Journal of the Pakistan Medical Association
Latest Publications


TOTAL DOCUMENTS

1232
(FIVE YEARS 1231)

H-INDEX

2
(FIVE YEARS 2)

Published By Scopemed International Medical Journal Managment And Indexing System

0030-9982

Author(s):  
Javeria Sajid ◽  
Muhammad Naveed Riaz

Objective: To examine the immediate and mediate inferences among depressive adults with and without brain damage. Methods: The descriptive, comparative study was conducted from November 6 to June 19, 2019, in Sargodha, Pakistan, and comprised depressive adults of either gender enrolled from various local mental health facilities. After applying Stroop test to identify brain damage, the subjects were divided into adults with brain damage in group A, and adults without brain damage in group B. Logical inferences of both groups were identified using three decision situations, and the findings were compared between the groups. Results: Of the 170 individuals approached, 120(70.5%) were included; 60(50%) in each of the two groups. Overall, there were 76(63%) males and 44(37%) females. The overall age range 18-60 years, with 105(88%) being young adults aged 18-49 years. Chi-Square Test was applied to test the hypotheses. Findings revealed that Group A exhibited higher frequency of immediate inferences on three conditions of certainty (55, 53, 58) as compared to Group B (23, 21, 20) while group B exhibited higher frequency on mediate inferences on the conditions of certainty (37, 39, 40) as compared to Group A (5, 7, 2). Group A exhibited higher frequency of immediate inferences on three conditions of risk (54, 55, 56) as compared to Group B (14, 23, 22) ----Continue


Author(s):  
Mehjabeen Musharraf ◽  
Ambreen Aslam ◽  
Lubna Baig

Objectives: To explore the role of media during mass casualty events and its impact on the people. Method: The qualitative thematic content analysis was conducted at Jinnah Sindh Medical University, Karachi, from 2028 to 2020 and comprised semi-structured in-depth interviews and focus group discussions involving participants from the health sector and policymakers at the provincial level. Besides, frontline workers such as the ambulance drivers and the first-aid-givers were also included. Data was subjected to conventional content analysis to generate themes. Results: There were 5 in-depth interviews and 4 focus group discussions in the study. Qualitative analysis revealed that the media has a great deal to do in times of a disaster. The media is the strongest weapon and largely impacts people's mind and behaviour, but it has been playing with their emotions and creating unrest among them. Conclusion: There is a need for the policymakers to set guidelines and define the role of the media in times of a disaster. Key Words: Mass casualty, Media, Catastrophe.


Author(s):  
Fouad Fathy Bahgat ◽  
Ibrahim Majed Fetyani ◽  
Ali Hamad Alnasser ◽  
Abdulmohsen Mohammed Alkhalaf ◽  
Mohammed Omar Baqais ◽  
...  

Type 2 Diabetes Mellitus (T2DM) is a major health issue in Saudi Arabia, with a prevalence of 23.7% in 2015. Several factors contribute to the occurrence of Mild Cognitive Impairment (MCI) and its progression to Alzheimer's disease in patients with T2DM. This study assesses MCI and fatigue severity and their relationship in patients with T2DM. Out of the 160 Saudi adults interviewed at the King Khalid University Hospital in Riyadh from October 2019 till March 2020, 80 were known cases of T2DM while the rest were non-diabetic individuals. The Montreal Cognitive Assessment (MoCA) test, Mini Mental State Exam (MMSE) and Fatigue Severity Score (FSS) were used to evaluate MCI and fatigue severity, respectively. According to the MoCA scale, 68.7% diabetic individuals as against 42.5% from the non-diabetic group had MCI. While the FSS showed that 40% of the diabetic group vs 26.3% of the non-diabetic were fatigued. In conclusion, patients with T2DM are at a higher risk of developing MCI. Keywords: Type 2 diabetes mellitus, Mild cognitive impairment, Fatigue, Mini mental state exam, Montreal Cognitive Assessment, Saudi Arabia.


