Welcome to Journal Of Pakistan Medical Association
   Issue Vol:66, No:9 September, 2016
Editorial >>

Epidemiology - Role of health professionals in prevention of disease

Aamir Omair.

Epidemiology according to the Greek origin of its terms \'epi\', \'demos\' and \'logos\' in its literal interpretation refers to the \'study upon people\'.1 The World Health Organization (WHO) defines epidemiology as "the study o

A national guideline and ILD PAK Registry Report: Recent landmarks in the understanding of interstitial lung diseases in Pakistan

Mosavir Ansarie.

Introduction to ILD
The Interstitial lung diseases (ILDs) are a heterogeneous group of pulmonary disorders, classified together because of similar clinical, radiological and pathological features. 1 These are often described as diffuse parenchymal lung disease

Original Articles >>

Assessment of the dietary pattern of dormitory students in Kerman, Iran

Farideh Doostan, Sahar Mohseni-Takalloo, Mohammad Nosrati.

Objective: Nowadays it is known that dietary imbalances are associated with non-communicable diseases which would be a major cause of worldwide deaths in 2020. This study was conducted to assess the dietary pattern of students who live in a dormitory in Kerman, Iran, based on Healthy Eatin

Comparison of serum anti-mullerian hormone among fertile and infertile normal and diminished ovarian reserve groups

Naila Parveen, Dur-e-Shewar Rehman, Shireen Jawed.

Objective: To compare anti-mullerian hormone among fertile and infertile groups of women in their reproductive age.
Methods: This case-control study was conducted at the Dow University of Health Sciences in collaboration with Civil Hospital, Karachi, from October 2011

The prevalence of autoantibodies among relatives for type 1 and 2 diabetic patients

Hadi Lazim Al-Abady, Nadham Kadham Mahdi, Lamia Mustafa Al-Naama, Jawad Kadham Mahdi.

Objective: To estimate the prevalence of islet cells autoantibodies among non-diabetic relatives of type 1 and type 2 diabetic patients.
Methods: The study was conducted at the College of Medicinal Technology, Basra, Iraq, from December 2010 to December 2012, and comprised bo

Metallo-beta-lactamase producing Escherichia coli and Klebsiella pneumoniae: A rising threat for hospitalized children

Humera Javed, Hasan Ejaz, Aizza Zafar, Ahsan Waheed Rathore, Ikram ul Haq.

Objective: To determine the frequency of metallo-beta-lactamase (MBL) producing E.coli and Klebsiella pneumoniae, better phenotypic techniques for MBL detection and choices of treatment available for such cases.
Methods: This study was conducted in The Children\'s Hospital,

Role of ascorbic acid supplement in amelioration of anaemia in lead intoxication

Yasir Farooq, Muhammad Asif Farooq, Aamir Hussain.

Objective: To assess anaemia and oxidative stress in rats that were injected lead and to evaluate the possible effects of ascorbic acid supplementation on these parameters.
Methods: This randomised control trial study was conducted at the Army Medical College, Rawalpindi, Pak

Frequency of hyponatraemia and hypokalaemia in malnourished children with acute diarrhoea

Asma Bilal, Mohammad Arif Sadiq, Nighat Haider.

Objective: To determine the frequency of hyponatraemia and hypokalaemia in malnourished children with acute diarrhoea.
Methods: This cross-sectional study was carried out at the Military Hospital, Rawalpindi, Pakistan, from September 2013 to March 2014, and comprised acute di

Morbidity of colostomy reversal

Salma Khan, Rehman Alvi, Naveed Haroon.

Objective: To determine morbidity after colostomy reversal at a tertiary care hospital.
Method: The retrospective case series was conducted at the Aga Khan University Hospital, Karachi, and comprised records of patients aged 15 years or more who underwent colostomy reversal f

Serum anti-mullerian hormone: Correlation with the ovarian follicular dynamics in healthy mice

Zehra Jamil, Khalida Perveen, Rabia Malik, Lubna Avesi.

