- Original Article
- Review Article
- Kap Study
- Case Reports
- Medical Education
The articles for the PJMD Volume 8 Issue 1 2019 are listed below. The articles are in PDF Format which requires Adobe Acrobat Reader for viewing.
PLACENTAL MALARIA- INSIGHT INTO VACCINE DEVELOPMENT
Malaria in pregnancy, a life-threatening situation for both mother and developing fetus, results in multiple complications, from low birth weight to still birth or abortion. Usually a healthy person after the parasitic infection, develop some immunity, but the pregnant status of a female lowers the protective immunity against Plasmodium falciparum which is worldwide considered as the most dangerous specie of all four human infecting malarial parasites. It is estimated that 125 million women worldwide, are threatened with malarial catastrophes which includes around 10,000 maternal and 200,000 neonatal deaths every year1. According to a study conducted in Pakistan in 2004, it was observed that mostly the pregnant patients get infected with Plasmodium vivax, but the majority of complications of malaria are associated with Plasmodium falciparum2. In Pakistan, Malarial infections are endemic, commonly caused by Plasmodium vivax, but now around 35-40% of cases are being reported with Plasmodium falciparum.3
- Saeeda Baig
- Department of Biochemistry, Ziauddin University, Karachi, Pakistan
MORPHOLOGICAL SPECTRUM OF NON MELANOMA SKIN CANCER EXPERIENCE AT A TERTIARY CARE HOSPITAL IN KARACHI, PAKISTAN
Jinnah post graduate medical center is a major tertiary care hospital in Karachi. People of varying skin color from different ethnic groups in this cosmopolitan city present to this hospital. The current study was designed to determine the histopathological spectrum of non melanoma skin cancer including basal cell carcinoma and squamous cell carcinoma in skin biopsy cases reported at pathology department, basic medical sciences institute, JPMC.
This retrospective cross sectional study included 142 cases of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) diagnosed over5-year duration at department of pathology, Basic Medical Sciences Institute, Jinnah Post Graduate Medical Center, Karachi. World Health Organization histologic classification of keratinocytic skin tumors was followed for subtyping of BCC and SCC.
Out of the total of 142 NMSC cases, 86 (60%) were (BCC) and 56 (40%) were (SCC). Majority among SCC i.e. 33 (58.9%) were well differentiated carcinoma. The most common single morphology in BCC was the nodular variant constituting 56 (65.1%) cases. Mixed composition of BCC constituted 25 (29%) cases. A combination of two histological patterns was observed in 22 (25.5%) cases while 3 (3.5%) cases showed more than two morphologies.
Well differentiated squamous cell carcinoma was the most common variant of cutaneous SCC. Nodular variant was the most frequently observed subtype amongst BCC. A significant number of BCC cases revealed mixed histopathological patterns, a novel finding of the study. Our data include people from different ethnicities with variable skin color and thus provides useful reference for future studies.
Carcinoma, Basal Cell, Squamous Cell, Skin cancer.
- Nazish Jaffar
- Department of Pathology
- Shahnaz Imdad Kehar
- BMSI, Jinnah Post Graduate Medical Center
- Department of Pathology
- Jawed Iqbal
- Karachi Medical and Dental College
- Department of Pathology
- Rubina Ghani
- Jinnah Medical and Dental College, Karachi, Pakistan.
- Department of Biochemistry
- Syed Mehmood Hasan
- Department of Pathology,
- Jinnah Sindh Medical University
OUTCOME OF PERCUTANEOUS NEPHROLITHOTOMY IN RENAL ANOMALIES: SINGLE CENTER EXPERIENCE
PCNL is standard surgical treatment for renal stone > 2.0 cm and stone resistant to Extracorporeal Shock Wave Lithotripsy. This study was conducted to evaluate the outcome of percutaneous nephrolithotomy in renal anomalies.
This cross sectional study was conducted at The Kidney Center postgraduate training institute Karachi from January 2010 to June 2017, comprised of 60 patients of stone size (median, IQR) 2.75,1.2. Percutaneous nephrolithotomy was done under general anesthesia; intra operative flouroscopy was done for stone clearance. Post-operative x-ray KUB was done to verify the clearance of stone.