2022 ◽  
Vol 71 (12) ◽  
Author(s):  
Sana Javed ◽  
Muhammad Zaid ◽  
Sumera Imran ◽  
Ayesha Hai ◽  
Muhammad Junaid Patel

Objective: To estimate the frequency of patients with fibromyalgia (by using the 2010 Modified Criteria for Fibromyalgia by American College of Rheumatology ( ACR ) presenting to Internal Medicine clinics  Methods: A cross-sectional study conducted in the department of Internal Medicine, the Indus Hospital, khi, Pakistan between December 2016 and March 2018. Patients who visited internal medicine clinics, met the selection criteria, were included in the study. After taking informed consent patients were assessed for fibromyalgia according to the new 2010 Fibromyalgia Diagnostic criteria questionnaire. The patients were asked the questions in the national language, Urdu. Data analyzed using SPSS version 21. P value of < 0.05 was considered significant. Results: Of the 267 patients presenting to the internal medicine clinics and consenting for participating in the study 149 (55.80%) met at least one of the 2010 Fibromyalgia Criteria. The prevalence of fibromyalgia as estimated in this study was 56% with no difference in gender. Mean age of patients with fibromyalgia was 42.3 ± 14.6 and patients without fibromyalgia was 38.9 ± 13.7 which was statistically significant (p-value = 0.05, 10% level of significance). Of the 267 patient 197 (73.8%) were female and 70 (26.2%) were males, a male to female ratio of 1:2.81.  Conclusion: All patients with generalized pain should be evaluated for fibromyalgia and a diagnosis made to reduce the cost of further referrals and investigations and delay in the management of this debilitating disorder. Keywords: Fibromyalgia, Chronic fatigue, Generalized Pain  


2022 ◽  
Vol 71 (12) ◽  
Author(s):  
Pooja Deepak ◽  
Roha Saeed Memon ◽  
Fizza Tariq ◽  
Hassan Ahmed ◽  
Shaheen Bhatti

Systemic lupus erythematosus (SLE) is an autoimmune disease that has certain characteristic features but can also present with misleading signs and symptoms especially when it is of late-onset. Various case reports address its association with thrombotic thrombocytopenic purpura (TTP), however, its association with parkinsonism remains unclear. We present the case of a 58-year-old male who reported with acute-onset parkinsonism along with some gastrointestinal symptoms. Detailed laboratory investigations unmasked the underlying SLE with an overlapping picture of TTP. This unusual presentation in a resource-constrained setting created challenges and subsequent delays in the diagnosis and management of the patient. Despite urgent care, the patient’s age, presence of overlapping conditions, and multi-organ involvement were some of the factors due to which the treatment failed and he could not survive. We report the association of SLE with secondary TTP and parkinsonism.


2022 ◽  
Vol 71 (12) ◽  
pp. 2761-2765
Author(s):  
Lubna Ghazi ◽  
Murtaza Dhrolia ◽  
Aamna Hamid ◽  
Ruqaya Qureshi ◽  
Kiran Nasir ◽  
...  

Objective: Despite being an important predictor of morbidity and mortality, routine screening for malnutrition in dialysis patients is not a common practice in Pakistan. Modified Subjective Global Assessment (SGA) is a convenient, inexpensive and practical method to assess nutritional status particularly in resource limited setup. Methods: This cross sectional study was conducted in The Kidney Center Post Graduate Training institute (TKC-PGTI). Patients on maintenance hemodialysis (MHD) were included through non-probability consecutive sampling. A one-time SGA score was calculated based on the history and physical examinations using modified SGA or Dialysis Malnutrition Score (DMS). Chi square test was applied to find association between variables, while to observe the amount of effect of factors on SGA score; binary logistic regression analysis was run. P value of ? 0.05 considered significant. Results: Mild-Moderately malnourished patients were the most frequent in our study 96(64%).None of patient had severe malnourishment. Females were 2.6 times more prone for malnourishment (p value=0.009). More than 5- years on hemodialysis also increased the risk of malnourishment by 12.5 times (p value <0.001). Overweight patients had 85 % less chance of being malnourished as compare to patients with normal weight (p value=0.004). Conclusion: Malnutrition is quite common in hemodialysis patients, which necessitates its regular assessment and monitoring. There is a need to assess the reasons of more malnourishment in female as compared to male. Similarly, the longer duration (> 5 years) on hemodialysis also need attention for prevention and cure of malnourishment.  Continuous...


2022 ◽  
Vol 71 (12) ◽  
Author(s):  
Mudassir Hussain ◽  
Abdul Khalique ◽  
Pardeep Kumar ◽  
Asad Shehzad Hassan ◽  
Altaf Hashmi ◽  
...  

