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Biomedical subjects

Z Habib

Publications and source records attributed to Z Habib.

At least 19 recordsLinked to original sources
PubMed2004

Experience with laparoscopic adrenalectomy in children.

PURPOSE: The aim of this study was to review the authors' experience with laparoscopic adrenalectomy in the pediatric age group. METHODS: This is a retrospective analysis of laparoscopic adrenalectomies performed in children at King Faisal Specialist Hospital & Research Centre, between June 1997 and March 2003. Ten children had laparoscopic adrenalectomies during this period. They were between 3 weeks to 12 years of age and there was an equal number of boys and girls. Case selection was based mainly on the size of the lesion and its localized nature as seen on the imaging studies. The transperitoneal approach was used in all cases. RESULTS: Eleven laparoscopic adrenalectomies were performed in 10 children (1 was bilateral adrenalectomy). Presenting features were virilization (n = 3), Cushing's syndrome (n = 1), antenatally detected adrenal cyst (n = 1), hypertension (n = 1), hepatomegaly (n = 1), loin pain with hematuria (n = 1) and an incidental adrenal mass (n = 1). One was a child with stage IV adrenal neuroblastoma postchemotherapy for resection of the residual tumor. On imaging studies, the tumors were between 2.8 and 7 cm in their largest dimension. Operating time ranged from 118 to 180 minutes in the unilateral resections, whereas the bilateral laparoscopic adrenalectomy required 330 minutes. Two had to be converted to open procedures. Postoperative hospital stay was between 2 and 15 days. Pathologic diagnoses were as follows: adrenal cortical adenoma (n = 3), adrenal medullary hyperplasia (n = 2), adrenal cortical carcinoma (n = 1), ganglioneuroma (n = 1), and neuroblastoma (n = 3). There were no complications. Follow-up ranged from 3 months to 6 years. The only mortality in our study group was in the child with stage IV neuroblastoma who died of disseminated disease 9 months later. In the rest, there has been no local recurrence or metastases, and the biochemical and hormonal parameters have remained normal in the functional tumors. CONCLUSIONS: We believe that in a select group of pediatric adrenal lesions, laparoscopic adrenalectomy is a safe and effective procedure with the potential benefits of minimally invasive procedures.

Adrenal Gland Diseases↗
PubMed2003

Febrile seizures: factors affecting risk of recurrence in Pakistani children presenting at the Aga Khan University Hospital.

OBJECTIVES: To (a) describe the effect of temperature rise on seizure recurrence in the ER (b) investigate the effect of age, gender, family and developmental history, type, duration and multiple seizures, past history and number of seizures and treatment given (either late or early) on seizure recurrence in the ER and (c) explore prognostic indicators for seizure recurrence. METHODS: Data from 352 children [ages 3-84 months; 220 males (62.5%) 132 females (37.5%)] was taken using chart reviews for the years January 1998-August 2000 inclusive, from the Pediatric department of the Aga Khan University Hospital. Descriptive statistics, Chi-square, and Discriminant Analysis were used. RESULTS: Of the 52 (16%) cases that had seizure recurrence in the ER, majority (36.5%) occurred in > 38.5 degrees < or = 39.5 degrees C temperature range. The percentage declined to 15% at higher temperatures. Bivariate tests showed that age, family and developmental history, type of seizure and treatment given did not affect seizure recurrence in the ER. Past history number of seizures (p = .006), duration of seizure (p < 0.001), past history of seizures (p = 0.004) and multiple seizure (p = 0.024) were factors significantly associated with seizure recurrence in the ER at the bivariate level of analysis. Duration of seizure was the most important prognostic indicator for FS recurrence in the ER at the multivariate level with beta = .79. CONCLUSION: Duration of seizure (> 5 minutes) was the most important prognostic factor for FS recurrence. Early treatment did not affect recurrence,suggesting timely anti-pyretic vs. anti-leptic medication use.

Age Distribution↗
PubMed2001

Parental [correction of Perinatal] consanguinity: a risk factor for developmental delay in Pakistani children.

OBJECTIVE: To investigate the association of parental consanguinity and delayed development in terms of gross motor, fine motor, speech and social aspects in their children. METHODS: One hundred and seventy seven children (age 15 days--72 months) were evaluated for their developmental status utilizing the Denver Developmental Screening Test (DDST). An unmatched case-control study design was used. Case group consisted of 94 children and control group 83 children. Odds ratios were calculated for parental consanguinity and delay in gross and fine motor, speech and social development in their children, for cases and controls, utilizing Binary Multiple Logistic Regression Analysis. Acquired delay was excluded through detailed birth history in both cases and control group respectively. RESULTS: Univariate analysis showed high significant Odds ratios for all areas of developmental delay (viz. gross and fine motor, speech and social development), between cases and controls (p < .001). At the multivariate analysis level however, our results showed no increased risk of parental consanguinity on delayed gross and fine motor, speech and social development in their children. CONCLUSION: Our results show no increased risk of parental consanguinity on delayed gross and fine motor, speech or social development (as measured by the DDST), in their children.

