Journal of Muhammad Medical College ( J Muhammad Med Coll)
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Bilateral multiple giant juvenile fibroadenomas of breast.
Full text linkA case of adolescent girl, with bilateral giant fibroadenomas. On history first appeared as small nodules at the age of eleven years and attempt mass of 1855 grams by seven nodules of various sizes measuring, largest 15 x 14 x 10 cm and smallest 1.5 x 1.5 x 1 in dimensions. Although these developed insidiously over the period of seven years, patient ignored the lesion as well the increased in size. Soon after marriage, her husband realizes that the lesions needs consultation and brought her to Combined Military Hospital Chhor Umerkot
Gastrointestinal and Hepatic manifestations of COVID-19 in patients attending tertiary care hospital
Full text linkIntroduction: To evaluate the frequency of Gastrointestinal (GI) symptoms and elucidate the association of GI symptoms and hepatic injury markers with the severity of COVID-19 and mortality.Methodology: Single-centered observational study recruited 160 confirmed COVID-19 positive patients who were admitted in Medical Unit-1/C1 of Civil hospital Karachi, Pakistan from 21 February to 30 April 2021. Data was ana-lyzed using SPSS version 23.0.Objective: To evaluate the frequency of GI symptoms and elucidate the as-sociation of GI and hepatic abnormalities with the severity of COVID-19 and its mortality.Results: Among 160 patients, 20% presented with digestive symptoms; ab-dominal pain (33.1%), and nausea (33.1%) being the most common. GI symptoms and liver injury markers notably ALT, AST, and GGT were signifi-cantly associated with severity of disease (p value<0.05), ICU admissions (p value<0.01), and poor outcomes (p value<0.01).Conclusion: COVID-19 infected patients presenting with GI symptoms and liver dysfunction have a worse prognosis and needs to be addressed on ur-gent basis to avoid complications and reduce mortality.Key words: Covid-19, Hepatic injury, Gastrointestinal symptoms, Liver dysfunction
Diagnostic yield of FNAC: Our Experience
Full text linkIntroduction: Fine needle aspiration cytology (FNAC) is currently recommended as first line investigation in suspected malignancy as it provide useful information to plan surgery. FNAC is the most cost-effective method of obtaining a morphological diagnosis and prognostic purpose of superficial and deep-seated lesion throughout body and also as less expensive than diagnostic surgery.
Objective: To document diagnostic yield of FNAC at Mirpurkhas.
Methodology: This retrospective study was conducted between 1st January 2019 to August 2020 at My Diagnostic Laboratory Mirpurkhas city. A total of 162 patients with the mostly swelling of head and neck and Breast underwent Fine needle aspiration procedure was performed. Tuberculosis suspected was additional sample was sent for slides were also stained with Ziehl Neelsen (Z.N) methods to detected acid fast bacilli (AFB) directly.
Results: In our series 162 cases were analyzed that had underwent FNAC. In 29.62% cases, finding was cystic & mesenchymal lesion, followed by granulomatous inflammation in 28.22% cases. In 20.37% cases lesion diagnosed as malignant.
Conclusion: Tuberculosis is found as most common cause of cervical lymphadenopathy. Breast malignant lesion particularly in young patient can also be diagnosed with reasonable accuracy
Evaluating Factors Influencing Memorization in Undergraduate Medical Students.
Full text linkObjectives: To evaluate the techniques used by medical students for better memo-rization and identify factors that directly or indirectly influence the process of memorization.Method: This cross-sectional study included undergraduate medical students from four public/private medical schools of Karachi. Through stratified random sampling, 400 medical students were administered a questionnaire that had been developed through focused group discussions and pre-tested on a smaller population. Data was analyzed using SPSS version 26.0 by applying Pearson’s chi square test for cate-gorical variables and Mann Whitney U test for scale variables.Results: Passion for the medical field was the key motivating factor for most the students (n=133; 33.3%). The source of motivation to study in students was related to the phase of their training at medical school, with preclinical and clinical years showing a slightly significant difference (P=0.049). Silent reading (n=203; 50.8%), intermittent power naps (n=125; 31.2%) and making notes and flowcharts (n=169; 42.2%) were the preferred memorization techniques. 46.9% (n=188) students re-quired < 4 hours of study daily and no significant difference in the number of study hours required per week was observed between the two genders and the students of preclinical and clinical years. Majority of the students considered lack of sleep (n=232; 58%) and social media (n=146;36.5%) their biggest sources of distraction.Conclusion: Desire to help humanity is the main driving force for medical students. The extensive syllabus requires dedicated number of study hours and use of memo-rization techniques suited for oneself.Keywords: Learning preference, Memorization technique, Motivation factor, Memory aid, Academic performance
COVID – 19: Lessons to Learn.
