Journal of Bahria University Medical and Dental College
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Future Physicians of Pakistan Towards National Health Priorities
Get PDFWith the dawning of 2011, Pakistan medical education direction continues towards preparing graduates for functioning in tertiary care settings. Medical educators and institutions take greater pride in producing specialists and sub-specialists who achieve laurels in developed countries. While Pakistan’s failure to meet the Millennium Development Goals (MDGs) by 20151 suggest reorientation of physicians’ education and research towards improvement of health of individuals and population
Family Medicine Necessity but Still A Neglected Medical Specialty in Pakistan
No full textFamily Medicine is the primary care medical specialty concerned with provision of widespread health care to the person and the family irrespective of sex, age or kind of problem. It is the specialty of extensiveness that integrates the natural, medical and behavioral sciences. It is emerging as a frame of knowledge that is being constantly developed , explored and qualified as an integrative entity. In our country, this specialty was announced in late eighties. The number of qualified family medicine specialists is still alarmingly low in our society. There is also a lack of understanding in majority of our population regarding the existence as well as importance of Family Medicine. Rotation of students in family medicine facility as part of undergraduate medical curriculum may help in fostering an interest among medical students in this newly emerging subspecialty which could have profound effect on delivery of quality health care in Pakista
Obstetric Restless Legs Syndrome in Industrialized Area of Pakistan
Get PDFObjective:To determine the frequency of obstetrics Restless legs syndrome(RLS) in industrialized area of Karachi and to identifypossible risk factors of RLS in Pakistani population.Materials and Methods:This cross-sectional study was carried out in a Teaching Hospital from 1st January 2013 to 31st January2014.All pregnant women of 20- 44 years old in first trimester without peripheral vascular disease, painful legs, peripheralneuropathy, nocturnal leg cramps and moving toes were enrolled in the study. A close-ended questionnaire developed fromInternational RLS Study Group was used.The diagnosis of RLS was then ascertained by the obstetrician by using the criteriaof the International RLS Study Group and they were labeled as “RLS sufferers and were kept in RLS group while others thatis non RLS sufferers were kept in the healthy group. Descriptive and comparative statistical analyses were performed usingSPSS Statistical Software 17.Results:During a period of thirteen months, 900 pregnant women were interviewed and examined out of these 85.7% fulfilledthe criteria and constituted the study population. Out of these 31.90 % were RLS suffers. Among RLS suffers 55% were residentof industrialized area. The majority of RLS suffers were multigravida and in their advance pregnancies.Conclusion: The frequency of obstetrics Restless legs syndrome (RLS) in industrialized area of Karachi is 31.90 % Possiblerisk factors of RLS in Pakistani population are multigravidity, advance pregnancy, industrialized area etc
Total Sialic Acid (TSA) Level as a Tumor Marker in the Diagnosis of Oral Cancer
Get PDFObjective: To estimate serum Total Sialic Acid (TSA) levels in different grades of oral squamous cell carcinoma and to accessit`s utility as a tumor marker in this cancer.Materials and Methods: This study was conducted in 68 adult subjects equally divided into two groups, healthy individualsand patients with oral squamous cell cancer. Under aseptic precautions venous blood was drawn and serum was separated.Estimationof serum total sialic acid level was done according to Spectrophotometeric method of Plucinsky. Statistical analysis was carriedout by using SPSS 19.Results: Total subjects in the study included were 58.82% males and 41.17% females. Mean age of oral cancer patients was48.05 ± 8.82 years. There was significant male predominance with P<0.05. Oral cancer was most common in Tobacco+ Chaliya+ Areca nut and Gutka+pan groups. Mean serum total sialic acid (TSA) level in control group was 60.2 ± 4.27 mg/dl, whereasit was 99.1 ± 18.30 mg/dl in oral cancer group. It was significantly increased in oral cancer group when compared to controlgroup with P value < 0.01. There was progressive elevation in mean serum TSA level in oral squamous cell carcinoma,Conclusion:Estimation of serum total sialic acid level (TSA) in different grades of oral squamous cell carcinoma showedpositive relation with stage of malignancy, specifically with the tumor burden. It can be used as a diagnostic biomarker in oralsquamous cell cancers
