Hira Ahmad

109 timestamped statements across 7 collections — auto-found in recorded discussions, each timestamp jumps to the exact moment.

Colorectal / ARM & Hirschsprung · guest expert

Featured diaries

▶ Ep 40 · 14:11
So just reading the contrast enema, it doesn't look like there's a lot of postrations in the colon that are causing these potentially you could interpret as like postrations as contractions of the colon. And usually the colon moves too fast. You have a smaller caliber colon with a lot of postrations and not as dilated. When you're concerned about it moving too slow, there's a dilation of the colon. There's lack of postrations.
quote · Anorectal Malformation
▶ Ep 111 · 14:11
So just reading the contrast enema, it doesn't look like there's a lot of postrations in the colon that are causing these potentially you could interpret as like postrations as contractions of the colon. And usually the colon moves too fast. You have a smaller caliber colon with a lot of postrations and not as dilated. When you're concerned about it moving too slow, there's a dilation of the colon. There's lack of postrations.
quote · Colorectal / ARM & Hirschsprung
▶ Ep 111 · 14:11
So just reading the contrast enema, it doesn't look like there's a lot of postrations in the colon that are causing these potentially you could interpret as like postrations as contractions of the colon. And usually the colon moves too fast. You have a smaller caliber colon with a lot of postrations and not as dilated. When you're concerned about it moving too slow, there's a dilation of the colon. There's lack of postrations.
quote · Colorectal / ARM & Hirschsprung
▶ Ep 48 · 14:11
So just reading the contrast enema, it doesn't look like there's a lot of postrations in the colon that are causing these potentially you could interpret as like postrations as contractions of the colon. And usually the colon moves too fast. You have a smaller caliber colon with a lot of postrations and not as dilated. When you're concerned about it moving too slow, there's a dilation of the colon. There's lack of postrations.
quote · Hirschsprung disease
▶ Ep 40 · 15:41
In both scenarios, patient need a bowel management program. If your sphincters are poor and your dentate line is deficient, probably mechanical, as we mentioned before, with an enema program. If the sphincters and dentate line are intact, we could potentially start with a mechanical and then switch them over to laxative program.
quote · Anorectal Malformation
▶ Ep 48 · 15:41
In both scenarios, patient need a bowel management program. If your sphincters are poor and your dentate line is deficient, probably mechanical, as we mentioned before, with an enema program. If the sphincters and dentate line are intact, we could potentially start with a mechanical and then switch them over to laxative program.
quote · Hirschsprung disease

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Anorectal Malformation 15 entries

The Colorectal Quiz Episode 23: Hirschsprung Disease - The Soiling Patient Part 2 -The Dentate Line and Motility

▶ Ep 40 · 2:12
clinical If a patient has voluntary bowel movements during the day but accidents at night when sleeping, their external sphincters are working but internal sphincters are not—when sleeping they relax the external sphincter and lose control. ↗
▶ Ep 40 · 2:12
quote So their external sphincters are working and the internal sphincters are not. So when they're sleeping, they relax their external sphincters and that's how they lose the control. ↗
▶ Ep 40 · 13:55
clinical On contrast study, a colon that moves too fast shows smaller caliber with many haustrations (appearing as contractions), while a colon that moves too slow shows dilation with lack of haustrations. ↗
▶ Ep 40 · 13:55
quote So it definitely doesn't look like the colon that moves too fast. It could potentially be a colon that moves slow. ↗
▶ Ep 40 · 14:11
quote So just reading the contrast enema, it doesn't look like there's a lot of postrations in the colon that are causing these potentially you could interpret as like postrations as contractions of the colon. And usually the colon moves too fast. You have a smaller caliber colon with a lot of postrations and not as dilated. When you're concerned about it moving too slow, there's a dilation of the colon. There's lack of postrations. ↗
▶ Ep 40 · 15:41
clinical For a hypomotile (slow-moving) colon with intact sphincters and dentate line, treatment can start with mechanical emptying then switch to laxative program; if sphincters and dentate line are deficient, mechanical enema program is needed. ↗
▶ Ep 40 · 15:41
quote In both scenarios, patient need a bowel management program. If your sphincters are poor and your dentate line is deficient, probably mechanical, as we mentioned before, with an enema program. If the sphincters and dentate line are intact, we could potentially start with a mechanical and then switch them over to laxative program. ↗
▶ Ep 40 · 17:11
quote So in this one, the colon is decompressed and you see a lot of prostration. So potentially the colon is moving too fast. ↗
▶ Ep 40 · 17:45
clinical For hypermotile patients (7-8 stools daily), treatment involves constipating them and then ensuring timed emptying—either spontaneous if sphincters intact or mechanical if deficient. ↗
▶ Ep 40 · 17:45
quote So I think in both cases, we can start off with constipating diet, add bulking agents, add PPIs. But if the sphincters and dentate lines are not intact or it's deficient, then we may have to start with irrigations or say like small enemas, small volume enemas. ↗

