Issue Vol:65, No:1 January, 2015

From the Editor's Desk
Fatema Jawad Editor-in-chief

The sun rises on a new year morning bringing hopes and aspirations for achieving even more success in research and its publication in our country, in order to keep pace with the rest of the world.If we look back on the last year, we have had a larger number of submissions from within the country, but the standard desires much more. Our researchers find it easier to take up a questionnaire and fill it and end up with a descriptive survey. Retrospective studies are also being done as they are more convenient. Prospective, case controlled studies are in a smaller volume as they are costly, take longer and demand more expertise. But the hope is always there for improvement and more ethical research.


Medical research and science culture in Pakistan
Fatema Jawad,

"The grass looks greener on the other side of the fence", is a proverb true to its roots. People think that they would be better placed in a different set of circumstances. This is what we are experiencing with our young medical graduates who have an ultimate goal of migrating to USA. M....

Original Articles

Clinical predictors of mortality in hospitalized patients with infective endocarditis at a tertiary care center in Pakistan
Sadia Arshad, Safia Awan, Syedah Saira Bokhari, Muhammad Tariq,

Objective: To evaluate the clinical characteristics and predictors of in-hospital mortality in patients with infective endocarditis at a tertiary care centre in Pakistan.
Methods: The cross-sectional study was conducted at the Aga Khan University Hospital, Karachi, from Janua....

Dermatological evaluation of counter irritant potential of Human urine in rabbits
Imran Ahmad Khan, Abdul Aziz, Shaukat Hussain Munawar, Zahid Manzoor, Muhammad Asif Raza,

Objective: To confirm the effect of human urine in the treatment of wounds, burns and irritation.
Methods: The study was conducted at Bahauddin Zakariya University, Multan, in November 2013 and comprised 15 rabbits of either gender. Irritation was induced by clockwise frictio....

Multi-Drug Resistant Pseudomonas Aeruginosa: A threat of nosocomial infections in tertiary care hospitals
Zaheer Ali, Nusrat Mumtaz, Sehar Afshan Naz, Nusrat Jabeen, Maryam Shafique,

Objective: To determine the resistance patterns of Pseudomonas aeruginosa to currently available anti-pseudomonal drugs and frequency of nosocomial infections caused by multi drug resistant Pseudomonas aeruginosa in hospitals.
Methods: Clinical isolates of Pseudomonas aerugin....

Knowledge, attitude and practices regarding respiratory symptoms among textile workers of Karachi, Pakistan: a cross-sectional survey
Aneeta Khoso, Asaad Ahmed Nafees,

Objectives: To determine the prevalence and predictors of good knowledge, appropriate attitude and appropriate protective practices regarding respiratory symptoms among textile workers, and to determine the association of knowledge, attitude and practices with respiratory symptoms.

Student's perceptions of educational environment across multiple undergraduate medical institutions in Pakistan using DREEM inventory
Nazish Imran, Faiza Khalid, Imran Ijaz Haider, Masood Jawaid, Muhammad Irfan, Asmah Mahmood, Muhammad Ijlal Haider, Sami-ud-din,

Objective: To objectively assess whether the medical education environment across Pakistan was at an acceptable standard and to determine factors influencing its perception.
Methods: The cross-sectional study was conducted from August to November 2012 at six undergraduate med....

Comparison of placebo and intrauterine lidocaine with/or without rectal diclofenac sodium suppositories used in office endometrial biopsy
Cengiz Kaya, Elif Bengi Sener, Ersin Koksal, Yasemin Burcu Ustun, Handan Celik, Ali Haydar Sahinoglu,

Objective: To compare the effects of intrauterine lidocaine, intrauterine lidocaine plus rectal diclofenac, and a placebo on analgesia and to determine the satisfaction of patients and surgeons in cases of endometrial biopsy.
Methods: The double-blind, randomised, placebo-con....

The role of Positron Emission Tomography in mediastinal staging of patients with non-small cell lung cancer
Andrea d Amico, Maria Turska-d Amico, Barbara Jarzab, Marcin Zielinski,

Objective: To examine the diagnostic accuracy of positron emission tomography/computed tomography in evaluating the mediastinum of patients with non-small cell lung cancer compared to histopathology results.
Methods: The prospective study was conducted at the Department of Th....

Effect of smoking on serum xanthine oxidase and malondialdehyde levels in patients with acute myocardial infarction
Muhammad Atif Ata, Fatehuddin Khand, Shumaila Shabbir Shaikh, Muhammad Adeel Ata,

Objective: To evaluate the effect of smoking on blood levels of xanthine oxidase and malondialdehyde in acute myocardial infarction patients.
Methods: The cross-sectional study was conducted from June to November 2013 and comprised myocardial infarction in-patients at Liaquat....

Effect of phoenix dactyliferia (date palm) pit powder on nicotine induced spermatotoxicty in adult albino mice
Kanwal Saeed, Mohammad Tahir, Khalid Pervez Lone,

Objective: To study the effect of Phoenix Dactyliferia pit powder on nicotine-induced spermatotoxicty in adult albino mice.
Methods: The study was conducted at the University of Health Sciences, Lahore, from February to November 2012, and comprised adult male albino mice aged....

