5900 Coit Rd
Plano TX 75023
Medical School: Other - 1996
Accepts Medicare: Yes
Participates In eRX: Yes
Participates In PQRS: Yes
Participates In EHR: No
Taxonomy Codes:174400000X 207W00000X
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Awards & Recognitions
Dr. Syed Ahmad is associated with these group practices
|HCPCS Code||Description||Average Price||Average Price
Allowed By Medicare
|HCPCS Code:67904||Description:Repair eyelid defect||Average Price:$2,956.83||Average Price Allowed
|HCPCS Code:67900||Description:Repair brow defect||Average Price:$2,516.33||Average Price Allowed
|HCPCS Code:67917||Description:Repair eyelid defect||Average Price:$2,431.53||Average Price Allowed
|HCPCS Code:15823||Description:Revision of upper eyelid||Average Price:$2,402.85||Average Price Allowed
|HCPCS Code:67916||Description:Repair eyelid defect||Average Price:$2,102.00||Average Price Allowed
|HCPCS Code:67875||Description:Closure of eyelid by suture||Average Price:$571.60||Average Price Allowed
|HCPCS Code:99204||Description:Office/outpatient visit new||Average Price:$375.00||Average Price Allowed
|HCPCS Code:99214||Description:Office/outpatient visit est||Average Price:$266.75||Average Price Allowed
|HCPCS Code:99203||Description:Office/outpatient visit new||Average Price:$255.68||Average Price Allowed
|HCPCS Code:92082||Description:Visual field examination(s)||Average Price:$178.49||Average Price Allowed
|HCPCS Code:99213||Description:Office/outpatient visit est||Average Price:$175.51||Average Price Allowed
|HCPCS Code:92083||Description:Visual field examination(s)||Average Price:$193.90||Average Price Allowed
|HCPCS Code:92285||Description:Eye photography||Average Price:$123.30||Average Price Allowed
|HCPCS Code:99212||Description:Office/outpatient visit est||Average Price:$120.00||Average Price Allowed
|HCPCS Code:92002||Description:Eye exam new patient||Average Price:$136.53||Average Price Allowed
|HCPCS Code:92004||Description:Eye exam new patient||Average Price:$188.23||Average Price Allowed
|HCPCS Code:92014||Description:Eye exam & treatment||Average Price:$151.90||Average Price Allowed
|HCPCS Code:92012||Description:Eye exam established pat||Average Price:$106.18||Average Price Allowed
HCPCS Code Definitions
- Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 15 minutes are spent face-to-face with the patient and/or family.
- Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.
- Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; comprehensive, established patient, 1 or more visits
- Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 45 minutes are spent face-to-face with the patient and/or family.
- Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed history; A detailed examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 25 minutes are spent face-to-face with the patient and/or family.
- Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A detailed history; A detailed examination; Medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate severity. Typically, 30 minutes are spent face-to-face with the patient and/or family.
- Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; intermediate, established patient
- Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; comprehensive, new patient, 1 or more visits
- Blepharoplasty, upper eyelid; with excessive skin weighting down lid
- Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; intermediate, new patient
- Repair of ectropion; extensive (eg, tarsal strip operations)
- Temporary closure of eyelids by suture (eg, Frost suture)
- Repair of ectropion; excision tarsal wedge
- Repair of brow ptosis (supraciliary, mid-forehead or coronal approach)
- Repair of blepharoptosis; (tarso) levator resection or advancement, external approach
- External ocular photography with interpretation and report for documentation of medical progress (eg, close-up photography, slit lamp photography, goniophotography, stereo-photography)
- Visual field examination, unilateral or bilateral, with interpretation and report; intermediate examination (eg, at least 2 isopters on Goldmann perimeter, or semiquantitative, automated suprathreshold screening program, Humphrey suprathreshold automatic diagnostic test, Octopus program 33)
- Visual field examination, unilateral or bilateral, with interpretation and report; extended examination (eg, Goldmann visual fields with at least 3 isopters plotted and static determination within the central 30°, or quantitative, automated threshold perimetry, Octopus program G-1, 32 or 42, Humphrey visual field analyzer full threshold programs 30-2, 24-2, or 30/60-2)
Medical Malpractice Cases
Medical Board Sanctions
Cardiovascular Disease (Cardiology)
*These referrals represent the top 10 that Dr. Ahmad has made to other doctors
Adjuvant Therapy in Pancreas Cancer: Does It Influence Patterns of Recurrence? - Journal of the American College of Surgeons
