Issue Vol:64, No:11 November, 2014


Non communicable diseases in Pakistan: Burden, challenges and way forward for health care authorities
Mohammad Wasay, Shehla Zaidi, Maria Khan, Rashid Jooma,

Pakistan will be celebrating its 67th year of independence this year. As the country undergoes economic development, the changing lifestyles have resulted in a transition in the health profile of the population. According to World Health Organization (WHO) under 5 year mortality is 86 per 1000 li....

Original Articles

Nutritional assessment of adolescent girls living in Cherah Union Council
Fariha Fatima, Asad Hafeez, Asifa Yaqoob,

Objective: To assess the nutritional status of adolescent girls living in the Cherah union council, Islamabad and to determine the association between dietary intake and iron deficiency anaemia.
Methods: It was a cross sectional survey conducted in union council Cherah of Isl....

Body Mass Index or body fat! Which is a better obesity scale for Pakistani population?
Syeda Sadia Fatima, Rehana Rehman, Bushra Chaudhry,

Objective: To compare two methods of classifying obesity based on body mass index and body fat percentage.
Methods: The cross-sectional study was conducted from November 2012 to August 2013 at Jinnah Postgraduate Medical Centre, Karachi.
Male and female volunteers between the....

Vitamin D and cardiometabolic risk factors in adult non-diabetic offspring of type 2 diabetic parents
Mudassar Ali Roomi, Khalid Parvez Lone, Ansa Madassar,

Objective: To measure serum vitamin D levels and assess its correlation with the various components of metabolic syndrome in adult non-diabetic offsprings of type 2 diabetics.
Methods: The analytical cross-sectional study was conducted from February to December 2012 at the De....

Test anxiety levels and related factors: students preparing for university exams
Ayse Sonay Kurt, Serap Balci, Dilek Kose,

Objective: To assess test anxiety levels and related factors among students preparing for university exams.
Methods: The descriptive, cross-sectional study was conducted at Istanbul University, Turkey, and comprised students preparing for exams in two private courses for the ....

Outcomes of Splenectomy for Idiopathic Thrombocytopenic Purpura in adults: A Developing Country Perspective
Amyn Pardhan, Aamir Hameed, Hasnain Zafar, Samia Mazahir, Ghulam Murtaza,

Objective: to determine the outcome of splenectomy done in adult patients of Idiopathic Thrombocytopenic Purpura over a period of 10 years and, secondarily, to determine the predictors of complete response to therapy.
Methods: The retrospective review comprised of adult patie....

Students' perceptions of educational environment of a private medical school in Pakistan
Iram Khursheed, Lubna Baig,

Objectives: To measure the students' perceptions of educational environment of a medical school, to compare the perceptions of high, average and low academic achievers, and to explore the relation between these perceptions and their academic achievements in order to identify specific prob....

Diametral tensile strength of two dental composites when immersed in ethanol, distilled water and artificial saliva
Abdur Rehman, Faiza Amin, Muhammad Abbas,

Objective: To examine the effect of distilled water, artificial saliva and ethanol on the tensile strength of direct tooth-coloured restorative material.
Methods: The study was conducted at Dr. Ishrat ul Ebad Khan Institute of Oral Health Sciences, Dow ....

Carbohydrate (CHO), protein and fat intake of healthy Pakistani school children in a 24 hour period
Sina Aziz, Kehkashan Hosain,

Objective: To determine the frequency pattern of CHO, protein and fat intake in 24 hours by Pakistani school children of different socioeconomic and cultural backgrounds) 6 to 16 years of age.
Methods: The cross-sectional study was a multistage stratified sampling, done in a ....

Radical surgical management of periampullary duodenal adenocarcinoma: A single institution experience
Abu Bakar Hafeez Bhatti, Muhammad Aasim Yosuf, Aamir Ali Syed,

Objective: To share a single-centre experience with radical resection of adenocarcinoma of the second part of duodenum.
Methods: The retrospective review was conducted at Shaukat Khanum Memorial Cancer Hospital, Lahore, and comprised data of patients who underwent pancreatico....