Out of the 60 patients, most patients had horseshoe kidney 35 (58.3%) with right sided renal stone and majority of the stones are located in pelvis 37 (61.7%). 48 (80.0%) patients required nephrostomy while only 24 (40%) required Double J Stent insertion. In 42 (70%) patients 100% clearance was achieved and only 20 (33.3%) patients needed secondary procedures. Double J Stent insertion was done in both types of renal abnormality. In case of 100% clearance Double J Stent was inserted in 3 (33.3%) patients with malrotation while 7 (46.7%) horseshoe kidneys required Double J Stent insertion.
Percutaneous nephrolithotomy is a safe treatment option in renal anomalies patients with renal stones.
Percutaneous, nephrolithotomy, renal anomalies, horseshoe kidney, malrotation
- Shariq Anis Khan
- Department of Urology, The Kidney Center hospital, Karachi, Department of Community Medicine
- Salman El Khalid
- Suneel Kumar
- Department of Urology, The Kidney Center hospital, Karachi, Department of Community Medicine
- Fouzia Naeem Effendi
- Liaquat National Hospital and Medical College, Karachi
- Adnan Siddiq Awan
- Department of Urology, The Kidney Center hospital, Karachi, Department of Community Medicine
- Muhammad Hammad Ali Mithani
- Department of Urology, The Kidney Center hospital, Karachi, Department of Community Medicine, 4
LIFESTYLE FACTORS INFLUENCING THE PREVALENCE OF SKIN DISEASES AT A PRIMARY CARE CENTER IN KARACHI
To determine the burden and assess the risk factors of skin diseases in Primary Health Care Centers in Karachi.
A total of 360 patients came to the primary health care center over the span of 6 months from May 2017 to October 2017 .Out of them 151 had some sort of dermatological ailment. They were examined thoroughly for skin lesions and interviewed. Data was collected by reading out questionnaires to the patients, and filled accordingly.
It was observed in our study that 151(41.9%) patients presenting to primary care center had dermatological complaints. Mean age determined was 25 years. 87% of the study population was female whilethe rest were males. In our study, skin ailments were broadly divided into 3 categories out of which chronic skin conditions ( 43%) like lichen planus, alopecia and pityriasis alba turned out to be most common, followed by infectious skin diseases ( 36.4%) such as scabies, tineas and impetigo. Least recurring were allergic skin disorders ( 20.5%)such as atopic dermatitis. Sharing of personal items and animal contact were statistically significant variables and had strong association with skin ailments. While overcrowding, family history of similar skin condition and past personal history of same skin condition were not determined to be significantly associated with the presentation.
Our study shows a spectrum of skin diseases prevalent in high numbers in our population. This identifies the need for qualified family physicians with special training in dermatology to treat the masses effectively and decrease the morbidity. Detailed counseling should be offered to avoid sharing of clothes and minimizing animal contact as muchsince possible since skin diseases are mostly contagious. Community awareness programs should be conducted in which personal hygiene should be discussed. Scarcity of water is a social issue prevalent in this area so some policies regarding this issue should be imposed to improve the situation.
Dermatological ailments, Contagious, Prevalence, Primary care
- Fatima Jehangir
- Ayla Hasan
- Fatima Bashir
- Noor Rahman
- Department of Family Medicine, Ziauddin University, Karachi
THE ROLE OF PAROXETINE IN POST- MENOPAUSAL HOT-FLASHES FREQUENCY REDUCTION
To evaluate the effects and safety profile of Paroxetine on hot – flashes in post – menopausal women.
It was prospective open label control clinical trial. This study is conducted in the Department of pharmacology & Therapeutics in collaboration with the Department of Obstetrics & Gynecology JPMC. The patients were selected from outpatients department (OPD) of Obstetrics & Gynecology. Duration of the study was 12 month from January 2014 to January 2015. Enrolling 180 outpatients who had menopause with hot flushes divided into three groups. The Greene Climacteric Score Scaling was applied to observe the effects of 12.5mg, 20mg Paroxetine on frequency of hot flashes as compared to Placebo.
Mean GCS scoring frequency in 12.5mg Paroxetine group at 12 week was 1.97±0.31 and the baseline 2.64±0.29. In 20mg Paroxetine mean GCS at baseline was 2.76±0.23 and 12 week 2.04±0.12. Where as in Placebo mean GCS scoring frequency at 12 week was 2.80±0.24 and at baseline 2.76±0.24.
Conclusion: The frequency of hot flashes with Paroxetine 20mg and 12.5mg, is significantly reduced in post menopauseal women as compared to Placebo.
