Welcome to Journal Of Pakistan Medical Association
   Issue Vol:65, No:7 July, 2015
Editorial >>

Integrated care - a new buzz word in health care

Qudsia Anjum,

The advent of integrated care dates back to 1970s and 1980s where it gained popularity in the developed world. It caught attention of health care providers and became a public health concern in the 1990s. Integrated care is now a buzz word internationally; it is gaining attention with an aim to d....

Original Articles >>

The levels of trace elements and heavy metals in patients with acute migraine headache

Hayriye Gonullu, Edip Gonullu, Sevdegul Karadas, Mehmet Arslan, Orhan Kalemci, Abdurrahman Aycan, Refah Sayin, Halit Demir,

Objective: To compare the levels of trace elements and heavy metal in patients with acute migraine and healthy controls.
Methods: The prospective study was conducted at Yuzuncu Yil University, Turkey, from May to July 2013, and comprised migraine patients and an equal number ....

Difficult laparoscopic cholecystectomies. Is conversion a sensible option?

Arshad Mahmood Malik,

Objective: To assess the overall impact of conversion of laparoscopic cholecystectomy to open cholecystectomy.
Methods: The observational descriptive study was conducted at Liaquat University Hospital, Jamshoro, Pakistan, and various private hospitals in the same town by the ....

Genetic polymorphisms of hspa1b and hspa1l in infertile men

Halil Ciftci, Bulent Celepkolo, Fuat Dilmec, Mete Koksal, Ercan Yeni, Ismail Yagmur, Kemal Gumus,

Objective: To investigate the relationship between the HSP 70 genepolymorphism and primary infertility in males with normal sperm-parameters.
Methods: The case-control study was conducted in Sanliurfa, Turkey, from September 2010 to August 2011and comprised infertile males as....

Morphological study of Pipelle biopsy specimens in cases of abnormal uterine bleeding

Muhammad Tahir Khadim, Talat Zehra, Hafiz Murtuza Ashraf,

Objective: To determine the frequencies of common morphological patterns of abnormal uterine bleeding on Pipelle biopsy specimen.
Methods: The cross-sectional study was conducted at PNS Shifa Hospital, Karachi, and comprised endometrial Pipelle biopsies of patients with abnor....

Retrospective comparison of Computed Tomography Enterography and Magnetic Resonance Enterography in diagnosing small intestine disease

Gong Pei-You, Li Jun-Xia, Liu Feng-Li, Zhang Liang-Ming, Xie Hai-Zhu, Yan-Bin,

Objective: To compare the efficacy of computed tomography enterography and magnetic resonance enterography in diagnosing small intestinal diseases.
Methods: The retrospective study comparing computed tomography enterography and magnetic resonance enterography for diagnosing d....

Pattern of external injuries sustained during bomb blast attacks in Karachi, Pakistan from 2000 to 2007

Arif Anwar Surani, Salman Ali, Asif Surani, Sohaib Zahid, Akber Shoukat, Joseph Varon, Salim Surani,

Objective: To evaluate patterns of external injury resulting from bomb blasts in Karachi, and compare the injury profile resulting from explosions in open versus semi-confined blast environments.
Methods: The retrospective, cross-sectional study was conducted in Karachi and c....

Feasibility, relevance and effectiveness of teaching and assessment of ethical status and communication skills as attributes of professionalism

Abid Jameel, Sahibzada Mahmood Noor, Shahid Ayub, Sobia Sabir Ali, Yoon Soo Park, Ara Tekian,

Objective: To examine the feasibility and effectiveness of teaching and assessing professionalism in a developing country.
Methods: The pre-intervention and post-intervention study was conducted from January to August 2012 and comprised 7 workshops of three days each that wer....

Open proximal & distal fractures of tibia treated with Naseer Awais External Fixator with T-clamp

Asadullah Makhdoom, Lachman Das Maheshwari, Muhammad Ayoub Laghari, Syed Muhammad Tahir, Syed Muhammad Ali, Khaleeque Ahmed Siddiqui,

Objective: To compare the outcome of the open proximal and distal fractures of tibia treated by Nasser Awais External Fixtator with T-clamp.
Methods: The descriptive case series was conducted from August 2009 to July 2012 at Department of Orthopaedic Surgery & Traumatolog....