The Colorectal Quiz Episode 23: Hirschsprung Disease - The Soiling Patient...

▶ Ep 41 · 2:17
quote So their external sphincters are working, um, and the internal sphincters are not. So when they're sleeping, they relax their external sphincters and that's how they lose the control. ↗
▶ Ep 41 · 11:55
quote I will always blame the fellow. ↗
▶ Ep 41 · 15:50
clinical In both scenarios (intact or deficient sphincters/dentate line), patients with slow-moving colon need a bowel management program; if sphincters are poor and dentate line deficient, mechanical emptying with enema program is needed; if intact, can start mechanical and potentially switch to laxative program. ↗
▶ Ep 41 · 17:55
quote So, um, I think in both cases we can start off with constipating diet, add bulking agents, in add PPIs, um, but if the sphincters and dentate lines are not intact or it's deficient, then we may have to start with, um, irrigations or, um, say like small enemas, small volume enemas. ↗
▶ Ep 41 · 24:19
quote So if you guys had to pick a soiling or an obstructive problem, which one would you pick? ↗
Cloaca 2 entries

Colorectal Quiz Episode 18: Cloaca Part 2

▶ Ep 20 · 0:12
quote Hey everyone, this is Kira Ahmad from Nationwide Children's Hospital. ↗

Colorectal Quiz Episode 17: Cloaca Part 1

▶ Ep 21 · 5:41
epidemiological In a large majority of patients with cloaca, the diagnosis is made at birth ↗
Colorectal / ARM & Hirschsprung 45 entries

Colorectal Quiz Episode 19: Hirschsprung Disease - The Obstructed Patient Part 1

▶ Ep 105 · 6:45
clinical Post-pull-through obstruction can be caused by stricture, twist (any pull-through type), Soave cuff (Soave procedure), Duhamel spur or non-functional distended segment (Duhamel procedure), or non-functional segment (Rehbein procedure). ↗
▶ Ep 105 · 6:45
clinical Post-pull-through obstruction can be caused by stricture, twist (any pull-through type), Soave cuff (Soave procedure), Duhamel spur or non-functional distended segment (Duhamel procedure), or non-functional segment (Rehbein procedure). ↗

The Colorectal Quiz Episode 20: Hirschsprung Disease Obstruction Part 2

▶ Ep 107 · 1:36
clinical For exam under anesthesia in Hirschsprung's patients, digital exam should assess for circumferential stricture at the anastomosis ↗
▶ Ep 107 · 1:36
clinical For exam under anesthesia in Hirschsprung's patients, digital exam should assess for circumferential stricture at the anastomosis ↗
▶ Ep 107 · 1:43
quote I usually do a digital exam and then feel for the anastomosis and if there's any circumferential stricture. ↗
▶ Ep 107 · 1:43
quote I usually do a digital exam and then feel for the anastomosis and if there's any circumferential stricture. ↗
▶ Ep 107 · 1:57
clinical Hagar dilator can be used to size the anastomotic opening to ensure adequate caliber ↗
▶ Ep 107 · 1:57
clinical Hagar dilator can be used to size the anastomotic opening to ensure adequate caliber ↗
▶ Ep 107 · 2:04
clinical Foley catheter passage can determine if there is a twist in the pull-through segment ↗
▶ Ep 107 · 2:04
clinical Foley catheter passage can determine if there is a twist in the pull-through segment ↗
▶ Ep 107 · 2:11
quote Sometimes if you're blessed with longer fingers, you may be able to feel that and enter the peritoneum, but I have size 6 gloves, so I usually use the Foley catheter to determine if there's a twist or not. ↗
▶ Ep 107 · 2:11
quote Sometimes if you're blessed with longer fingers, you may be able to feel that and enter the peritoneum, but I have size 6 gloves, so I usually use the Foley catheter to determine if there's a twist or not. ↗
▶ Ep 107 · 2:23
clinical Swabe cuff presents as a 1-2 centimeter circumferential narrowing that is not the anastomosis itself ↗
▶ Ep 107 · 2:23
clinical Swabe cuff presents as a 1-2 centimeter circumferential narrowing that is not the anastomosis itself ↗
▶ Ep 107 · 2:33
clinical For patients with previous Duhamel procedure, full-thickness rectal biopsy should be performed posteriorly because that segment should be ganglionic ↗
▶ Ep 107 · 2:33
clinical For patients with previous Duhamel procedure, full-thickness rectal biopsy should be performed posteriorly because that segment should be ganglionic ↗

