Welcome to Journal Of Pakistan Medical Association
   Issue Vol:67, No:6 June, 2017
Editorial >>

Human Cytomegalovirus: a neglected public health area of significant relevance to women, the foetus and new born. Time for action!

Amna Rehana Siddiqui, Saira Ibrahim, Anwar Ali Siddiqui, Paul Moss, El-Nasir Lalani.

Persistent infection with human cytomegalovirus (HCMV) infection is extremely common in many parts of the world. Indeed, in the Pakistani population this is reported to be more than 90%, when measured using HCMV specific IgG antibody.1-4 HCMV-IgMsero-prevalence was 4.3%, bu

Original Articles >>

Clinicopathological profile of gastric cancers in Al-Madinah, Saudi Arabia

Abdulkader Mohammed Albasri, Zeinab Moustafa Elsawaf, Akbar Shah Hussainy, Ahmed Safar Alhujaily.

Objective: To characterise the clinicopathological features of gastric cancer.
Methods: This retrospective study was conducted at the histopathology laboratory of King Fahad Hospital, Madinah, Saudi Arabia, and comprised record of gastric cancer patients from January 2006 to

Comparison of position-related changes on uroflowmetric parameters in healthy young men

Rehan Nasir Khan, Syed Zafar Zaidi.

Objective: To determine the mean difference in maximum urine flow rate and post-void residual urine volume in sitting as well as standing voiding position in healthy males.
Methods: This descriptive, cross-sectional study was conducted at the Department of Urology, Indus Hosp

Classification of normal and arrhythmic ECG using wavelet transform based template-matching technique

Wajahat Hassan, Saqib Saleem, Aamir Habib, Qamar-ul-Islam.

Objective: To propose a wavelet-based template matching technique to extract features for automatic classification of electrocardiogram signals of normal and arrhythmic individuals.
Methods: The study was conducted from December 2014 to December 2015 at the Department of Elec

Stages of chronic kidney disease and soluble Transferrin Receptor (sTfR), Ferritin, ratio

Faiza Alam, Syeda Sadia Fatima, Sabeela Noor, Ahmed Bilal, Rehana Rehman.

Objective: To assess the ratio of soluble transferrin receptor to ferritin in different stages of chronic kidney disease.
Methods: This case-control study was conducted at the Aga Khan University Hospital and the Jinnah Postgraduate Medical Centre, Karachi, from January to Se

Serum APOE, leptin, CFH and HTRA1 levels in Pakistani age related macular degeneration patients

Irfan Zia Qureshi, Fareeha Ambreen.

Objective: To determine the association between serum levels of apolipoprotein E, leptin, complimentary factor H and high temperature requirement A-1 in patients with age-related macular degeneration.
Methods: This case-control study was conducted at the Quaid-i-Azam Universi

Factors associated with mortality to drug-resistant tuberculosis and their programmatic management in treatment centres of Punjab, Pakistan

Shamsa Kanwal, Abdul Majeed Akhtar, Anzar Ahmed.

Objective: To describe the characteristics and assess the factors of mortality in drug-resistant tuberculosis patients.
Methods: This retrospective study was conducted at 11 programmatic management of drug-resistant tuberculosis centres located in different cities of the Punj

PhD programs in nursing in Iran and Canada: A qualitative study

Hossien Karimi Mooneghi, Najmeh Valizadehzare, Fatemeh Khorashadizadeh.

Objective: To compare doctoral programmes of nursing in Iran and Canada.
Methods: This qualitative study was conducted in Mashhad, Iran, in April 2014. It was based on Beredy\'s model, including description, interpretation, juxtaposition and comparison. The validity of the

Dietary practices and severity of depression. Comparative study among housewives and working women in Karachi

Lubna Raza, Tahira Mohsin Ali, Abid Hasnain.

Objective: To compare levels of depression and locate difference in effects of dietary practices on depression severity in housewives and working women.
Methods: This comparative, cross-sectional study was conducted at the University of Karachi and the Dow University of Heal

Comparing the effectiveness of Betamethasone Gel with Lidocaine Gel local application on endotracheal tube in preventing post-operative sore throat (POST)

Aatir Fayyaz, Aamir Furqan, Ali Ammar, Rahat Akhtar.