Analysis of Variance↗
PubMed2000

Fanconi's anemia with solitary crossed renal ectopia, vesicoureteric reflux, and genital abnormalities.

Fanconi's anemia is an autosomal recessive disease, the main feature being pancytopenia secondary to bone-marrow hypoplasia. However, multiple congenital abnormalities may be encountered, urogenital malformations being common. We describe a patient with solitary crossed renal ectopia, vesicoureteric reflux, hypospadias, and unilateral undescended testis with absent vas deferens.

Child, Preschool↗
PubMed2000

Bladder-wall abscess in a girl with neurogenic bladder.

We report a case of a bladder-wall abscess in a patient with myelodysplasia and a neurogenic bladder. The aetiology of the abscess was obscure, but the patient had recurrent urinary tract infections and was being managed by clean intermittent catheterisation.

Abscess↗
PubMed2000

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↗
PubMed2000

Liver failure attributable to hepatitis A virus infection in a developing country.

In young children hepatitis A virus (HAV) infections are usually subclinical events. However, HAV is also associated with progressive hepatic failure and even death in some patients. This study was undertaken to characterize the course of hepatitis A-related acute liver failure in children from a developing country where hepatitis A is endemic and produces significant morbidity. Patients <15 years of age with confirmed hepatitis A, seen at the Aga Khan University Hospital between January 1991 and August 1998 were identified using the patient registry. Of the 2735 patients seen with hepatitis A, 232 were admitted to the hospital. Of these 30 patients developed progressive hepatic dysfunction and liver failure. During this period, 45 children were admitted with liver failure attributable to other causes. Of the patients admitted with hepatitis A-related liver failure, 25 (83.3%) were encephalopathic at presentation and 36.7% of the patients died. The prothrombin time was the most significant predictor of survival. There was a significant difference between those who survived and those who died on discriminant analysis with respect to age, grade of hepatic encephalopathy, duration of hospitalization, prothrombin time, and duration of jaundice when taken as a group. There is a striking prevalence of liver dysfunction progressing to hepatic failure among children seen at a hospital in Karachi, Pakistan. This study demonstrates the significant morbidity and mortality that can attend HAV infections in children in a developing country despite tertiary medical facilities. The risk of HAV and its sequelae could probably be effectively reduced in these settings with improved sanitation and universal immunization.

Acute Disease↗
PubMed1999

Dermoid cyst: a rare cause of clitorimegaly.

A 1-year old girl with clitorimegaly was investigated for an intersex disorder before surgical referral. Examination revealed a normal introitus and the clitoral lesion proved to be a dermoid cyst.

Clitoris↗
PubMed1993

Childhood appendicitis. A clinical profile.

A study to assess the reliability of clinical symptoms and signs in 50 patients with a presumptive diagnosis of acute appendicitis is presented. The male to female ratio was 3: 2, with age ranging from 2 to 15 years. Abdominal pain was present in 42; tenderness was localized in 35, generalized in 11 and diffuse in 4 patients. Total leucocyte count was above 11,000/cu mm in 31, below 11,000/cu mm in 17 and above 18,000/cu mm in 2. Of the 48 operated patients, 8 had normal appendices and the diagnosis in them was Meckel's diverticulitis 3, ruptured ovarian follicle 2, mesenteric adenitis 2, and salpingo-oophoritis 1. Abdominal pain and right iliac fossa tenderness with contributory investigations are the most reliable indicators of acute appendicitis with a false positive rate of 16.66% only.

Abdominal Pain↗
PubMed1981

Genetics and genetic counselling in neonatal hydrocephalus.

In the majority of cases, neonatal hydrocephalus is a genetic disease. The obstetrician's role in antenatal diagnosis of this disease is important. It is essential to take an accurate family history and to perform autopsies on affected infants if successful genetic counselling is to be pursued. Every woman, at her first antenatal visit, should be asked if she had a positive family history of hydrocephalus. Advanced experience in sonography will make the detection of hydrocephalus possible before the 20th week of gestation.

Cerebral Aqueduct↗