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Mansoor M.,Jinnah Postgraduate Medical Center
Journal of the College of Physicians and Surgeons Pakistan | Year: 2017

Application of constricting objects over penis for auto-erotic purpose can lead to dangerous results. A variety of metallic and non-metallic objects are used. The removal of these objects is a great challenge. We report a case of a young man who placed a hard metallic ring around his penis for sexual pleasure. A 22-year old man presented in emergency department with complain of painful swelling of his penis since 4 hours. Physical examination revealed part of penis distal to ring as congested and markedly tender with decreased sensation. He was diagnosed as grade 2 penile incarceration injury. After giving analgesic, intravenous fluid and antibiotics, the patient was shifted to emergency operation room. Under general anaesthesia, the metallic ring was removed by string method and multiple aspirations technique. The ring was successfully removed. His postoperative recovery was uneventful.


Bhutta Z.A.,Aga Khan University | Hafeez A.,Health Services Academy | Rizvi A.,Aga Khan University | Ali N.,John Snow | And 6 more authors.
The Lancet | Year: 2013

Globally, Pakistan has the third highest burden of maternal, fetal, and child mortality. It has made slow progress in achieving the Millennium Development Goals (MDGs) 4 and 5 and in addressing common social determinants of health. The country also has huge challenges of political fragility, complex security issues, and natural disasters. We undertook an in-depth analysis of Pakistan's progress towards MDGs 4 and 5 and the principal determinants of health in relation to reproductive, maternal, newborn, and child health and nutrition. We reviewed progress in relation to new and existing public sector programmes and the challenges posed by devolution in Pakistan. Notwithstanding the urgent need to tackle social determinants such as girls' education, empowerment, and nutrition in Pakistan, we assessed the Effect of systematically increasing coverage of various evidence-based interventions on populations at risk (by residence or poverty indices). We specifi cally focused on scaling up interventions using delivery platforms to reach poor and rural populations through community-based strategies. Our model indicates that with successful implementation of these strategies, 58% of an estimated 367 900 deaths (15 900 maternal, 169 000 newborn, 183 000 child deaths) and 49% of an estimated 180 000 stillbirths could be prevented in 2015.