Wound healing in rat skin subjected to loud noise stress; a light microscopic study
Aisha Rafi, Muhammad Yunus Khan, Liaqat Ali Minhas,

Objective: To determine the effect of loud noise stress on wound healing in a skin tissue.
Methods: The randomised control trial was conducted at the Department of Anatomy, College of Physicians and Surgeons Pakistan Regional Centre, Islamabad, from September 2007 to Septembe....

Modified Limberg’s flap versus primary closure for treatment of pilonidal sinus disease: A comparative study
Faisal Shabbir, Mahmood Ayyaz, Muhammad Waris Farooka, Asad Ali Toor, Hassan Sarwar, Awais Amjad Malik,

Objectives: To compare the outcome of Rhomboid excision and Modified Limberg's flap closure with excision and primary closure for the treatment of Sacrococcygeal Pilonidal sinus.
Methods: The study was conducted at the Surgical Department of Mayo Hospital, Lahore, from 2009 ....

Vitamin D levels in children diagnosed with acute otitis media
Atilla Cayir, Mehmet Ibrahim Turan, Ozalkan Ozkan, Yasemin Cayir,

Objective: To investigate the relationship between Vitamin D deficiency and acute otitis media infection.
Methods: The randomised, single-blind, case-control study was conducted at the Paediatric Department of Ataturk University, Erzurum, Turkey, from January to April 2010. I....

Treatment of ganglions; a five year experience
Ansar Latif, Anila Ansar, Muhammad Qasim Butt,

Objective: To evaluate and determine the effectiveness of surgical excision, aspiration and injection in the treatment of symptomatic ganglions.
Methods: The prospective randomized control trial based on non-probability convenience sampling was conducted at the Department of ....

Foetal central nervous system anomalies: Frequency and foeto-maternal outcome
Nuzhat Amer, Muhammad Amer, Mohamed Kolkailah, Magdy Al-Dumairy,

Objective: To assess the frequency and outcome in pregnant females suspected to have foetal central nervous system anomalies on the basis of ultrasonography.
Methods: The retrospective study was conducted at the Department of Obstetrics and Gynaecology, Armed Forces Hospital,....

Psychological problems among women with infertility problem: A comparative study
Bibi Nooreen Begum, Shazia Hasan,

Objective: To explore the difference between anxiety and depression among infertile and fertile women.
Methods: The study was conducted in 2009 and comprised fertile and infertile women. The sample of infertile women was drawn from the Liaquat National Hospital, Patel Hospita....

Clinical course and outcome of acute severe asthma (status asthmaticus) in adults
Ali Khawaja, Hira Shahzad, Murtaza Kazmi, Ali Bin Sarwar Zubairi,

Objective: To evaluate the clinical course and outcomes in patients with acute severe asthma in a tertiary care setting.
Methods: The retrospective cross-sectional study was conducted at the Aga Khan University Hospital, Karachi, and comprised data of patients of age 16 and a....

Comparison of hypoglycaemia episodes in people with type-2 diabetes fasting in Ramazan, treated with vildaglipton or sulphonylurea: Results of the Pakistani cohort of the VIRTUE study
Saeed Ahmed Mahar, Mohammad Imtiaz Hasan, Mohammad Imran Hasan Khan, Asher Fawwad, Shakir Hussain, Neeta Maheshwary, Kishore Kumar, Ahson Siddiqi, Muhammad Athar Khan,

Objective: To assess the effect of vildagliptin  in comparison to sulphonylurea (SU) on hypoglycaemia in Muslim patients with type 2 diabetes mellitus fasting during Ramadan.
Methods: VIRTUE was a multicenter, prospective, observational study, which enrolled 244 patients....

Short Communication

Effect of late vs early clamping of the umbilical cord (on haemoglobin level) in full-term neonates
Hassan Mahmoodi Nesheli, Seddigheh Esmailzadeh, Mohsen Haghshenas, Ali Bijani, Tahereh Galini Moghaddam,

Sixty term infants delivered vaginally were assigned randomly to one of the two management groups; early cord clamping (ECC) or delayed cord clamping (DCC). Six months after delivery, the children in both groups were called back for follow-up. Blood samples were obtained for measuring haemoglobin....

