Welcome to Journal Of Pakistan Medical Association
   Issue Vol:67, No:3 March, 2017
Editorial >>

Emerging protagonists in cancer metastasis: An oath of allegiance by platelets

Akbar Shoukat Ali, Arzoo Ajaz, Heeba Hamid.

The global burden of cancer is burgeoning at steady rate on account of genetic insults (5-10%), as well as an increasing prevalence of unhealthy and preventable lifestyle risk factors (90-95%) such as smoking, alcohol, stress and sedentary habits.1 More recent mortality dat

Original Articles >>

Assessment of knowledge and practices about breastfeeding and weaning among working and non-working mothers

Asif Khaliq, Mehak Qamar, Syed Abdullah Hussaini, Kiran Azam, Nosheen Zehra, Mujtaba Hussain, Huzaifa Ali Jaliawala.

Objective: To assess the knowledge and practices of working and non-working mothers regarding breastfeeding and weaning.
Methods: This cross-sectional study involving working and non-working mothers was conducted from May 2015 to May 2016 at different hospitals of Karachi. Da

Fistulotomy versus fistulectomy for simple fistula in ano: a retrospective cohort study

Ghulam Murtaza, Fareed Ahmed Shaikh, Tabish Chawla, Batool Urooj Rajput, Noman Shahzad, Sumaiya Ansari.

Objective: To compare fistulotomy with fistulectomy for wound healing, duration of surgery, post-operative pain, incontinence and recurrence in patients with fistula in ano.
Methods: This retrospective cohort study was conducted at the Aga Khan University Hospital, Karachi, a

Determination of attitude and knowledge of type 2 diabetic patients towards insulin therapy in Northern Cyprus

Umran Dal Yilmaz, Sule Tarhan.

Objective: To determine the attitude and knowledge of type-2 diabetics related to insulin therapy.
Methods: The descriptive cross-sectional study was conducted from January to March 2014 at the Dr. Burhan Nalbantoglu Public Hospital, Nicosia in the Turkish Republic of Norther

Comparison of oral Candida species prevalence and carriage among gutka-chewers and betel-quid chewers

Tariq Abduljabbar, Mudassir Hussain, Tariq Adnan, Fahim Vohra, Fawad Javed.

Objective: To compare prevalence and carriage of Candida species among gutka-chewers and betel-quid-chewers.
Methods: The cross-sectional case-control study was conducted between January and December, 2015 at the Oral Surgery department of Abbasi Shaheed Hospital and the Dent

Obesity and associated risk factors among students of health colleges of King Saud University, Saudi Arabia: A cross-sectional study

Elshazaly Saeed, Asaad Mohammed Assiri, Ibrahim AwadEljack, Abdullah S Aljasser, Abdulrahman Mohammed Alhuzimi, Ahmed Assad Assiri, Nasser Ali Alqahtani, Saud Amer Alshahrani, Yousif A Al-Ammar.

Objective: To determine the prevalence of obesity and associated risk factors among medical students in Saudi Arabia.
Methods: The cross-sectional study was conducted from December 2012 to March 2013 at King Saud University, Riyadh, Saudi Arabia. Using stratified sampling tec

Twin chorionicity and prospective stillbirth risk: experience at a tertiary care hospital

Shazia Masheer, Zaheena Islam, Dhanwanti Dileep, Shama Munim.

Objective: To determine the prospective risk of stillbirth, perinatal death and neonatal morbidities in twins.
Methods: This retrospective cohort study was conducted at the Aga Khan University Hospital, Karachi, and comprised cases of twin pregnancies from January 2001 to Dec

Frequency of osteopenia and associated risk factors among young female students

Rabail Rani Soomro, Syed Imran Ahmed, Muhammad Khan.

Objective: To find out the frequency of osteopenia and associated risk factors among young female students.
Methods: This observational, cross-sectional study was conducted at the Dow University of Health Sciences, Karachi, from August 2011 to January 2012, and comprised youn

Silent killers: Transfusion Transmissible Infections-TTI, among asymptomatic population of Pakistan

Muhammad Saeed, Shahida Hussain, Farhan Rasheed, Maqsood Ahmad, Mizna Arif, Muhammad Tariq Hamid Rahmani.

Objective: To analyse transfusion transmissible infections in asymptomatic population.
Methods: This study was conducted at the Allama Iqbal Medical College and Jinnah Hospital, Lahore, Pakistan, from December 2014 to November 2015, and comprised healthy asymptomatic blood do

Pattern of antimicrobial drug resistance of Salmonella Typhi and Paratyphi A in a Teaching Hospital in Islamabad

Azmat Ali, Hafiz Awais Ali, Fazal Hussain Shah, Arslan Zahid, Hina Aslam, Benazir Javed.