Level 1 data demonstrate that adjuvant chemotherapy (ACT) improves survival after surgical resection of pancreatic ductal adenocarcinoma (PDAC), (adjuvant gemcitabine, CONKO-001 study; adjuvant 5-FU, ESPAC3 study). The role of adjuvant chemoradiation therapy (ACRT) remains controversial. What is less clear is whether adjuvant therapy influences patterns of recurrence. The purpose of this study was to perform the first multicenter study analyzing patterns of recurrence after adjuvant therapy for PDAC.Patients undergoing resection for PDAC from 8 medical centers over a 10-year period were analyzed. Demographics, tumor characteristics, operative treatment, type of adjuvant therapy, recurrence pattern, and survival were reviewed. Using Cox-proportional hazards multivariate (MV) regression, the impact of ACT and ACRT on overall survival (OS), local recurrence (LR), and distant recurrence (DR) was investigated.There were 1,130 patients who were divided into those having surgery alone (nÂ = 392), ACT (nÂ = 291), or ACRT (nÂ = 447). Median follow-up was 18 months. Compared with patients undergoing surgery alone, ACT, but not ACRT, demonstrated a significant OS advantage on MV analysis. Patients receiving ACT had significantly fewer recurrences (LR and DR); those receiving ACRT had significantly less LR but not DR. On subset MV analysis, ACT and ACRT resulted in less LR in patients with lymph node (LN) positive and margin negative disease. No improvements in LR, DR, or OS were seen in margin positive patients with either ACT or ACRT.This is the first analysis demonstrating differences in recurrence patterns in PDAC patients based on type of adjuvant therapy. Adjuvant chemotherapy provided an OS advantage likely related to its effect on reducing both LR and DR. Adjuvant chemoradiation therapy appears to decrease LR, but not DR, and therefore has less impact on OS. Future investigations and treatment protocols should consider additional ACT rather than ACRT in the treatment of PDAC.Copyright Â© 2016. Published by Elsevier Inc.
Evaluation of a commercial MRI Linac based Monte Carlo dose calculation algorithm with geant 4. - Medical physics
This paper provides a comparison between a fast, commercial, in-patient Monte Carlo dose calculation algorithm (GPUMCD) and geant4. It also evaluates the dosimetric impact of the application of an external 1.5 T magnetic field.A stand-alone version of the Elektaâ„¢ GPUMCD algorithm, to be used within the Monaco treatment planning system to model dose for the Elektaâ„¢ magnetic resonance imaging (MRI) Linac, was compared against geant4 (v10.1). This was done in the presence or absence of a 1.5 T static magnetic field directed orthogonally to the radiation beam axis. Phantoms with material compositions of water, ICRU lung, ICRU compact-bone, and titanium were used for this purpose. Beams with 2 MeV monoenergetic photons as well as a 7 MV histogrammed spectrum representing the MRI Linac spectrum were emitted from a point source using a nominal source-to-surface distance of 142.5 cm. Field sizes ranged from 1.5 Ã— 1.5 to 10 Ã— 10 cm(2). Dose scoring was performed using a 3D grid comprising 1 mm(3) voxels. The production thresholds were equivalent for both codes. Results were analyzed based upon a voxel by voxel dose difference between the two codes and also using a volumetric gamma analysis.Comparisons were drawn from central axis depth doses, cross beam profiles, and isodose contours. Both in the presence and absence of a 1.5 T static magnetic field the relative differences in doses scored along the beam central axis were less than 1% for the homogeneous water phantom and all results matched within a maximum of Â±2% for heterogeneous phantoms. Volumetric gamma analysis indicated that more than 99% of the examined volume passed gamma criteria of 2%-2 mm (dose difference and distance to agreement, respectively). These criteria were chosen because the minimum primary statistical uncertainty in dose scoring voxels was 0.5%. The presence of the magnetic field affects the dose at the interface depending upon the density of the material on either sides of the interface. This effect varies with the field size. For example, at the water-lung interface a 33.94% increase in dose was observed (relative to the Dmax), by both GPUMCD and geant4 for the field size of 2 Ã— 2 cm(2) (compared to no B-field case), which increased to 47.83% for the field size of 5 Ã— 5 cm(2) in the presence of the magnetic field. Similarly, at the lung-water interface, the dose decreased by 19.21% (relative to Dmax) for a field size of 2 Ã— 2 cm(2) and by 30.01% for 5 Ã— 5 cm(2) field size. For more complex combinations of materials the dose deposition also becomes more complex.The GPUMCD algorithm showed good agreement against geant4 both in the presence and absence of a 1.5 T external magnetic field. The application of 1.5 T magnetic field significantly alters the dose at the interfaces by either increasing or decreasing the dose depending upon the density of the material on either side of the interfaces.