Evaluation of Retinoblastoma According to Histological Grading, TNM Staging and Age at Presentation
Get PDFObjective: To evaluate retinoblastoma, according to histological grades, TNM staging and age at presentation.Materials and Methods: This cross sectional study was conducted in Department of Pathology BMSI- JPMC Karachi from1st January 2009 to 31st December 2013 during which a total of 80 cases of retinoblastoma were received. Out of which 68 werereviewed and morphological diagnosis was done on H&E staining. Histological grades and TNM staging were categorized.The data was analyzed by using SPSS version 22.Results: In 80 cases of retinoblastoma the mean age of patients was 3.64 years with 3-4 years (53.75%) of age being thecommonest. Amongst 68 cases, well differentiated retinoblastoma were seen in 7.35%, moderately differentiated 11.76%, poorlydifferentiated 26.47% and undifferentiated 51.41% cases. Varied pattern of TNM staging were observed. Majority (60.29%)in stage IV followed by 19.11% in stage I and 10.29% each in TNM stage II and III. Regional lymph node metastasis was seenin 4/68 cases (5.88%) while 3/68 (4.41%) showed distant (CNS) metastasis. All these cases (7/7) were in TNM stage IV withmajority showing grade 4 (75%) and grade 3 (25%) histology.Conclusion: Evaluation of retinoblastoma showed that commonest age group was 3-4 years. Majority of retinoblastoma caseswere undifferentiated (G4) followed by poorly differentiated (G3). While in TNM staging system varied pattern was observed,majority were in stage IV followed by Stage I. Majority of lymph node and distant metastasis were seen in grade 4 histologyand all of them were in TNM stage IV.Evaluation of Retinoblastoma According to HistologicalGrading, TNM Staging and Age at Presentatio
Walking Step Towards Healthy Life (Sajid Abbas)
No full textHealth benefits of regular physical activity are noticeably increased in recent years and considered as a critical step towards a healthier population. Walking is one of the most accessible forms of physical activity which is appropriate for all age groups and costs nothing.1 Several studies have shown that walking has higher levels of adherence than other forms of physical activity, possibly because it is convenient and overcomes many of the commonly perceived barriers to physical activity such as lack of time, lack of fitness or lack of skil
Immediate Post-Placental Insertion versus Interval Insertion of Intrauterine Devices for Contraception
Get PDFObjective: To compare the frequency of uterine perforation, expulsion and pelvic infection rate of multiload 375 in womenof immediate post-placental (IPP) insertion versus interval insertion (I).Materials and Methods: This Quasi-experimental study was carried out in the Department of Obstetrics & Gynecology, PNSSHIFA Hospital Karachi from 6th October 2008 to 5th October 2009. Fifty patients were selected by consecutive samplingtechnique for Group A (immediate post-placental insertion of multiload 375). Fifty women for group B (interval insertion ofmultiload 375) were selected by simple random sampling during their postnatal follow-up visit. Post- insertion follow up visitwas done within six weeks. The results were analyzed by SPSS version 12 and expressed in frequencies and percentages.Pearson’s Chi-square test was used as the test of significance.Results: Mean age of women in group A was 29.02 ± 2.97 and in group B it was 31.24 ± 5.59 years. Multiparous women optedfor IUD in both groups (48% in group A versus 44% in group B). IUD expulsion was 14% & 18% in group A & B respectively.While infection rate was 4% in group A and 2% in group B. Statistically non significant (P>0.05) results were found. No caseof uterine perforation was noted in both the groups.Conclusion: Although both methods have almost same complication rate but for non compliant women IPP insertion of anIUD is a convenient selection for contraception.Keywords: Intrauterine device (IUD), Immediat
Heat Stroke: Deadly but Preventable
