Welcome to Journal Of Pakistan Medical Association
   Issue Vol:68, No:1 January, 2018
Editorial >>

Diabetic Neuropathy - situational analysis in Pakistan

Fatema Jawad.

The rising incidence of Diabetes Mellitus (DM) all over the world is a matter of concern for the authorities, health professionals and most of all the affected person. With changing lifestyles in the low and middle income countries, supplemented with inadequate health education, insufficient heal

Original Articles >>

Association of single nucleotide polymorphism in CD28(C/T-I3 + 17) and CD40 (C/T-1) genes with the Graves' disease

Saima Mustafa, Hira Fatima, Sadia Fatima, Tafheem Khosa, Atif Akbar, Rehan Sadiq Shaikh, Furhan Iqbal.

Objective: To find out a correlation between the single nucleotide polymorphisms in cluster of differentiation 28 and cluster of differentiation 40 genes with Graves\' disease, if any.

Clinical presentations and outcomes of the children with tuberculous meningitis: An experience at a tertiary care hospital

Naveed Anjum, Nuzhat Noureen, Imran Iqbal.

Objective: To determine the clinical presentations and outcomes of the children suffering from tuberculous meningitis.
Methods: This prospective, descriptive study was conducted at the Children\'s Hospital and the Institute of Child Health, Multan, Pakistan, from February t

Research Article >>

Achilles tendon elasticity decreases with intermittent claudication in patients by Acoustic Radiation Force Impulse Imaging (ARFI)

Birnur Yilmaz.

Objective: To investigate the value of Acoustic Radiation Force Impulse elastography and its application in Achilles tendon elasticity of intermittent claudication due to lower extremity arterial ischaemia.
Methods: This prospective case-control study was conducted at the De

Complement factor 3 among children with hepatitis A: Assessment of bilirubin levels

Wei Lin, Jing Zhang, Jian Zhang, Nan Geng, Maimaitijiang Ubuli-aishan, Xinhuan Wei.

Objective: To evaluate the complement factor 3 levels in children with hepatitis A
Methods: This observational study was conducted at the Infectious Diseases Hospital of Hotan District, China, from September 2014 to January 2015, and comprised children with hepatitis A and co

Frequency of underweight and stunting among children entering school in a small urban locality and their association with academic performance

Mirza Sultan Ahmad, Syed Aizaz Husain Zaidi, Naila Medhat, Hadia Farooq, Danial Ahmad, Waqar Nasir.

Objective: To determine the frequency of underweight and stunting among the children entering first year of school and to assess its associated factors.
Methods: This descriptive, analytical study was conducted at 5 schools of Rabwah, Pakistan, from August to September 2015,

Diagnostic validation of rapid molecular detection of Mycobacterium tuberculosis in pus samples by GeneXpert

Komal Shakeel, Shagufta Iram, Mehwish Akhtar, Shahida Hussain, Hannana Maryam, Ambreen Anwar.

Objective: To evaluate the performance of GeneXpert for detection of mycobacterium tuberculosis in pus samples and compare its results with conventional techniques in terms of validity, rapidity and rifampicin resistance.
Methods: This longitudinal, descriptive study was con

Relationship between hydrocephalus etiology and ventriculoperitoneal shunt infection in children and review of literature

Objective: The purpose of this retrospective study was to clarify the relationship of shunt infection to childhood hydrocephalus etiology
Methods: We analyzed 1021 patients with childhood hydrocephalus who underwent V-P shunting over a period of approximately 15 years. The et

High incidence of malaria along the Pak-Afghan bordering area

Zahid Ullah, Aamer Ali Khattak, Rahila Bano, Javaid Hussain, Usman Ayub Awan, Saif Ur Rahman, Muhammad Amin Jan Mahsud.

Objective: To check the epidemiology of malaria along Pak-Afghan bordering area.
Methods: The prospective study was conducted at Hatmi Medical Centre, Barmal district, Afghanistan, from March 2014 to February 2016, and comprised patients living in bordering areas between Paki

Symptom management in Behcets disease

Filiz Ozel, Aynur Esen Tureyen, Fisun Senuzun Aykar.

