood transfusion, a low mortality and morbidity, and comparable outcomes to Western studies in spite of the large, low and often advanced stage of the tumours managed. Local recurrence rates following curative resection and re-anastomosis for low rectal cancers may be reduced by resisting patient pressure to avoid stomata.

Female↗

[Stents for bifurcational coronary lesion].

We describe two cases of coronary angioplasty with stents implantation in bifurcational lesion of the left anterior descending artery and the diagonal branch using new techniques successfully performed. Angiographic reestenosis was not present after seven months in one case and the patient was asymptomatic after six months of clinical follow-up in the other.

Aged↗

[Percutaneous approach for the treatment of unprotected left main coronary stenosis. New perspectives with the use of coronary stents].

We describe a case of coronary stenosis located in an unprotected left main coronary artery, treated primarily and electively with the placement of a coronary stent. As a function of the large mass of myocardium involved, this patient would be considered a classical candidate for direct surgery, because the inherent risk involved with conventional balloon angioplasty, mainly due to the eventual occurrence of acute closure during the procedure. Since the previsibility of the immediate results with the use of coronary stents was significantly improved, we propose this new therapeutic approach for this traditionally surgical case, that has been performed with success and without any complication. This strategy for the treatment of unprotected left main lesions with the elective placement of Palmaz-Schatz stents, has not yet been proposed or applied in our country, and may represent a new universe of indication of percutaneous treatment of coronary artery disease, no longer approaching the left main stem only in special or emergency situations, usually a result of complications of left main manipulation during angioplasty of the coronary system. The patient involved in this case did not show any contraindication for the treatment with conventional open heart surgery.

Angioplasty, Balloon, Coronary↗

[Coronary angioplasty through the transradial approach].

We describe a coronary angioplasty procedure performed by transradial approach, on a 53 year old male with a reestenotic lesion in his right coronary artery, done 19 months after the initial dilatation. This is a new technique and has not been applied in our country.

Angioplasty, Balloon, Coronary↗

Inadequacy of a polyester (Mersilene) suture for the reduction of astigmatism after penetrating keratoplasty.

Through two prospective studies, we evaluated the use of polyester (Mersilene) sutures in penetrating keratoplasty. Study 1 was a randomized comparison of combined running and interrupted Mersilene and nylon sutures (n = 45). Study 2 was a case series of single running Mersilene with postoperative adjustment of suture tension to manage astigmatism (n = 23). Study 1 demonstrated that Mersilene interrupted sutures were 5.5 times more likely to have handling-related complications compared to nylon (P = 0.01); in addition, they were 3 times as likely to have tissue-related complications as nylon interrupted sutures (P = 0.16). Study 2 demonstrated a complication rate of 69% when Mersilene was used as a single adjustable running suture. At 6 months postoperatively, the median refractive astigmatism for the adjustable cases was 3.37 D (mean, 4.03 +/- 2.37 D). Eyes in Study 2 with significant suture-related complications were 2.85 times more likely to have greater than 4 D of refractive astigmatism than were eyes without suture-related complications. We concluded that Mersilene is an undesirable suture for use in penetrating keratoplasty.

Adult↗

Improved visualization of aortopulmonary collateral arteries by abdominal aortic compression during angiography.

Increased filling of aortopulmonary collateral arteries occurs when the descending aorta is obstructed distal to their origin. We used this fact to develop a simple, safe technique for improving angiographic visualization of these arteries. The abdominal aorta is manually compressed against the spine during injection of contrast medium. A slight reflex bradycardia resulted, which probably also enhanced filling of the collateral arteries. In eight infants and children with either pulmonary atresia and a ventricular septal defect or truncus arteriosus communis, excellent visualization was consistently achieved without complication.

Angiography↗