The Colorectal Quiz Episode 22: Hirschsprung Disease - the Soiling Patient Part 1

▶ Ep 109 · 12:20
clinical Patients with poor potential for bowel control (like anorectal malformation with poor spine/sacrum or spina bifida) need to be in a dedicated bowel management program with enemas or antegrade options. ↗
▶ Ep 109 · 12:20
clinical Patients with poor potential for bowel control (like anorectal malformation with poor spine/sacrum or spina bifida) need to be in a dedicated bowel management program with enemas or antegrade options. ↗

The Colorectal Quiz Episode 23: Hirschsprung Disease - The Soiling Patient Part 2 -The Dentate Line and Motility

▶ Ep 111 · 2:12
quote So their external sphincters are working and the internal sphincters are not. So when they're sleeping, they relax their external sphincters and that's how they lose the control. ↗
▶ Ep 111 · 2:12
clinical If a patient has voluntary bowel movements during the day but accidents at night when sleeping, their external sphincters are working but internal sphincters are not—when sleeping they relax the external sphincter and lose control. ↗
▶ Ep 111 · 2:12
quote So their external sphincters are working and the internal sphincters are not. So when they're sleeping, they relax their external sphincters and that's how they lose the control. ↗
▶ Ep 111 · 2:12
clinical If a patient has voluntary bowel movements during the day but accidents at night when sleeping, their external sphincters are working but internal sphincters are not—when sleeping they relax the external sphincter and lose control. ↗
▶ Ep 111 · 13:55
quote So it definitely doesn't look like the colon that moves too fast. It could potentially be a colon that moves slow. ↗
▶ Ep 111 · 13:55
clinical On contrast study, a colon that moves too fast shows smaller caliber with many haustrations (appearing as contractions), while a colon that moves too slow shows dilation with lack of haustrations. ↗
▶ Ep 111 · 13:55
clinical On contrast study, a colon that moves too fast shows smaller caliber with many haustrations (appearing as contractions), while a colon that moves too slow shows dilation with lack of haustrations. ↗
▶ Ep 111 · 13:55
quote So it definitely doesn't look like the colon that moves too fast. It could potentially be a colon that moves slow. ↗
▶ Ep 111 · 14:11
quote So just reading the contrast enema, it doesn't look like there's a lot of postrations in the colon that are causing these potentially you could interpret as like postrations as contractions of the colon. And usually the colon moves too fast. You have a smaller caliber colon with a lot of postrations and not as dilated. When you're concerned about it moving too slow, there's a dilation of the colon. There's lack of postrations. ↗
▶ Ep 111 · 14:11
quote So just reading the contrast enema, it doesn't look like there's a lot of postrations in the colon that are causing these potentially you could interpret as like postrations as contractions of the colon. And usually the colon moves too fast. You have a smaller caliber colon with a lot of postrations and not as dilated. When you're concerned about it moving too slow, there's a dilation of the colon. There's lack of postrations. ↗
▶ Ep 111 · 15:41
quote In both scenarios, patient need a bowel management program. If your sphincters are poor and your dentate line is deficient, probably mechanical, as we mentioned before, with an enema program. If the sphincters and dentate line are intact, we could potentially start with a mechanical and then switch them over to laxative program. ↗
▶ Ep 111 · 15:41
clinical For a hypomotile (slow-moving) colon with intact sphincters and dentate line, treatment can start with mechanical emptying then switch to laxative program; if sphincters and dentate line are deficient, mechanical enema program is needed. ↗
▶ Ep 111 · 15:41
quote In both scenarios, patient need a bowel management program. If your sphincters are poor and your dentate line is deficient, probably mechanical, as we mentioned before, with an enema program. If the sphincters and dentate line are intact, we could potentially start with a mechanical and then switch them over to laxative program. ↗
▶ Ep 111 · 15:41
clinical For a hypomotile (slow-moving) colon with intact sphincters and dentate line, treatment can start with mechanical emptying then switch to laxative program; if sphincters and dentate line are deficient, mechanical enema program is needed. ↗
▶ Ep 111 · 17:11
quote So in this one, the colon is decompressed and you see a lot of prostration. So potentially the colon is moving too fast. ↗
▶ Ep 111 · 17:11
quote So in this one, the colon is decompressed and you see a lot of prostration. So potentially the colon is moving too fast. ↗
▶ Ep 111 · 17:45
quote So I think in both cases, we can start off with constipating diet, add bulking agents, add PPIs. But if the sphincters and dentate lines are not intact or it's deficient, then we may have to start with irrigations or say like small enemas, small volume enemas. ↗
▶ Ep 111 · 17:45
clinical For hypermotile patients (7-8 stools daily), treatment involves constipating them and then ensuring timed emptying—either spontaneous if sphincters intact or mechanical if deficient. ↗
▶ Ep 111 · 17:45
quote So I think in both cases, we can start off with constipating diet, add bulking agents, add PPIs. But if the sphincters and dentate lines are not intact or it's deficient, then we may have to start with irrigations or say like small enemas, small volume enemas. ↗
▶ Ep 111 · 17:45
clinical For hypermotile patients (7-8 stools daily), treatment involves constipating them and then ensuring timed emptying—either spontaneous if sphincters intact or mechanical if deficient. ↗