Menopause, Hot flashes, Greene Climacteric Scale, Paroxetine
- Zareen Naz
- Department of Pharmacology, Liaquat College of Medicine and Dentistry, Karachi,
- Moosa Khan
- Department of Pharmacology. Shaheed Zulfiqar Ali Bhutto Medical University Islamabad,
- Faiz Ahmed Siddiqui
- Department of Radiology. Agha Khan Hospital,
- Faiza Siddiqui
- Department of Pediatric Medicine, Agha Khan University, Karachi
METHODS USED TO ESTABLISH THE POSTERIOR PALATAL SEAL FOR MAXILLARY COMPLETE DENTURE PROSTHESIS
The survey was conducted in Pakistani teaching hospitals to determine techniques and concepts which are used to establish the posterior seal in complete dentures. The aim of this study is to obtain the existing curriculum which is used for teaching the concepts of posterior palatal seal establishment for complete dentures.
A questionnaire was made on online survey development software (Survey Monkey) that consisted of 7 multiple-choice based questions. The questions were related exclusively to the methods for establishing posterior palatal seal for complete denture prosthesis. The forms were forwarded and distributed via e-mail to 75 faculty members of 13 dental Institute of Pakistan who were teaching prosthodontics. A total of 64 faculty members (41 from public sector and 23 from private) responded and participated in the study.
Results of our survey indicated that 37.5% of the faculty members were teaching a combination of phonation, nose blowing and fovea palatinae methods. The two vibrating line concept for establishing posterior palatal seal was taught by 64.06% of faculty members, 53.65 % of these place the border of maxillary dentures at the posterior flexion line. Carving the maxillary posterior palatal seal on the master cast was taught by 92.18 % of faculty members. 64% were teaching the post palatal seal carving depth of 0.5–1.5 mm on the maxillary cast, along with consideration of Compressibility of the palatal tissues. The butterfly pattern was the mostly (79.6%) described pattern for carving post palatal seal on the maxillary cast.
Statistically there was no significant difference in techniques and concepts which are used to establish the posterior palatal seal, between government and private dental institutes.
Palatal tissues, Posterior palatal seal, Complete denture prosthesis.
- Bharat Kumar
- Department of Prosthodontics, Dow International Dental College, Karachi,
- Muhammad Rameez
- Department of Prosthodontics, Hamdard University, Karachi,
- Haroon Rashid
- Department of Prosthodontics, Ziauddin University, Karachi
EFFECTIVENESS OF HOME BASED DECONGESTIVE LYMPHATIC THERAPY FOLLOWING AXILLARY LYMPH NODE DISSECTION AMONG BREAST CANCER SURGERY PATIENTS
Lymphedema is abnormal accumulation of interstitial fluid in skin due to malfunction of lymphatic system. After axillary lymph node dissection breast surgery lymphedema of involved arm is one of the complications. So the aim of current study is to evaluate the effectiveness of home based decongestive lymphatic therapy on lymphedema and range of motion.
A quasi experimental study was conducted on 100 female patients who have undergone axillary lymph node dissection in Shuakat khanum Memorial hospital Lahore. Study period was from March 2017 to September 2017. Sampling technique utilized was non probability convenience sampling. Written informed consent was taken from each patient. Patients were trained to do self massage and self lymphatic drainage technique once a day. Exercises were instructed to the patients keeping diaphragmatic exercises in between. Girth measurement was assessed pre and post operatively using calibrated tape. Range of motion was measured pre and post operatively through goniometer. Measurement was taken at baseline, and on 1st day, 10th day and 4th week of treatment. Effectiveness of home based decongestive lymphatic therapy was assessed through repeated measure ANOVA.
Home based decongestive lymphatic therapy showed statistically significant changes in arm and forearm circumference (p value < 0.05). Significant increase in degree of shoulder flexion, shoulder abduction, shoulder external rotation and shoulder internal rotation was observed after home based treatment (p value < 0.001)
Home based lymphatic decongestive therapy proved to be effective in improving shoulder range of motion and reducing lymphaedema post breast cancer surgery.
Arm circumference Home based decongestive lymphatic therapy, lymphedema,
- Muhammad Nouman Tabassum
- Hafiz Muhammad Asim
- Samreen Sadiq
- Shahzad Ahmed
- Lahore College of Physical therapy, LM&DC,
- Sundas Zahra
- Government College University, Faisalabad.