Factors Associated with Readmission After Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis. - Annals of surgical oncology
Cytoreductive surgery/hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) for peritoneal carcinomatosis is a morbid endeavor. Despite improvement in perioperative management of these patients, there are subsets of patients requiring hospital readmission after discharge. We sought to identify variables associated with readmission rates for CRS/HIPEC.We conducted a retrospective review of CRS/HIPEC cases at the University of Cincinnati between 1999 and 2014. Patient-, tumor-, and treatment-specific characteristics were evaluated. The association between patient- and outcome-specific variables for 30- and 90-day readmission were evaluated.Of 215 CRS/HIPEC patients, the 7-, 30-, and 90-day readmission rates were 9.8Â % (nÂ =Â 21), 14.9Â % (nÂ =Â 32), and 21.4Â % (nÂ =Â 46), respectively. The most common reasons for readmission within 90Â days included abdominal pain (nÂ =Â 14), intra-abdominal abscess (nÂ =Â 9), malnutrition/failure to thrive (nÂ =Â 8), and bowel obstruction (nÂ =Â 7). The primary factor associated with readmission at all time points (7, 30, and 90Â days) was the presence of an enterocutaneous fistula (pÂ <Â 0.01). Six patients (2.8Â %) had multiple readmissions; 3 of these had ECF. Factors not associated with higher admission rates included sex, age, race, operative blood loss, pancreatectomy or liver resection at the index operation, and postoperative complications of wound infection, line infection, and thromboembolic events.In patients undergoing CRS/HIPEC, readmission was primarily associated with poor pain control, malnutrition, and infectious complications. Patients with enterocutaneous fistula were also disproportionately readmitted multiple times. These data should inform clinicians about patients at high risk for readmission after CRS/HIPEC and encourage more comprehensive coordination of postdischarge planning and care for specific patient populations.
Impact of Rating Scale Categories on Reliability and Fit Statistics of the Malay Spiritual Well-Being Scale using Rasch Analysis. - The Malaysian journal of medical sciences : MJMS
Few studies have employed the item response theory in examining reliability. We conducted this study to examine the effect of Rating Scale Categories (RSCs) on the reliability and fit statistics of the Malay Spiritual Well-Being Scale, employing the Rasch model.The Malay Spiritual Well-Being Scale (SWBS) with the original six; three and four newly structured RSCs was distributed randomly among three different samples of 50 participants each.The mean age of respondents in the three samples ranged between 36 and 39 years old. The majority was female in all samples, and Islam was the most prevalent religion among the respondents. The predominating race was Malay, followed by Chinese and Indian. The original six RSCs indicated better targeting of 0.99 and smallest model error of 0.24. The Infit Mnsq (mean square) and Zstd (Z standard) of the six RSCs were "1.1"and "-0.1"respectively. The six RSCs achieved the highest person and item reliabilities of 0.86 and 0.85 respectively. These reliabilities yielded the highest person (2.46) and item (2.38) separation indices compared to other the RSCs.The person and item reliability and, to a lesser extent, the fit statistics, were better with the six RSCs compared to the four and three RSCs.
A benign presentation of primary ductal adenocarcinoma of lacrimal gland: A rare malignancy. - Indian journal of ophthalmology
A 34-year-old patient with a swelling over the upper eyelid for nearly 1 year was seen in our clinic. The history, examination and investigations were suggestive of a benign lacrimal gland tumor. The tumor and lacrimal gland were resected. Subsequent histopathological examination revealed the tumor was a primary ductal adenocarcinoma of the lacrimal gland. This is a very rare tumor with less than half a dozen cases reported so far. This case report is being presented to highlight an unusual presentation of this rare malignancy.
