Haider Ghazanfar

MemorialCare Health System

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Abhilasha Jyala

American University

Harish Patel

Montefiore Health System

Sajida Naseem

University of Education

Nismat Javed

MemorialCare Health System

Bhavna Balar

Mount Sinai Health System

Salman Assad

University of Nebraska Medical Center

Zaheer Qureshi

Quinnipiac University

Ghazanfar Ali

Korea Institute of Science and Technology

Sridhar Chilimuri

Montefiore Health System

Anil Dev

MemorialCare Health System

Cooperative Institutions

MemorialCare Health System

125

Icahn School of Medicine at Mount Sinai

Montefiore Health System

Mount Sinai Health System

Shifa International Hospital

Bronx-Lebanon Hospital Center

Shifa Tameer-e-Millat University

American University of the Caribbean School of Medicine

Sinai Health System

Albert Einstein College of Medicine

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Colitis Induced by Colon-Cleansing Agent

Case Reports in Gastroenterology (2021)

Shehriyar Mehershahi Haider Ghazanfar Shoaib Ashraf Danial Shaikh Harish Patel

Constipation is one of the most common functional gastrointestinal disorders and affects 20% of the general population. Irritable bowel syndrome (IBS) is a functional disorder of the gastrointestinal tract that affects the large intestine and is characterized by chronic abdominal pain and altered bowel habits. We report a case of a 35-year-old African American man with a past medical history of IBS who presented to the clinic with a chief complaint of abdominal pain and bloody diarrhea for 1 week. The patient stated that he used a colon-cleansing agent because of persistent constipation. Computed tomography scan of the patient’s abdomen and pelvis with contrast was performed which showed diffuse contiguous segmental mural thickening and nodularity seen along the distal transverse, descending, and sigmoid colon. Colonoscopy showed moderate diffuse inflammation characterized by altered vascularity, erythema, and granularity from the rectum to the descending colon, and localized mild inflammation characterized by erythema was found at the ileocecal valve. The patient’s clinical condition improved with symptomatic management over 10 days. Patients with IBS should be advised to restrain from using a colon-cleansing agent without advice from their primary doctor as it can lead to various complications.

Descending colon

Ileocecal valve

Transverse colon

Ascending colon

10.1159/000514440

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Citations (1)

A Rare Case of Parvovirus B19 Infection Manifesting as Chronic Aplastic Anemia and Neutropenia in a Human Immunodeficiency Virus-Infected Patient

Cureus (2020)

Elona Shehi Haider Ghazanfar Ked Fortuzi Efraín González Cosmina Zeana

Parvovirus B19 (PVB19) is a deoxyribonucleic acid (DNA) virus, the only member of the Parvoviridae, which has a direct cytopathic effect on erythroid progenitor cells, resulting in an arrest of hematopoiesis and subsequent anemia. Less frequently, neutropenia and thrombocytopenia have been reported with the PVB19 infection. We report a rare case of chronic neutropenia due to PVB19 in a human immunodeficiency virus (HIV) patient. A 51-year-old male with a medical history of HIV presented to the Emergency Department (ED) with complaints of generalized weakness. His laboratory tests were significant for severe anemia and new neutropenia. PVB19 DNA by polymerase chain reaction (PCR) was positive. PVB19 immunoglobulin M (IgM) and IgG were reported negative. He was diagnosed with aplastic anemia from PVB19 and neutropenia. From June 2013 to January 2019, the patient was admitted 23 times with severe neutropenia and anemia, and on each occasion, PVB19 DNA by PCR was positive. During these multiple admissions, he was treated with antibiotics for neutropenic fever, methicillin-resistant Staphylococcus aureus (MRSA) bacteremia, and methicillin-sensitive Staphylococcus aureus (MSSA) skin abscesses. On each occasion, he required multiple blood transfusions, and he received intravenous immunoglobulin (IVIG) that resulted in significant improvement of absolute neutrophil count (ANC) count. He had bone biopsy twice, which showed normal maturation of the myeloid series and reduced erythroid progenitor cells consistent with PVB19 infection. PVB19 DNA by PCR remains positive to date. Immunocompromised individuals usually develop a chronic infection from PVB19, and rarely infection with PVB19 can cause severe neutropenia that can be long-lasting and life-threatening. Early recognition and treatment with IVIG are the key to improve the clinical outcome.