Role of Interleukin-I b in conception after intracytoplasmic sperm injection
Rehana Rehman, Shireen Jawed, Syed Faisal Zaidi, Mukhtiar Baig, Kanwal Ahmed,

Objective: To identify the role of Interleukin-I Beta(IL- Ib) in patients undergoing intracytoplasmic sperm injection.
Methods: The quasi-experimental study was conducted at an infertility clinic in Islamabad from June 2010 to August 2011, and comprised couples opting for int....

Frequency of metabolic syndrome in psychiatric patients, is this the time to develop a standardized protocol to reduce the morbidity from an acute care psychiatry unit
Tariq Munshi, Archana Patel, Mir Nadeem Mazhar, Tariq Hassan, Emad uddin Siddiqui,

Objective: To determine the frequency of Metabolic Syndrome among psychiatric patients and to look for the correlation between the two medical conditions.
Methods: The cross-sectional study was conducted from February to April 2013 at the acute care psychiatry in-patient unit....

Evaluation of the effect of smoking on complete blood counts, serum C-reactive protein and magnesium levels in healthy adult male smokers
Fatehuddin Khand, Shumaila Shabbir Shaikh, Muhammad Atif Ata, Saeed Sattar Shaikh,

Objective: To examine the effect of smoking on complete blood count, serum C-reactive protein and magnesium levels in male smokers.
Methods: The prospective case-control study was conducted in two villages of Matiari district in rural Sindh, Pakistan, from July to December 20....

Ocular manifestation, complications and aetiological factors in Stevens-Johnson syndrome/toxic epidermal necrolysis
Shaukat Ali Chhipa, Sadia Masood, Yasir Salarzai, Qazi Assad Khan, Khabir Ahmad, Sara Sajid,

Objective: To describe the ocular manifestations of Stevens-Johnson Syndrome/Toxic Epidermal Necrosis among inpatients at a tertiary care hospital.
Methods: The retrospective observational descriptive study was carried out at the Aga Khan University Hospital, Karachi, and com....

Power doppler ultrasonography guided and random prostate biopsy in prostate cancer diagnosis - a comparative study
Shahzada Khalid Sohail, Rahat Sarfraz, Muhammad Imran, Naeem Ahmed Khan, Noshin Wasim Yusuf,

Objective: To compare the diagnostic accuracy of power Doppler-guided targeted prostate biopsy and random sextant biopsy in the diagnosis of prostate cancer.
Methods: The prospective study was carried out at the Allama Iqbal Medical College and Jinnah Hospital, Lahore, Pakist....

Prognosis of stroke in children after three months of regular physical therapy in Lahore
Sarah Khalid, Muhammad Salman Bashir, Syed Imtiaz Hussain Shah, Rabiya Noor,

Objective: To evaluate the effects and significance of Proprioceptive Neuromuscular Facilitation exercises on stroke patients.
Methods: The prospective follow-up study was conducted from January, 2012, to June, 2012, and comprised randomly-selected patients at the Department ....

Effectiveness of simple strategies in reducing multidrug resistant blood stream infections in Neonatal Intensive Care Unit of tertiary care hospital in Karachi, Pakistan
Maqbool Qadir, Farah Naz Qamar, Shahzadi Resham, Syed Rehan Ali, Ahmad Khalil, Shakeel Ahmed, Hasina Amin, Sunaina Mossani,

Objectives: To report reduction in transmission of multidrug resistant organisms from the neonatal intensive care unit after the implementation of simple risk-reduction strategies.
Methods: Using a pre-and-post design, the study was carried out from June 2010 to December 2011....

Review Articles

Botulinum-A Toxin's efficacy in the treatment of idiopathic overactive bladder
Marius Alexandru Moga, Simona Banciu, Oana Dimienescu, Nicusor-Florin Bigiu, Ioan Scarneciu,

The systematic literature review was carried out to point out the efficacy of botulinum type A toxin (BTX-A) intra-detrusor injections in adults with idiopathic overactive bladder (OAB) and urgency urinary incontinence (UUI). A PubMed search for clinical studies with BTX-A intra-detrusor injectio....

Short Reports

Rates of caesarian section and trials and success of vaginal birth after caesarean sections in secondary care hospital
Raffat Bano, Ammara Mushtaq, Mehreen Adhi, Muhammad Danish Saleem, Areeba Saif, Arsalan Siddiqui, Tahmina Parveen, Aneeqa Saif,

We planned to investigate the rates of Caesarean Section (CS), potential Vaginal Births After previous Caesarean Section (VBAC), and successful VBAC in a secondary care hospital. We conducted an analytical retrospective study at Aga Khan Hospital for Women, Karimabad, Karachi, from October 2011 t....