The Colorectal Quiz Episode 23: Hirschsprung Disease - The Soiling Patient...

▶ Ep 118 · 2:17
quote So their external sphincters are working, um, and the internal sphincters are not. So when they're sleeping, they relax their external sphincters and that's how they lose the control. ↗
▶ Ep 118 · 11:55
quote I will always blame the fellow. ↗
▶ Ep 118 · 15:50
clinical In both scenarios (intact or deficient sphincters/dentate line), patients with slow-moving colon need a bowel management program; if sphincters are poor and dentate line deficient, mechanical emptying with enema program is needed; if intact, can start mechanical and potentially switch to laxative program. ↗
▶ Ep 118 · 17:55
quote So, um, I think in both cases we can start off with constipating diet, add bulking agents, in add PPIs, um, but if the sphincters and dentate lines are not intact or it's deficient, then we may have to start with, um, irrigations or, um, say like small enemas, small volume enemas. ↗
▶ Ep 118 · 24:19
quote So if you guys had to pick a soiling or an obstructive problem, which one would you pick? ↗

Colorectal Quiz Episode 18: Cloaca Part 2

▶ Ep 237 · 0:12
quote Hey everyone, this is Kira Ahmad from Nationwide Children's Hospital. ↗

Colorectal Quiz Episode 17: Cloaca Part 1

▶ Ep 238 · 5:41
epidemiological In a large majority of patients with cloaca, the diagnosis is made at birth ↗
Enterocolitis 1 entry

The Colorectal Quiz Episode 22: Hirschsprung Disease - the Soiling Patient Part 1

▶ Ep 15 · 12:20
clinical Patients with poor potential for bowel control (like anorectal malformation with poor spine/sacrum or spina bifida) need to be in a dedicated bowel management program with enemas or antegrade options. ↗
Hirschsprung-associated Enterocolitis 15 entries

Colorectal Quiz Episode 19: Hirschsprung Disease - The Obstructed Patient Part 1

▶ Ep 2 · 6:45
clinical Post-pull-through obstruction can be caused by stricture, twist (any pull-through type), Soave cuff (Soave procedure), Duhamel spur or non-functional distended segment (Duhamel procedure), or non-functional segment (Rehbein procedure). ↗