How Much Should We Pay to Minimize Pancreatic Leak? The Cost-effectiveness of Pasireotide in Pancreatic Resection: RETRACTED. - Annals of surgery
Pasireotide was recently shown to decrease leak rates after pancreatic resection, though the significant cost of the drug may be prohibitive. We conducted a cost-effectiveness analysis to determine whether prophylactic pasireotide possesses a reasonable cost profile by improving outcomes.A cost-effectiveness model was constructed to compare pasireotide administration after pancreatic resection versus usual care, populated by probabilities of clinical outcomes from a recent randomized trial and hospital costs (2013 US$) from a university pancreatic disease center. Sensitivity analyses were performed to identify the most influential clinical components of the model.Without considering pasireotide cost, prophylactic use of the drug saved an average of $8,109 per patient. However, when the cost of pasireotide was included, per patient costs increased from $42,159 to $77,202. This was associated with a 56% reduction in pancreatic fistula/pancreatic leak/abscess (PF/PL/A) (21.9% to 9.2%). The resultant cost per PF/PL/A avoided was $301,628. Threshold analysis demonstrated that for this intervention to be cost neutral, either the purchase price of pasireotide ($43,172) must be reduced by 92.3% (to $3324) or drug reimbursement must be $39,848. Sensitivity analyses exploring variable perioperative mortality, rate of PF/PL/A, and readmission rates did not significantly alter model outcomes.Our analyses demonstrate that when prophylactic pasireotide is administered, the cost per PF/PL/A avoided is approximately $300,000. Aggressive pricing negotiation, payer reimbursement for the drug, high-volume use, and consensus among the public, payers, and surgical community regarding the value of reducing morbidity will ultimately determine the utility of widespread pasireotide application in pancreatic resection.
Natural history and treatment trends in hepatocellular carcinoma subtypes: Insights from a national cancer registry. - Journal of surgical oncology
Histopathologic advancements have identified several rare subtypes of hepatocellular carcinoma (HCC), but the clinical significance of these distinctions is incompletely understood. Our aim was to investigate pathologic and treatment differences between HCC variants.The American College of Surgeons National Cancer Data Base (1998-2011) was queried to identify 784 patients with surgical management of six rare HCC subtypes: fibrolamellar (FL, nâ€‰=â€‰206), scirrhous (SC, nâ€‰=â€‰29), spindle cell (SP, nâ€‰=â€‰20), clear cell (CC, nâ€‰=â€‰169), mixed type (M, nâ€‰=â€‰291), and trabecular (T, nâ€‰=â€‰69). We examined associations between demographic, tumor and treatment-specific variables, and overall survival (OS).Patients with FL-HCC were younger than other variants (median age 27 vs. 54-61, Pâ€‰<â€‰0.001), more commonly female (56.3%, Pâ€‰<â€‰0.001), and less likely to receive a transplant (3.66%, Pâ€‰<â€‰0.001). Patients with FL- and Sp-HCC presented more frequently with larger tumors (>5â€‰cm, Pâ€‰<â€‰0.001) and node-positive disease (Pâ€‰<â€‰0.001). Better OS was associated with lower pathologic stage, node-negative disease, FL-HCC, and liver transplant. Adjuvant therapy (11% of patients) was not associated with better OS.This largest series of recognized HCC variants demonstrates distinct differences in presentation, treatment, and prognosis. These findings can provide a valuable reference for clinicians and patients who encounter these rare clinical entities. J. Surg. Oncol. 2015;112:872-876. Â© 2015 Wiley Periodicals, Inc.Â© 2015 Wiley Periodicals, Inc.
Glandular odontogenic cyst - Literature review and report of a paediatric case. - Journal of oral biology and craniofacial research
Glandular odontogenic cyst (GOC) is an extremely rare lesion occurring in the jawbones. The present paper is a review of 181 cases of GOCs reported in English literature, since it was first reported by Padayache and Van Wyk in 1987. Mandible was involved in 130 cases and maxilla in 51 cases. Anterior mandible was the most common area of involvement. Radiographic appearance was that of a unilocular radiolucency in 98 of 176 reported cases. Rest presented as multilocular radiolucency. Cortical expansion was observed in 136 of the 180 reported cases while cortex breach or perforation was seen in 81 cases. The treatment of choice was that of minor procedures that included enucleation with or without curettage, peripheral ostectomy, cryotherapy, etc. in 157 of the total 177 reported cases. Marginal jaw resection, segmental mandibulectomy etc. was reported in 20 cases. Although minor surgical procedures were the treatment of choice in most studies, two major studies of Kaplan et al. and Fowler et al. involving 111 and 46 cases, recorded a recurrence rate of 35.9 and 19.6%, respectively. The age range was between 11 and 82 years. The respective mean age of patients in the above mentioned studies was 45.7 for Kaplan's and 51 years for Fowler's whereas in our study, the mean age was 45.9 years. Very rarely does GOC presents itself in a paediatric patient. The paper also reports a case of an 11-year-old child whose histopathogy came out to be a case of a GOC.
