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1. Reliability and validity of Urdu PARENTS for assessing non-technical skills of paediatric residents in a teaching hospital in Pakistan

Author

Nabila Talat, Rehan Ahmed Khan, Khalid Ahmad Khan, Muhammad Usama Aziz, Warda Tahir, and Muhammad Bilal Mirza

Subjects
Assessment, Feedback, Nontechnical skills (NTS), Urdu, PARENTS, Pediatric residents performance, Special aspects of education, LC8-6691, Medicine
Abstract

Abstract Purpose The primary objective of our study is twofold. First, we assessed nontechnical skills (NTSs), such as the cognitive, social, and personal skills of postgraduate residents (PGRs), from paediatric caregivers’ perspectives in a paediatric emergency department (PED) of a tertiary care hospital. Second, we evaluated the reliability and validity of the ‘Parents’ Assessment of Residents Enacting Non-Technical Skills’ (PARENTS) instrument in its Urdu-translated version, ensuring its applicability and accuracy in the Pakistani context. Materials and methods This mixed-method study used an instrument translation and validation design. We translated an existing instrument, PARENTS, into Urdu, the national language of Pakistan, and administered it to paediatric caregivers in the PED of a tertiary care hospital. We collected data from 471 paediatric caregivers and coded them for analysis in AMOS and SPSS. Results The Urdu-translated version of the PARENTS demonstrated reliability and internal validity in our study. The findings from the assessment revealed that paediatric caregivers expressed satisfaction with the knowledge and skill of residents. However, there was comparatively lower satisfaction regarding the residents’ display of patience or empathy towards the children under their care. Conclusion The study findings support the validity and reliability of the PARENTS as an effective instrument for assessing the NTS of PGRs from the perspective of paediatric caregivers. With its demonstrated efficacy, medical educators can utilize PARENTS to pinpoint specific areas that require attention regarding the NTS of PGRs, thus facilitating targeted interventions for enhanced patient care outcomes.

Published
2023
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2. Performance analysis of ISO Management System Standards certification Consulting Firms of Pakistan

Author

Muhammad Bilal Mirza and Nawar Khan

Subjects
iso management system standards certification, consulting firms, government initiatives, irca, performance, Environmental pollution, TD172-193.5
Abstract

International Standards of Organization (ISO) management system standards certification (IMS) is the most common standard way to benefit the companies that decided to use it. The reason for this research is to analyze the performance of IMS consulting firms in Pakistan and the initiatives taken by the Government of Pakistan (GoP) in the implementation of IMS in the organizations with a moderating role of International Register of Certificated Auditors (IRCA) to maintain quality of products and services in Pakistan. A positivist examination worldview with expressive cross-sectional exploration configuration was chosen to gather essential information from the top-level management, the middle-level, and the low-level employees of ISO-certified firms and team members working in ISO consultancy firms. The data was collected from different cities using an online survey, skype, and telephone because of COVID-19 restrictions. The findings of this study are that there are a total of 31 ISO-certified consulting firms/certification bodies working in Pakistan. Only eight of these are registered with Pakistan National Accreditation Council (PNAC) whereas the remaining are unregistered. The reason identified for the lesser amount of ISO certification in Pakistan is the lack of interest from the GOP. It is because they are not providing any incentive programs to IMS consulting firms.

Published
2023
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5. Complicated gastric duplication cyst presenting as cystic intraperitoneal collection: a case report

Author

Muhammad Bilal Mirza, Asim Shahzad, Nasir Mahmood, Ahmed Imran, Mahvish Hussain, Zafar Fayyaz, and Nabila Talat

Subjects
Gastric duplication cyst, Intraperitoneal collection, Pseudocyst, Liver abscess, Case report, Pediatrics, RJ1-570, Surgery, RD1-811
Abstract

Abstract Background Alimentary tract duplications are rare anomalies and any delay in the diagnosis may develop various complications. Infection, hemorrhage, or perforation of the duplication cyst may lead to an acute presentation. Occasionally, it may lead to a diagnostic and management dilemma. Herein, we report an unusual complication of gastric duplication cyst. Case presentation A 2.5-year-old girl presented with recurrent abdominal distension, fever, and abdominal pain. The imaging workup revealed a huge intraperitoneal collection. Intraoperatively, a huge pseudocyst was encountered communicating with the gastric duplication cyst. The gastric duplication cyst was sharing a common wall with the greater curvature of the stomach but was not communicating with the gastric lumen. Pseudocyst along with gastric duplication cyst was completely excised. The resultant seromuscular defect of the stomach was also closed. The postoperative period was uneventful. Conclusion Perforation of the gastric duplication cyst should be kept in differentials of intraperitoneal collection not amenable to multiple aspirations. Huge intraperitoneal collection secondary to perforation of gastric duplication is exceedingly rare and scarcely reported in the literature.

Published
2020
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7. Use of simulation based technology in pre-clinical years improves confidence and satisfaction among medical students

Author

Muhammad Bilal Mirza, Anjiya Sulaiman, Satwat Hashmi, Samar Zaki, Rehana Rehman, and Rozmeen Akbar

Subjects
Medicine
Abstract

Objective: To determine perception of medical students about learning from integrated simulated clinical skills sessions in Respiration and Circulation module of Year 1 undergraduate medical curriculum at Aga Khan University. Subjects & Methods: This cross-sectional study was conducted at the Centre for Innovation in Medical Education, Aga Khan University (AKU) from July 2018 to February 2019. Integrated clinical skills session involves use of a combination of live simulated patient and mechanical simulator to teach clinical skills. These sessions were conducted in Respiration and Circulation Module of MBBS Year I curriculum after which quantitative data was collected by a questionnaire that assessed usefulness of integrated clinical skills teaching method and confidence gained by students. The responses acquired were assessed on a Likert scale ranging from 1-5, (strongly agree -strongly disagree). Descriptive analysis was performed. A focused group discussion (FGD) with students and an in-depth interview with a facilitator conducting the clinical skills sessions was arranged. Simple verbatim transcription of FGD recordings and thematic analyses was executed. Results: Quantitative analysis showed that more than 90% of the students believed integrated sessions were effective in acquiring the learning objectives and found them enjoyable and motivating. 80% expressed confidence that they had accomplished learning objectives and felt they have learned practical clinical skills. Qualitative analysis revealed that these sessions enhanced understanding of subject matter and student engagement during sessions. Conclusion: Integrated clinical skills sessions improved student interest, engagement and promoted student confidence. It should be implemented in undergraduate medical teaching curriculum. Continuous...

Published
2021
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8. Congenital segmental dilatation of intestine with different morphology: A case report

Author

Muhammad Bilal Mirza, Sumaira Noor Maham, and Nabila Talat

Subjects
Neonatal intestinal obstruction, Anorectal malformation, Congenital segmental dilatation, Pediatrics, RJ1-570, Surgery, RD1-811
Abstract

Background: Congenital segmental dilatation of intestine is a rare entity characterized by a localized dilated segment of the intestine. It manifests as neonatal intestinal obstruction. Occurrence with another surgical anomaly may masquerade it and complicate the treatment course. Case Presentation: A 1-day-old male neonate with anorectal malformation underwent colostomy as first stage of the treatment. The stoma did not function postoperatively. At repeat surgery, congenital segmental dilatation of the ileum, with slightly different morphology, was found. Resection of the lesion and ileostomy were formed. Postoperative course remained uneventful. Conclusion: Congenital segmental dilatation of intestine may be missed at initial surgery. Complete surgical resection is curative.

Published
2021
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11. Reliability and Validity of PARENTS Tool for Assessment of Pediatric Residents’ Non- Technical Skills in a Tertiary Care Teaching Hospital of Pakistan

Author

Nabila Talat, Rehan Ahmed Khan, Muhammad Usama Aziz, Warda Tahir, and Muhammad Bilal Mirza

Abstract

Background: Non-Technical Skills (NTS) of post graduate residents (PGR) are as important as their clinical skills. Other than direct observation of supervisors, the feedback of caregivers provides an objective assessment of medical residents’ ability to effectively deal with patients. Our research objective was to test the validity and reliability of an instrument named “PARENTS Tool” in a local environment and its use to evaluate NTS of residents at the hospital. Methods: This multi-phase mixed-method study used an Instrument Design Model called PARENTS Tool to assess NTS of residents. The PARENTS tool was translated into Urdu for our local environment and administered in the emergency department of Children’s Hospital and The University of Child Health Sciences. Results: The authors collected data from 471 parents and coded them for analysis in AMOS and SPSS. Both tests met acceptance criteria to establishes the validity and reliability of the Urdu version of PARENTS tool. Results showed that parents were satisfied with the knowledge and skill of residents but less satisfied with the patience or empathy that the residents showed towards the children under their care. Conclusion:PARENTS has shown to be valid and reliable tool for measuring the NTS of residents from the patient’s perspective. Medical administrators can use PARENTS as a performance measurement tool for monitoring the soft side of patient care.