The Colorectal Quiz Episode 20: Hirschsprung Disease Obstruction Part 2

▶ Ep 3 · 1:36
clinical For exam under anesthesia in Hirschsprung's patients, digital exam should assess for circumferential stricture at the anastomosis ↗
▶ Ep 3 · 1:36
clinical For exam under anesthesia in Hirschsprung's patients, digital exam should assess for circumferential stricture at the anastomosis ↗
▶ Ep 3 · 1:43
quote I usually do a digital exam and then feel for the anastomosis and if there's any circumferential stricture. ↗
▶ Ep 3 · 1:43
quote I usually do a digital exam and then feel for the anastomosis and if there's any circumferential stricture. ↗
▶ Ep 3 · 1:57
clinical Hagar dilator can be used to size the anastomotic opening to ensure adequate caliber ↗
▶ Ep 3 · 1:57
clinical Hagar dilator can be used to size the anastomotic opening to ensure adequate caliber ↗
▶ Ep 3 · 2:04
clinical Foley catheter passage can determine if there is a twist in the pull-through segment ↗
▶ Ep 3 · 2:04
clinical Foley catheter passage can determine if there is a twist in the pull-through segment ↗
▶ Ep 3 · 2:11
quote Sometimes if you're blessed with longer fingers, you may be able to feel that and enter the peritoneum, but I have size 6 gloves, so I usually use the Foley catheter to determine if there's a twist or not. ↗
▶ Ep 3 · 2:11
quote Sometimes if you're blessed with longer fingers, you may be able to feel that and enter the peritoneum, but I have size 6 gloves, so I usually use the Foley catheter to determine if there's a twist or not. ↗
▶ Ep 3 · 2:23
clinical Swabe cuff presents as a 1-2 centimeter circumferential narrowing that is not the anastomosis itself ↗
▶ Ep 3 · 2:23
clinical Swabe cuff presents as a 1-2 centimeter circumferential narrowing that is not the anastomosis itself ↗
▶ Ep 3 · 2:33
clinical For patients with previous Duhamel procedure, full-thickness rectal biopsy should be performed posteriorly because that segment should be ganglionic ↗
▶ Ep 3 · 2:33
clinical For patients with previous Duhamel procedure, full-thickness rectal biopsy should be performed posteriorly because that segment should be ganglionic ↗
Hirschsprung disease 30 entries

The Colorectal Quiz Episode 20: Hirschsprung Disease Obstruction Part 2

▶ Ep 44 · 1:36
clinical For exam under anesthesia in Hirschsprung's patients, digital exam should assess for circumferential stricture at the anastomosis ↗
▶ Ep 44 · 1:36
clinical For exam under anesthesia in Hirschsprung's patients, digital exam should assess for circumferential stricture at the anastomosis ↗
▶ Ep 44 · 1:43
quote I usually do a digital exam and then feel for the anastomosis and if there's any circumferential stricture. ↗
▶ Ep 44 · 1:43
quote I usually do a digital exam and then feel for the anastomosis and if there's any circumferential stricture. ↗
▶ Ep 44 · 1:57
clinical Hagar dilator can be used to size the anastomotic opening to ensure adequate caliber ↗
▶ Ep 44 · 1:57
clinical Hagar dilator can be used to size the anastomotic opening to ensure adequate caliber ↗
▶ Ep 44 · 2:04
clinical Foley catheter passage can determine if there is a twist in the pull-through segment ↗
▶ Ep 44 · 2:04
clinical Foley catheter passage can determine if there is a twist in the pull-through segment ↗
▶ Ep 44 · 2:11
quote Sometimes if you're blessed with longer fingers, you may be able to feel that and enter the peritoneum, but I have size 6 gloves, so I usually use the Foley catheter to determine if there's a twist or not. ↗
▶ Ep 44 · 2:11
quote Sometimes if you're blessed with longer fingers, you may be able to feel that and enter the peritoneum, but I have size 6 gloves, so I usually use the Foley catheter to determine if there's a twist or not. ↗
▶ Ep 44 · 2:23
clinical Swabe cuff presents as a 1-2 centimeter circumferential narrowing that is not the anastomosis itself ↗
▶ Ep 44 · 2:23
clinical Swabe cuff presents as a 1-2 centimeter circumferential narrowing that is not the anastomosis itself ↗
▶ Ep 44 · 2:33
clinical For patients with previous Duhamel procedure, full-thickness rectal biopsy should be performed posteriorly because that segment should be ganglionic ↗
▶ Ep 44 · 2:33
clinical For patients with previous Duhamel procedure, full-thickness rectal biopsy should be performed posteriorly because that segment should be ganglionic ↗