Prevalence, correlates, and changes in tobacco use between 2006 and 2010 among 13-15 year Moroccan school attending adolescents
Masood Ali Shaikh,

Tobacco use is a preventable cause of disease and death globally. Adolescents using tobacco tend to continue its use in adulthood. Analysis of data from Moroccan Global School-based Student Health Surveys for 2006 and 2010 showed statistically significant differences in prevalence of current ciga....

Case Reports

Is it safe to be calcified? Porcelain gallbladder perforation and review of literature
Selcuk Coskun, Lutfi Soylu, Isa Kilicaslan, Fuat Atalay,

Calcification of the gallbladder wall (porcelain gallbladder) is an intense structure and uncommon manifestation seen in chronic cholecystitis and resulting from chronic inflammation of the gallbladder wall. Patients with porcelain gallbladder are usually considered not at risk of acute cholecyst....

A rare case of Palizaeus Merzbacher Disease in a female patient diagnosed radiologically
Naseebullah, Maimoona Siddiqui, Sadia Saeed, Yousuf Chaudary,

Pelizaeus Merzbacher's Disease is an inherited X-linked recessive trait. Males have the disease, while females are usually carriers. We report the case of a 6-years-old girl who had nystagmus since birth and later on developed head nodding. She started talking at one year and walking at 18 month....

Eagle syndrome; radiological evaluation and management
Ahmed Kamal, Rashed Nazir, Muhammad Usman, Badar-us- Salam, Farah Sana,

Eagle syndrome is a rare condition where elongated temporal styloid processes, or calcified stylohyoid ligaments, are in conflict with the adjacent anatomical structures giving rise to a complex range of symptoms including otalgia, dysphagia, foreign body sensation in throat, pain along carotid a....

Accidental intrathecal administration of high dose Diamorphine
Muhammad Faisal Jafar, Priyakam Chowdhry,

A case of accidental administration of high dose intrathecal diamorphine is reported in a patient who underwent total knee replacement. Initially a regional technique was planned for this patient, but due to inadvertent administration of three milligrams of diamorphine intrathecally, it was decid....

Giant Nasolabial Cyst
Saime Guzelsoy Sagiroglu, Selma Ates Guler,

Nasolabial (nasoalveolar) cysts are nonodontogenic soft tissue lesions derived from epithelial remanant of the nasolacrimal duct. These are generally slow-growing painless lesions. Additionally, they can cause obstruction, facial deformity and pain. This case report evaluates the facial deformity....

Palatal perforation, the most rarely observed complication after deviated septum surgery
Ali BalOnur Gokdemir, Ali Bal,

Numerous complications after septoplasty have been identified in the literature. Blindness and palatal perforation are among the rarest complications. The palatal perforation experienced by the presented patient was because he was not thoroughly examined before surgery. Secondly, we wanted to emp....

Student's Corner

Assessment of knowledge about childhood autism among medical students from private and public universities in Karachi
Farah Shaukat, Ambreen Fatima, Nosheen Zehra, Mohammed Amirali Ghulam Hussein, Ozair Ismail,

Objective: To Assess the knowledge about childhood autism among fourth year medical students in public and private medical universities of a metropolitan city.
Methods: The cross-sectional descriptive study was conducted in Karachi from January to August 2012. Two medical uni....

A day experience at Research Methodology Workshop held by PAME
Mehwish Farrukh, Aiyesha Nasir,

Madam, through your esteemed journal we would like to share our experience of the workshop on Research Methodology and Writing conducted by Pakistan Association of Medical Editors (PAME) in collaboration with Eastern Mediterranean Association of Medical Editors (EMAME). We attended this one full ....

Learning Research

Plagiarism detection softwares: Useful tools for medical writers and editors
Farooq Azam Rathore, Fareeha Farooq,

In 2010, Pakistan ranked 43rd in the world in the scientific publications and it is expected that Pakistan will rise to the 27th place by 2018.1 Nowadays medical writing is no more an optional activity for the undergraduate medical students, residents and faculty members. S....