Published
2022
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12. Pediatric Germ Cell Tumors- Pathological Variations and Challenges

Author

Nabila Talat, Rija Khalid, Warda Tahir, Muhammad Bilal Mirza, Farrukh Mahmood Sattar, Adnan Mahmood, Sajid Iqbal Nayyer, and Kamran Azam

Abstract

Aims:Germ cell tumors (GCT) are uncommon in children and adolescent but when they appear, gonads are the most frequent site. Testicular tumors constitute 1-2% of all pediatric solid tumors among them 84% are GCT. Incidence of ovarian GCT is 67%. This study from a single center focus on highlighting clinical features, investigations, treatment and outcome of GCTs in children to look for peri operative challenges and long term prognosis.MethodsA prospective study of 45 patients with GCTs was done from March 2018 to January 2022. The detailed data of each patient was scrutinized including history, physical examination, investigations, management, and follow-up. Forty-five patients presented during this period. Fifteen male (33.3%) and 30(66.7%) female with median age of 4.8 years. Twenty-eight( 62.2%) patients presented with abdominal mass, 15(34.88%) with scrotal swelling and 2(4.65%) with acute abdomen. Hematological and radiological investigations were done in all patients. α-fetoprotein level was high in 30 patients. All patients were managed combinedly with Paediatric Oncology. After being discussed in multidisciplinary tumor board, surgical excision was done.Results:On gross, 75% were mixed and 25% were solid tumors. Median size of testicular tumors ranged from 3cm to 8cm while ovarian tumors ranged from 5cm to 23cm. on histology, Twenty six(57.8%) were mature teratoma, 6 (15.5%) immature teratoma, 8(17.7%) yolk sac tumors, while 1(2.32%) mixed stromal tumor, 1 (2.32%) sex cord tumor and 1(2.2%) Leydig cell tumor also reported. Neo-adjuvant chemo was given in 4 (8.88%) patients while 6 (13.33%) patients received chemotherapy postoperatively. Rest of the patients didnot receive chemotherapy as they had stage I & II disease. Thirty-three patients are doing fine, 11 had lost follow up and 1 patient expired due to sepsis. Long term follow-up with tumor markers and radiological investigations showed no recurrence in majority of patients (73%).ConclusionGCTs in Pediatric population are not uncommon. However good prognosis can be expected if diagnosed at early stage. Majority of tumors doesn’t require post-operative chemotherapy. Tumor markers especially alpha-fetoprotein seems reasonable prognostic marker on follow up in centers where other genetic studies aren’t available due to limited resources.

Published
2022
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13. Complicated gastric duplication cyst presenting as cystic intraperitoneal collection: a case report

Author

Mahvish Hussain, Asim Shahzad, Ahmed Imran, Nabila Talat, Zafar Fayyaz, Nasir Mahmood, and Muhammad Bilal Mirza

Subjects
medicine.medical_specialty, Abdominal pain, Gastric duplication cyst, Perforation (oil well), lcsh:Surgery, 03 medical and health sciences, 0302 clinical medicine, Pseudocyst, 030225 pediatrics, Gene duplication, Case report, medicine, Cyst, Gastric duplication, business.industry, Stomach, digestive, oral, and skin physiology, lcsh:RJ1-570, lcsh:Pediatrics, lcsh:RD1-811, Abdominal distension, medicine.disease, Curvatures of the stomach, digestive system diseases, Surgery, Liver abscess, Intraperitoneal collection, medicine.anatomical_structure, Pediatrics, Perinatology and Child Health, 030211 gastroenterology & hepatology, medicine.symptom, business
Abstract

Background Alimentary tract duplications are rare anomalies and any delay in the diagnosis may develop various complications. Infection, hemorrhage, or perforation of the duplication cyst may lead to an acute presentation. Occasionally, it may lead to a diagnostic and management dilemma. Herein, we report an unusual complication of gastric duplication cyst. Case presentation A 2.5-year-old girl presented with recurrent abdominal distension, fever, and abdominal pain. The imaging workup revealed a huge intraperitoneal collection. Intraoperatively, a huge pseudocyst was encountered communicating with the gastric duplication cyst. The gastric duplication cyst was sharing a common wall with the greater curvature of the stomach but was not communicating with the gastric lumen. Pseudocyst along with gastric duplication cyst was completely excised. The resultant seromuscular defect of the stomach was also closed. The postoperative period was uneventful. Conclusion Perforation of the gastric duplication cyst should be kept in differentials of intraperitoneal collection not amenable to multiple aspirations. Huge intraperitoneal collection secondary to perforation of gastric duplication is exceedingly rare and scarcely reported in the literature.

Published
2020

14. 14 Years’ experience of esophageal replacement surgeries

Author

Jamal Butt, Nabila Talat, Fatima Majeed, Naveed Haider, Muhammad Saleem, Asif Iqbal, Hassan Mahmud, Imran Hashim, Muhammad Bilal Mirza, and Uzma Ather

Subjects
medicine.medical_specialty, medicine.medical_treatment, Fistula, Jejunal transposition, Esophageal replacement, Context (language use), Anastomosis, Trans hiatal route, Colonic interposition, LMIC, 03 medical and health sciences, 0302 clinical medicine, Retrosternal route, 030225 pediatrics, Pediatric surgery, medicine, Thoracotomy, Corrosive strictures, Wound dehiscence, business.industry, General Medicine, Gastric pull-up, medicine.disease, Surgery, Stenosis, Esophageal atresia, Pediatrics, Perinatology and Child Health, Original Article, 030211 gastroenterology & hepatology, Dumping syndrome, business
Abstract

Background Esophageal replacement is a challenge to the therapeutic skills of surgeons and a technically demanding operation in the pediatric age group. Various conduits and routes have been described in the literature, each with their specific advantages and disadvantages. We carried out this retrospective study to share our experience of esophageal replacement. Methodology This study was conducted at the department of pediatric surgery The Children’s Hospital and The Institute of Child Health, Lahore. The records of patients treated for esophageal replacement were reviewed. The patients under follow-up were called for clinical evaluation and assessed of long terms complications if any. Results A total of 93 patients with esophageal replacement were included in the study. Esophageal replacement was done with gastric transposition in 84 cases (90%), colon interposition in 7 cases (7.5%) including one case of redo colonic interposition, and jejunal interposition in 2 cases (2%). Routes of esophageal replacement were trans-hiatal in 71 (76%), retrosternal in 13 (14%), and trans-hiatal with thoracotomy in 9 (10%) patients. Postoperatively, all of the conduits maintained viability. Wound infection was seen in 10 (11%), wound dehiscence in 5 (5%), anastomotic leak in 9 (10%), anastomotic stenosis in 12 (13%), fistula formation in 4 (4%), aortic injury 1 (1%), dumping syndrome 8 (9%), reflux 18 (19%), dysphagia 15 (16%) and death occurred in 12 patients (13%). Conclusion There are problems with esophageal replacement in developing countries. In this context, gastric conduit appeared as the best conduit for esophageal replacement, using the trans-hiatal route for replacement, in the authors’ experience.

Published
2020
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16. Use of simulation based technology in pre-clinical years improves confidence and satisfaction among medical students

Author

null Muhammad Bilal Mirza, null Anjiya Sulaiman, null Satwat Hashmi, null Samar Zaki, null Rehana Rehman, null Rozmeen Akbar, and null Admin

Subjects
Medical education, Technology, Students, Medical, Descriptive statistics, business.industry, Teaching method, education, Student engagement, General Medicine, Personal Satisfaction, Session (web analytics), Simulated patient, Likert scale, Cross-Sectional Studies, Facilitator, Medicine, Humans, Clinical Competence, Curriculum, business, Education, Medical, Undergraduate
Abstract

Objective: To determine perception of medical students about learning from integrated simulated clinical skills sessions in Respiration and Circulation module of Year 1 undergraduate medical curriculum at Aga Khan University. Subjects & Methods: This cross-sectional study was conducted at the Centre for Innovation in Medical Education, Aga Khan University (AKU) from July 2018 to February 2019. Integrated clinical skills session involves use of a combination of live simulated patient and mechanical simulator to teach clinical skills. These sessions were conducted in Respiration and Circulation Module of MBBS Year I curriculum after which quantitative data was collected by a questionnaire that assessed usefulness of integrated clinical skills teaching method and confidence gained by students. The responses acquired were assessed on a Likert scale ranging from 1-5, (strongly agree -strongly disagree). Descriptive analysis was performed. A focused group discussion (FGD) with students and an in-depth interview with a facilitator conducting the clinical skills sessions was arranged. Simple verbatim transcription of FGD recordings and thematic analyses was executed. Results: Quantitative analysis showed that more than 90% of the students believed integrated sessions were effective in acquiring the learning objectives and found them enjoyable and motivating. 80% expressed confidence that they had accomplished learning objectives and felt they have learned practical clinical skills. Qualitative analysis revealed that these sessions enhanced understanding of subject matter and student engagement during sessions. Conclusion: Integrated clinical skills sessions improved student interest, engagement and promoted student confidence. It should be implemented in undergraduate medical teaching curriculum. Continuous...

