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Khan A.Z.,Fatima Jinnah Medical College
Journal of the College of Physicians and Surgeons Pakistan | Year: 2013

Objective: To identify the non-academic attributes developed during 5 years of training in medical school. Study Design: Sequential mixed method. Place and Duration of Study: The study was conducted on final year medical students of four medical colleges in the city of Lahore, from March to September 2010. Methodology: Probability random sampling was employed to identify public sector medical colleges for inclusion in the study through Lottery method. In the first phase, survey was done with the help of questionnaires, distributed amongst 280 students, selected on the basis of convenience sampling. It was triangulated with data collected by in-depth structured interviews on 46 students selected using purposive sampling after formal informed consent. For quantitative data percentages of the categorical variables were calculated through SPSS version 10. For qualitative data, themes and patterns were identified using Content Analysis technique. Results: Majority of the medical students (80%) learn the attributes of integrity, self-reliance, tolerance and independence during their schooling. Sixty five percent students thought that the values of humanity, forbearance, righteous attitude in face of adversities and sympathetic behaviour towards peers and patients helped them in being better medical students. Thirty five percent said they faced the negative influences of gender bias and gender discrimination which has led to their impaired professional growth. Eighty percent of the students believe that the teaching methodology employed is teacher centric which does not let them become problem solvers, team players, reflective learners and hampers development of effective communication skills. Conclusion: Medical schooling in our part of the world helps in developing untaught attributes such as integrity, selfreliance, tolerance, independence, sympathetic attitude and good communication skills which are the same as are developed in the medical students of advanced countries, which can be fostered further by formally addressing them in the curriculum. Source

Shakoor M.T.,St. Mary Mercy Hospital | Ayub S.,Harvard University | Ayub Z.,Fatima Jinnah Medical College | Mahmood F.,Aga Khan University
Journal of Medical Case Reports | Year: 2012

Introduction: Invasive aspergillosis is a serious complication in immunocompromised patients. It is an opportunistic disease, which predominantly occurs in the lungs, although dissemination to virtually any organ is possible. Invasive aspergillosis in an immunocompetent patient with extension to the mediastinum has rarely been reported. Here, we present the case of a patient with no apparent immunodeficiency state, who presented with Aspergillus endocarditis and fulminant invasive aspergillosis with extensive involvement of the mediastinal structures, which ultimately was responsible for her death. To the best of our knowledge, this is the first reported case in the literature on fulminant invasive mediastinal aspergillosis with extension to the pulmonary vasculature and concomitant Aspergillus endocarditis in an apparently immunocompetent patient without pre-existing lung disease. Case presentation: Our patient was a previously healthy 47-year-old Asian woman, who presented to our emergency room with severe progressive shortness of breath of one month's duration, associated with orthopnea and unstable vital signs. Conclusion: Invasive aspergillosis has been described in the presence of pulmonary disease, such as chronic obstructive pulmonary disorder, and one case has been reported in a patient without preexistent disease, but none of these have been fatal. Our case is therefore the first reported case of its kind. Our case shows that fulminant aspergillosis can occur in an immunocompetent host and can be fatal. We conclude that invasive aspergillosis should not be excluded from the differential diagnosis on the basis of immunocompetency. © 2012 Shakoor et al.; licensee BioMed Central Ltd. Source

Naeem F.,Lahore Institute of Research and Development | Ayub M.,Tees | Masood K.,Sheikh Zayed Medical College | Gul H.,Sir Ganga Ram Hospital | And 5 more authors.
Journal of Affective Disorders | Year: 2011

Background: On average in a year 939 earthquakes of a magnitude between 5 and 8 on the Richter scale occur around the world. In earthquakes developing countries are prone to large-scale destruction because of poor structural quality of buildings, and preparedness for earthquakes. On 8th October 2005, a major earthquake hit the remote and mountainous region of northern Pakistan and Kashmir. We wanted to find out the rate of PTSD in a randomly selected sample of participants living in earthquake area and the correlates of the PTSD. Method: The study was conducted 18 months after the earthquake. We selected a sample of men and women living in the houses and tents for interviews. Using well established instruments for PTSD and general psychiatric morbidity we gathered information from over 1200 people in face to face interviews. We gathered information about trauma exposure and loss as well. Results: 55.2% women and 33.4% men suffered from PTSD. Living in a joint family was protective against the symptoms of PTSD. Dose of exposure to trauma was associated with the symptoms of PTSD. Living in a tent was associated with general psychiatric morbidity but not with PTSD. Limitations: We used questionnaire instead of interviews to detect the symptoms of psychiatric disorders. Conclusions: The symptoms of PTSD are common 18 months after the earthquake and they are specifically associated with the dose of trauma exposure. This may have implications for rehabilitation of this population. © 2010 Elsevier B.V. Source