Objective: To see the pattern of antimicrobial drug resistance among Salmonella serovars.
Methods: This longitudinal, observational study was conducted at Khan Research Laboratories Hospital, Islamabad, Pakistan, from May 2012 to December 2014. All patients presenting with ty

Assessing decision of inpatient or outpatient care in community acquired pneumonia: APT care study

Saleem Ullah, Javaid Khan, Amanullah Khan, Irfan Hashemy.

Objective: To estimate the proportion of community-acquired pneumonia patients with disagreement between Confusion, Uraemia, Respiratory rate, Blood pressure, age > 65 years recommendation and physician\'s decision to hospitalise or not.
Methods: This cross-sectional nat

Development of Islamic Spiritual Health Scale (ISHS)

Fatemeh Khorashadizadeh, Abbas Heydari, Fatemeh Heshmati Nabavi, Seyed Reza Mazlom, Mahdi Ebrahimi, Habibollah Esmaili.

Objective: To develop and psychometrically assess spiritual health scale based on Islamic view in Iran.
Methods: The cross-sectional study was conducted at Imam Ali and Quem hospitals in Mashhad and Imam Ali and Imam Reza hospitals in Bojnurd, Iran, from 2015 to 2016 In the f

Cystoid macular oedema after phacoemulsification with and without type 2 diabetes mellitus; a hospital-based clinical prospective trial in Karachi

Abdul Haleem, Aziz-ur-Rehman, Adil Saleem, Saleh Memon, Nasir Memon, Muhammad Faisal Fahim.

Objective: To know the outcomes of cystoid macular oedema after phacoemulsification in patients with and without type 2 diabetes mellitus using optical coherence tomography.
Methods: This non-concurrent, clinical, prospective study was carried out at Al-Ibrahim Eye Hospital,

Frequency of worsening liver function in severe dengue hepatitis patients receiving paracetamol: A retrospective analysis of hospital data

Ahsan Ali Syed, Faisal Aslam, Haris Hakeem, Faraz Siddiqui, Noreen Nasir.

Objective: To determine the frequency of worsening liver function among hospital in-patients with severe dengue hepatitis receiving paracetamol.
Methods: This retrospective study was conducted at the Department of Medicine, Aga Khan University Hospital, Karachi, and comprised

Diagnostic dilemma of granulomatous inflammation in cancer patients

Azizullah Khan Dhiloo, Aun Raza, Naseem Akhtar, Waleed Zafar, Faisal Sultan.

Objectives: To determine the frequency of granulomatous inflammation on histopathological findings amongst cancer patients and correlating them with tuberculosis.
Methods: The retrospective review was conducted at Shaukat Khanum Memorial Cancer Hospital and Research Centre, L

Managerial barriers and challenges in Iran public health system: East Azerbaijan health managers' perspective

Jafar Sadegh Tabrizi, Kamal Gholipour, Mostafa Farahbakhsh, Alireza Hasanzadeh.

Objective: To investigate managerial barriers and challenges facing East Azerbaijan Province health system.
Methods: This qualitative study was conducted in Tabriz, Iran, from August 2014 to August 2015, and comprised professionals, experts and informants working at the East

Predicting dengue outbreak in the metropolitan city Lahore, Pakistan, using dengue vector indices and selected climatological variables as predictors

Ejaz Mahmood Ahmad Qureshi, Amtul Bari Tabinda, Seemal Vehra.

Objective: Dengue viruses have rapidly spread in Southeast Asia, particularly in Pakistan, during the last few years, so the present study was undertaken to formulate a model for predicting dengue outbreak.
Methodology: A panel data using STRATA statistical software was emplo

Predictive factors for pregnancy outcome following controlled ovarian stimulation and intrauterine insemination

Goncayetkin Yildirim, Lale Susan Turkgeldi, Nadiye Koroglu, Sebileguler, Mervetalmac.

Objectives: To establish predictive factors for positive pregnancy outcome in cases of controlled ovarian stimulation and intrauterine insemination.
Methods: The retrospective study was conducted at Kanuni Sultan Suleyman Training and Research Hospital and comprised subjects

Association of IL-6 C-174G (rs 1800795) single nucleotide polymorphism with type 2 diabetes mellitus in Pakistani population

Amina Nadeem, Sadaf Mumtaz, Abdul-Khaliq Naveed, Qaiser Mansoor, Muhammad Aslam, Arif Siddiqui, Muhammad Ismail.