Published
2021

17. The insufflated baloon

Author

Nabila Talat, Muhammad Bilal Mirza, and Abdul Lateef Leghari

Subjects
medicine.medical_specialty, business.industry, Pediatric surgery, medicine, business, Surgery, Neonatal surgery
Published
2021
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18. Postoperative gastric Outlet Obstruction following hiatal hernia repair in an infant: A case report

Author

Sajid Iqbal Nayyer, Shabbir Ahmad, Farrakh Mehmood Satar, Muhammad Afzal, Muhammad Bilal Mirza, and Nabila Talat

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, Stomach, Gastric outlet obstruction, Pyloromyotomy, medicine.disease, Pylorus, digestive system diseases, Pyloric stenosis, Surgery, Hiatal hernia, medicine.anatomical_structure, medicine, Vomiting, medicine.symptom, business, Hypertrophic Pyloric Stenosis
Abstract

Background: Infantile hypertrophic pyloric stenosis (IHPS) is an exceedingly rare cause of postoperative emesis in a case of hiatal hernia. Occasionally it may simulate other etiology of gastric outlet obstruction. Case Presentation: A 32-day-old male baby presented with respiratory distress and vomiting since birth. Diagnosis of eventration of left hemi diaphragm was made on CT Chest. At surgery, hiatal hernia with an intrathoracic stomach was found, which was repaired. On 5th postoperative day, the baby developed vomiting after feeding which gradually turned to be projectile in nature over a week. Contrast meal performed showed malpositioned stomach with delayed emptying. At re-operation, a well-formed olive of pylorus was encountered; Ramstedt pyloromyotomy was done. Postoperative course remained uneventful. Conclusion: IHPS is a rarely described association with hiatal hernia. Pyloric stenosis should be considered in differential diagnoses of postoperative emesis in infants with hiatal hernia.

Published
2021
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19. Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Author