Bacteremia

Aplastic anemia

10.7759/cureus.12174

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Mo1587 CLINICAL COURSE OF AUTOIMMUNE HEPATITIS IN HISPANICS AND AFRICAN AMERICANS: A RETROSPECTIVE STUDY IN A SOUTH BRONX POPULATION

Gastroenterology (2024)

Haider Ghazanfar Abhilasha Jyala Priscilla G. Lajara Franklin Sosa Raúl Reina

Autoimmune Hepatitis

10.1016/s0016-5085(24)04380-4

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Penile Necrosis Associated with Local Intravenous Injection of Cocaine

American Journal of Case Reports (2022)

Haider Ghazanfar Paola Valeria Espinosa Cosmina Zeana Sridhar Chilimuri Donald Rudikoff

BACKGROUND:Cocaine is a highly addictive drug and its use has increased in recent years. It is the second most popular illicit drug in the United States and is the second most trafficked illicit drug in the world. Intravenous (i.v.) drug use leads to severe injury to the veins, including erythema, thrombophlebitis, vasoconstriction, necrosis, development of venous ulceration, and vein occlusion. CASE REPORT:A 35-year-old man presented to our Emergency Department with a 3-day history of excruciating and progressive penile and scrotal pain after having injected cocaine in the dorsal vein of the penis. A genital examination revealed ulcerations and swelling on the ventral proximal penis and scrotum junction, with foul-smelling serous discharge. There was no crepitus. He also had stellate purpura with necrosis of the dorsum of the penis and tender bilateral inguinal lymphadenopathy. Computed tomography of the pelvis, with contrast, showed subcutaneous edema of the penis with ulceration of the penile tip on the right. It also revealed left inguinal adenopathy. Vasculitis and concomitant sexually transmitted disease were ruled out as well as Fournier gangrene, and he was started on i.v. broad-spectrum antibiotics. The patient’s clinical condition improved with antibiotics and local wound care. CONCLUSIONS:Our case highlights the importance of taking a thorough history from i.v. drug users, as they are at risk of injecting drugs into unusual sites, such as the dorsal penile vein. It is important for the physician to counsel active i.v. drug users regarding possible complications of injecting drug into unusual sites.

Intravenous drug

10.12659/ajcr.935250

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Lupus-Mediated Kidney Damage: Lupus Nephritis or Collapsing Glomerulopathy?

Cureus (2021)

Angel DeLaCruz Haider Ghazanfar Nayrobi M Pena-Cotui Rabih Nasr

Systemic lupus erythematosus (SLE) is a systemic autoimmune disease. It has a myriad of presentations and can involve almost every organ. Its effects on the kidney hold critical importance because patients can ultimately progress to end-stage renal disease (ESRD) if inadequately treated. There are many published cases of collapsing glomerulopathy (CG) in patients with SLE. However, there are not many cases reported of both SLE-related CG and lupus nephritis. Based on our review of the medical literature, fewer than 25 cases have been written about this finding. There are no guidelines to manage these types of patients. Lupus causing CG poses particular challenges in terms of management, particularly treatment options. We present a case of a 47-year-old female who was found to have biopsy findings of both CG and lupus nephritis.

Glomerulopathy

10.7759/cureus.14468

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Disseminated Cryptococcal Disease in a Patient With Monoclonal Gammopathy of Undetermined Significance and Polycythemia Vera: A Case Report and Review of the Literature

Cureus (2021)

Muhammad Khurram Guhjjar Haider Ghazanfar Shoaib Ashraf Maneesh Gaddam Ajsza Matela

Cryptococcosis is a life-threatening opportunistic infection caused by Cryptococcus gattii and Cryptococcus neoformans. It affects both immunocompetent and immunosuppressed hosts. Disseminated cryptococcal infection is rare in immunocompetent patients, but the cryptococcal disease's neurological sequelae may be more prominent in this group. We present a case of a 58-year-old male patient with medical comorbidities of monoclonal gammopathy of undetermined significance (MGUS) and polycythemia vera. The patient presented with gradual worsening of mental status over one week. He was found to have Cryptococcus neoformans meningoencephalitis and fungemia. The patient received two weeks of liposomal amphotericin B (LAmB) and flucytosine with excellent clinical response. He was discharged on high dose fluconazole, and he returned to the hospital in one week with new-onset hemiplegia and cryptococcomas on imaging. Prolonged intravenous (IV) treatment of six weeks duration resulted in significant clinical improvement and disease-free state at two years follow-up. This article aims to stress the importance of individualized prolonged IV treatment with liposomal amphotericin B and flucytosine despite good initial response in patients with polycythemia vera and MGUS. This is the first reported case of cryptococcal disease, to the best of our knowledge, in a patient with MGUS and the third case of cryptococcal infection in patients with polycythemia vera in a non-HIV non-transplant state. Prolonged individualized IV treatment should be considered in immunocompetent patients with the above conditions, as this condition, if not adequately treated and relapses, lead to high morbidity and mortality.