Objective: To determine the association of interleukin-6 C-174G single nucleotide polymorphism with type 2 diabetes mellitus and metabolic parameters.
Methods: This case-control study was conducted from June 2012 to December 2013 at the Military Hospital Rawalpindi, the Centr

Assessment of the quality of life of spinal cord injury patients in Peshawar

Sayed Zulfiqar Ali Shah, Rafiullah, Syed Mohammad Ilyas.

Objective: To assess the quality of life of spinal cord injury patients.
Methods: This cross-sectional study was conducted at Paraplegic Centre Hayatabad, Peshawar, Pakistan, from November 2015 to January 2016, and comprised spinal cord injury patients. A 26-item World Health

Are we performing a lot of simple nephrectomies?

Muhammad Akmal, Zahoor Iqbal Mirza, Badar Murtaza.

Objective: To assess the frequency of simple nephrectomies for benign diseases and compare it with the frequency of nephrectomies for malignant diseases\\.
Methods: The observational study was conducted at the Armed Forces Institute of Urology, Rawalpindi, Pakistan, from Oc

Right ventricular involvement in patients with inferior myocardial infarction, correlation of electrocardiographic findings with echocardiography data

Sumbul Javed, Ali Raza Rajani, Pushparani Govindaswamy, Ghazi Ahmed Radaideh, Harb Ahmed Abubaraka, Tariq Ilyas Qureshi, Hassaan Bin Arshad.

Objective: To determine the right ventricular involvement in patients with inferior myocardial infarction by echocardiography in relation to electrocardiographic findings.
Methods: This observational, prospective study was conducted at Rashid Hospital, Dubai, the United Arab

MiR-16: A novel hereditary marker in breast cancer and their offspring

Ambreen Usmani, Amir Ali Shoro, Bushra Shirazi, Zahida Memon, Mehvish Hussain.

Objective: To analyse micro ribonucleic acid-16 in sera of invasive intraductal breast carcinoma in stage III and compare its expression in their daughters and healthy women.
Methods: The study took place from January 2013 till December 2015. This case-control study was condu

Review Articles >>

Case reports and their importance in Medical Literature

Syed Hasan Danish, Zawwar Reza, Abdul Ahad Sohail.

It is important to appreciate how case reports have paved the way for modern research. They are still largely considered the first line of evidence. Indeed global endemics such as HIV and Zika Virus have been traced back to initial case reports. Strictly speaking; case reports are anecdotes &mdas

Outcome-based approach to medical education towards academic programmes accreditation: A review article

Abdelmarouf H. Mohieldein.

The rapid change worldwide, as a consequence of advances in science and technology, necessitates the graduation of well-qualified graduates who have the appropriate knowledge and skills to fulfill specific work requirements. Hence, redesigning academic models by focusing on educational outcomes b

Short Communication >>

Influence of free drug samples on prescribing by physicians: A cross sectional survey

Samina Rafique, Waseem Sarwar, Asima Rashid, Fatima Sheerin.

Free drug samples are distributed among doctors as a promotional tool.
We investigated the effects of dispensing samples on prescriptions by the doctors and their opinion about samples through a cross-sectional survey.
A questionnaire was distributed among the doctors in the Departm

Case Reports >>

A huge Thornwaldt’s cyst causing hearing loss in an adult patient

Nazim Bozan, Yunus Feyyat Sakin, Pinar Kundi, Muzaffer Ari, Ferhat Bozkus.

Nasopharynx (NP) is anatomically difficult to explore adequately. The pharyngeal bursa (PB) is a recess lined with respiratory epithelium along the posterior wall of the nasopharynx between the longus capitis muscles. If the opening through which the bursa drains into the nasopharynx becomes obst

X-linked agammaglobulinemia - first case with Bruton tyrosine kinase mutation from Pakistan

Samreen Kulsom Zaidi, Sonia Qureshi, Farah Naz Qamar.

X-linked agammaglobulinemia (XLA) is a primary immunodeficiency with more than 600 mutations in Bruton tyrosine kinase (Bkt) gene which are responsible for early-onset agammaglobulinemia and repeated infections. Herein we present a case of a 3-year-old boy with history of repeated diarrhoea and a

Cubital tunnel syndrome secondary to gouty tophi: A case report

Hatice Resorlu, Coskun Zateri, Ayla Akbal, Ferhat Gokmen, Gurhan Adam, Serhad Bilim, Emre Bozkurt.