Objective: To see whether betamethasone gel or lidocaine gel is superior in reducing the incidence of post-operative sore throat after tracheal extubation.
Methods: This clinical study was conducted at the Nishtar Hospital and Medical College, Multan, Pakistan, from July to D

Effects of sevoflurane on female reproductive functions in Wistar rats

Serkan Dogru, Hatice Yilmaz Dogru, Ilknur Butun, Akgul Arici, Ismail Benli, Tugba Karaman, Hakan Tapar, Aynur Sahin, Serkan Karaman, Semih Arici, Asker Zeki Ozsoy.

Objective: To determine the effects of sevoflurane by inhalation on female reproductive hormones and ovarian tissues.
Methods: This experimental study was conducted at the Gaziosmanpasa University, Tokat, Turkey, and comprised Wistar-Albino female rats. The rats were divided

Depression and anxiety in patients undergoing elective and emergency surgery: Cross-sectional study from Allama Iqbal Memorial Teaching Hospital, Sialkot

Ansar Latif, Rana Mozammil Shamsher Khan, Kalsoom Nawaz.

Objective: To determine the frequency of depression and anxiety in post-operative patients undergoing elective and emergency surgery.
Methods: The cross-sectional analytical study was conducted at the Department of Surgery and Department of Psychiatry of the Allama Iqbal Memo

Non-pharmacological strategies used to reduce procedural pain in infants by nurses at family health centres

Diler Aydin, Nejla Canbulat Sahiner, Esra Karaca Ciftci.

Objective: To determine the methods used by nurses working in family health centres to decrease pain during medical procedures in infants.
Methods: This descriptive, cross-sectional study was conducted at family health centres in the county town of Bandirma, and city centres

Use of polypharmacy and herbal medication on quality of life in elderly patients at Okmeydani hospital's polyclinics in Istanbul, Turkey

Mehmet Ziya Gencer, Secil Arica.

Objective: To determine what should be done as a preventive medicine physician by analysing the effect of polypharmacy and herbal treatment.
Methods: This survey-based, cross-sectional study was carried out at Istanbul Okmeydani Training and Research Hospital, Istanbul, Turke

Isolation of potentially pathogenic fungi from selected pigeons' feeding sites in Karachi: A new dimension to health hazard

Sehar Afshan Naz, Muhammad Yaseen, Nusrat Jabeen, Maryam Shafique.

Objective: To determine the presence of pathogenic fungal strains in areas where pigeons are present in a large number.
Methods: This study was conducted at the Federal Urdu University of Arts, Science and Technology, Karachi, from February 2015 to March2016, and comprised sa

Review Articles >>

Current status of Helicobacter pylori association with haematological and cardiovascular diseases: A mini review

Jibran Sualeh Muhammad, Syed Faisal Zaidi, Sheikh Abdul Saeed, Muhammad Ishaq.

Helicobacter pylori infection is considered the most commonly prevalent gastrointestinal pathogen where it manages to survive despite the hostile environment of human stomach, leading to various gastric diseases including gastric cancer. Due to the chronic inflammatory state induced by H. pylori

Short Reports >>

Treatment of chronic Hepatitis C in Thalassemia major patients

Shaimuna Fareeha Sajjad, Waquaruddin Ahmad, Syed Sarafaraz Hussain Jaffery, Mohammad Asif, Syed Ejaz Alam.

Treatment of chronic hepatitis C (HCV) is difficult in thalassemics due to the haemolytic side effects of therapy. This study evaluated the treatment response to conventional interferon and ribavirin in HCV patients with thalassemia major. It was conducted at PMRC Research Centre, Jinnah Postgrad

Sexual self-esteem in mothers of normal and mentally-retarded children

Jahanshir Tavakolizadeh, Mostafa Amiri, Fahimeh Rastgoo Nejad.

Sexual self-esteem is negatively influenced by the stressful experiences in lifetime. This study compared the sexual self-esteem and its components in mothers with normal and mentally-retarded children in Qaen city, in 2014. A total of 120 mothers were selected and assigned into two groups of 60

Effects of chronic exposure to Formaldehyde on micronucleus rate of bone marrow cells in male mice

Yunru Liu, Dee Yu, Sha Xiao.