INACCURACY OF NONINVASIVE BLOOD PRESSURE MONITOR DEVICES, DO WE HAVE AN ALTERNATIVE?
Blood pressure (BP) is obligatorily measured each time a patient visits Emergency room (ER) or is admitted in ICU/CCU. Accuracy of blood pressure measurement in clinical settings is the key to appropriate diagnosis of hypertension in a patient. It remains elusive, however, whether oscillatory automated BP measurement yields lower values than auscultatory manual methods. It has been witnessed that both the devices give different readings of the same patient at one point in time. This study helped to determine the accurate or more reliable of the two devices.
A double-blind randomized clinical cross over trial was carried out at Ziauddin University Hospital from February 2018 to June 2018. Sample of 100 was taken through random sampling. The device used in this study was the Dinamap Procare 100. SPSS 20 was used for data entry and analysis.
Results: The mean of difference in systolic manual Blood Pressure (sMBP) and systolic automated Blood Pressure (sABP) was estimated to be 15.62 with a standard deviation of ± 8.57, while the mean of difference in diastolic MBP and ABP was 12.6 with a standard deviation of ± 24.7. Both systolic and diastolic readings were far low by automated devices in comparison to Manual devices.
The results of this study suggested that automated method in measurement of BP frequently shows lower BP. This can influence diagnosis of hypertension and management of certain medical conditions.
Blood Pressure Calibration; Hypertension; Intensive care Unit; Emergency room
- Aisha Khan Jadoon
- Fasiha Sohail
- Arzu Jadoon
- Sumera Nawaz Qabulio
- Department of Medicine, Ziauddin Medical University, Karachi
QUANTITATIVE ASSESSMENT OF THYROID GLAND VOLUME AMONG THE ETHNIC GROUPS OF KARACHI POPULATION
Thyroid gland volume varies from population to population. In this study mean thyroid gland volume among the ethnic groups in Karachi population was determined.
A prospective cross-sectional study was carried out in the Radiology Department of Ziauddin University Hospital Clifton Karachi, from January 2013 to in May 2014. Healthy subjects aged 21 years and above were recruited through convenient sampling. Serum thyroid stimulating hormone was evaluated in order to recruit euthyroid subjects. Ultrasonography of 416 euthyroid subjects was performed to determine the thyroid gland volume.
Mean thyroid volumes reported were as follow: In Urdu speaking it was reported to be 5.47± 2.29 ml, in Sindhi 6.44 ± 3.23ml, in Pathan 6.52 ± 3.07ml, in Punjabi 7.02 ± 4.28ml, in Hazarah 7.05 ±3.91ml and in Balochi7.56 ± 4.52ml. Mean thyroid volumes were significantly different among all the ethnic groups (P-Value 0.015).
Mean total thyroid gland volumes, right and left lobe volumes were found to be significantly different among the ethnic groups that exist in Karachi population. Long term variations in the level of intake of iodine among the ethnic groups may have resulted alterations in genotype that probably has resulted in significant variation in the mean TGV among the ethnic groups.
Ethnic Groups, Reference Values, Thyroid Gland, Thyrotropin, Ultrasonography.
- Mahrukh Kamran
- Department of Anatomy, Dow University of Health Sciences,
- Iffat Raza
- Karachi Institute of Medical Sciences,
- Maria Mohiuddin
- Humdard Medical and Dental College,
- Nausheen Adnan
- Karachi Institute of Medical Sciences,
- Sadaf Saheen
- Mohtarma Benazir Bhutto Shaheed Medical College,
- Rabia Rehan
- Dow University of Health Sciences.
TO COMPARE THE EFFECTS OF ORAL MISOPROSTOL ALONE AND IN COMBINATION WITH INTRACERVICAL FOLEY’S IN INDUCTION OF LABOR
Induction of labor (IOL) is an obstetric intervention designed,usedin 20-30% of all pregnancies. The aim of this study was to assess the efficacy of oral misoprostol alone versus oral misoprostol and Foley’s catheter for IOL.
All pregnant women age ≥18 years requiring induction of labor for various reasons and with unfavorable cervixes admitted in Ziauddin University Hospital Karachi are included in the study. Women were induced in “Group A” with an intracervical Foley’s catheter and tablet misoprostol 25 microgram given orally. In group B, women were given misoprostol 25 microgram tablets alone orally, subsequently every6 hourly for a maximum of four doses.