Short Communication

U-Turns and road safety - perspective from Karachi
Salman Zubair, Masood Ali Shaikh,

U-turn is a complex driving manoeuvre entailing 180-degree turn to change the direction of travel towards the opposite direction. A cross-sectional survey based on convenience sampling was conducted at 120 U-turns in Karachi from February to October 2013. Shopkeepers operating in the close vicini....

Case Reports

Poland's syndrome: a case report and review of literature
Malay Kumar Sur Chowdhury, Rajashish Chakrabortty, Sudipta Gope,

Poland's Syndrome is a rare congenital condition. It is classically characterised by absence of unilateral chest wall muscles and sometimes ipsilateralsymbrachydactyly (abnormally short and webbed fingers). The condition typically presents with unilateral absence of the sternal or breast bone po....

Urethral duplication: a rare cause of recurrent urinary infection
Tufan Cicek, Yalcin Kizilkan, Gokcen Coban, Murat Kosan,

Urethral duplication is quite a rare congenital anomaly with ill-defined aetiology. Patients often present with penile deformity, recurrent urinary infections, urinary incontinence, serosal discharge from the accessory urethra, and difficulty in urinating. Urethral duplication is most commonly gr....

Surviving shot through the heart: Management in two cases
Fraz Anwar Siddiqui, Jamal Kabeer, Syed Shahabuddin,

Penetrating cardiac injuries after gunshot are usually fatal and are very challenging to manage for surgeons even in fully-equipped centres. Such injuries can cause ventricular septal defect (VSD) or cardiac tamponade depending upon the distance, direction and velocity of the bullet. Stable patie....

Palmar initial lesion in pityriasisrosea
Yalcin Bas, Goknur Kalkan, Havva Yildiz Seckin,

Pityriasisrosea is a frequently encountered skin disease associated with typical erythematous-squamous lesions. Majority of the cases relate to patients between 10 and 35 years of age. In clinically typical cases, the disease appears with the initial lesion called herald patch. The initial lesion....

Secondary malignant melanoma in primary mediastinal germ cell tumour
Abdul Hannan, Noreen Akhter, Ather Saeed Kazmi, Narjis Muzaffar,

Secondary transformation in Germ Cell Tumours (GCT) is an extremely rare event. We report here a case of malignant melanoma arising in primary mediastinal GCT. A young male presented with new onset dyspnoea and a mediastinal mass. As serum alpha fetoprotein was raised, a diagnosis of primary medi....

Student's Corner

Frequency of proven risk factors for deep vein thrombosis in clinical patients: Results of a study on patients being treated at a tertiary care hospital in Rawalpindi, Pakistan

Objective: To enlist the dominant risk factors predisposing patients to deep venous thrombosis.
Methods: The prospective study was conducted in surgical and medical departments of Combined Military Hospital, Rawalpindi, and Fauji Foundation, Islamabad, from January 2012 to ....

Letter to the Editor

Writing tips for medical students/researchers following a comparative study
Mohammad Amin Mozaheb, Mahnaz Saeidi, Saeideh Ahangari,

Madam, writing, especially the writing of highly-cited research papers, is a breathtaking process which needs a lot of time and energy.  In Iran, a country of the Middle East, there are a large number of students and professors working on medical projects in an attempt to bridge more gaps in....

The decrepit state of trauma care in under-developed healthcare settings and the need to integrate trauma rehabilitation as a continuum of care
Farooq Azam Rathore, Sohail Muzammil,

Madam, we have read "The decrepit state of trauma care in under-developed healthcare settings"1 by Shah and Shah with interest.
They correctly point out the lack of adequate trauma care services in Pakistan and the urgent need to develop these services in o....

Recent Advances In Endocrinology

Sanjay Kalra, Yashdeep Gupta,

This review describes the basic and clinical pharmacology of sulfonylureas. It undertakes a balanced assessment of the advantages and limitations of sulfonylureas, and compares the use of various sulfonylureas in different clinical situations. The authors suggest pragmatic guidance to facilitate ....

Primary Care Diabetology

Screening for diabetes
Yashdeep Gupta, Sanjay Kalra,

This article discusses the rationale and method of screening for diabetes in a primary care setting. It describes guidelines laid down by international organizations, while adding pragmatic suggestions based upon reality in South Asian and other developing countries.
Keywords: Type 2 diabe....

News & Events

The DIABETES AND RAMADAN International Alliance 3rd Forum will be held in Dubai on 17th April, 2015. Important topics as Education, acute emergencies, CREED Study, Insulin in Ramadan, Incretins in Ramadan,and many more will be discussed. The Forum will provide intense learning opportunity to all participants. The International Faculty will include President, IDF and many others.

The Sixth Regional Conference on Medical Journals in the Eastern Mediterranean Region(EMMJ6) will take place from February 18-20,2015 in Shiraz,Islamic Republic of Iran.
Important dates:
Abstract Submission Deadline: January 15,2015
Abstract Acceptance Notification: January 22,2015
Registration (Conference and Workshops) Deadline: January 30,2015


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




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