Objective: To determine the symptoms experienced by patients diagnosed with Behcet\'s Disease and how they cope with them.

Methods: The qualitative study was conducted from September 2013 to March 2014 at Ege University Medical Faculty Hospital, Turkey, comprising patient

KAP Study >>

Frequency of carrier screening and preventive orientation among first degree relatives of Thalassaemia patients

Seemab Hashim, Mohsin Sarwar, Armish Arsalan, Isma Awan, Sajida Naseem.

Objective: To get preliminary data regarding the prevention of thalassaemia major in future generations.

Methods: This Knowledge Attitude Practices study was conducted at Pakistan Institute of Medical Sciences, Islamabad, Pakistan, from January to June 2016, using non-probab

Awareness of risk factors and fallacies associated with urinary bladder cancer in our population: A prospective survey

Muhammad Hammad Mithani, Shariq Anis Khan, Salman El Khalid, Rakhshanda Siddique, Hafsa Humayun, Adnan Siddiq Awan.

Objective: To determine the awareness of risk factors for bladder cancer and false beliefs associated with this disease.

Methods: This cross-sectional study was conducted at the Kidney Centre, Karachi, from January to February 2015, and comprised subjects who presented to th

Learning preferences among dental students using the VARK questionnaire: A comparison between different academic levels and gender

Nasser AlQahtani, Khalid AlMoammar, Sahar Taher, Sahar AlBarakati, Eman AlKofide.

Objectives: To examine the learning style preferences of undergraduate dental students and determine the influence of gender on their selection.
Methods: This descriptive, cross-sectional study was conducted at the College of Dentistry, King Saud University, in Riyadh, Saudi

Knowledge and attitude of blood donation among female medical students in Faisalabad

Saba Tariq, Sundus Tariq, Shireen Jawed, Saffee Tariq.

Objective: To assess the knowledge, practices and attitude of medical students towards blood donation.
Methods: This cross-sectional study was conducted at the University of Faisalabad, Faisalabad, Pakistan, from April to August 2016, and comprised female medical students. Mu

Physiotherapy and pharmacy students perception of educational environment in a medical university from Pakistan

Aamir Raoof Memon, Bahadur Ali, Mubin Mustafa Kiyani, Imran Ahmed, Attiq-ur-Rehman Memon, Jam Feroz.

Objective: To assess and compare the perceptions of the educational environment between physiotherapy and pharmacy students in a public-sector medical university.
Methods: This cross-sectional study was conducted at the Peoples University of Medical and Health Sciences for Wo

Audit >>

Outcomes of cataract surgery at teaching hospital in Karachi

Shaukat Ali Chhipa, Mustafa Kamal Junejo.

Objective: To assess outcomes of cataract surgery at a tertiary care hospital in Karachi.

Methods: This retrospective study was conducted at Aga Khan University Hospital, Karachi, and comprised data of patients who underwent cataract surgery from January 2011 to December 201

How close are we? An audit of biometry of a tertiary care hospital in Karachi

Abdul Hameed Siddiqui, Maria Khan, Marium Hussain.

Objective: To evaluate the accuracy of biometry in the post-op phase of cataract surgery.
Methods: This study was conducted at Liaquat National Hospital, Karachi, from June 2015 to July 2016, and comprised the audit of patients who underwent cataract surgery during the period

Review Articles >>

Diabetic neuropathy and painful diabetic neuropathy: Cinderella complications in South East Asia

Hamad Almuhannadi, Georgios Ponirakis, Adnan Khan, Rayaz Ahmed Malik.

The most common and debilitating microvascular complication of diabetes is diabetic peripheral neuropathy (DPN), affecting 50-90% of people with diabetes. The major manifestations of DPN are painful (pDPN) and painless diabetic peripheral neuropathy. Painful symptoms, occur in the feet and are wo

Association of arg16gly and gln27glu, b2-adrenergic receptor gene polymorphism with asthma. A systematic review and meta-analysis of case control studies

Ihsanullah Khan, Zia Ul-Haq, Asmat Shaheen, Mukhtiar Zaman, Nafees Ahmad, Rashda Abbasi, Sami Siraj.

