Masood Umer.
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Attitude of Health Personnel↗
Biomedical subjects
Masood Umer
Publications and source records attributed to Masood Umer.
Autoclaved tumor bone for reconstruction: an alternative in developing countries.
The options for reconstruction after excision of skeletal tumors include reimplanting the autoclaved tumor-bearing bone. We asked whether such bone will survive and unite with normal bone and whether the local tumor recurrence rate increases after its use. We ascertained the functional outcome (Musculoskeletal Tumor Society score) and complications in 19 patients. After wide excision, the bony segment was autoclaved at 120 degrees for 10 minutes and reimplanted at the original defect with intramedullary nails and compression plates. Twelve of our 19 patients were available for followup. The autoclaved segment united with the normal bone in 11 of the 12 patients. No patients had fracture or resorption of the autoclaved segment. Two patients had local tumor recurrence in nearby soft tissues, apparently unrelated to the autoclaved bone. The mean functional score was 70%. Complications included fatigue failure of the nail in one patient, superficial infection in three patients, and deep infection in two patients. Reconstruction with autoclaved tumor-bearing bone is a simple and effective tool in limb salvage. This technique is a cost-effective alternative for developing countries circumventing complications of prosthetic and allograft reconstruction.
Adolescent↗
Prophylaxis of DVT with enoxaparin in patients undergoing total knee replacement.
OBJECTIVE: To evaluate the efficacy and safety of the low molecular weight heparin as prophylaxis against thromboembolism following total knee replacement surgery. METHODS: Post-operative bilateral lower extremity colour duplex scan was performed on 55 patients subjected to total knew arthroplasty. The scan was performed 7 days after surgery for detection of DVT. All patients were given Enoxaparin 40mg subcutaneous daily for 2 weeks as prophylaxis against DVT. RESULTS: Two patients were diagnosed as DVT by color duplex scanning and both were distal but only one was asymptomatic. Another patient developed pulmonary embolism and died subsequently. The major and minor wound problems were seen in two and six patients respectively; nearly all complications were seen in obese patients. CONCLUSION: DVT is not a nonexistent entity in our population. Low molecular weight heparins are safe drugs but apparently the bleeding complications are more as compared to Western literature. Larger case control studies are required to determine the true efficacy and safety of LMWH.
Adult↗
Berneese periacetabular osteotomy for residual hip dysplasia in adults--a case report and review of literature.
Pelvic osteotomy for acetabular dysplasia has been introduced to improve acetabular coverage of the femoral head and reduce the risk of secondary osteoarthrosis. Several surgical methods for acetabular reorientation have been proposed for this purpose by reorientation of the acetabulum single, double, triple, spherical and periacetabular osteotomies. We report our first experience with periacetabulur berneese osteotomy described by Prof. R. Ganz and now the procedure of choice in appropriately selected patients. Fifteen years old boy who presented with complaints of fall and pain in the right gluteal region for 5 days duration that increased with walking. Examination revealed an antalgic gait. Rest of his examination was normal except mild tenderness in the right buttock area. His plain X-rays revealed an incidental finding of dysplastic left hip with deficient lateral coverage, deformed femoral head, coxa magna and mild coxa valga. In addition he had focal arthritic changes over the superolateral acetabulam with sclerosis and cyst formation. His anterior center-edge angle was 24 degrees with an acetabular index of 44 degrees. He had grade II arthritic changes according to the Tonnis classification of osteoarthritis. A periacetabulur ganz osteotomy was performed. Correction was confirmed with intraoperative X-rays. His post operative course was smooth and he was allowed full weight bearing at 8 weeks when X-rays showed satisfactory healing of osteotomy.
Acetabulum↗
Frequency of osteomalacia in elderly patients with hip fractures.
OBJECTIVE: To determine the frequency of Osteomalacia and biochemical abnormalities in patients with hip fracture who presented at our Institution. METHODS: All patients with operatively treated hip fractures (Aga Khan University Hospital, Karachi from June 1996 to June 2001) were included. The total number of patients was 168 with 59 males and 109 females. Eighty nine patients presented with intracapsular hip fracture and 79 had Intertrochanteric fractures. All fracture types and grade of osteoporosis were determined. Laboratory investigations included Serum Calcium, Phosphorus and Alkaline phosphatase. During surgery, small amount of curetted cancellous bone from fracture site was sent for histopathology. An elaborate questionnaire was completed for every patient. RESULTS: The average age of patients with hip fractures was 61 years with 94.5% of the female patients being postmenopausal. Most of the patients (94%) had low velocity trauma. Singh's index for most of the fractures was grade II (n=48) and grade III (n=65). About one fourth of the patients showed abnormal values of serum Calcium, Phosphorus and Alkaline Phosphatase. Bone biopsy showed osteomalacia to be present in 13 patients (7.7 %). Among these 13 patients, 6 had abnormal values of Serum Calcium, Phosphorus and Alkaline phosphatase. Out of these 13 patients, 4 were male and eight out of nine females were postmenopausal. CONCLUSION: Frequency of osteomalacia in cases of hip fractures was found with no association with known risk factors. Bone histopathology was the gold standard of diagnosis and biochemical markers like serum calcium, phosphorus and alkaline phosphates were not very helpful.
Aged↗
Earthquake relief experience of Aga Khan University trauma team.
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Disasters↗
Suicidal bus bombing of French Nationals in Pakistan: physical injuries and management of survivors.
BACKGROUND: Suicidal bombing is particularly devastating and an increasingly common form of terrorist violence. In this paper, we present an epidemiologic description of the physical injuries of patients who survived the suicidal bombing attack in the context of the limited medical resources of a developing nation. METHODS: The management of individual patients was reviewed from a preprinted trauma form. Information on the nature of injuries, operative management and hospital course was recorded and data analyzed using the Trauma Registry. RESULTS: Twelve survivors out of 36 bomb blast victims brought to the Aga Khan University Hospital were transferred from primary receiving hospitals. The average number of injuries per patient was eight. The mean Injury Severity Score was 10.8. The majority of patients had secondary and tertiary blast injuries. Most of the survivors had calcaneal injuries; these have not been reported in the literature in similar terrorist attacks. Twelve operative interventions were undertaken. All of the 12 patients were stabilized and evacuated within 24 h of admission. CONCLUSIONS: All of the 12 patients transferred to the Aga Khan University Hospital survived. Unlike the reported injuries, calcaneal fractures were most commonly encountered in the survivors.
Adult↗