Pre-operative antibiotic use reduces surgical site infection

Asad Ali Toor, Muhammad Waris Farooka, Mahmood Ayyaz, Hassan Sarwar, Awais Amjad Malik, Faisal Shabbir,

Objective: To assess the efficacy of World Health Organisation Surgical Safety Checklist as a simple, reliable and effective tool to ensure appropriate administration of intravenous antibiotics.
Methods: The prospective interventional study was conducted in three phases at Ma....

Comparison of single intra operative versus an intra operative and two post operative injections of the triamcinolone after wedge excision of keloids of helix

Muhammad Mustehsan Bashir, Hazqeel Ahmad, Nadeem Yousaf, Farid Ahmad Khan,

Objective: To compare single intra-operative versus an intra-operative and two post-operative injections of triamcinolone after wedge excision of keloids of helix.
Methods: The randomised controlled trial was conducted at the King Edward Medical University, Lahore, from Janua....

An application of a theory of planned behaviour to determine the association between behavioural intentions and safe road-crossing in college students: perspective from Isfahan, Iran

Mohsen Jalilian, Firoozeh Mostafavi, Behzad Mahaki, Ali Delpisheh, Gholamreza Sharifi Rad,

Objective: To identify the determinants of behavioural intention towards safe road-crossing among college students.
Methods: The cross-sectional study was conducted in 2013-14 and comprised students of Isfahan University of Medical Sciences, Isfahan, Iran. A self-administrate....

Evaluation of Hormone Receptor Status (ER/PR/HER2-neu) in Breast Cancer in Pakistan

Fahad Pervaiz, Sahrish Rehmani, Sana Majid, Hina Anwar,

Objective: To evaluate the biological markers that are commonly assessed in breast cancer to estimate a patient's response to endocrine therapy and their prognosis for better clinical outcomes.
Methods: The retrospective study was conducted at Bahawalpur Institute of Nuclear....

Factors associated with stress among medical students

Khadija Qamar, Najamus Saqib Khan, Muhammad Rizwan Bashir Kiani,

Objective: To determine the probable factors responsible for stress among undergraduate medical students.
Methods: The qualitative descriptive study was conducted at a public-sector medical college in Islamabad, Pakistan, from January to April 2014. Self-administered open-end....

Development and validation of a semi-quantitative food frequency questionnaire to assess dietary intake in Turkish adults

Fatma Esra Gunes, Nese Imeryuz, Arzu Akalin, Burcu Calik, Nural Bekiroglu, Emel Alphan, Aytekin Oguz, Mahshid Dehghan,

Objectives: To validate the original food frequency questionnaire in Turkish adult population.
Methods: The cross-sectional study was conducted in June and December 2008 and 2009, and comprised adults of either gender aged 30-70 years. All subjects were Caucasians and were na....

Difficulties experienced by caregivers of patients diagnosed with osteogenesisimperfecta (OI): example of a hospital

Leyla Baysan Arabaci, Sati Bozkurt, Senay Vara, Samim Ozen, Sukran Darcan, Damla Goksen Simsek,

Objective: To identify the difficulties experienced by medical caregivers of inpatients diagnosed with osteogenesisimperfecta.
Methods: The descriptive, cross-sectional study was conducted at a university hospital in western Turkey from April to May, 2012, and comprised relat....

Review Articles >>

Review and analysis of quality healthcare system enhancement in developing countries

Zohra Kurji, Zahra Shaheen Premani, Yasmin Mithani,

Quality has multidimensional perspectives. It is a continuous and dynamic process. A systematic search of national and international literature was conducted from peer-reviewed databases MEDLINE, CINAHL and PubMed during January to July 2012. There are many frameworks to assess and measure qualit....

Short Communication >>

Correlations between stress hormone levels in umbilical cord blood and duration of delivery

Yoko Sano, Takayuki Doi, Suguru Kikuchi, Kennta Kawai, Minoru Tanaka,

Correlations between umbilical cord blood concentration of stress response hormone cortisol and prolactin, and delivery duration were examined. Thirty-three cases were selected in which both mothers and neonates were healthy, and the neonates were delivered at full term. The umbilical cord blood ....