Objective: To evaluate the relationship between serum anti-Mullerian hormone and follicular dynamics in mice.
Methods: This experimental study was conducted in November, 2014 at the Dow University of Health Sciences, Karachi, and comprised laboratory-bred albino mice. They we

Fractionated stereotactic radiosurgery for vestibular schwannomas using cyberknife: A single institution experience

Mihriban Erdogan Kocak, Adem Sengul, Kemal Ekici, Ali Olmezoglu, Ozgur Seseogullari.

Objective: To assess tumour control, hearing preservation status, and complication ratio after fractionated stereotactic radiosurgery/radiotherapy by using CyberKnife device in patients with vestibular schwannomas.
Methods: This retrospective study was conducted at Izmir Atat

Academic performance of day scholars versus boarders in pharmacology examinations of a medical school in Pakistan

Rizwan Faisal, Laiyla Shinwari, Saadia Izzat.

Objective: To compare the academic performance of day scholar and boarder students in Pharmacology examinations.
Methods: This comparative study was conducted at Rehman Medical College, Peshawar, Pakistan, from June to September, 2015. It comprised third-year medical students

Amiodarone vs digoxin in the treatment of atrial fibrillation in postoperative rheumatic cardiac valvular patients

Sharjeel Abbas, Waseem Riaz, Junaid Fayyaz Khan, Sharif Nassery, Madiha Iqbal, Abdul Waheed.

Objective: To compare the efficacy of amiodarone and digoxin for patients who underwent valve-related cardiac surgery and had atrial fibrillation in the first 72 hours post-operatively.
Methods: The observational/descriptive study was conducted at the Punjab Institute of Card

Association of metabolic factors with dengue viral infection on admission triage which predict its clinical course during Lahore dengue epidemic

Amena Moazzam Baig Mirza, Madiha Fida, Ghulam Murtaza, Rizwan Niazi, Asif Hanif, Khadija Irfan, Faisal Masud.

Objective: The study was done to identify metabolic factors which were associated with an increased risk of dengue haemorrhagic fever in clinically diagnosed patients of dengue viral infection.
Methods: 563 patients with dengue viral infection that presented to 3 tertiary car

The effect of topical finasteride 0.5% on the outcome of diode laser therapy in the treatment of excess facial hairs in the women with hirsutism

Robabeh Alijanpour.

Objective: To determine the effects of topical finasteride 0.5% on the results of diode laser therapy in the treatment of hirsutism.
Methods: This double-blind, placebo-controlled, clinical trial study was conducted at a private clinic in Babol, Iran, between June 2012 and Ju

Protection of nurses rights in Turkey: A study on nurses' opinions

Nefise Bahcecik, Havva Ozturk, Hanife Tiryaki.

Objective: To evaluate nurses\' opinions on the violation and protection of their rights at public hospitals.
Methods: The descriptive study was conducted between May and November 2013 at 11 hospitals affiliated with the Association of Public Hospitals in Istanbul, Turkey.

False negativity in AFB Smear microscopy: An insight into the caveats of the most widely used screening tool for tuberculosis

Muhammad Yahya Noori, Zaheer Ali, Syed Adnan Ali Wahidi, Muhammad Nouman Mughal, Shaheen Sharafat, Muhammad Masroor, Muhammad Rafiq Khanani.

Objective: To study the ratio of false negativity in sputum samples in diagnostic smears received for acid fast bacilli smear microscopy.
Methods: The retrospective cross-sectional study was conducted at the Ojha Institute of Chest Diseases, Karachi, and comprised specimens f

Tuberculosis knowledge and health seeking behaviour: A tale of two districts of Sindh, Pakistan

Syed Mohammad Ali Warsi,, Syed Hasan Danish, Farah Ahmad, Aneela Iqbal Khan, Muzammil Parvaiz Khan, Salma Bano, Vedwiyas Lohana.