Naomi Jane Wright, Andrew J.M. Leather, Niyi Ade-Ajayi, Nick Sevdalis, Justine Davies, Dan Poenaru, Emmanuel Ameh, Adesoji Ademuyiwa, Kokila Lakhoo, Emily Rose Smith, Abdel Douiri, Maria Elstad, Marcus Sim, Cristiana Riboni, Bruno Martinez-Leo, Melika Akhbari, Stephen Tabiri, Ashrarur Mitul, Dayang Anita Abdul Aziz, Camila Fachin, Alliance Niyukuri, Muhammad Arshad, Fowzia Ibrahim, Natalie Moitt, Mohamed Fahmy Doheim, Hannah Thompson, Harmony Ubhi, Isabelle Williams, Sophia Hashim, Godfrey Sama Philipo, Laura Herrera, Aayenah Yunus, Dominique Vervoort, Samuel Parker, Yousra-Imane Benaskeur, Osaid H. Alser, Nana Adofo-Ansong, Ahmad Alhamid, Hosni khairy Salem, Mahmoud Saleh, Safa Abdal Elrais, Sadi Abukhalaf, Patricia Shinondo, Ibrahim Nour, Emrah Aydin, Agota Vaitkiene, Kelly Naranjo, Andile Maqhawe Dube, Sodumisa Ngwenya, Mina A. Yacoub, Henang Kwasau, Gabriella Hyman, Shrouk Mahmoud Elghazaly, Ibrahim Al-Slaibi, Intisar Hisham, Helena Franco, Hana Arbab, Lubna Samad, Aqil Soomro, Muhammad Amjad Chaudhry, Safina Karim, Muhammad Adnan Khan Khattak, Shireen Anne Nah, Doris Mae Dimatatac, Candy SC Choo, Niveshni Maistry, Ashrarur Rahman Mitul, Samiul Hasan, Sabbir Karim, Hina Yousuf, Taimur Qureshi, Ibrahim Rabi Nour, Raed Nael Al-Taher, Osama Abdul Kareem Sarhan, Luis Garcia-Aparicio, Jordi Prat, Eva Blazquez-Gomez, Xavier Tarrado, Martí Iriondo, Paolo Bragagnini, Segundo Rite, Lars Hagander, Emma Svensson, Sheila Owusu, Alhassan Abdul-Mumin, Dominic Bagbio, Vijay Anand Ismavel, Ann Miriam, Shajin T, Marlene Anaya Dominguez, Monica Ivanov, Andreea Madalina Serban, Miliard Derbew, Mahmoud Elfiky, Maricarmen Olivos Perez, Marcia Abrunhosa Matias, Alexis P Arnaud, Ahmed Negida, Sebastian King, Mohamad Rafi Fazli, Nadia Hamidi, Souhem Touabti, Rossana Francisco Chipalavela, Pablo Lobos, Brendan Jones, Damir Ljuhar, Georg Singer, Annelien Cordonnier, Lorena Jáuregui, Zlatan Zvizdic, Janice Wong, Etienne St-Louis, Qiang Shu, Yang Lui, Catalina Correa, Lucie Pos, Elvyn Alcántara, Erick Féliz, Luis Enrique Zea-Salazar, Liza Ali, Matthieu Peycelon, Nzanzu Kipata Anatole, Cherno S. Jallow, Judith Lindert, Dhruv Ghosh, Cathline Freya Adhiwidjaja, Ahmad Khaleghnejad Tabari, Saran Lotfollahzadeh, Haidar Mohammad Mussein, Fabrizio Vatta, Noemi Pasqua, David Kihiko, Hetal Gohil, Ibrahim R. Nour, Muhammed Elhadi, Suad Ahmed Almada, Gilvydas Verkauskas, Toni Risteski, Alejandro Peñarrieta Daher, Oumaima Outani, James Hamill, Taiwo Lawal, Jack Mulu, Benjamin Yapo, Lily Saldaña, Beda Espineda, Krystian Toczewski, Eugene Tuyishime, Isaac Ndayishimiye, Enaam Raboe, Philip Hammond, Gregor Walker, Ivona Djordjevic, Milind Chitnis, Joonhyuk Son, Sanghoon Lee, Muaad Hussien, Sawazen Malik, Enas Musa Ismail, Ampaipan Boonthai, Nesrine Ben Hadj Dahman, Nigel Hall, Fabiola Ruth Castedo Camacho, Helena Sobrero, Marilyn Butler, Aliev Makhmud, Nathan Novotny, Ahmad G. Hammouri, Maisara Al-Rayyes, Bruce Bvulani, Qais Muraveji, Muhammad Yousuf Murzaie, Ajmal Sherzad, Sayed Aman Haidari, Abdul Baqi Monawar, Dr. Ahmad Zia Samadi, Jesh Thiessen, Ntakarutimana Venant, Sonia Inamuco Hospital, Niyonkuru Jérémie, Jean Claude Mbonicura, Butoyi Jean Marie Vianney, Amezene Tadesse, Samuel Negash, Charles A. Roberts, John N. Jabang, Abdoulie Bah, Kajali Camamra, Armandou Correa, Babucarr Sowe, A. Gai, Musa Jaiteh, Kwizera Jean Raymond, Jean Paul Mvukiyehe, Innocent Itangishaka, Emmanuel Kayibanda, Emery Manirambona, Joseph Lule, Ainhoa Costas-Chavarri, Ian Shyaka Gashugi, Albert Ndata, Georges Gasana, Yves Castar Nezerwa, Turatsinze Simeon, Jean De Dieu Muragijimana, Sakina Rashid, David Msuya, Joseph Elisante, Meghna Solanki, Emmanuel Manjira, Jay Lodhia, Mubashir Jusabani, Murad Tarmohamed, Sengua Koipapi, Touabti Souhem, Nabti Sara, Brahimi Sihem, Bouguermouh Dania, Iaiche Achour Toufik, Baghdadi Nour el islam Mounira, Alouani Habiba, Liliana Aragão, Victor Gonçalves, Marcelo Mauricio Lino Urquizo, Maria Florencia Varela, Pedro Mercado, Bonavia Horacio, Andrea Damiani, Carlos Mac, Daniel Putruele, Karen Liljesthrom, Marianela Bernaus, Cesar Jauri, Alejandrina Cripovich, Ezequiel Bianchin, Maria Gabriela Puig, Lorna Andreussi, Susana Iracelay, Dolores Marcos, Carina Herrera, Nelly Palacios, Romina Avile, Belen Serezo, Debora Montoya, Rodrigo Cepeda, Justo Vaquila, Sofficci Veronica, Liliana Pardo, Pelussi Valeria, Lapalma Julio, Aranda Diego Martin, Palazzi Lucio, Comba Gabriel, Depetrini Marianella, José Alfredo Calderón Arancibia, Enrique Huespe, Gabriela Natalia Losa, Elsa Arancibia Gutiérrez, Humberto Scherl, Daniel Emilio Gonzalez, Valentina Baistrocchi, Yanina Silva, Marcelo Galdeano, Pablo Medard, Ines Sueiras, Enrique Romero Manteola, Victor Hugo Defago, Carlos Mieres, Carlos Alberto, Fabio Cornelli, Marcelo Molina, Pablo Ravetta, Celeste Carolina Patiño Gonzalez, Maria Belen Dallegre, Maria Tatiana Szklarz, Marcos Federico Leyba, Nahuel Ignacio Rivarola, Maria Delia Charras, Adriana Morales, Paloma Caseb, Luzia Toselli, Carolina Millán, Maria del Carmen Junes, Oscar Di Siervi, Jose Gilardi, Soledad Simon, Carla Sofia Contreras, Nair Rojas, Lucia Beatriz Arnoletto, Otilia Eva Blain, Mauro Nicolas Bravo, Nancy Sanchez, Luciana Martina Herrera Pesara, Maria Eugenia Moreno, Carlos Ariel Sferco, Umama Huq, Tamanna Ferdousi, Abdullah Al-Mamun, Sadia Sultana, Refoyez Mahmud, Khalid Mahmud, Fatema Sayeed, Alexander Svirsky, Denisse Sempertegui, Amalia Negrete, Araceli Teran, Mariana Sadagurschi, Nusret Popovic, Kenan Karavdic, Emir Milisic, Asmir Jonuzi, Amira Mesic, Sabina Terzic, Nejra Dendusic, Elna Biber, Anesa Sehic, Nada Zvizdic, Emina Letic, Adna Saracevic, Ajla Hamidovic, Nejra Selak, Dzan Horozic, Lamija Hukic, Amila Muhic, Nedim Vanis, Emir Sokolovic, Adnan Sabic, Karin Becker, Elis Novochadlo Klüppel, André Iván Bradley dos Santos Dias, Miguel Angelo Agulham, Cristiano Bischoff, Stella Sabbatini, Rachel Fernandes de Souza, Ana Beatriz Souza Machado, Juliana Werneck Raposo, Maria Lucia da Silva Augusto, Bianca M.R. Martins, Mariana de Souza Santos Ferreira, Darli Fernandes de Oliveira, Carla Silva dos Santos, Fernanda Ribeiro de Fernández y Alcázar, Érika Alves Dutra da Silva, Mariana Furtado, Horácio Tamada, Marília Silva Ferreira dos Santos, Thayná Lopes de Almeida, Susy Oliveira de Andrade, Antonio Cipriano Gurgel do Amaral, Lais Sartori Giovanoni, Kamila de Deus Passos Leles, Eduardo Corrêa Costa, Leticia Feldens, Luciano Ferraz Schopf, José Carlos Soares de Fraga, Felipe Colombo de Holanda, Paola Maria Brolin Santis Isolan, Julia Loyola Ferreira, Carla Luisa Bruxel, Danielle Lopes Teixeira Ferdinando, Fabricio Zottis Barcelos, Natalia Baseggio, Nicole Knorr Brenner, Rafael Trindade Deyl, Carolina Dure, Iuri Nunes Kist, Rafael Bueno Mazzuca, Sarah Bueno Motter, Yna Ramos, Cristine Suzana Trein, Bianca Rezende Rosa, Murilo de Assis Silva, Flavio Augusto Menin, Isabela Cristina Semensato Carloni, Juliana Antinarelli Norberto da Silva, Adriano Luis Gomes, Mariana Girão Tauffer, Paulo César Bassan Gonçalves, Geraldo Magela Nogueira Marques, Eliane Moriya, Carla Labonia, Ana Lucia Carrasco, Karine Furtado Meyer, Luiz Farion-Aguiar, Fernando Amado, Amanda Antunes, Elisângela Silva, Leila Telles, Giovana Almeida, Aluísio Augusto Belmino Gadelha, Flavia de Azevedo Belesa, Acimar Gonçalves da Cunha, Jr, Beatriz Souza Barros, Josiane Bernartt Zanellato, Patricia Guimarães, Karina Ilheu da Silva, Bianca Ribas, Cristina Reuter, Francis Tanise Casado, Mila Torii Correa Leite, Daniela Testoni, Ruth Guinsburg, Simone de Campos Vieira Abib, Edson Khodor Cury, Suely Dornellas do Nascimento, Arthur Almeida Aguiar, Rodrigo Melo Gallindo, Carolina Gonçalves Borges, Yang Liu, Cai Duote, Jinhu Wang, Zhigang Gao, Liang Liang, Wenjuan Luo, Xiaoxia Zhao, Rui Chen, Peng Wang, Yijiang Han, Ting Huang, Hu Donglai, Guo Xiaodong, Chen Junjie, Libin Zhu, Guowei Wu, Xiaozhou Bao, Haijing Li, Junying Lv, Zhongrong Li, Feng Yong, Zhou Chong Gao, Qiang Bai, Weibing Tang, Hua Xie, Jethishka Motee, Jianming Zhu, Gang Wen, Weiwei Ruan, Shungen Li, Lulu Chen, Shungen Huang, Zhibao Lv, Jinjing Lu, Liuming Huang, Mengnan Yu, Wang Dajia, Yu Zuo Bai, Luis Carlos Rincon, Juliana Mancera, Edgar Alzate Gallego, Laura Torres-Canchala, Nathalia Silva Beltrán, Ghordana Osorio Fory, Daniela Castaño Avila, Angelica Maria Forero Ladino, Juanita Gomez, Martha Jaramillo, Otto Morales, Beatriz Sanchez, Nestor Julien Tinoco Guzmán, Sergio Castañeda Espinosa, Osbaldo Prieto Vargas, Lina Maria Pardo, Eliana Toral, Freud Cáceres Aucatoma, Daniel Hinostroza, Santiago Valencia, Vicente Salinas, Enrique Landivar Cino, Gabriela Yulissa Ponce Fajardo, Miguel Astudillo, Virginia Garcia, Guillermo Muñoz, Leonardo Verduga, Ivan Verduga, Ericka Murillo, Elena Bucaram, Marisol Guayelema, Monica Marmol, Janina Sanchez, Carolina Vergara, Adriana Mena, Junior Velaña, Karla Salazar, Sandra Lara, Elena Chiriboga, Julian Silva, Dalia Gad, Doaa Samy, Menan Ahmed Elsadek, Hanan