Recent Advances In Endocrinology

Quaternary prevention and diabetes
Sanjay Kalra, Aswathy Sreedevi, AG Unnikrishnan,

Sixtyeight year old man, a farmer by profession, with diabetes for the past 10 years, experienced chest pain, and was referred to a cardiology centre in the city, after the family physician diagnosed coronary artery disease. The cardiologist suggested a coronary artery bypass graft (CABG), an exp....

Evidence Based Medicine Review

Association of hypertension with stroke recurrence may depend on ischaemic stroke subtype
Quratulain Nauman Shaikh, Adeel Ali Memon, Ayeesha Kamran Kamal,

Why is this study Important?
Although well recognized as the major risk factor for Ischaemic strokes (IS), hypertension (HTN) has not been well considered as a risk factor for recurrence of ischaemic stroke. This study intended to discover whether HTN contributes to the recurrence o....

News & Events


Sindh Institute of Urology and Transplantation (SIUT), Karachi will celebrate 40 years of its services by holding an International Symposium on Recent Advances in Urology, Nephrology, GI Hepatology, Paediatrics, Transplantation & Bioethics from 8th to 12th December, 2015.Social and economic aspects of health care especially in a developing country will also be included.
Important Dates: Last date for Abstract submission:31st July 2015
Last Date for early registration: 30. September, 2015