Formaldehyde (FA) is the major volatile organic chemical (VOC) present in indoor air, and a constituent known to be associated with sick building syndrome. In the present study, mice were exposed to different concentrations of FA (0, 1, 10 mg/ m3) through static inhalation for 2 hours per day for

Short Communication >>

Role of early contrast enhanced CT scan in severity prediction of acute pancreatitis

Noman Shahzad, Muhammad Rizwan Khan, K M Inam Pal, Dawar Burhan Khan, Muhammad Shahrukh Effendi.

Severe pancreatitis occurs in approximately 15-25% of patients with acute pancreatitis. The objective of our study was to compare the CT Severity Index (CTSI) with a clinical score (BISAP score) to predict severity of acute pancreatitis. Forty-eight consecutive patients with acute pancreatitis wh

Case Reports >>

Pulmonary hypertensive crisis and its efficient management. A Case report and literature review

Karima Karam Khan, Fazal Hameed Khan.

Perioperative anaesthetic management of patients with pulmonary hypertensive crisis is complex and challenging because of limited window period and treatment options. This case report describes the successful management of a patient with severe valvular heart disease superimposed by severe pulmon

Discordant disease expression of neonatal lupus erythematosus in twins

Faiza Mustafa, Yawar Najam, Mohammad Tauqeer Akbar, Tahir Aziz Ahmed.

Neonatal lupus erythematosus is an autoimmune disease resulting from the trans-placental passage of maternal anti-SSA/Ro, anti-SSB/La, and less frequently anti-RNP antibodies to the foetus. At the time of diagnosis 50% of mothers are asymptomatic. Neonatal manifestations of this multisystem disea

Perforation of Meckel's diverticulum with a foreign body mimicking acute appendicitis: A rare complication

Amaar Aamery, Ruqaiya Al-Shehhi, Kamran Malik, Abdullah Al-Harthy.

Meckel's diverticulum mimicking acute appendicitis is a very rare condition encountered in practice. MD is asymptomatic in most of cases and only about 4 to16% of cases develop complications. Perforation of MD by a foreign body is even rarer being only reported in few cases in the literature. Th

Student's Corner >>

Knowledge and attitude of physicians about antimicrobial resistance and their prescribing practices in Services hospital, Lahore, Pakistan

Azib Shahid, Fatima Iftikhar, Mohammad Kamil Arshad, Zainub Javed, Muhammad Sufyan, Resham Sajjad Ghuman, Zenab Tarar.

A cross sectional study was conducted in Services Hospital, Lahore using a self administered questionnaire to test the knowledge, attitude and prescribing practices of residents and attending physicians using non-probability convenience sampling. A total of 116 questionnaires were filled (Respons

Letter to the Editor >>

Microangiopathic haemolytic anaemia (maha) caused by non O157:H7 E-coli

Mahum Shahid.

Thrombotic microangiopathy (TMA) often needs detailed investigations to identify the etiology especially in patients who present with multisystem pathology.
Causes of TMA include thrombotic thrombocytopenic purpura, haemolytic uraemic syndrome, drug-induced TMA, HELLP syndrome, systemic in

Hysteroscopic Myomectomy can lead to intrauterine adhesions and infertility

Afifa Riaz, Ahsan Zil-E-Ali.

Neuwirth with his team perfomed the first hysteroscopic myomectomy in 1976 which largely replaced the conventional surgical interventions and began a new age of minimally invasive gynaecological procedure.1 Soon after the first case, multiple trials and procedures were done

Comment on Ahsan Ali Syed et al (J Pak Med Assoc 2017; 67: 400-404) Frequency of worsening liver function in severe dengue hepatitis patients receiving paracetamol: A retrospective analysis of hospital data

Mohammad Yawar Yakoob.

Madam, I read with interest the article by Syed AA et al. in the March 2017 issue of Journal of Pakistan Medical Association.1However, I have a few concerns regarding the methods used in this article. Firstly, a major flaw in the analysis is that Wilcoxon ranked-sum test (M

Response to comment on Ahsan Ali Syed et al (J Pak Med Assoc 2017; 67: 400-404 Frequency of worsening liver function in severe dengue hepatitis patients receiving paracetamol: A retrospective analysis of hospital data

Syed Ahsan Ali.