Mahmoud Mohammed, Mohamed Abouheba, Karim Osamy Ali, Hayssam Rashwan, Omar Moustafa Fawzy, Tarek mohamed Kamel, Rawan Nemer, Mohamed Abada Hassan, Eyad Hassan Falah, Dina Sobhy Abdelhady, Mostafa Zain, Eman Abouzeid Abouzeid Ibrahim, Omar Ossama Elsiraffy, Ahmed Aboelela, Eman mohamed Farag, Ahmed Mohamed Oshiba, Omar Sameh Emam, Alaa Mobarak Attia, Moustafa A. Laymouna, Islam Abdelmonem Ghorab, Mansour Mkayed Mohammed, Nourhan Akram Soliman, Khaled Abd elrahman Ghaly, Kareem Sadek, Mohamed Elsherbiny, Amr Saleh, Hesham Sheir, Tamer Wafa, Mohamed Abd Elmenam, Sherif Abdelmaksoud, Ahmed Reda, Islam Mansour, Mohamed Elzohiri, Basma Waseem, Mohamed Elewaily, Mohammed El-Ghazaly, Ahmad Elhattab, Amr Shalaby, Adham Elsaied, Ahmad Adawy, Mirna Sadek, Mahmoud Abdelfattah Ahmed, Mohamed Omar Herdan, Gena Mohamed Hamed Elassall, Azhar Arabi Mohammed, Mohammed Hamada Takrouney, Tarek Mohamed Essa, Ahmed Mokhtar Mahmoud, Alshaimaa M. Saad, Mariam Albatoul Nageh Fouly, Mahmoud abdelshakour Ibrahim, Mohammad Nageh, Mahmoud M. Saad, Helmy Badr, Mohamed Fayez Fouda, Ahmed Hassan Nofal, Hisham Almohamady, Mohamed Ahmed Arafa, Mohamed Amad, Mohamed Awad Mansour, Jennifer O'Connor, Zachary O'Connor, Nzanzu Anatole, Elysé Nkunzimana, Solomon Machemedze, Lemfuka Dieudonné, William Appeadu-Mensah, Theophilus Teddy Kojo Anyomih, Priscilla Alhassan, Francis A. Abantanga, Vishal Michael, Roshine Mary Koshy, Ankit Raj, Vijay Kumar, Sundeep PT, P Santosh Prabhu, Armin Vosoughi, Ali Farooq Al-Mayoof, Muhamed Jassim Fadhle, Ali Egab Joda, Hayder Nadhim Obaid Algabri, Sultan S. Abdelhamid, Hashem M. Al-Momani, Marzouq Amarin, Louay Y. Zaghlol, Nijmeh Nasser Alsaadi, Yasmeen Z. Qwaider, Hibah Qutishat, Ahmad Hasan Aliwisat, Esraa Arabiat, Isam Bsisu, Raghad M. Murshidi, Mohammad S. Jabaiti, Ziad A. Bataineh, Husam Aldean Abuhayyeh, Thekraiat M. Al Quran, Faris J. Abu Za'nouneh, Mohanad Mutasem Alebbini, Hamzah Abullah Qudah, Omar Ghazi Hussein, Amir M.I. Murad, Justin Z. Amarin, Haya H. Suradi, Sayel H. Alzraikat, Rand Y. Omari, Bashar M. Matour, Layana Al-Halbouni, Rajai O. Zurikat, Ahmad H. Yanis, Sara Al Hussein, Ali Shoubaki, Waleed H. Ghanem, Kuria David, Soita Wycliffe Chitiavi, Moraa Mose, Robert Mugo, James Ndungu, Timothy Mwai, Swaleh Shahbal, Janan Malik, Nirav Chauhan, Francisa Syovata, Kevin Ochieng, Polycarp Omendo Liyenzero, Syeda Ra'ana Hussain, Stanley Mugambi, Roseline Ochieng, Ebtesam Othman Abdulsalam Elkhazmi, Ala Khaled, Aya Albozidi, Manal Ben Enbaya, Mala Elgammudi, Enas Soula, Wegden ibrahim almabrouk Khalel, Yasmine Ali Elhajjaji, Nouriyah Ali Alwaggaa, Sumayyah Ghayth, Dafer abdulhakim .S. Zreeg, Sara Abobaker Tantush, Fatma Bibas, Tesneem Layas, Randa Alamen M Sharif, Wesal Omar F. Saied Aljadidi, Ahmed Tarek, Hazem Ahmed, Kamila Almabrouk Mohammed Essamilghi, Mabroka Alfoghi, Ma'aly A. Abuhlega, Saddam Arrmali, Fatima Mousa Abduljawad, Hasan Mustafa Alosta, Abdulsalam Abuajaila, Fakereldeen Abdelmutalib, Fatma Bashir, Inas Almengar, Mohammad hasan Annajjar, Abdelaziz Deyab, Fathi Elzowawi, Yousef Krayem, Weam Drah, Asma Meftah, Abobaker Mohammed, Lina Ali Arrmalli, Hajir Aljaboo, Abdallah Elayeb, Mohamed Altomi, Ahmed Altaweel, Mohamed Tumi, Hana Milad Bazozi, Aisha Shaklawoon, Mohammed Meftah Alglaib, Abdullahn Abdousalam Elkaloush, Sara Trainba, Hisham Swessi, Ali Alnaeri, Aya Essam Shnishah, Hamassat Mustufa, Sondas Ali Gargum, Sara Ali Tarniba, Hawa Ahmed Shalluf, Hajer Ali Shokri, Taher L. Sarkaz, Osama Tababa, Ahmed Elhadi, Vesna Cvetanovska Naunova, Laze Jovcheski, Marjan Kamilovski, Aleksandra Gavrilovska-Brzanov, Zarina Abdul Latiff, Siti Farhan Moh Pauzi, Marjmin Osman, Felicia Lim, Ainal Huda Abu Bakar, Azrina SK Zaman, Shareena Ishak, Rufinah Teo, Dr. Tammy Teoh Han Qi, Mohd Yusran Bin Othman, Dato' Dr Zakaria bin Zahari, Zulfitri bin Md Hassan, Cheah Hui Shan, Abhirrami Lechmiannandan, Hafatin Fairos bt Tamaddun, Mohd Fitri Shukri bin Mohamed Adanan, Mohd Yusof bin Abdullah, Wang Junyi, Mohd. Tarmizi Mohd Nor, Wan Ruzaimie Noor, Mohd Razin bin Hassan, Noor Fa'izatul Rahil Ambok Dalek, Hidayah Hayati binti Hashim, Ahmad Zulhisyam bin Zarwawi, V Muthualhagi M Vellusamy, Quah Soong Yuen, Hemasutha a/p Kannessan, Najua binti Ramli, Ahmad Shafiee bin Bujarimin, Jessmine Anntinea, Anthony Dass, Hazlina Mohd. Khalid, Nur Atiqah binti Mohd Hanifah, Keily Wong Yue Jyun, Rahilah binti Abd Razak, Nur Atifah binti Mohd Naim, Siti Nur Aien binti Hamid Hamzah, Cristian R. Zalles Vidal, Eduardo Bracho Blanchet, Roberto Dávila Perez, Emilio Fernandez Portilla, Raúl Villegas Silva, Daniel Ibarra, Antonio Calderon Moore, Cesar Carrasco-Ortega, Monica Noguez Castillo, Dorihela Herappe Mellado, Guillermo Yanowsky Reyes, Luis Fernando Gonzalez Cortez, Rafael Santana Ortiz, Jamie Orozco Perez, Jorge Román Corona C.Rivera, Juan Jose Cardenas Ruiz Velasco, Moises Quiles Corona, Christian Peña Padilla, Lucina Bobadilla Morales, Alfredo Corona Rivera, Izabel Maryalexandra Rios Flores, Cristian Irela Aranda Sánchez, Gabriela Ambriz-González, Nestor Martínez Hernández Magro, Francisco Javier León Frutos, José de Jesús Cárdenas Barón, Alejandro González Ojeda, Jessica Yarza Fernández, Juan Domingo Porras, Pastor Aguirre-Lopez, Vicente Sánchez Paredes, Arturo Montalvo Marin, Jose Manuel Diaz Gomez, Lorenzo Juvencio Caamal, David Bulnes Mendizabal, Pablo Sanchez Valladares, Humberto Garcia Martinez, Opeoluwa Adesanya, Moses Olanrewaju, Rilwan Adegboyega, Nurudeen Abdulraheem, Anuoluwapo Aremo, Florence Dedeke, Anyanwu Lofty-John Chukwuemeka, Mohammad Aminu Mohammad, Abdullahi Lawalbarau, Nwokoro Collins, Ogundele Ibukunolu, Amo Shonubi, Oluwaseun Ladipo-Ajayi, Olumide Abiodun Elebute, Justina Seyi-Olajide, Felix Alakaloko, George Ihediwa, Kayode Olayade, Christopher Bode, Olakayode Ogundoyin, Dare I. Olulana, Ifeanyichukwu Kelvin Egbuchulem, Felix O. Kumolalo, Ikechukwu Ulasi, Uchechukwu Obiora Ezomike, Sebastian Okwuchukwu Ekenze, Elochukwu Perpetua Nwankwo, Emmanuel Ifeanyi Nwangwu, Isaac Chukwu, Christopher Chim Amah, Nene Elsie Obianyo, Omolara Williams, Roland Iheanyichukwu Osuoji, Omolara Moronkeji Faboya, Olalekan Temitope Ajai, Moruf Adekunle Abdulsalam, Titiloye Hannah Agboola, Bolarinwa Bolanle Temilade, Maryrose Osazuwa, Morayo Monsurat Salawu, Eze Chukwuemeka Ejinkeonye, Mariya Mukhtar Yola, Amsa B. Mairami, Adekunle T. Otuneye, Matthias Igoche, Adebayo Gbenga Tanimola, Emmanuel Akinlabi Ajao, Efeturi Agelebe, Samson Olori, Philip Mari Mshelbwala, Olabisi Osagie, Adewale Oyinloye, Auwal M Abubakar, Lateef Oyebanji, Ibrahim Shehu, Cyril Cletus, Ahmed Bamanga, Faruk Suleiman, Sani Adamu, David C.Nwosu, Yahya S.Alkali, Iliya Jalo, Aliu Rasaki, Yusuf T.Sambo, Kalakwa A.Mohammed, Abubakar M.Ballah, Victor Modekwe, Okechukwu Hyginus Ekwunife, Ugochukwu S Ezidiegwu, Andrew N Osuigwe, Jideofor O Ugwu, Chuka A Ugwunne, Nadeem Akhter, Mudassir Fayaz Gondal, Rafee Raza, Ali Raza Chaudary, Hassan Ali, Muhammad Umar Nisar, Muhammad Umer Jamal, Ghuri Shankar Pandit, Uzma Mumtaz, Muhammad Bin Amjad, Nabila Talat, Wajeeh ur Rehman, Muhammad Saleem, Muhammad Bilal Mirza, Imran Hashim, Naveed Haider, Soban Hameed, Ayesha Saleem, Sohail Dogar, Muhammad Sharif, Muhammad Kashif Bashir, Fatima Naumeri, Zarqa Rani, Muath A.M. Baniowda, Basheer Ba'baa', Majd Yousef Mohammed Hassan, Ammar Darwish, Abrar Shaheen Sehwiel, Mohammed Shehada, Abrar ghassan Balousha, Yara Ajrami, Ainaa Ata Mohammad Alzamari, Bashar Yaghi, Hasan Subhi Hasan Abu Al-saleem, Mervat Sufian Abu Farha, Mohammad Omar Mohammad Abdelhafez, Firas Anaya, Asef belal Qadomi, Abd Al-Naser Bany Odi, Muath Abdelrahem Fuad Assi, Fadwa Sharabati, Ahmad Abueideh, Doha mustafa saleh Beshtawi, Hasan Arafat, Lara Zahi Adel Khatatba, Safa' Jamal Abatli, Hiba Al-Tammam, Dania Jaber, Yara Imad Omar Kayed, Ali Abdelhay Abumunshar, Rami Anwar Misk, Asmahan Mohammad Suliman Alzeer, Mutassem Sharabati, Ihsan Ghazzawi, Osama Majed Darras, Mahmoud M.Qabaja, Ma'alem sameer Hajajreh, Yasmeen Ahmad Samarah, Dua Hasan Yaghi, Moradallah Asad Fahmi Qunaibi, Abdelrazzaq Abu Mayaleh, Sharehan Joubeh, Annan Ebeido, Samer Adawi, Ihda Adawi, Mohammad Omar Ibrahim Alqor, Ahmad Samih Arar, Hadeel Awad, Fawzi Abu-Nejmah, Osaid Shaher Shabana, Firas Alqarajeh, Tareq Z. Alzughayyar, Jomana Madieh, Mahmoud Fuad Sbaih, Raghad mohammad abdu Alkareem, Raghad abdullateef Lahlooh, Yasmeen Adly Halabi, Wisam Baker, Tasneem Fathi Hasan Almusleh, Abdulraheem Adnan Abdulraheem Tahyneh, Yazid yousef mahmoud Atatri, Najlaa Abu Jamie, Nasrallah Ashraf Al Massry, Walaa Lubbad, Ayoub A.Nemer, Mohammed Alser, Aya Azmi Shehda Salha, Khaled Alnahhal, Aya Mahmoud Elmzyyen, Amir Talat Sheda Ghabayen, Abdulwhhab Ayman Abu Alamrain, Samar H. Al-Shwaikh, Omar Adly Elshaer, Nureddin Shaheen, Jehad Fares, Hisham Dalloul, Anas Qawwash, Mustafa abu Jayyab, Dina Ayman Ashour, Ahmad Ashraf Shaheen, Samy Rafat Ramadan Naim, Eman Abu Shiha, Nagham Mohammed Al Dammagh, Walaa Almadhoun, Ashraf Ayman