Objective: To assess the knowledge about tuberculosis and health-seeking behaviour of people living in rural areas of Sindh.
Methods: This cross-sectional survey was conducted by the Pakistan Red Crescent Society in Dadu and Badin districts of Sindh, Pakistan, from January to

Comparison of the safety and efficacy of single injection of subtenon triamcinolone and topical dexamethasone in reducing postoperative inflammation after phacoemulsification and intraocular lens implantation

Habibullah Khan, Mumtaz Alam, Akbar Khan.

Objective: To compare the safety and efficacy of single injection of sub-tenon triamcinolone and topical dexamethasone in reducing post-operative inflammation after phacoemulsification and intraocular lens implantation.
Methods: The randomised controlled study was conducted a

Effect of topical application of hard water in weakening of hair in men

Muhammad Waqas Luqman, Roshan Ali, Zahid Khan, Muhammad Haris Ramzan, Fazal Hanan, Usama Javaid.

Background: Hard water is thought to play a key role in weakening of hair (not Hair Loss) and breakage especially when travelling is involved. In our community, commonly men do the travelling and complain more about hair problem which is why only young male individuals were included in thi

SNP rs3088308 is a risk factor for poor lung function in healthy smokers

Tania Ahmed Shakoori, Donald Don Sin.

Objective: To see if single nucleotide polymorphisms of pulmonary innate immune molecule surfactant protein D were associated with poor lung function in smokers.
Methods: The study was conducted at Shaikh Zayed Hospital, Lahore, Pakistan, from April 2008 to August 2010, and c

Long-term results of reverse Liss plate applied to unstable proximal femur extracapsular fractures in Istanbul, Turkey

Harun Mutlu, Serhat Mutlu, Engin Cetinkaya, Armagan Arslan, Ufuk Ozkaya, Atilla Sancar Parmaksizoglu.

Objective: To evaluate the results of the minimally invasive internal fixation method using reverse Less Invasive Stabilisation System locking plate in unstable proximal femur extracapsular fractures.
Methods: The retrospective study was conducted at Department of Ortho

Review Articles >>

Nutrition in intensive care in adults review of the literature and development of evidence based feeding protocols

Sarah Ikram, Erfan Hussain, Ali Bin Sarwar Zubairi.

The subject of nutrition in intensive care is broad.Thenutrition support therapy plays a crucial role in the management of critically ill patients. This review was carried out to address the existing controversies and to recognise the current practice guidelines for the management of nutrition in

Socio-economic, environmental and demographic determinants of rise in obesity among Pakistani women: A Systematic Review

Beenish Mehboob, Nilofer Fatimi Safdar, Sidra Zaheer.

Nutrition transition is a shift in eating and disease patterns towards diet-nutrition-related non-communicable diseases (NR-NCDs). This shift in many developing countries has been accompanied with changes in behaviours, lifestyles, diets, physical inactivity, smoking and alcohol consumption. In a

Short Communication >>

Spectrum of abdominal-tuberculosis in emergency surgery: 100 cases at a tertiary care Centre Dow University of Health Sciences and Civil Hospital Karachi, Pakistan

Shahida Parveen Afridi, Rameez Ahmed Siddiqui, Akram Rajput, Shams Nadeem Alam.

The study highlights the spectrum of abdominal TB in emergency surgery and its outcome. A proforma based prospective cross sectional study was conducted from March 2008 - March 2014, at the Department of General Surgery, Dow University of Health Sciences & Civil Hospital Karachi, Pakistan. To

Case Reports >>

Intraoperative ventilatory management of adult tracheoesophageal fistula

Samie Asghar Dogar, Mohammad Hamid.

Iatrogenic Tracheo Esophageal Fistula (TEF) in adults is a rare complication occurring secondary to trauma and prolonged intubation. There is very scarce data regarding its airway management and that too is from the paediatric age group. We describe the case of a young male undergoing TEF repair.

Successful management of septic patient with concealed left persistent superior vena cava: anaesthetic perspective

Dileep Kumar, Faraz Shafiq.