Peritoneal VEGF-A expression is regulated by TGF-Î²1 through an ID1 pathway in women with endometriosis. - Scientific reports
VEGF-A, an angiogenic factor, is increased in the peritoneal fluid of women with endometriosis. The cytokine TGF-Î²1 is thought to play a role in the establishment of endometriosis lesions. Inhibitor of DNA binding (ID) proteins are transcriptional targets of TGF-Î²1 and ID1 has been implicated in VEGF-A regulation during tumor angiogenesis. Herein, we determined whether peritoneal expression of VEGF-A is regulated by TGF-Î²1 through the ID1 pathway in women with endometriosis. VEGF-A was measured in peritoneal fluid by ELISA (nâ€‰=â€‰16). VEGF-A and ID1 expression was examined in peritoneal biopsies (nâ€‰=â€‰13), and primary peritoneal and immortalized mesothelial cells (MeT5A) by immunohistochemistry, qRT-PCR and ELISA. VEGF-A was increased in peritoneal fluid from women with endometriosis and levels correlated with TGF-Î²1 concentrations (Pâ€‰<â€‰0.05). VEGF-A was immunolocalized to peritoneal mesothelium and TGF-Î²1 increased VEGFA mRNA (Pâ€‰<â€‰0.05) and protein (Pâ€‰<â€‰0.05) in mesothelial cells. ID1 was increased in peritoneum from women with endometriosis and TGF-Î²1 increased concentrations of ID1 mRNA (Pâ€‰<â€‰0.05) in mesothelial cells. VEGF-A regulation through ID1 was confirmed by siRNA in MeT5A cells (Pâ€‰<â€‰0.05). Our data supports role for ID1 in the pathophysiology of endometriosis, as an effector of TGFÎ²1 dependent upregulation of VEGF-A, and highlights a novel potential therapeutic target.
Selective modulation of the prostaglandin F2Î± pathway markedly impacts on endometriosis progression in a xenograft mouse model. - Molecular human reproduction
Selective activation or blockade of the prostaglandin (PG) F2Î± receptor (FP receptor) affects ectopic endometrial tissue growth and endometriosis development.FP receptor antagonists might represent a promising approach for the treatment of peritoneal endometriosis.Eutopic and ectopic endometrium from women with endometriosis exhibit higher expression of key enzymes involved in the PGF2Î± biosynthetic pathway. It has also been shown that the PGF2Î±-FP receptor interaction induces angiogenesis in human endometrial adenocarcinoma.For this study, a mouse model of endometriosis was developed by inoculating human endometrial biopsies into the peritoneal cavity of nude mouse (n = 15). Mice were treated with AL8810 (FP receptor antagonist), Fluprostenol (FP receptor agonist) or PBS. Endometriosis-like lesions were collected and analysed for set of markers for angiogenesis, tissue remodelling, apoptosis, cell proliferation and capillary formation using qPCR and immunohistochemistry.We found that selective inhibition of the FP receptor with a specific antagonist, AL8810, led to a significant decline in the number (P < 0.01) and size of endometriosis-like lesions (P < 0.001), down-regulated the expression of key mediators of tissue remodelling (MMP9, P < 0.05) and angiogenesis (VEGF, P < 0.01) and up-regulated the pro-apoptotic factor (Bax, P < 0.01) as compared with controls. Immunohistochemical analyses further showed a marked decrease in cell proliferation and capillary formation in endometrial implants from AL8810-treated mice, as determined by proliferating cell nuclear antigen (PCNA) and von Willebrand factor (vWF) immunostaining, respectively. Moreover, Fluprostenol, a selective FP receptor agonist, showed the opposite effects.We carried out this study in nude mice, which have low levels of endogenous estrogens which may affect the lesion growth. Caution is required when interpreting these results to women.This study extends the role of PG signalling in endometriosis pathogenesis and points towards the possible relevance of selective FP receptor antagonism as a targeted treatment for endometriosis.Not Applicable.This work was supported by grant MOP-123259 to the late Dr Ali Akoum from the Canadian Institutes for Health Research. The authors have no conflict of interest.Â© The Author 2015. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
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5900 Coit Rd Plano, TX 75023