Normal vaginal delivery was significantly higher in group A (n=62, 59.6%) than that of group B (n=42, 40.4%) patients. Caesarean section was found higher in group B (n=25, 83.3%) patients than that of group A patients (n=516.7%; p-value <0.001). Frequency of meconium was found in 3 (14.3%) patients in group A while 18 (85.7%) in group B (p-value <0.001.
The number of successful inductions within 24 hours was found better among women receiving oral misoprostol with intracervical Foley’s. Moreover, spontaneous vaginal delivery was also found higher in women receiving oral misoprostol only.
Oral misoprostol, intracervical Foley, Induction of labor
- Dania Junaid
- Habiba Sharaf Ali
- Department of Obstetrics and Gynecology, Ziauddin University Hospital,Karachi, Pakistan.
PERCEPTION OF DENTAL STUDENTS ABOUT PBL METHOD FOR CONSTRUCTIVE LEARNING
Problem Based Learning (PBL) is a widely used constructive teaching approach for undergraduate Medical and Dental students for many years. This is an effective teaching tool which integrates students’ prior knowledge which he/she has obtained in their initial years and applies it for solving actual clinical cases which they usually encounter in the clinical rotations.This exercise broadens their thinking and learning capacity and makes them active, self-directed and vigilant learners. They also learn how to work in a team and collectively come up with the best possible answers of the given clinical scenario.
The main objective of this study is to evaluate dental students’ perception regarding Problem Based Learning (PBL), which is a fruitful teaching strategy for student’s effective professional development and also to assess the extent students benefit from this teaching method and to help them develop professional skills and attitude.
A cross sectional study was conducted amongst the Dental students of all (four) years of Bachelors of Dental Surgery (BDS) from Aug to Sep 2017 at Ziauddin University (College of Dentistry), Karachi, Pakistan. A Verbal consent was taken from all the students and each student was asked to fill a 21-item questionnaire for evaluating their perceptions about PBL teaching methodology. The students’ response about PBL was measured by a 5 point Likert scale. The statistical analysis of data was calculated by SPSS version 20. Percentage and frequencies were calculated for qualitative data and Mean/SD for quantitative statistics. ANOVA was applied to suggested strong association between PBL and development of professional attitude and skills. The p-value of > 0.05 was statistically significant.
Students’ thoughts regarding PBL as an effective teaching strategy were assenting. They positively benefited from this learning method which is represented by mean scores of ≥ 3 in the study. The mean score of 1.85 (<2) indirectly highlights that students are not wasting their time by performing this exercise. There is a significant association between PBL method and development of professional attitude and skills by p-value of < 0.00001
It aids the medical educators to perform internal evaluation to record students’ progress in every module for marking their final assessment.
- Mehwish Feroz Ali
- Saima Akram Butt
- Maryam Basim
- Department of Oral Pathology, College of Dentistry, Ziauddin University, Karachi, Pakistan.
IMPACT OF STRESS ON VARIOUS ORGAN SYSTEMS AND ITS THERAPEUTIC MANAGEMENT
The marked disruption of homeostasis of a physiological system (a cell, tissue, organ, or whole organism), is more commonly known as stress. However, physiological systems are constantly exposed to more acute stresses. Psychological stress is an important component with the potential to affect physiology adversely as has become evident from various studies in this area. Advances in our understanding of molecular response of several physiological systems to stress are discussed in this review article. It is hoped that such understanding will facilitate the development of approaches to ameliorate some of the limitations these stresses place on individuals. Although studies have established numerous effects of psychological stress on human physiology, yet there is no such review article in which effects of stress on different organ systems is compiled.
Stress, Organ system, Management
- Ambreen Malik Uttra
- UmmeHabiba Hasan
- College of Pharmacy, University of Sargodha, Sargodha, Pakistan
- Mehreen Malik Uttra
- District Head Quarter (DHQ) Teaching Hospital Sargodha, Sargodha, Pakistan
- Malik Ghulam Muhammad Uttra
- Department of Community Medicine, Sargodha Medical College, Sargodha, Pakistan
ENDODONTIC RETREATMENT USING SURGICAL AND NON-SURGICAL METHODS. A BRIEF REVIEW OF LITERATURE
The success rates for root canal therapy, when done under acceptable clinical guidelines and aseptic conditions are generally high. The microbial etiology of periradicular periodontitis is such that it sometimes requires great effort to eliminate the infection from the peri-radicular tissues and the root canal system. Majority of the pariapical radiolucent lesions heal after endodontic treatment uneventfully. However, there may be some cases that require periradicular surgical procedures so that the pathological tissues from the per-apical areas could be removed which could not have been removed by orthograde root canal treatment. In clinical endodontics, such decisions are very important especially when surgical and non-surgical retreatment has to be provided. The aim of the current paper is to briefly discuss the different factors responsible for failures in endodontics, the prognosis and decision making, and to further evaluate the retreatment of surgical and non surgical endodontic procedures as a whole. The factors responsible for success and failure of different treatment modalities have also been addressed in the current descriptive review.