The study was planned to assimilate quantitatively the available evidences on association of Arg16Gly and Glu27Gln with asthma and to produce more precise results. All case-control studies conducted on adults were searched on Medline, Embase, PubMed, Wiley online library according to Preferred Re

Systemic Review >>

Role of multi-parametric (mp) MRI in prostate cancer

Syed Muhammad Nazim, Muhammad Hammad Ather, Basit Salam.

Multi-parametric magnetic resonance imaging is increasingly being recommended as standard imaging modality for prostate cancer diagnosis and staging. It comprises structural T2 and T1 sequences supplemented by functional imaging techniques, i.e. diffusion-weighted, dynamic contrast enhanced and s

Short Communication >>

Spatial distribution of road traffic crash fatalities in Karachi: Perspective from 2008-2012

Rashid Jooma, Mir Shabbar Ali, Masood Ali Shaikh.

Road Traffic Crash (RTC) mortality and morbidity is one of the major public health problems in Karachi. In this study we used geographic information systems (GIS) to visualize and quantify the spatial distribution of RTC mortality and yearly trend from 2008 to 2012, for all 24 administrative subd

Short Reports >>

Co-morbid depression in individuals with type 2 diabetes mellitus

Ume Sughra, Muhammad Imran.

It was a descriptive cross-sectional study conducted to determine the frequency of depression and association with factors in type 2 diabetics in diabetic clinic of Fauji Foundation Hospital Rawalpindi from 1st January - 30th June 2014.
In all 110 diabetic patients were selected using conv

Nurses interventions to reduce unwanted noise

Birsel Canan Demirbag, Sevilay Hintistan, Betul Bayrak.

The study evaluated the nurses\' interventions to reduce unwanted noise. This hospital-based, descriptive study was conducted at a Training Hospital in the Eastern part of Turkey, Trabzon, between 15-30 January 2016. It was participated by 248 volunteer nurses. Nurses express the noise of visit

Prevalence of Toxoplasma gondii oocysts through Copro-PCR in cats at Pet Center (UVAS), Lahore, Pakistan

Habibun Nabi, Muhammad Imran Rashid, Saher Islam, Amna Arshad Bajwa, Rahim Gul, Wasim Shehzad, Haroon Akbar, Nisar Ahmad, Aneela Zameer Durrani, Muhammad Waqas, Kamran Ashraf.

Toxoplasmosis is a major zoonotic disease of warm-blooded animals caused by Toxoplasma gondii. Cats are the only definitive host and they excrete environmentally resistant T. gondii oocysts in their faeces. Coproscopy was used to detect oocysts of enteric coccidians and then Copro-PCR was employe

Case Reports >>

Leukocyte adhesion defect: An uncommon immunodeficiency

Sehar Nigar, Ejaz Ahmed Khan, Tahir Aziz Ahmad.

Leukocyte adhesion deficiency (LAD) is a rare primary immunodeficiency disorder with autosomal recessive inheritance which is characterized by presence of a defect of phagocytic function resulting from a lack of leukocyte cell surface expression of b2 integrin molecules (CD11 and CD18) that are e

Artery of Percheron Infarct - a diagnostic and prognostic conundrum!

Aun Raza Shah, Rubab Ali.

A 39 year old male was found unconscious at home. On arrival to the hospital the patient was profoundly somnolent but easily rousable, with no focal neurological deficits. Imaging confirmed bilateral thalamic infarcts from the occlusion of Artery of Percheron, a rare anatomic variant which is a s

Haemophagocytic lymphohistiocytosis in a preterm infant: A case report

Na Mi Lee, Dae Yong Yi, Shin Weon Yoon, Soo Ahn Chae, In Seok Lim, Yong-Sung Choi.

Haemophagocytic lymphohistiocytosis (HLH) is a rare disease with a sepsis-like progression that leads to multiple organ dysfunction syndrome, especially in preterm infants. We present herein a case of HLH in a premature infant presenting with disseminated intravascular coagulopathy (DIC) and live

Haemophagocytic lymphohistiocytosis in a preterm infant: A case report

Na Mi Lee, Dae Yong Yi, Shin Weon Yoon, Soo Ahn Chae, In Seok Lim, Yong-Sung Choi.