Al-Salhi, Abdalkarim Yhya Hammato, Jamal Mohammed Salim, Doaa Khalil Hasanain, Soha Marwan Salem Alwadia, Ismail Nassar, Hala M. Al-Attar, Haya Abdulnasser Ali Alshaikhkhalil, Yasmin Mohammed Khalil Abu Jamie, Yara shareef Ashour, Sharif S. Alijla, Mohamed Anwer El Tallaa, Adham Ashraf Abuattaya, Bisan D.M. Wishah, MOHAMMED A.M. ALDIRAWI, Ahmed S Darwish, Sulaiman T. Alzerei, Nidal Wishah, Sharif Alijla, Isidora Garcia, Marlene Diaz Echegaray, Veronica Raquel Cañapataña Sahuanay, Fernando Trigoso Mori, Jackelyne Alvarado Zelada, Juan Jose Salinas Barreto, Porfirio Rivera Altamirano, Cesar Torres Miranda, Rocio Anicama Elias, Julio Rivera Alvarez, Juan Pedro Vasquez Matos, Fernando Ayque Rosas, Jesmarina Ledesma Peraza, Andrea Gutarra Palomino, Stephany Vega Centen, Victor Casquero, María Rosa Ortiz Argomedo, Francisco Lapouble, Genaro Llap Unchón, Florangel Patricia Delgado Malaga, Luis Ortega Sotelo, Segundo Gamboa Kcomt, Araceli Villalba Villalba, Nancy Rossana Mendoza Leon, Loreley Raquel Cardenas Alva, Maria Susana Loo Neyra, Cathy Lee Alanguia Chipana, Cintya Maria de Jesus Torres Picón, Natalia Huaytalla Quiroz, Danny Dominguez, Carlos Segura Calle, Jenny Arauco, Luis Ormeño Calderón, Ximena Ghilardi Silva, Miriam Daniela Fernandez Wilson, Joan Elizabeth Gutierrez Maldonado, Cesar Diaz Leon, Waldo Berrocal Anaya, Patricia Chavez Galvez, Prince Pamela Aguilar Gargurevich, Flor de Maria Diaz Castañeda, Carmen Guisse, Erika Ramos Paredes, Jose Luis Apaza Leon, Faye Aguilar Aguilar, Raul Ramirez De La Cruz, Lenny Flores Carbajal, Carlos Mendoza Chiroque, Gladys Johana Sulca Cruzado, Natalia Tovar Gutierrez, Jennifer Sotelo Sanchez, Carolina Paz Soldan, Karina Hernández Córdova, Edgar Fernando Delgado Quinteros, Luz Mery Brito Quevedo, Juan Jose Mendoza Oviedo, Angel Samanez Obeso, Patricia Paredes Espinoza, Johann de Guzman, Raisa Yu, Vlad Cosoreanu, Sebastian Ionescu, Aurel Mironescu, Lucian Vida, Adrian Papa, Roxana Verdeata, Bogdan Gavrila, Liviu Muntean, Marija Lukac, Miona Stojanovic, Djordje Toplicic, Milan Slavkovic, Andjelka Slavkovi, Dragoljub Zivanovic, Ana Kostic, Maja Raicevic, Delphine Nkuliza, Daniel Sidler, Corné de Vos, Elmarie vd Merwe, David Tasker, Omar Khamag, Cecilia Rengura, Thozama Siyotula, Uzair Jooma, Dirk von Delft, Marion Arnold, Hansraj Mangray, Shamaman Harilal, Sanele Madziba, Naveen Wijekoon, Tharanga Gamage, Benedict Paul Bright, Alaa Abdulrahman, Ola Ahmed Abdulmjeed Mohammed, Mohammed Salah, Ahmad Elian Abu Ajwa, Mohammed Morjan, Mohammad Mohannad Batal, Vivian Faks, Mohamad Bassel Mouti, Ahmadfateh Assi, Ahmad Al-Mouakeh, Ahmad Sankari Tarabishi, Ziad Aljarad, Aos Alhamid, Jiraporn Khorana, Wannisa Poocharoen, Sirima Liukitithara, Anan Sriniworn, Wasun Nuntasunti, Monawat Ngerncham, Ratiyaporn Phannua, Kanokrat Thaiwatcharamas, Patchareeporn Tanming, Lassaad Sahnoun, Nahla Kchiche, Roua Abdelmoumen, Egemen Eroğlu, Mehmet Ali Ozen, Hatice Sonay Yalçın Cömert, Mustafa İmamoğlu, Haluk Sarıhan, Şebnem Kader, Mehmet Mutlu, Yakup Aslan, Ahmet Beşir, Şükran Geze, Bahanur Çekiç, Ali Yalcinkaya, Kaan Sönmez, Ramazan Karabulut, Zafer Türkyılmaz, Kıvanç Şeref, Merve Altın, Merve Aykut, M.Eren Akan, Melisa Erdem, Ebru Ergenekon, Canan Türkyılmaz, Elif Keleş, Ali Canözer, Aslı Öztürk Yeniay, Elif Eren, İlknur Banlı Cesur, Zerrin Özçelik, Gökmen Kurt, Mustafa Kurthan Mert, Hatice Kaya, Müge Çelik, Suleyman Cuneyt Karakus, Nazile Erturk, Alev Suzen, Nilay Hakan, Fatih Akova, Mehmet Pasaoglu, Shukurali Eshkabilov, Rustam Z. Yuldashev, Dekhkonboev Avazjon Abdunomonovich, Aliev Makhmudjan Muslimovich, Azad Patel, Chisengo Kapihya, Nicholas Ensar, Ramesh M Nataraja, Mithila Sivasubramaniam, Matthew Jones, Warwick Teague, Sharman Tan Tanny, Gordon Thomas, Kiera Roberts, Soundappan Sannappa Venkatraman, Holger Till, Manon Pigeolet, Martine Dassonville, Anas Shikha, Win Sabai Phyu Win, Zahidah Adlynee Haji Ahmad, Léamarie Meloche-Dumas, Louise Caouette-Laberge, Dickens St-Vil, Ann Aspirot, Nelson Piché, Shahrzad Joharifard, Nadia Safa, Jean-Martin Laberge, Sherif Emil, Pramod Puligandla, Kenneth Shaw, Hussein Wissanji, Eileen Duggan, Elena Guadagno, Maria Consuelo Puentes, Paola Osses Leal, Carolina Mendez Benavente, Michal Rygl, Barbora Trojanová, Klára Berková, Tereza Racková, Ladislav Planka, Jan Škvařil, Radek Štichhauer, Shahad Sabti, Alex Macdonald, Nordeen Bouhadiba, Dorothy Kufeji, Caroline Pardy, Simon Mccluney, Alireza Keshtgar, Rebecca Roberts, Hannah Rhodes, Kate Burns, Robin Garrett-Cox, Kat Ford, Hannah Cornwall, Krithi Ravi, Felicity Arthur, Paul Losty, Tony Lander, Ingo Jester, Suren Arul, Oliver Gee, Giampiero Soccorso, Michael Singh, Max Pachl, Benjamin Martin, Afnan Alzubair, Arun Kelay, Jonathan Sutcliffe, Thomas Middleton, Amy Hughes Thomas, Merina Kurian, Fraser Cameron, Jayaram Sivaraj, Mark C Thomas, Dean Rex, Ceri Jones, Kate Bradshaw, Arnaud Bonnard, Xavier Delforge, Camille Duchesne, Caroline Le Gall, Coralie Defert, Samia Laraqui Hossini, Florent Guerin, Géraldine Hery, Virginie Fouquet-Languillat, Jules Kohaut, Aline Broch, Thomas Blanc, Luke Harper, Thomas Delefortrie, Quentin Ballouhey, Laurent Fourcade, Céline Grosos, Benoit Parmentier, Guillaume Levard, Maria Giovanna Grella, Mariette Renaux Petel, Lucie Grynberg, Olivier Abbo, Sofia Mouttalib, Mélodie Juricic, Aurelien Scalabre, Elodie Haraux, Anke Rissmann, Hardy Krause, Peter Goebel, Ludwig Patzer, Udo Rolle, Andrea Schmedding, Alexandra Antunez-Mora, Bernd Tillig, Sylvester von Bismarck, Patricia Reis Barbosa, Christian Knorr, Domitille Stark, Marco Brunero, Luigi Avolio, Francesco Manni, Matilde Molinelli, Marinella Guazzotti, Alessandro Raffaele, Piero Giovanni Romano, Silvia Cavaiuolo, Gian Battista Parigi, Laszlo Juhasz, Anna Rieth, Arunas Strumila, Rūta Dagilytė, Arunas Liubsys, Pranas Gurskas, Dalius Malcius, Agne Mikneviciute, Asta Vinskaite, Vidmantas Barauskas, Liam Vierboom, Timothy Hall, Spencer Beasley, Lucy Goddard, Mark Stringer, Naveen Weeratunga, Stephen Adams, Jitoko Cama, Marilyn Wong, Sridharan Jayaratnam, Askar Kukkady, Udaya Samarakkody, Sylwester Gerus, Dariusz Patkowski, Agnieszka Wolny, Tomasz Koszutski, Szymon Tobor, Marta Osowicka, Piotr Czauderna, Dariusz Wyrzykowski, Hanna Garnier, Stefan Anzelewicz, Osowicka Marta, Agata Knurowska, Alicja Weiszewsk, Andrzej Grabowski, Wojciech Korlacki, Michal Pasierbek, Przemyslaw Wolak, Aneta Piotrowska, Anna Roszkiewicz, Piotr Kalicińsk, Agata Trypens, Grzegorz Kowalewsk, David Sigalet, Amer Alsaied, Mansour Ali, Ameen Alsaggaf, Alaa Ghallab, Yazeed Owiwi, Ali Zeinelabdeen, Mohamed Fayez, Ahmed Atta, Mazen Zidan, Asaad saleh Radwan, Hanin Shalaby, Reem Abdelbaqi, Khalid Alattas, Yar Kano, Omar Sindi, Abdullah Alshehri, Tariq Altokhais, Fahad Alturki, Mohammad Almosaibli, Dasha Krisanova, Wisam Abbas, Hee-Beom Yang, Hyun-Young Kim, Joong Kee Youn, Jae Hee Chung, Seok Hyeon Cho, In ji Hwang, Ju yeon Lee, Eung song Song, Jenny Arboleda, Mercedes Ruiz de Temiño Bravo, Alexander Siles Hinojosa, Miriam García, Isabel Casal Beloy, Detlef Oliu San Miguel, Maria Elena Molina Vazquez, Verónica Alonso, Alberto Sanchez, Oscar Gomez, Isabel Carrillo, Tomas Wester, Carmen Mesas Burgos, Martin Salö, Erik Omling, Niclas Rudolfson, Christina Granéli, Helena Arnadóttir, Emma Grottling, Kate Abrahamsson, Vladimir Gatzinsky, Michaela Dellenmark Blom, Daniel Borbonet, Paul Puglia, Vinicio Jimenez Morejon, Gaston Acuna, Mario Moraes, Jonathan Chan, Pavan Brahmamdam, Alan Tom, Karen Sherer, Brandy Gonzales, Aaron Cunningham, Sanjay Krishnaswami, Reto Baertschiger, Mary Leech, Regan Williams, Lauren Camp, Ankush Gosain, Maria Mora, Bailey D. Lyttle, Jeremy Chang, Lydia McColl Makepeace, Kathryn L Fowler, Sara Mansfield, Erica Hodgman, Chukwubinyelum Amaechi, Alana Beres, Mark N. Pernik, Luke J. Dosselman, Murad Almasri, Sunil Jain, Varun Modi, Marianelly Fernandez Ferrer, John Coon, Joann Gonzalez, Medhavi Honhar, Nensi Ruzgar, Griffin Coghill, Sarah Ullrich, Maija Cheung, Katrine Løfberg, Jodie Greenberg, Kate Davenport, Samir Gadepalli, Sarah Fox, Stephanie Johnson, Mercedes Pilkington, April Hamilton, Nicole Lin, Juan Sola, Yang Yao, Jenna Kylene Davis, Monica Langer, Jonathan Vacek, Fizan Abdullah, Julie Khlevner, William Middlesworth, Marc Levitt, Hira Ahmad, Sabina M Siddiqui, Alex Bowder, Terry Derks, Afua Amoabin Amoabin, Brooke Pinar, Frank Owusu-Sekyere, Benmanseur Saousen, Rasika Naidoo, Azra Karamustafic, Danielle Paula de Oliveira, Jerhy Andrade, Antonín Šafus, Jason Langley, Alexandra Wilke, Corazone Deya, Habib Mansour Murtadi, Mindaugas Berzanskis, Nwachukwu Calistus, Olalekan S. Ajiboye, Michael Felix, Osagie O Olabisi, Seçil Erçin, Teymursha Muradi, Stephen S. Burks, Sergio Lerma, Jillian Jacobson, Calin Calancea, Rafael Valerio-Vazquez, Guigui Sikwete, Owusu Sekyere, Akhona Mbonisweni, Shahnoor Syed, Cho Seok Hyeon, Fatemeh Pajouhandeh, Sheba Mary Pognaa Kunfah, Global PaedSurg Research Collaboration, and Tıp Fakültesi