Retreatment, Root Canal Therapy, Clinical Endodontics, Treatment Failure
- Abdul Hakeem Qureshi
- Division of Operative Dentistry, Ziauddin College of Dentistry, Karachi, Pakistan.
- Azizullah Qureshi
- Department of Operative Dentistry, Liaquat University of Medical & Health Sciences, Karachi, Pakistan.
- Shoaib Razi
- Muntazar Mehdi
- Fatima Farhan
- Haroon Rashid
- Division of Prosthodontics, Ziauddin College of Dentistry, Karachi, Pakistan.
VDR GENE POLYMORPHISMS: THE INDEPENDENT LINK TO ASTHMA
Vitamin D is synthesized in the body via the action of UV light on the skin or obtained from dietary sources and supplements. It helps the body regulate calcium and phosphate levels, plays a critical role in the development of immunity against infectious diseases and several studies have suggested a link between vitamin D supplementation and prevention of colon, prostate and breast cancers. Low levels of serum 25-hydroxyvitamin D have also been implicated in the development of pulmonary diseases including asthma, chronic obstructive pulmonary disease, pneumonia and viral/bacterial upper respiratory tract infections.
Asthma, a chronic inflammatory condition involving the lower airways, has become exceedingly prevalent in Pakistan. According to a study conducted in 2014, the prevalence of asthma is 14.7% among children between 3-7 years of age, with an overall prevalence of 23% for wheezing in the pediatric age group. Since the prevalence of asthma has grown, the factors that influence asthma development as well as the implications of those findings need to be explored in detail.
Vitamin D receptor gene polymorphisms have been studied to determine their association with asthma risk, development and severity. However, even though multiple studies have been carried out to determine an association, the results are inconclusive and unclear. The purpose of this review article is to go through the vast amount of literature published online, summarize it and discuss the reasons why the results found may be inconclusive.
Vitamin D, Vitamin D3 receptor, Calcitriol, Asthma
- Amenah Jafarey
- Saeeda Baig
- Department of Biochemistry, Ziauddin University
SUCCESSFUL DIAGNOSIS OF PULMONARY ALVEOLAR MICROLITHIASIS BY A NEW MODALITY
Pulmonary alveolar microlithiasis is a rare disease with an almost unheard of pathogenesis. With very few cases to document worldwide, predominantly being discovered in Turkey, Italy, and America, it has been nearly impossible to determine a concrete etiology. However, one standout biochemical finding most cases of PAM have in common is a mutation in the SLC34A2 gene coding for the sodium-phosphate cotransporter found in Type II alveolar cells. This cotransporter is responsible for maintaining equilibrium of phosphorus which is a vital component of surfactant. Diagnostic exploration is achieved via radiological imaging, bronchoalveolar lavage and above all, transbronchial lung biopsy. However, in this particular case, due to the patient’s hypoxic condition, Technetium 99m diphosphonate scanning was employed in place of the biopsy. A non-invasive procedure, technetium 99m can detect extensive pulmonary uptake, hereby diagnosing the patient and protect against the physical damage and accompanying side effects inflicted upon the patient by various invasive procedures. In future, to avoid wastage of resources, the use of technetium 99m diphosphonate scanning should be more prevalent in the diagnosis process of PAM.
- Ashok Kumar
- Mehroze Rehman
- Waliya Badar Hossain
- Rubaab Majida Mohammed
- Nadeem Rizvi
- Deparment of Pulmonolgy, Ziauddin University, Karachi,
- Maria Malik
- NHS, UK.