Get PDFA severe wave with temperature as high as 49 oC(120oF) struck southern Pakistan in June 2015. It caused deaths of approximately 2000 people from dehydration and heat stroke mostly in Sindh province and its capital city Karachi.Mr.AsifShuja former DG of Pakistan Environmental Protection Agency claimed that heat wave was a symptom of global climate change, aggravated by de-forestations, expansion asphalt highways and rapid urbanisation1.Dunya News reported at least 1360 patients died due to heat stroke in different hospitals of Karachi2. HEAT EXPOSURE SYNDROME: Four medical disorders comprise a spectrum of illness that can result from exposure to hot environments (1)Heat Cramps(2)Heat Syncope(3)Heat Exhaustion And (4)Heat Stroke.Health conditions that inhibit sweat production or evaporation and increase susceptibility to heat disorders include Obesity, Skin disorders (Miliaria),Reduced cutaneous blood flow(by use of vasoconstrictors and beta adrenergic blocking agents) ,Dehydration ( by use of alcohol and illicit drugs e.g. phencyclidine, LSD, amphetamines and cocaine),Malnutrition,Hypotension and reduced cardiac output,Medications such as anticholinergics, antihistamines, phenothiazines, tricyclic antidepressants, monoamine oxidase inhibitors, diuretics etc.Risk of heat disorder increases with (1) Age (2)Impaired cognition (3) Concurrent illness(4) Reduced physical fitness (5)Insufficient acclimatization etc3. HEAT STROKE: Heat Stroke is a life threatening medical emergency that results from failure of thermo-regulatory mechanism. It is imminent when the core (rectal) temperature approaches 41oC or 105oF and presents in one of two forms: (a) Classic heat stroke that occurs in patients with compromised homeostatic mechanisms. (b) Exertional heat stroke that occurs in healthy persons undergoing strenuous exertion in a thermally stressful environment
Maternal and Fetal Outcomes in Pregnancies Conceived with In-Vitro Fertilization
Get PDFObjective: To assess the outcome of pregnancies conceived by in vitro fertilization.Materials and Methods: A retrospective study utilizing case notes of 110 cases of in vitro fertilization (IVF) delivered in EastSussex Hospital Trust (ESHT)was carried out from 2010 to 2011 in two district general hospitals, Eastbourne and Conquesthospital that come under ESHT. All cases with IVF during these two years were included. Demographic details, predisposingrisk factors, body mass index, causes of infertility, antenatal care, onset of labour, mode of delivery and details of baby werecollected and analysed.Results: Infertility was female related in 46% and male related in 38%. In females tubal factor was the main cause. 18% hadpre-existing medical conditions, polycystic ovaries being the commonest. 75% had singleton pregnancy and 25% twin’s .Nearly6% had antepartum haemorrhage, twins having higher (11%) rates compared to singleton pregnancy (3.6%). The incidence ofpregnancy induced hypertension and diabetes were the same being more in twin compared to singleton pregnancy .There were8.4% singleton preterm deliveries. The singleton babies born with weight of less than 2500 gms were 4.8%. There were 2(1.8%) stillbirths. 3.6% babies had congenital abnormality. In 42 % mode of delivery was caesarean section.Conclusion: Majority ofchildren born following IVF had a good outcome but increased risk of obstetrics and fetal complicationswas found when compared to spontaneously conceived pregnancies. Multiple births remain a major cause of morbidity amonginfertility patient
Trauma Management: Should it be a part of Medical Curriculum?
Get PDFTrauma management is an approach to assess and treat multiply injured patients. Casualties that present within the first twohours of injury are deaths that can be prevented. Medical professionals need to be trained to appraise and manage these patientsduring this period. A variety of courses are available, designed entirely to teach medical professionals to treat trauma patients.Many counties have adopted these programs and now they are being taught in over 60 countries worldwide. In developingcountries, injuries due to trauma are regrettably neglected, and accounts for more than five million deaths each year. This isnearly equal to combined number of deaths from tuberculosis, malaria and HIV/AIDS. Medical graduates are supposed to beable to handle all types of emergencies, common or traumatic. Lack of ATLS, BCLS and ACLS certified doctors in emergencydepartments lead to improper and un-necessary delay in provision of medical care to patients