The Colorectal Quiz Episode 22: Hirschsprung Disease - the Soiling Patient Part 1

▶ Ep 47 · 12:20
clinical Patients with poor potential for bowel control (like anorectal malformation with poor spine/sacrum or spina bifida) need to be in a dedicated bowel management program with enemas or antegrade options. ↗

The Colorectal Quiz Episode 23: Hirschsprung Disease - The Soiling Patient Part 2 -The Dentate Line and Motility

▶ Ep 48 · 2:12
quote So their external sphincters are working and the internal sphincters are not. So when they're sleeping, they relax their external sphincters and that's how they lose the control. ↗
▶ Ep 48 · 2:12
clinical If a patient has voluntary bowel movements during the day but accidents at night when sleeping, their external sphincters are working but internal sphincters are not—when sleeping they relax the external sphincter and lose control. ↗
▶ Ep 48 · 13:55
quote So it definitely doesn't look like the colon that moves too fast. It could potentially be a colon that moves slow. ↗
▶ Ep 48 · 13:55
clinical On contrast study, a colon that moves too fast shows smaller caliber with many haustrations (appearing as contractions), while a colon that moves too slow shows dilation with lack of haustrations. ↗
▶ Ep 48 · 14:11
quote So just reading the contrast enema, it doesn't look like there's a lot of postrations in the colon that are causing these potentially you could interpret as like postrations as contractions of the colon. And usually the colon moves too fast. You have a smaller caliber colon with a lot of postrations and not as dilated. When you're concerned about it moving too slow, there's a dilation of the colon. There's lack of postrations. ↗
▶ Ep 48 · 15:41
quote In both scenarios, patient need a bowel management program. If your sphincters are poor and your dentate line is deficient, probably mechanical, as we mentioned before, with an enema program. If the sphincters and dentate line are intact, we could potentially start with a mechanical and then switch them over to laxative program. ↗
▶ Ep 48 · 15:41
clinical For a hypomotile (slow-moving) colon with intact sphincters and dentate line, treatment can start with mechanical emptying then switch to laxative program; if sphincters and dentate line are deficient, mechanical enema program is needed. ↗
▶ Ep 48 · 17:11
quote So in this one, the colon is decompressed and you see a lot of prostration. So potentially the colon is moving too fast. ↗
▶ Ep 48 · 17:45
clinical For hypermotile patients (7-8 stools daily), treatment involves constipating them and then ensuring timed emptying—either spontaneous if sphincters intact or mechanical if deficient. ↗
▶ Ep 48 · 17:45
quote So I think in both cases, we can start off with constipating diet, add bulking agents, add PPIs. But if the sphincters and dentate lines are not intact or it's deficient, then we may have to start with irrigations or say like small enemas, small volume enemas. ↗

The Colorectal Quiz Episode 23: Hirschsprung Disease - The Soiling Patient...

▶ Ep 49 · 2:17
quote So their external sphincters are working, um, and the internal sphincters are not. So when they're sleeping, they relax their external sphincters and that's how they lose the control. ↗
▶ Ep 49 · 11:55
quote I will always blame the fellow. ↗
▶ Ep 49 · 15:50
clinical In both scenarios (intact or deficient sphincters/dentate line), patients with slow-moving colon need a bowel management program; if sphincters are poor and dentate line deficient, mechanical emptying with enema program is needed; if intact, can start mechanical and potentially switch to laxative program. ↗
▶ Ep 49 · 17:55
quote So, um, I think in both cases we can start off with constipating diet, add bulking agents, in add PPIs, um, but if the sphincters and dentate lines are not intact or it's deficient, then we may have to start with, um, irrigations or, um, say like small enemas, small volume enemas. ↗
▶ Ep 49 · 24:19
quote So if you guys had to pick a soiling or an obstructive problem, which one would you pick? ↗
Hydrocolpos 1 entry

Colorectal Quiz Episode 17: Cloaca Part 1

▶ Ep 4 · 5:41
epidemiological In a large majority of patients with cloaca, the diagnosis is made at birth ↗