A DEBILITATING COMPLICATION OF MEASLES VIRUS: SSPE
Subacute sclerosing panencephalitis (SSPE) is a rare and chronic neurodegenerative disease caused by an unceasing infection of the brain by an altered form of the measles virus acquired earlier in life. The initial symptoms usually involve regressive changes in intellect and personality. Over a span of several months, the psychological symptoms are augmented by neurologial symptoms, which most often composes of myoclonic jerks. This disorder more often affects male children or adolescents as compared to females and adults. SSPE cases are now mostly seen in developing countries where measles virus is still highly prevalent. Here we report a case of a 6 years old male who presented to the Primary Health Care Centre in a small settlement area of Karachi; with complaints of gradual weakness of all four limbs associated with loss of power and mild fever. The boy was also having myoclonus seizures involving right upper arm and right facial jerks. Brain MRI showed no physical abnormality although the Electroencephalogram revealed abnormal signals which confirmed SSPE.
- Neha Kamran,
- Fatima Jehangir
- Department of Famliy Medicine, Ziauddin University, Karachi, Pakistan.
EFFECTIVENESS OF TEACHING ECG STRATEGY IN PRECLINICAL YEARS: STUDENTS’ PERSPECTIV
ECG interpretation is an important skill in patient care provision in all levels of health care system. Although its importance cannot be denied in clinical practice, ECG patterns of patients are often misdiagnosed causing adverse outcomes and even death of patients. This study aims to assess the basic knowledge in undergraduates about ECG interpretation and to determine the effectiveness of teaching ECG strategy during the preclinical years.
A cross sectional study was conducted in Ziauddin University Karachi in which 232 MBBS and BDS students from preclinical years participated. A structured questionnaire was administered regarding ECG teaching in preclinical years. Answers were recorded on Likert scale. Statistical analysis was done on SPSS version 20. Frequencies and percentages were calculated for categorical variables. Chi square test was used to compare groups. P value of ≤0.05 was considered as significant.
Among 232 students 132(81.5%) MBBS and 62(88.6%) BDS, considered the use of practical classes as a good mode of teaching ECG while 124(76.5%) MBBS and 59(84.3%) BDS students considered problem based learning to teach ECG. 54(77.1%) BDS and 134(82.7%) MBBS students considered ECG to be taught by a cardiologist. The correct response rate of the basic knowledge of ECG was 83% among MBBS and 80% among BDS students.
The basic knowledge of ECG interpretation was good among students of Ziauddin University. However there is a need of more integrated program along with collaboration with cardiologists to teach this competency.
Electrocardiogram, learning, interpretation, competency.
- Shazia Hashmat
- Syed Tousif Ahmed
- Department of Physiology, Ziauddin University,
- Zulfania Akhtar
- Rehman Medical College Peshawar,
- Moazzam Shahid
- Department of Biochemistry, Ziauddin University,
- Hiba Noor
- Hira Abdul Qayyum Memon
- Peoples Medical College, Nawabshah,
KNOWLEDGE, AWARENESS AND PRACTICE OF FORENSIC ODONTOLOGY AMONG DENTAL PRACTITIONERS IN KARACHI, PAKISTAN
Forensic odontology is an expanding field within the domain of forensic sciences, where dental knowledge is applied in identification of individual(s) through analysis of the dental related records. In this study we aimed to assess the knowledge, awareness and practices of dentists in the field of forensic odontology.
This cross-sectional study was conducted over 248 dentists practicing in teaching hospitals as well as private practice in Karachi, Pakistan. Multiple close-ended questions were answered by the respondents, in which their knowledge and awareness about forensic odontology was evaluated. They were also asked about their practices of maintaining dental records of the patients.
Majority of the dentists had knowledge about importance of forensics in dentistry (86.2%) and mostly (88.7%) were aware that they could be of help to forensics experts if they maintain proper records. But when asked about their practices in maintaining dental records, only 64.5% responded positively.
The results of this study show that the dentists have sufficient knowledge and positive attitude in the field of forensic odontology. Lack of practice in dental record management was demonstrated amongst majority of the dental practitioners.
Dental Practices, Forensic dentistry, dental records
- Saima Akram
- Zaeem Arif
- Department of Oral Pathology, Ziauddin College of Dentistry, Ziauddin University. Karachi, Pakistan,
- Shoaib Khan
- Department of Science of Dental Materials, Ziauddin College of Dentistry, Ziauddin University. Karachi, Pakistan
- Sanam Tauheed
- Department of Orthodontics, Jinnah Medical and Dental College, Karachi, Pakistan