Flucytosine

Fungemia

10.7759/cureus.12458

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Citations (4)

Knowledge of Postgraduate Medical Trainees Regarding Epidemiology

Cureus (2018)

Shoaib Shafi Tayyaba Faisal Sajida Naseem Sajida Javed Haider Ghazanfar

Introduction An understanding of epidemiology is fundamental for designing research and understanding evidence-based medicine (EBM). The purpose of our study was to determine the knowledge of epidemiology among postgraduate medical trainees. Methods We carried out a cross-sectional study from January 2017 to June 2017 at the Regional Centre Islamabad, College of Physicians and Surgeons Pakistan. About 204 postgraduate medical trainee were enrolled in the study after taking written consent. All of the participants were working as a postgraduate medical trainee in different hospitals of Rawalpindi and Islamabad. A self-designed structured questionnaire containing 20 multiple choice questions regarding knowledge of epidemiology was given to all the participants. Knowledge of epidemiology was measured and compared with gender, hospital, and previous history of research. Statistical Package for the Social Sciences (SPSS), version 21.0 (IBM, Armonk, NY) was used for data analysis. Results Out of 204 participants, 46.1% participants were males while 53.9% were females. The mean age of the participant was 28.5 ± 2.5. Majority fo the trainees (33.8%) were training in an Internal Medicine residency program. Most of the trainees (76%) had average knowledge of epidemiology while 18.6% of the trainees had good knowledge. Only 17.6% had some experience of research projects in the past, but this was not related to knowledge of epidemiology (p > 0.05). Conclusion Only 18.6% of the postgraduate trainees had good knowledge regarding epidemiology and 76% had average knowledge. This knowledge did not relate to their gender, hospital settings, and previous experience of conducting research proposals and articles.

10.7759/cureus.2171

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A Unique Case of Empyema Secondary to Amoebic Liver Abscess

Cureus (2017)

Adeel Nasrullah Shujaul Haq Haider Ghazanfar Abu Baker Sheikh Aisha Akhtar

An amoebic liver abscess is an extraintestinal manifestation of amoebiasis that can present with complaints such as right upper quadrant pain and fever. It might not necessarily be associated with abdominal complaints and can have many other atypical presentations. It may present with lung diseases, cardiac diseases, or brain abscesses. We present a case of a patient with empyema secondary to amoebic liver abscess whose diagnosis was delayed due to an unusual presentation. A combination of radiology, serology, and therapeutic interventions led to the accurate management of the patient.

Amoebiasis

Amoebic liver abscess

Brain abscess

Quadrant (abdomen)

Lung abscess

Presentation (obstetrics)

Actinomycosis

10.7759/cureus.1377

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PREDICTORS OF QUALITY OF BOWEL PREPARATION FOR IN-PATIENT COLONOSCOPY: A RETROSPECTIVE STUDY IN A TERTIARY CARE HOSPITAL IN SOUTH BRONX, NY

Gastrointestinal Endoscopy (2024)

Abhilasha Jyala Haider Ghazanfar Sameer Datta Kandhi A Qasim Franklin Sosa

Tertiary care

Bowel preparation

10.1016/j.gie.2024.04.2820

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Practice of breastfeeding and Immunisation in a periurban community in Pakistan.

PubMed (2017)

Haider Ghazanfar Sualeha Saleem Sajida Naseem Ghazanfar Ali

To assess the practice of breastfeeding and immunisation in a peri-urban community and correlate it with maternal care during pregnancy of the index child.This community-based, cross-sectional survey was conducted at Shifa Tameer-e-Millat University and Shifa College of Medicine, Islamabad, Pakistan, from June 2014 to January 2016, using a self-generated questionnaire. Systemic random sampling method was used to collect data. SPSS 21 was used to analyse the data and to find associations between maternal care and practices of breastfeeding.There were 1,275 participants in the study. The mean age of the participants was 31.61±8.026 years and the mean number of family members was 7.28±3.42. Overall, 1,121(87.9%) women had exclusively breastfed all their children while 906(71.1%) women had their children fully vaccinated. The mean duration of exclusive breastfeeding was 5.30±1.31 months while the mean duration of mixed breastfeeding was 16.70±8.62 months. Mothers who were given prenatal care were 2.60 and 2.91 times more likely to do exclusive breastfeeding and immunisation, respectively, compared to women who were not given prenatal care (p<0.05).There is a dire need to focus more on routine services compared to massive immunisation and breastfeeding campaigns.

Cross-sectional study

Systematic sampling

Prenatal Care

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Citations (3)