Surviving sepsis guideline supports the placement of central venous cannulation (CVC) to target the deranged physiology. The placement of CVC is still challenging, which requires detailed knowledge of venous anatomy and orientation of congenital venous anomalies. Double or persistent left superio

Sudden-onset paraplegia during pregnancy caused by haemorrhage in a spinal cord haemangioblastoma: A case report

Cemile Ayse Gormeli, Kaya Sarac, Zeynep Maras Ozdemir, Gokay Gormeli, Aysegul Sagir Kahraman, Bayram Kahraman, Mustafa Namik Oztanir, Nese Karadag.

Spinal cord haemangioblastomas are rare central nervous systems tumours, and haemorrhage.It is an uncommon occurance.
We report a 28-year-old pregnant patient who presented with paraplegia due to acute haemorrhage of a spinal haemangioblastoma. Magnetic resonance imaging showed extensive s

Reattachment of a partially amputated ear without microsurgery

Nazim Bozan, Yunus Feyyat Sakin, Ferhat Bozkus, Mehmet Ali Ciftci.

Traumatic ear amputations are relatively rare. Whenever possible, ear re-implantation should be attempted; however the choice of the surgical procedure must be judicious. In the current report, a case of complete non-microsurgical salvage of a partially amputated ear treated by the pocket techniq

Student's Corner >>

Infantile metachromatic leukodystrophy in an 18 month old girl

Muhammad Saad Ali Mallick, Ansab Godil, Akash Khetpal, Ather Hasan Rizvi, Fahad Khan.

Metachromatic leukodystrophy is a rarely occurring neurodegenerative metabolic disorder with an incidence of 1-9 individuals out of 1,000,000. We present a similar case in an eighteen month old child which was extremely challenging to diagnose. Clinical symptoms suggested motor regression and dev

Letter to the Editor >>

Sports-related concussion awareness in Pakistan

Mohammad Nadir Haider.

Concussions are mild traumatic brain injuries (mTBI) which cause short-lived neurological impairments that can develop immediately or over several hours and can produce functional cognitive, emotional and autonomic symptoms rather than a structural injury. They can cause significant impact on edu

Case Series >>

The different cutaneous presentations in three cases of Kawasaki disease as confounding factor of diagnosis

Aysegul Dogan Demir, Nilufer Goknar, Selcuk Uzuner, Aysel Vehapoglu, Turkay Saritas, Faruk Oktem.

We report three paediatric cases of Kawasaki disease (KD). Erythema multiforme (EM) was the presenting cutaneous feature in two patients, with young age (43 days old), macular rash and meningitis in the third patient. Diagnosis of KD was difficult due either to initial misdiagnosis of drug erupti

Recent Advances In Endocrinology >>

Recent advance in lipid management: Focus on PCSK9I (Proprotein Convertase Subtilisin/ Kexin 9 Inhibitors)

Sanjay Kalra.

This review discusses recent advances in lipid management, focusing on a new class of drugs known as pcsk9i (proprotein convertase subtilisin/ kexin 9 inhibitors. It describes the basic and clinical pharmacology of these drugs.
Keywords: Aliorcumab, Bocicizumab, Evolcumab, LDL chole

Primary Care Diabetes >>

Diabetic tuberculosis

Sanjay Kalra, Atulya Atreja.

Diabetes and tuberculosis coexist together, and influence each other\'s natural history and treatment outcomes significantly. This assumes clinical as well as public health significance. This article describes these associations, and discusses action that can be taken at the primary care level

Innovation >>

Innovation in ethics and professionalism course: Early experience with portfolio-workbook

Muhammad Shahid Shamim, Nadeem Alam Zubairi, Mohamad Hesham Sayed, Zohair Jamil Gazzaz.

Objective: To analyse students\' perception regarding the use of portfolio-workbook in ethics course.
Methods: This mixed method study was conducted at the King Abdulaziz University, Jeddah, Saudi Arabia, in 2014, and comprised fourth-year medical students. The "portfo

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