Since the declaration of a COVID-19 pandemic in March 2020 teaching institutions started the process of adjusting to the new challenge. Medical education could not be imparted the way it used to be and some new methods had to be taken to adapt to the pandemic. At our institute, each week two lectures were recorded and later uploaded on the Youtube Channel and shared with students. This was followed by an MCQs based test using Google forms. Ten lectures were delivered in 5 weeks to 55 participants.  Majority of residents agreed that this activity increased their knowledge of the subject and opted to continue it in future.  With help of short online lectures (< 30 mins) and short online tests (5 MCQs), the learning experience of residents can be enhanced. In future, more online resources can be used to incorporate this method of teaching. 


2022 ◽  
Vol 71 (12) ◽  
pp. 2838-2838
Author(s):  
Muhammad Umer ◽  
Syed Wasif Bukhari

Endoscopy nowadays is widely used as a diagnostic and therapeutic tool for various gastrointestinal diseases due to it being less invasive and safer. However, amongst some adverse events is delayed bleeding. The definition of delayed bleeding requires endoscopic hemostasis and/or blood transfusion after at least two days of treatment. (1) Oesophageal cancer is comparatively more common in Pakistan, being 7th most common malignancy in men and 6th most common in women in Karachi. (2) Oesophageal endoscopic submucosal dissection (E-ESD) employed in the treatment of the above- mentioned cancer has an incidence of delayed bleeding of about 1.3-6.7%. (1) The prevalence of gastric cancer across Pakistan was about 2-18% (3), for which endoscopic submucosal dissection is often used has an incidence of delayed bleeding of 4.7-15.6%. (1) Endoscopic therapy for gastroesophageal varices can also result in delayed bleeding, the incidence of which easily reaches up to 10%. (1) In a retrospective cohort study of 124,422 patients conducted in Japan, it was found that vonoprazan was more effective in reducing the risk of delayed bleeding compared to omeprazole. (OR= 0.75) (1) Vonoprazan works by competitively inhibiting the potassium-acid channel resulting in strong and sustained acid inhibition. (4) It was also found to have a superior effect in the eradication of H Pylori and an equal effect in acid-related disorders. (5)  In the retrospective study mentioned above, it is also worth noting that the efficacy of vonoprazan was variable with respect to procedures and was most prominent with gastroduodenal endoscopic submucosal dissection (OR=0.70). (1) Other procedures did not elicit any significant difference. In addition, standard/high dose vonoprazan proved to be most efficacious in reducing the risk of delayed bleeding compared with standard/high-dose PPI and low-dose vonoprazan. It was also observed that patients taking anti-thrombotic medications at a higher risk of delayed bleeding also benefited from high-dose vonoprazan. (OR=0.74) (1) The findings above compel the conclusion that high dose vonoprazan should be ideal for reducing the risk of delayed bleeding in patients who have undergone gastroduodenal endoscopic submucosal dissection and/or are on anti-thrombotics. Though high-dose vonoprazan does look promising, it is imperative that more randomized controlled trials on more diverse populations be conducted to further explore its efficacy and safety as the drug might be a potential first line of therapy.


2022 ◽  
Vol 71 (12) ◽  
pp. 2850-2850
Author(s):  
Muhammad Khuzzaim Shakeel Khan

No abstract has been written separately as it is a Letter to the Editor.


2022 ◽  
Vol 71 (12) ◽  
Author(s):  
Maleeha Shah ◽  
Muhammad Daniyal Nadeem ◽  
Ayesha Saleem ◽  
Muhammad Taimoor Khan ◽  
Neelam Asghar

The artery of Percheron is a rare variant of the posterior cerebral circulation. It is characterised by a single arterial trunk that supplies blood to bilateral paramedian thalami and rostral midbrain. Its occlusion can have a very wide range of presentation, and initial imaging including CT of the head maybe normal. Diagnosis and eventual treatment is usually delayed. We describe the case of an elderly man who presented with loss of consciousness, aphasia, and bilateral lower limb weakness. He was diagnosed with bilateral thalamic infarction due to the occlusion of the artery of Percheron only after an MRI of the brain was performed. Despite treatment his symptoms did not resolve completely. Keywords: Thalamus/blood supply, Cerebral arteries, Magnetic Resonance Imaging.


Sign in / Sign up

Export Citation Format

Share Document