Subjects
Male, Pediatrics, medicine.medical_specialty, Adolescent, Gastrointestinal Diseases, Psychological intervention, Disease, Global Health, Specialties, Surgical, Congenital Abnormalities, Cohort Studies, medicine, Humans, Prospective Studies, Prospective cohort study, Child, Developing Countries, business.industry, Gastroschisis, Developed Countries, Intestinal atresia, Infant, Newborn, Gestational age, Congenital diaphragmatic hernia, Infant, Articles, General Medicine, medicine.disease, Gastrointestinal Tract, Atresia, Child, Preschool, Female, business
Abstract

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p

Published
2020

20. Changes in surgical practice by surgical residents and consultants during COVID-19 pandemic: A cross-sectional survey

Author

Asad Ameer, Nishant Singh, Kashif Nawaz, Nabila Talat, Warda Tahir, Usama Aziz, Muhammad Bilal Mirza, Muhammad Rehan, and Muhammad Kamran

Subjects
medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Cross-sectional study, business.industry, Family medicine, Pandemic, Health care, medicine, Qualitative property, Elective surgery, business, Shut down
Abstract

Background: During the COVID-19 pandemic, surgical practice is greatly changed as a strategy to prevent infection to the health care workers. This study was done to see what changes have been made in the surgical practice by the surgical consultants and residents in various surgical disciplines. Methods: A Survey form was developed on the “Google Forms” application and distributed to surgical consultants and residents. The submission was received online during May 2020. The collected data were entered and analyzed using SPSS V.23. Qualitative data were presented as frequencies and percentages. Quantitative data were presented as mean and standard deviation. Results: Overall, 272 consultants and residents from 45 teaching hospitals from Pakistan and around the world participated in the survey. Among the participants, 100 (36.8%) were surgical consultants and 172 (63.2%) were surgical residents. About 42% of participants were not performing elective surgeries during this pandemic of COVID-19 but almost all participants were performing emergency surgeries (93%). Over 60% of the respondents admitted that their practice is either reduced to more than 50% or completely shut down during this pandemic. Over 80% stated that their training activities were compromised due to the pandemic. Conclusion: COVID-19 pandemic has greatly affected surgical practice both in the public and corporate sectors. Elective surgeries are affected the most in addition to the suspension of training activities of the residents.

Published
2020
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21. Congenital biliary web- a rare cause of obstructive jaundice in an infant: A case report

Author

Allah Ditta, Farrakh Mehmood Satar, Muhammad Waqas-ur-Rehman, Muhammad Bilal Mirza, Maria Fahim, and Nabila Talat

Subjects
medicine.medical_specialty, Magnetic resonance cholangiopancreatography, Common bile duct, medicine.diagnostic_test, business.industry, Jaundice, medicine.disease, Surgery, medicine.anatomical_structure, Common hepatic duct, Biliary atresia, medicine, Acholic stools, Cystic duct, Obstructive jaundice, medicine.symptom, business
Abstract

Background: Congenital biliary web of the extra-hepatic biliary tree is becoming exceedingly rare cause of obstructive jaundice in children. Case Presentation: We report a case of 5-month-old male baby who presented with acholic stools and persistent jaundice since birth. Magnetic resonance cholangiopancreatography (MRCP) showed contracted gall bladder and focal narrowing at mid portion of the common bile duct (CBD) with proximal dilatation of biliary channels. On exploration, a complete web was found just proximal to the confluence of cystic duct and common hepatic duct causing complete obstruction of biliary tree. A Roux-en-Y hepatico-jejunostomy was done. Postoperative recovery was uneventful. Conclusion: We conclude that congenital biliary web is a rare entity and should be considered in the dif­ferential diagnosis of biliary atresia.

Published
2020
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22. Rapunzel Syndrome with a gastric ulcer

Author

Sajid Iqbal Nayyar, Nabila Talat, Hamza Malik, Allah Ditta, and Muhammad Bilal Mirza

Subjects
medicine.medical_specialty, business.industry, Internal medicine, medicine, Rapunzel syndrome, Trichophagia, medicine.disease, business, Gastroenterology
Published
2020
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23. Congenital segmental dilatation of intestine with different morphology: A case report

Author

Sumaira Noor Maham, Muhammad Bilal Mirza, and Nabila Talat

Subjects
medicine.medical_specialty, RD1-811, business.industry, medicine.medical_treatment, Colostomy, Ileum, Repeat Surgery, Anorectal malformation, Pediatrics, RJ1-570, Surgery, Resection, Lesion, Ileostomy, medicine.anatomical_structure, Stoma (medicine), Pediatrics, Perinatology and Child Health, medicine, Neonatal intestinal obstruction, medicine.symptom, Stage (cooking), business, Congenital segmental dilatation
Abstract

Background: Congenital segmental dilatation of intestine is a rare entity characterized by a localized dilated segment of the intestine. It manifests as neonatal intestinal obstruction. Occurrence with another surgical anomaly may masquerade it and complicate the treatment course. Case Presentation: A 1-day-old male neonate with anorectal malformation underwent colostomy as first stage of the treatment. The stoma did not function postoperatively. At repeat surgery, congenital segmental dilatation of the ileum, with slightly different morphology, was found. Resection of the lesion and ileostomy were formed. Postoperative course remained uneventful. Conclusion: Congenital segmental dilatation of intestine may be missed at initial surgery. Complete surgical resection is curative.