Full text linkWe witness a dramatic change, in all aspect of Life, throughout the world after Covid-19. It started in Wuhan, Hubei Province, China where few cases of atypical pneumonia presented in late November and early December 2019. Clinical picture mimicking viral pneumonia1. According to an unpublicized report from the Chinese government, the first case can be traced back to 17 November 2019; the person was a 55-year-old citizen in the Hubei province. There were four men and five women reported to be infected in November. The number of coronavirus cases in Hubei gradually increased, reaching 60 by 20 December and at least 266 by 31 December2. A coronavirus was soon identified as the cause of the outbreak and tentatively named as the 2019-nCoV by the World Health Organization. On 11 Feb 2020, the World Health Organization officially named it SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2) and the SARS-CoV-2 infection was named COVID-19.1
One can easily understand the impact upon routine life just by seeing these numbers; As on 30 Nov 2020, there were 63, 360234 confirmed cases and 1, 475825 confirmed deaths.
Trends of expenditure on Immunization in Pakistan since 2000.
Full text linkWorld health organization started Expanded Program on Immunization in 1974. At that time only 5% of the children were covered globally in the first year on pro-gram. In Pakistan 16.34% of the total population is under five years’ children. In 2000 Global Alliance for Vaccines and Immunizations (GAVI) was introduced in Paki-stan. Since 2000 by the finance and HR support from GAVI, additional 370 million children have been vaccinated from deadly disease. It has been noticed that the expenditure on immunization remained inconsistent over the time period. Since 2000 the massive change is seen in the pattern of expenditure on immunization both routine and campaigns to meet the goals. In Pakistan, expenditure on immun-ization has reached to $240 million annually but still the fully immunized children are between 43-62% of all the under-five population of the country. Immunization services needed to be on time and efficiently provided to the communities. The growth in fiscal gap and need for expenditure competition in financing, has subju-gated policymaking. There is a need for reviewing the current policies for budgeting immunization program and needful risk assessment will support future financial crisis.Key Words: Immunization, Global Alliance for Vaccines and Immunization,Extended Program of Immunization
The frequency of vibrio cholera 01 EL TOR (Inaba And Ogawa) and its Resistance Pattern in Karachi.
Full text linkIntroduction: Cholera is an acute infectious disease of small intestine, caused by the bacterium Vibrio cholerae. More than 200 serogroups of V. cholerae have been identified. In Iran, Inaba strains were 75% resistant against trimethoprim-sulfamethoxazole in 2011, while during 2012-13 it was 100%. Ogawa strains showed 96% resistance against trimethoprim-sulfamethoxazole in 2011, whereas 100% resistant in 2012, while no resistance was seen in 2013 against the same antibiotic.
Objective: To determine the frequency of vibrio cholera 01 EL TOR (Inaba And Ogawa) and its resistance pattern in Karachi.
Methodology: Samples were collected from patients with acute diarrhea with rice-water stool from Medical Unit, JPMC and NICH, Karachi between October 2015 to August 2016. These samples were then transported to Microbiology Department, Basic Medical Sciences Institute, JPMC, Karachi and processed according to standard protocol.
Results: No growth was noticed in 147 (66.81%) samples while a total of 28 (12.7%) were V. cholerae species, and 45 (20.45%) were other organisms. The distribution of V. cholerae serotypes, out of 28 V. cholerae species, 13 (46.4%) were of Inaba serotypes, 09 (32.1%) were of Ogawa serotypes while 06 (21.4%) were of Non-01 serotypes.
Conclusion: The susceptibility results of tetracycline and trimethoprim-sulfamethoxazole are not very favorable. Involvement of multidrug resistant V. cholerae O1 serotypes in the community is a very serious public health concern. Such patients were observed to be very difficult to treat in the community.
 
Pattern and localization of headache in cerebral venous sinus thrombosis (CVST).