Naeem S.,Lahore Medical College | Bukhari M.H.,Fatima Jinnah Medical College
Journal of the College of Physicians and Surgeons Pakistan | Year: 2015

Objective: To analyze the expression of various antigens on the leukemic blasts and to determine the hematological parameters, in Acute Lymphoblastic Leukemia (ALL) patients at presentation. Study Design: Observational study. Place and Duration of Study: King Edward Medical University, Lahore and Hameed Latif Hospital, Lahore, from February2013 to March 2014. Methodology: A total of 50 newly diagnosed and untreated patients of ALL were selected from Mayo Hospital and Hameed Latif Hospital. These patients included both genders and all age groups. Hemoglobin, total leukocyte count and platelet count were determined on hematology analyser-Sysmex-Kx-2I. Blast cell percentage was estimated on Giemsa stained blood smears. Immunophenotyping was done on bone marrow samples by 5 colour flowcytometery on Beckman Coulter Navious Flowcytometer. An acute leukemia panel of 23 antibodies was used. The data was entered and analyzed in SPSS version 22. Results: Of the 50 ALL patients, 36 (72%) were B-ALL and 14 (28%) T-ALL. There were 18 (36%) children and 32 (64%) adults. T-ALL included 22% of the childhood and 31% of the adult cases. Immunophenotypic analysis showed that CD19, CD79a and CD20 were B-lineage specific markers whereas cCD3, CD3 and CD5 were T-lineage specific. CD10 was the most sensitive marker for B-ALL and CD7 was the most sensitive marker of T-ALL. TdT was expressed in 92% B-ALL and 71% T-ALL cases, CD34 in 58% and 43% cases and CD45 in 83% and 100% respectively. High leukocyte count (> 50 x 109/L) was present in 58% cases. Hemoglobin was < 10 g/dl in 74% patients and platelet count was below 20 × 109/L in 12% patients. Leukocyte count, hemoglobin, platelet count and blast cell % did not show a significant difference in the two ALL immunotypes. Conclusion: The frequency of T-ALL is higher in childhood as well as adult ALL in our population compared to the Western literature. Antigenic expression of the blast cells also shows some interesting differences. A large number of our patients present with high leukocyte count which is a known factor associated with poor prognosis. Source

Rashid A.,Fatima Jinnah Medical College
Journal of Ayub Medical College, Abbottabad : JAMC | Year: 2010

Osteoporosis has emerged a major health hazard in postmenopausal women. The process of osteoporosis accelerates two year prior to menopause, reaching the peak level during first 3 years of menopause when women loss 3 (see symbol) 5% of their bone mass per year. This study tried to find out the role of phytoestrogne in improving the bone mineral density and bone related biochemical parameters in group of postmenopausal women. Fifty postmenopausal women with age range 50 (see symbol) 60 years were included in the study. Phytoestrogen with mineral supplement were given twice daily for 3 months. Biochemical parameters like serum calcium, magnesium, alkaline phosphatase, uric acid, total protein and oestrogen were determined before and after phytoestrogen therapy by autoanalyser and ELIZA (oestrogen assay). T-score before and after phytoestrogen were find out by densitometer DEXA. The level of serum calcium, magnesium, uric acid and oestrogen was increased in women after taking phytoestrogen but significant difference (p < 0.01) was only observed in case of serum calcium. Level of serum alkaline phosphatase and total serum protein were slightly increased with no significant different before and after phytoestrogen therapy. Value of T-score was although markedly decreased after phytoestrogen therapy but it showed no significant difference. It is concluded that as the early years of menopause are a period of rapid bone loss, and the risk for osteoporosis increases substantially, the habitual intake of soy protein and isoflavones may play a role in the retardation of bone loss. Source

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