Gout is a chronic rheumatic disease resulting from accumulation of monosodium urate crystals in tissues. The most important risk factor for the disease is hyperuricaemia. Precipitation of uric acid in the joint in the form of monosodium urate crystals is the main factor responsible for triggering

Tonsillar solitary fibrous tumour: A interesting rare case

Gulay Bulut, Remzi Erten, Ayse Oter Almali, Mehmet Deniz Bulut, Irfan Bayram.

A solitary fibrous tumour (SFT) is a rare mesenchymal tumour that frequently originates in the mesothelium-covered surfaces, such as the pleura and peritoneum. It may develop in various body parts, including the head and neck. These tumours may arise in several different patterns, which results i

Student's Corner >>

Loop-mediated isothermal amplification (TB-lamp): a step forward in the diagnosis of tuberculosis?

Hanieya Saiyed, Sarosh Fatima.

Madam, Tuberculosis (TB), caused by Mycobacterium Tuberculosis, is still a social stigma yet a curable disease in most instances. It can affect multiple organs of the body other than lungs.1 TB remains the leading cause of death, alongside HIV, among infectious diseases wit

Viral haemorrhagic fever: A case of systematic neglect

Zafir Zohab Hussain Khan, Sayed Mustafa Mahmood Shah.

Madam, Crimean Congo Haemorrhagic Fever (CCHF) is a disease that has afflicted the populace of many a developing nation.1 CCHF is a zoonotic, tick borne and viral infection caused by Nairovirus of the Bunyaviridae family; the most genetically diverse form of Arbovirus which

Letter to the Editor >>

Skeletons in the closet…. Apprehensions of a histopathologist

Asim Qureshi.

Anatomical pathology is one branch of medical science where the signed out report becomes a legal document whether you like it or not. The signing out pathologist has nightmares on any difficult or challenging case even months after it has been signed out.
There a few institutions in the c

Establishment of site specific multi-disciplinary tumour boards in Pakistan: Sharing experience of neuro oncology team based at a tertiary care university hospital

Muhammad Waqas, Ahmed Nadeem Abbasi.

Madam, site specific multi-disciplinary tumour (MDT) board meetings provide a platform to various specialists involved in patient care to exchange ideas and discuss various aspects of management of oncology patients. Several studies have demonstrated that MDT meetings improve clinical outcomes of

Challenges of conducting animal based research and teaching in medical colleges of Karachi, Pakistan

Muhammad Ulusyar Khan, Faiq Amin, Fazal Manzoor Arain.

Madam, poor living conditions, such as chronic food and water deprivation and uncontrolled temperature, humidity and light/dark cycle significantly alters the results of animal based studies because they result in increased stress response, altered circadian rhythm and modulation of endocrine sys

Islamic studies and bioethics: Does the curriculum need revision?

Aamir Raoof Memon.

Madam, the curriculum for Bachelor of Medicine and Bachelor of Surgery (MBBS), Doctor of Physical Therapy (DPT), Doctor of Pharmacy (D.Pharm) and Bachelor of Nursing (BSN), has "Islamic Studies" as a compulsory subject in all the health sciences institutions of Pakistan.1-4&l

Special Communication >>

Students’ perceptions of usefulness of Anatomy demonstrations in traditional and hybrid undergraduate medical education curricula

Ayesha Saba Naz, Rehana Rehman, Zehra Jamil, Khalid Ahmed, Ambreen Surti.

A cross-sectional study was carried out to study students\' perceptions on the usefulness of Anatomy demonstrations (AD) in the undergraduate medical education by comparing the Conventional Medical College (CMC) and problem-based learning as hybrid curriculum (HMC). Purposive sampling technique

Recent Advances In Endocrinology >>

Diabetes mellitus in the context of blood transfusion

Nilotpal Chowdhury.

Diabetes mellitus is one of the commonest medical conditions affecting humans. However, knowledge of diabetes mellitus in the context of blood transfusion is lacking. In this article, the eligibility of people with diabetes as donors, issues faced during blood component transfusion to diabetics a

Primary Care Diabetes >>

Contraception in women with diabetes

Bharti Kalra, Sanjay Kalra.

This brief article covers the diabetes related aspects of contraception in women. It classifies various methods of contraception and describes how presence of diabetes influences their use. The article lists the high risk conditions in diabetes which may discourage use of combined hormonal contra


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