Case Reports >>

Metaplastic squamous cell carcinoma of breast. A pathology case report with review of literature

Abdulkader Mohammad Albasri, Akbar Shah Hussainy, Mohamed Aboulmaaty Elkablawy, Ahmed Alhujaily, Abdulaziz Aljohani,

Metaplastic Breast Carcinoma (MBC) is a group of rare breast cancers; squamous cell carcinoma (SCC) is its most common member. Due to rarity of the condition, frequent case reports have been published of late. In the last one year alone, there were about a dozen such reports. Here we report a cas....

Retroperitoneal Haematom due to Spontaneous Rupture and Haemorrhage of Adrenal Cyst Presenting with Grey Turnerís Sign

Bedriye Muge Sonmez, Fevzi Yilmaz, Fevzi Bircan Ozkan, Murat Ongar, Derya Ozturk, Fatma Cesur,

Spontaneous retroperitoneal haemorrhage is a rare entity and a potentially life-threatening condition. A 41-year-old woman presented to our emergency department with left flank pain and dysuria. Her physical examination disclosed left abdominal and costovertebral angle tenderness, left flank ecch....

Two accidental hanging cases of children

Ertugrul Gok, Selcuk Cetin, Erol Baduroglu, Recep Fedakar, Okan Akan, Naile Esra Saka,

The cases emphasise the implementation of safety measurements which may prevent the occurrence of accidental hanging in children. Two accidental hanging cases were autopsied at The Council of Forensic Medicine, Bursa Group Chairmanship, Morgue Department. The inquest papers written by police were....

Student's Corner >>

Prosthetic valve thrombosis in a patient with mitral valve replacement

Muhammad Bilal, Muhammad Shahzeb Khan, Abdul Haseeb, Abdul Bari Khan,

Prosthetic valve thrombosis within one year after mitral valve replacement is rarely seen in patients on warfarin therapy and without any risk factor. Here, we describe a case of a 39-year- old female, who presented with dyspnoea and shortness of breath 11 months after mitral valve replacement. T....

Case Series >>

Intermittent levetiracetam treatment in five patients with catamenial epilepsy

Jie Liu, Nengwei Yu, Hongbin Sun, Yi Liang, Yan Xie, Kai Chen,

Catamenial epilepsy is a periodic increase in seizure frequency in women with epilepsy during menstruation, or at any specific point in the menstrual cycle. We present five cases who attended the epilepsy outpatient clinic at the Sichuan Provincial People's Hospital, China, and who suffered cata....

Audit >>

Frequency, causes and outcome of neonates with respiratory distress admitted to Neonatal Intensive Care Unit, National Institute of Child Health, Karachi

Arit Parkash, Nighat Haider, Zubair Ahmed Khoso, Abdul Sattar Shaikh,

Objectives: To determine the frequency, aetiology and outcome of respiratory distress in neonates in intensive care unit.
Methods: The descriptive cross-sectional study was conducted at the Neonatal Intensive Care Unit, National Institute of Child Health, Karachi, from Octobe....

Recent Advances In Endocrinology >>

Once-weekly glucagon-like peptide 1 receptor agonists

Sanjay Kalra, Yashdeep Gupta,

The once-weekly glucagon-like peptide 1 receptor agonists (QW GLP1RA) represent a major advancement in diabetes pharmaco-therapeutics. This review describes the basic, clinical, and comparative pharmacology of this novel class of drugs. It highlights the clinical placement and posology of these d....

Letter To The Eimtor >>

Breast cancer prevention and role of the general physician

Muhammad Muhammad Saad, Faizan Sheraz, Saad Ullah, Hasnain Abbas Dharamshi,

Madam, Breast cancer is a common cancer worldwide. The age standardized incidence rate for breast cancer in women of Karachi, was 69 and is the second highest rate in Asia.1 We would like to highlight few strategies which general physicians can use to modify risk factors an....

Primary Care Diabetology >>

Starting titrating and intensifying metformin

Sanjay Kalra, Yashdeep Gupta,

Most persons with type 2 diabetes are treated with oral anti diabetic drugs (OADs). The drug of choice for initiating OAD therapy, in most cases, is metformin. This communication discusses how to start, titrate, and intensify metformin therapy in primary care. It discusses ways of improving toler....


The Bishwa Bandhan Foundation for cerebral Palsy will hold on International Medical Symposium on 2nd September 2015 at Kongresshaus, Zurich, Switzerland to prevent and design a cerebral palsy free world.
This will involve more than 200 countries in the world.



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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