Full text linkIntroduction: Cerebral Venous Sinus Thrombosis (CVST) is an underdiagnosed but not rare type of neurovascular disease. There is involvement of cerebral veins or dural sinuses instead of arteries. The vein or dural sinuses are blocked by thrombus resulting in increased pressure and leading to rupture of vessels and leakage of blood into the brain. Headache is the most frequent presenting symptom of CVST.Methodology: This descriptive study was conducted at Sheikh Zayed Medical Col-lege and Hospital Rahim Yar Khan. All consecutive patients with confirmed diagno-ses of CVST were included in the study. Diagnosis of CVST confirmed by MRI/MR Venogram. An informed consent was taken and the data was collected on a ques-tionnaire. Ethical permission was taken from Institutional ethical review com-mittee.Results: Headache was present in 51 (81%) of 63 confirmed CVST patients. Data regarding characteristics of headache from 51 patients was analyzed. The headache was associated with photophobia (4%), phonophobia (6%), loss of vision(6%), nau-sea (9%) and vomiting (42%) .The headache was not related with infarct and hem-orrhage on Computed Tomography scan and Magnetic Resonance Imaging. The site of headache was not linked with site of sinus thrombosis.Conclusion: Headache is the common symptom in patients with CVST. Usually the headache in CVST is subacute, throbbing, unilateral or localized to some specific region i.e frontal, temporal and occipital. There is no relation between headache and site of sinus thrombosis. Also there is no link between headache and hemor-rhage or infarct on Computed Tomography scan (CT) and Magnetic Resonance Im-aging (MRI).Key words: Cerebral Venous Sinus Thrombosis , Headache, MRI/MR Venogram
Diabetes Mellitus Type 2 and role of GINSENG as a Prevention and Control.
Full text linkIntroduction: Diabetes is one of the most challenging diseases of this era. Improper dietary habits and sedentary life style are considered as the foundation stone for metabolic disorders including diabetes. Intake of large amount of animal fat leads to insulin resistance (IR) and oxygen radical formation.IR leads to increase glucose level in blood resulting in diabetes mellitus.Objectives: This experimental study was intended to correlate high fat diet re-sulting in weight gain to diabetes and emphasized the role of ginsenoside in reduc-ing body weight and blood glucose level by both increasing insulin secretion as well as increasing the sensitivity of insulin receptors.Methodology: This is an experiment study on animal model, conducted at DUHS during the year 2017. It comprises of 50 male Albino Wister rats. They were divided into 5 groups for study purpose. Group1 was put on normal balanced diet and serve as control, while other 4 groups were treated with different diet. The ani-mals were sacrificed after 12 weeks; blood sugar was monitored weekly for 12 weeks and finally at the end of experiment, there blood sugar level were estimated. Statistical analysis was done by using SPSS 16, using ANOVA test to evaluate the significance among groups. P-Value < 0.05 was considered as significant.Results: The collected data was interpreted as Mean ± S.D. The results revealed that high fat diet increases blood glucose level, remarkably increase body weight as well as liver weight. By the administration of ginseng root extract significant de-crease in body weight, liver weight and blood glucose levels was observed in dose dependent manner.Conclusion: The results of this study revealed that high fat diet (HFD) is a major cause of metabolic syndrome including diabetes. It can be prevented by changing life style and introducing ginseng as anti-diabetic agent in obese.Key Words: Diabetic mellitus, body weight, Ginsenosid
Students’ perspective for online teaching program “Survive” during period of Covid-19.
Full text linkIntroduction: During panacea of Covid-19; educational institutes started online teaching program. This was first experience for almost all faculty members and the students. As we all are familiar with face-to-face learning; it is imperative to get feedback from the students regarding their experience of online academic activities.
Objective: To document the students’ perspective regarding online teaching program of Muhammad Medical College Mirpurkhas named as “SURVIVE”
Methodology: After approval from Research and Ethical Committee of Muhammad Medical College this questionnaire-based study conducted during month of July 2020. This self-constructed questionnaire has 6 components: Organization and Structure, Teaching and learning, Teaching staff and other students, Assessment, Attribute development and Unit performance as a whole. Each component had 3-4 questions and students had to rate their satisfaction level on Likert scale.
Results: Each component of the questionnaire was examined. Among participants; female students (n=103) outnumber male students (n=22). The highest number of students were from 4th year MBBS (n= 47; 37.6%) followed by 1st year BDS (n=26;20.8%) and final year MBBS (n=25; 20%). Overall, 106 (86%) students rated Survive as satisfactory.
Conclusion: Being first experience, yet survive was found nearly in all aspect as satisfactory way of leaning during pandemic of Covid-19