Published
2021
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24. Correction to: 14 Years’ experience of esophageal replacement surgeries

Author

Imran Hashim, Muhammad Bilal Mirza, Jamal Butt, Uzma Ather, Naveed Haider, Asif Iqbal, Nabila Talat, Hassan Mahmud, Fatima Majeed, and Muhammad Saleem

Subjects
Male, medicine.medical_specialty, Adolescent, Colon, ComputingMethodologies_IMAGEPROCESSINGANDCOMPUTERVISION, MEDLINE, Esophagus, Postoperative Complications, Pediatric surgery, medicine, Humans, Child, Retrospective Studies, business.industry, Published Erratum, General surgery, Stomach, Afghanistan, Infant, Newborn, Correction, Infant, General Medicine, Jejunum, Child, Preschool, Pediatrics, Perinatology and Child Health, Surgery, Female, business, Follow-Up Studies
Abstract

Esophageal replacement is a challenge to the therapeutic skills of surgeons and a technically demanding operation in the pediatric age group. Various conduits and routes have been described in the literature, each with their specific advantages and disadvantages. We carried out this retrospective study to share our experience of esophageal replacement.This study was conducted at the department of pediatric surgery The Children's Hospital and The Institute of Child Health, Lahore. The records of patients treated for esophageal replacement were reviewed. The patients under follow-up were called for clinical evaluation and assessed of long terms complications if any.A total of 93 patients with esophageal replacement were included in the study. Esophageal replacement was done with gastric transposition in 84 cases (90%), colon interposition in 7 cases (7.5%) including one case of redo colonic interposition, and jejunal interposition in 2 cases (2%). Routes of esophageal replacement were trans-hiatal in 71 (76%), retrosternal in 13 (14%), and trans-hiatal with thoracotomy in 9 (10%) patients. Postoperatively, all of the conduits maintained viability. Wound infection was seen in 10 (11%), wound dehiscence in 5 (5%), anastomotic leak in 9 (10%), anastomotic stenosis in 12 (13%), fistula formation in 4 (4%), aortic injury 1 (1%), dumping syndrome 8 (9%), reflux 18 (19%), dysphagia 15 (16%) and death occurred in 12 patients (13%).There are problems with esophageal replacement in developing countries. In this context, gastric conduit appeared as the best conduit for esophageal replacement, using the trans-hiatal route for replacement, in the authors' experience.

Published
2020

26. Gastrointestinal trichobezoar: An experience with 17 cases

Author

Muhammad Saleem, Muhammad Bilal Mirza, and Nabila Talat

Subjects
Male, medicine.medical_specialty, Abdominal pain, Vomiting, Perforation (oil well), Bezoars, Trichotillomania, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Intussusception (medical disorder), Intestine, Small, medicine, Humans, Rapunzel syndrome, Trichophagia, Child, business.industry, General Medicine, Abdominal distension, medicine.disease, Surgery, Abdominal Pain, Bowel obstruction, Acute abdomen, 030220 oncology & carcinogenesis, Pediatrics, Perinatology and Child Health, Female, medicine.symptom, business
Abstract

Background Trichobezoar is an exceedingly rare entity in children and mimics other chronic ailments such as abdominal tuberculosis or malignancy. Delayed diagnosis and management result in various complications. The study was conducted to describe our experience with 17 consecutive cases of gastrointestinal tract (GIT) trichobezoars. Materials and methods We reviewed medical records of 17 consecutive cases of GIT trichobezoar managed in our department between January 2005 and December 2018. Results There were 3 males and 14 females. The median age of presentation was 7 years. Fifteen patients (88%) presented with abdominal pain and vomiting, while 8 (47%) had abdominal distension. Seven (41%) patients developed complications secondary to the GIT trichobezoar (intussusception and gangrene in 1, small bowel obstruction in 4, gastric perforation and massive bleeding per rectum in 1, acute transient pancreatitis and hypertension in 1). At operation, 9 (54%) patients had Rapunzel syndrome, 6 (35%) had gastric trichobezoar, and 2 (12%) had small bowel trichobezoars. One patient presented with massive bleeding per rectum and gastric perforation, succumbed postoperatively. One patient developed a recurrent trichobezoar. Conclusion GIT trichobezoar is rare in children and simulates chronic gastrointestinal ailments. Trichobezoars may reside in the alimentary tract, remain unnoticed for years, and become overt with the onset of complications. The majority of trichobezoars had a tail in our series. Life threatening complications can occur with delayed presentations. Type of study Case series. Level of evidence Level IV.

Published
2019

27. Trend in the use of neo-adjuvant chemotherapy for the management of muscle invasive bladder cancer at a major tertiary care hospital in Pakistan

Author

Muhammad Bilal Mirza, Muhammad Asad Maqbool, and Adnan Abdul Jabbar

Subjects
Oncology, Cancer Research, medicine.medical_specialty, Chemotherapy, Standard of care, Bladder cancer, business.industry, medicine.medical_treatment, Muscle invasive, Tertiary care hospital, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, Internal medicine, medicine, Neo adjuvant chemotherapy, business, 030215 immunology
Abstract

e16033 Background: Although the use of Neoadjuvant Chemotherapy (NAC) has now become the standard of care for Muscle Invasive Bladder Cancer (MIBC) in the world, most patients in lower- middle-income countries (LMIC), like Pakistan, are still undergoing upfront surgery despite being ideal candidates for chemotherapy. Multi-disciplinary tumor boards have been critical in the change of this trend in the developed world. We aimed to assess the trends in the use of NAC for patients with muscle invasive bladder cancer before undergoing definitive surgery. Methods: We included patients who underwent surgery for ≥ cT2 MIBC without distant metastasis between 2011 and 2015 at a tertiary care hospital in Karachi, Pakistan. We retrospectively assessed the trends in NAC compared to upfront surgery in these patients. Results: Among the 171 patients included in our study, only 4 (2.34%) received NAC, whereas the other 167 (97.67%) underwent upfront surgery without NAC. Out of the 90 patients who underwent surgery for MIBC between 2011 and 2013, none of them received NAC and underwent upfront surgery. Among the 81 patients with MIBC in 2014 and 2015, 4 patients received NAC before surgery whereas the other 77 underwent upfront surgery. Conclusions: The adoption of NAC for MIBC remains a challenge in lower- middle-income countries such as Pakistan. Introduction of a multidisciplinary tumor board in our hospital since 2014 has shown a slight change in this trend. Better communication between different departments remains the key in significantly changing the trend of a much desired standard of care.

Published
2019
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29. Sirenomelia: Adding Something New

Author

Muhammad Bilal Mirza

Subjects
body regions, integumentary system, Mermaid syndrome, lcsh:RJ1-570, lcsh:Surgery, Twins, lcsh:Pediatrics, Case Report, lcsh:RD1-811, Sirenomelia, Variant, equipment and supplies
Abstract

A case of sirenomelia is being reported who was born in a twin pregnancy and showed different anatomy of lower torso.

Published
2012

31. Pyloroduodenal Duplication Cyst: The Rarest Alimentary Tract Duplication

Author

Muhammad Bilal Mirza

Subjects
Abdominal mass, Vomiting, Case Report, Pyloroduodenal duplication
Abstract

Pyloroduodenal duplication is the rarest alimentary tract duplication known so far. A 1-year-old female patient presented with abdominal pain, lump in the epigastrium and occasional vomiting. On ultrasound and CT scan of abdomen suspicion of duplication cyst was made. Operation revealed a duplication cyst along pylorus and first part of the duodenum. Excision of free part and mucosal stripping of the attached part of the duplication was done.

Published
2012

32. SCOPE OF JOURNAL OF NEONATAL SURGERY

Author

Muhammad Bilal Mirza

Subjects
Editorial, lcsh:RJ1-570, lcsh:Surgery, journal, lcsh:Pediatrics, scope, lcsh:RD1-811, neonatal surgery
Abstract

The primary scope of the journal is provision of a platform for publication of evidence-based neonatal surgery. It is the only available journal dedicated to the specialty. Neonatal surgery is often performed by pediatric surgeons in many parts of the world. Surgical neonates, the targeted proportion of the population, are entirely different with other age groups. Their body composition, requirements, immunity, pathophysiology, and response to various diseases are specific to this age group.

Published
2012

39. Auto-amputated Ovarian Cyst with Compression Sequelae: A Case Report

Author

Muhammad Bilal Mirza

Subjects
Ileal stenosis, endocrine system, endocrine system diseases, lcsh:RJ1-570, lcsh:Surgery, lcsh:Pediatrics, Case Report, lcsh:RD1-811, female genital diseases and pregnancy complications, Fallopian tubal atresia, Pediatrics, Perinatology and Child Health, parasitic diseases, Ovarian cyst, Surgery
Abstract

Ovarian cysts contribute a major share of cystic lesions in fetal life. Quite often, these cysts are benign and resolve spontaneously. Occasionally, these cysts can twist, resulting in ovarian loss. We report a case of auto-amputated ovarian cyst presetting with intestinal obstruction.

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