  • ladies petite sale
  • porn pics of katie price
  • anal cheap sex toy
  • watch free fuck videos online
  • post my home porn videos online
  • balck berry pussy pics online
  • pictures of halloween costumes for couples
  • classic porn videos for sale
  • naked women videos online
  • online videos dudes using anal toys
  • black farmgirl porn
  • watch movies online free legally blonde
  • cheap teen girls
  • mature woman sex buy
  • online videos teen porn
  • dr chua sex video online malaysia
  • naked girl movie free online
  • glamourshow dreamgirls foxes babes
  • free online young porn video
  • extreme youmg girls sex videos
  • video
  • free porn videos for i online
  • erotic lesbian love online
  • little girl porn online videos
  • free full lenght sex movies online
  • stream online celebrity sex videos
  • discount pleated petite skirts
  • bare little pussy mmmg
  • Teens sex online
  • video
  • online sex movies with storyline
  • sexy mature videos online
  • video
  • video
  • shemale lesbians online videos
  • video
  • lesbian sex online videos
  • video
  • fuck team five videos online
  • free black online lesbian scenes
  • video
  • video
  • bully movie sex scenes online
  • costume porn videos
  • free online teen blowjob vids
  • free online pictures of erotic mesages
  • sexy costumes topless
  • video
  • free classic vintage porn online video
  • young fuck buy
  • sexiest bubble butts online
  • sex online with naked teenage girls
  • video
  • petite whole sale clothing
  • salena gomez bikini pics
  • sexy babes online
  • freeonline family porn movies
  • free online porn vids flash player
  • video
  • teen girls in costumes
  • porn moviesfor sale
  • free online black booty porn movies
  • free teen japanese porn online
  • free online teen porn videos
  • video
  • free online big cock sex videos
  • free online pakistan fuck videos
  • free teen porn videos online
  • free online webcam girls
  • buy bi sex gang bang
  • video
  • free mature moms cowgirl position online
  • sell naked pictures online
  • video
  • free online porn video search engine
  • free online teen porn videos
  • free online simpson porn videos
  • naked costumes for girls
  • free online s with naked teens
  • free online sex vidoe gang bang
  • borderline personality disorder amateur wife
  • sexy girls in costumes
  • discount davids bridal flower girl dresses
  • video
  • la petite merveille durbuy fotos
  • free pregnant sex videos online
  • sidney caprice adult porn star anal
  • girl has sex with sale horn
  • hot ebony videos online
  • hot sex videos online
  • sue price sex movies
  • sexy halloween couples costumes
  • free online black anime porn
  • boobs sex online
  • free online xxx porn
  • american beauty video discount
  • borderlands porn pictures
  • asian shemale videos online girls
  • young black girls fuckinmg
  • sexy girls costume sex
  • video
  • free online porn black mature white
  • disorder young girls love older men
  • video
  • video
  • black out party winstonsalem
  • ethnic costumes pictures
  • free online xxx anal videos
  • costa careyes party sexy girls
  • sexy xxx teens online
  • husband buys wife a fuck present
  • video
  • vampire costumes for girl teens
  • free porn online black cocks
  • video
  • naked online vids
  • online naked female sex
  • sexy little girls costumes
  • video
  • watch victor mature movies online free
  • live black sex online
  • womens petite discount designer clothing
  • fake tits online video
  • teen online webcam rooms
  • free online huge tits sex videos
  • amateur sex video online
  • sexy weather girl online
  • video
  • free online asian teen sex
  • free movies online tits
  • video
  • download online porn movies
  • watch black love movies online freee
  • online free desi sex movies
  • watch porn movie taboo online
  • sleep sex video free online
  • salesman forces wife to fuck him
  • what are teen girls buying
  • sexy adult superhero costumes naked
  • free online teen titan porn videos
  • online woman orgasm videos
  • video
  • amateur video my japanese wife cumminmg
  • amateur sex online
  • free girl pics online
  • video
  • Indian sex online movie
  • video
  • online pictures of s butts
  • video
  • video
  • erotic lesbian online stories
  • womens petite suits on sale
  • sexy cigarette girl costume
  • reality bites moulin rouge girls online
  • club online girls naked
  • free watch movies online porn
  • free online anime porn tube movies
  • wholesale girls party dresses
  • lesbian online sex videos
  • katie price amateur video
  • black ebony singles online
  • free online adult porn video
  • buy young boys dvd xxx
  • professional tv lesbians movie online sex
  • free online asian pussy
  • Indian sex movies online
  • mail order asian girls
  • black pornstar worn panties for sale
  • streaming online ebony porn
  • asian teen ass mgp
  • online movie babes in toyland
  • girls party dress discount
  • free softcore adult movies online
  • video
  • orgasm free online video
  • video on girls fingering themselves online
  • video
  • porn pictures of hallow ween costumes
  • Sex and the city movie online
  • get free pussy online
  • video
  • video
  • Hot online sex videos
  • not another teen movie online free
  • facial videos online
  • balck berry pussy pics online
  • video
  • Girls having sex online
  • watch freeonline teen sex movies
  • video of sex online
  • free ass to mouth online video
  • online sex with wife
  • youmg girls threesome
  • sex sale video
  • full online porn movie
  • video
  • find fuck buy with pics
  • caprice sex videos
  • blueyedcass free online pussy pics