Haemophagocytic lymphohistiocytosis (HLH) is a rare disease with a sepsis-like progression that leads to multiple organ dysfunction syndrome, especially in preterm infants. We present herein a case of HLH in a premature infant presenting with disseminated intravascular coagulopathy (DIC) and live

Femoral artery pseudoaneurysm due to a gunshot injury

Abdullah Algin, Mehmet Ozgur Erdogan, Kaan Yusufoglu, Huseyin Avni Findikli, Hakan Aydin.

Femoral artery pseudoaneurysms are commonly iatrogenic due to increasing use of the artery for arterial interventions. Other reasons of pseudoaneurysm formation are intravenous drug use and penetrating trauma. Here, we have discussed the management strategy of a femoral artery pseuodoaneursym and

Case Series >>

Small cell neuroendocrine carcinoma of nose and paranasal sinuses: The Shaukat Khanum Memorial Cancer Hospital experience and review of literature

Muhammad Faisal, Irfan Haider, Mohammad Adeel, Omer Waqas, Raza Hussain, Arif Jamshed.

Small cell neuroendocrine carcinoma (SCNEC) is a rare disease of nose and paranasal sinuses. In contrast to other regions SCNEC of this region has been reported to be recurrent and locally aggressive. No definite treatment has been established till date because of rarity of this disease. The purp

Recent Advances In Endocrinology >>

Communication in diabetes care

Sanjay Kalra, Bharti Kalra.


The psychosocial domain of diabetes is as important as the biomedical aspects of the syndrome. This perspective traces the evolution of diabetes care model, describes the psychological morbidity of diabetes, enumerates management strategies, and supports readers

Primary Care Diabetology >>

The sixth vital sign in diabetes

Sanjay Kalra, Komal Verma, Yatan Pal Singh Balhara.

The vital signs are an integral part of clinical methods. In diabetes, determination of plasma glucose can be taken as the fifth vital sign. The sixth vital sign is well being, which can easily be measured by two item questionnaires designed to assess distress, depression and coping skills. This

Evidence Based Neuro-Oncology >>

Role of extent of resection on quality of life in patients with newly diagnosed GBM

Usama Khalid Choudry, Huzaifa Ismail Shaikh, Areeba Nisar, Saad Akhtar Khan, Muhammad Shahzad Shamim.

Glioblastomas known for their adverse outcomes are most reportedly managed by surgical resection. Studies on the impact of (Extent of Resection) EOR against Quality of Life (QOL) are very limited. We have collected data from recent studies in this review to extract a general consensus among the n

Letter to the Editor >>

Epidemiology and parasitological survey of malarial parasites in Khyber Pakhtunkhwa, Pakistan

Muhammad Wasim Khan, Muhammad Nadeem Khan, Rahmat Ali Khan.

Malaria is one of the main community health problems in South Asia including Pakistan. A study was conducted to evaluate the recent epidemiology of malaria in Bannu district. District Bannu is a plain area in the southern part of Khyber Pakhtunkhwa, Pakistan and has a high rate of transmission of

Student's Corner >>

Awareness, use and perceptions about E-cigarettes among adult smokers in Karachi, Pakistan

Maryam Sarfraz, Hamza Abdur Rahim Khan, Amna Urooba, Zainab Manan, Omar Irfan, Ramlah Nadeem, Huma Baqir, Saad Farooq, Zarrar Khan, Javaid Ahmed Khan, Sarah Saleem.

Objective: To estimate the prevalence of awareness, current use and intention to use of e-cigarettes among adult smokers.
Methods: This cross-sectional survey was carried out at the Aga Khan University Hospital, Karachi, from July to August 2016, and comprised people aged ab

Multiple complications in sickle cell anaemia

Taimoor Khalid Janjua, Syeda Amna Haider, Naila Raza.

Sickle Cell Disease (SCD) is a structural haemoglobinopathy which is extremely diverse in its presentation regarding disease severity and organ involved. The homozygous form if poorly managed gives rise to numerous life threatening conditions which are otherwise avoidable. Here we report the case



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