Thank you Dr. Yakoob for taking interest in our article. Having received your feedback and critique, we would like to respond to the comments.
Firstly, we agree that our data had both before and after values of ALT for patients with severe dengue hepatitis. However to clarify, we did not d

Case Series >>

Canakinumab treatment in four children with colchicine resistant familial mediterranean fever

Solmaz Ozkan, Bulent Atas.

Familial Mediterranean Fever (FMF) is an autosomal recessive and autoinflammatory disease, characterized with inflammation of serous membranes such as peritoneum, pleura, synovium with fever and pain. Colchicine is the main treatment of FMF, but 5-10 % of patients are unresponsive to colchicine.

Manual Vacuum Aspiration (MVA) - A safe option for evacuation of first trimester miscarriage in cardiac patients

Asma Ansari, Safdar Abbas.

This case series was done at Armed Forces Institute of Cardiology, National Institute of Heart Disease, Rawalpindi, to observe safety and efficacy of manual vacuum aspiration and frequency of complications in cardiac patients with missed abortion. All cardiac patients presenting in first trimeste

Etiological and epidemiological factors in hearing-impaired students in Van, East of Turkey: A case series

Ahmet Faruk Kiroglu, Muzaffer Ari, Nazim Bozan, Mehmet Parlak, Hakan Cankaya.

The aim of the present case series was to investigate the causes of hearing loss in the children studying at a primary School for the deaf in Van Province, Turkey. The present series included 95 children with sensorineural hearing loss. Otoscopic and ophthalmological examinations, pure-tone audio

Guest Editorial >>

Research publications and education in Pakistani medical universities: Avoiding predatory journals and improving the quality of research

Aamir Raoof Memon.

A country\'s higher education depends on the role of organizations and institutions in improving the quality of research. While the Higher Education Commission (HEC) is struggling enough to promote research environment in the universities by spending billions of rupees, output from them stays l

Recent Advances In Endocrinology >>

Drug addiction and diabetes: South Asian action

Yatan Pal Singh Balhara, Sanjay Kalra.

Both diabetes and drug addiction are common phenomena across the world. Drug abuse impacts glycaemic control in multiple ways. It becomes imperative, therefore, to share guidance on drug deaddiction in persons with diabetes. The South Asian subcontinent is home to specific forms and patterns of d

Primary Care Diabetes >>

Pragmatic selection of cooking oils

Lovely Gupta, Deepak Khandelwal.

Fats and oils are one of the very important components of diet. However excess of either overall fat or certain kind of fats in the diet may result in negative health impacts including risk of obesity, dyslipidaemia, cardiovascular diseases and certain malignancies. It is thus important to have a

Systematic Review >>

Magnetic resonance spectroscopy and magnetic resonance spectroscopic imaging in Cerebral Autosomal-Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy: A literature review

Ali Sibtain Farooq Sheikh, Mona Adel Mohamed.

This review focuses on the current literature directed towards the brain metabolite findings in Cerebral Autosomal-Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) disease using magnetic resonance spectroscopy (MRS) and magnetic resonance spectroscopic imaging (MR

Evidence Based Neuro-Oncology >>

Extent of resection and timing of surgery in adult low grade glioma

Farhan A. Mirza, Muhammad Shahzad Shamim.

Low grade glioma is a group of WHO grade II tumours including diffuse astrocytoma, oligodendroglioma, and oligoastrocytoma. Strong evidence exists in literature now to support early surgery and higher extent of safe resection in improving outcomes. In this review, we are highlighting some of the

Narrative Review >>

Incidentaloma: from general practice to specific endocrine frame

Ancuta Augustina Gheorghisan-Galateanu, Mara Carsote, Ana Valea.

Incidentaloma, a modern concept connected to technology progress, represents an accidentally discovered tumour, usually used for hypophysis and adrenals, and rarely for thyroid, parathyroids, and ovaries. This is a narrative review based on PubMed research, between 2012 and 2016 focusing on gener


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