  • Megyn price naked pics
  • video
  • free online erotic videos for couples
  • black girl online forum
  • couples sharing online adult videos
  • costa rican anal videos
  • free porn video online cumshot
  • anal fetish videos for sale
  • teen costume fetish fuck
  • tiffany price porn videos
  • nina mercedez sex videos online
  • hustler xxx fuck buy
  • teen girl pirate halloween costumes
  • free online young porn movies
  • video
  • free online sex videos porn
  • black friday sale sex toys
  • hot girls strippimg naked
  • japanese school girl uniform wholesale
  • video
  • best mature babes porn online free
  • online videos family sex
  • discount pagnent dresses for young girls
  • full length porn movies streaming online
  • free online amateur hardcore porn
  • british porn vids free online
  • video
  • teens kissing videos online
  • hardcore movies online
  • sexy adult couples costume
  • free indian muslimgirls pussy
  • kiie porn video sales
  • little girl singing dreamgirls asian
  • big wet black tits free online
  • free online couples sex videos
  • Lesbian sex online video
  • cool teenage girl clothes cheap
  • live ebony sex online
  • video
  • online free amateur sex photos
  • free online videos sex fucking
  • black megapixel digital video camcorder
  • video
  • free safe comics erotic sexy online
  • teen girls and reactive attachment disorder
  • kate beckinsale sex movies from underground
  • facial videos online
  • video
  • find fuck buy with pics
  • free online videos of sex
  • black shemale cams free online
  • video
  • amateur sexy halloween costume pictures
  • cost of la petite academy
  • video
  • best halloween costume girl sexy
  • online mature sex
  • video
  • video
  • watch nude pussy online
  • hot teen porn videos online
  • large object in pussy free online
  • online asian sex videos
  • free online cum inside porn movies
  • free online erotic movies video
  • katie price jordan sex video
  • video
  • truly amateur sex videos online
  • teen costume pussy
  • free online sex videos foot fucking
  • video
  • sex storie video online
  • video
  • watch mastasia videos online boobs
  • free downloadable sex movies online free
  • youmg girls small boobs
  • youmg naked teens
  • buy black beauties c o d
  • online sex nurses video
  • ebony porn vids online
  • dinosaur babes movie for sale
  • cheap blowjob videos
  • old malayalam sex free movies online
  • girls gone wild online full video
  • free online tits porn sex homemade
  • cheap girls black silver pagent dresses
  • video
  • free online hard core porn videos
  • video
  • video
  • video
  • real teen anal long online videos
  • video
  • online porn moview
  • selen porn videos online
  • little girl singing dreamgirls asian
  • japan sex movies online
  • video girl ai online comics
  • black reigns online movies
  • watch bondage video sex online free
  • free ebony lesbian porn ass lickimg
  • young girls online
  • free online teen porn movie
  • Kate beckingsale sex scene
  • free online close up porn videos
  • video
  • sexy racer girl costume
  • cheap movies on asian drama
  • free online black cunt fucking videos
  • girls masturbate movies online free
  • erotic halloween costume pictures
  • mggg cunt pussy
  • online videos of naked girls
  • sexy magical girl watch free online
  • video
  • erotic home sex videos for sale
  • buzz bake sale young teens
  • video
  • video
  • video
  • couples sex photos art erotica online
  • online instructional videos for sex positions
  • video
  • back seat suck buy pictures
  • free online young girls sex videos
  • free online hentai sex movies
  • sleepimg porn tube videos
  • anal sex pictures online
  • kate beckinsale topless movie
  • free ass to mouth online video
  • watch free online bgrade sex movies
  • free milf porn movies online
  • asian girl full videos online
  • dasi homemade sex videos online free
  • online sex video sharing sites
  • mature hbo videos online
  • online petite clothing
  • free online porn movie missionary
  • video
  • Sex videos to watch online
  • cheap mature sex
  • free online adult porn movie
  • judge pussy pics online
  • free anal fuck films online
  • online porn movies no crap
  • free pregnant porn videos online
  • free online video sex porn
  • Japan sex movie online
  • video
  • video
  • free online vintage porn movie
  • video
  • online gp sex movies
  • vintage blonde hairy farmgirl porn
  • buy woods shemale schoolgirls torrent
  • sex change hormones online suggested pictures
  • watch shemale lesbians porn videos online
  • watch asian porn online
  • free erotic sex manga online
  • video
  • elitetvonline nipple or pussy slip
  • porn and sex free online videos
  • video
  • video
  • online video sex positions
  • watch movies in sex online
  • hardcore xxx free online porn
  • video
  • video
  • romantic couples movies online
  • hot wife videos for sale
  • watch soft porn movies online fee
  • online naked female sex
  • teen girls halloween costumes
  • free erotic sex manga online
  • video
  • video of real naked buy massage
  • video
  • video
  • video
  • high quality online free sex videos
  • little caprice video foursome
  • camgirl carmen shows tits
  • video
  • strap on anal online videos
  • video
  • video
  • asian video movies wholesaler incorperated
  • video
  • video
  • sex online moms videos
  • sexy halloween costumes for three girls
  • teach my ass online video free
  • videosale ticklish chicks
  • video
  • video
  • naked men showering movie watch online
  • free online hardcore indian fuck videos
  • free online porn mature black dick
  • video