News Article | November 6, 2016
Site: marketersmedia.com

— New York’s innovative neurosurgeon, Dr. Saeed Bajwa has been chosen to join The Leading Physicians of the World, an organization recognizing doctors of excellence from across each field of medical specialization. Already an esteemed Fellow of the American College of Surgeons, the International College of Surgeons and the American Association of Neurological Surgeons, Dr. Bajwa was recently distinguished for his years of dedication, experience and superior patient care, and for his impressive, pioneering approach to the surgical treatment of the brain and spine. His inclusion in the respected medical group’s annual journal underscores a lifelong commitment to professional development and his insistence on using the most technologically advanced methods available. The Pakistani-born doctor’s well-earned reputation comes not only from an earnest drive to help those suffering from disease and chronic pain, but from his ability to keep his practice at the vanguard of medical progress. This forward-thinking approach can be traced back to 1976, when he received his MD degree at Nishtar Medical College of the University of Punjab in Lahore, Pakistan, where he was a gold medal recipient for First Position in Surgery. After completing his residency in General Surgery and Neurosurgery at the Combined Military Hospital in Lahore, Dr. Bajwa moved to the United States where he completed post-graduate studies in General Surgery at New York’s Mount Sinai Hospital, followed by two years in Philadelphia undertaking Neurosurgical training at the Medical College of Pennsylvania. In the two following years, he attended State University of New York Upstate Medical University in Syracuse, where the SUNY Health Science Center elected him to the national honor medical society, Alpha Omega Alpha, as well as presented him with the Distinguished Teaching Award for his work in education. As a specialist who now joins The Leading Physicians of the World, Dr. Saeed Bajwa’s learning is clearly an ongoing quest. Over the course of his thirty-year career, he has strengthened his extensive knowledge of neurological surgery by consistently training on the latest groundbreaking medical technology in the company of other leading specialists. In 2004, he was involved in the development of an artificial disc for alleviating lower back pain with DePuy Spine, a Johnson & Johnson company. He later became an early adopter of applications like the CyberKnife Robotic Radiosurgery System, a tool that emits focused doses of high radiation to inoperable tumors anywhere on the body. His patient-centered philosophy led him to American Spine in Maryland, where in August of 2015, he completed a certification program in Endoscopic and Minimally Invasive Operations of the Lumbar and Thoracic Spine. Last year he also acquired MAZOR robotics for his practice at Southern New York NeuroSurgical Group, P.C. in Binghamton, NY; Dr. Bajwa is one of very few surgeons certified to use MAZOR, the minimally invasive procedural instrument that allows for precise treatment of scoliosis, vertebral compression fractures and spinal deformities. His many accomplishments place him at the forefront of neurosurgery. Dr. Saeed Bajwa has delivered more than 100 speeches to community-based physicians on the topics of Neurology and Neurosurgery. He is affiliated with Wilson Regional Medical Center (Johnson City, NY), Binghamton General Hospital (Binghamton, NY), Lourdes Hospital (Binghamton, NY) and SUNY Upstate Medical University Hospital (Syracuse, NY) and serves on the boards of many community services dedicated to serving people with neural and spinal injuries. Additionally, Dr. Bajwa has generously donated to the Tameer-e-Nau Trust, which provides education and medical assistance for underprivileged communities of Pakistan. In 2012, he helped develop the first CyberKnife Radiosurgery Center for Pakistan at the Jinnah Postgraduate Medical Center (JPMC) in Karachi, and founded two premier institutions: Shifa International Hospital in Islamabad and Doctors Hospital and Medical Center in Lahore, Pakistan. Dr. Saeed Bajwa Proud Recepient of The ICNA Relief USA Award of Appreciation: http://www.abc6.com/story/33637050/dr-saeed-bajwa-proud-recepient-of-the-icna-relief-usa-award-of-appreciation Spine surgeon leader to know: Dr. Saeed Bajwa of Southern New York Neurosurgical Group: http://www.beckersspine.com/spine-leaders/item/28887-spine-surgeon-leader-to-know-dr-saeed-bajwa-of-southern-new-york-neurosurgical-group.html For more information, please visit http://www.ICMediaDirect.com


Minhas M.S.,Jinnah Postgraduate Medical Center
Journal of the Pakistan Medical Association | Year: 2010

Objectives: To evaluate clinical features, treatment and relationship to the time period between dislocation, reduction and early complications of traumatic dislocation of hip in children. Methods: Case series conducted at Jinnah Post Graduate Medical Centre Karachi from July 2005 to August 2009. Children with traumatic hip dislocation up to fifteen years of age who presented in last four years were included in this study. Their clinical information, etiology, associated injuries, duration, method of reduction and early complications are evaluated through emergency room proforma and indoor record. Follow up of patient was updated in outpatient department. Results: We had eight patients, six boys and two girls. Youngest 2.4 years and eldest was 12 years with mean age of 6.2 ± 3.8 years. All presented with posterior hip dislocation. Etiology was road traffic accident in two and history of fall in remaining six patients. Average duration of time between dislocation and reduction was 19 hours range 3-72 hours. Dislocated hips were reduced under General Anaesthesia in two patients and under sedation analgesia in six patients. No complications were noted in eight cases with mean 18.75±13.23 months follows up. Conclusion: Traumatic hip dislocation in children is not rare. Slight trauma causes dislocation in younger age and immediate closed reduction and Immobilization reduces complications.


Kumar A.,Jinnah Postgraduate Medical Center
Journal of Nepal Health Research Council | Year: 2013

Interstitial lung disease (ILD) is a group of disease characterized by fibrosis and scarring of the lung while Systemic Lupus Erythematosus is a multisystem disorder and both of these diseases are of unknown etiologies. Interstitial lung disease, as a presenting feature of SLE without any significant systemic involvement is a unique presentation and this case reports such example. Keywords: interstitial lung disease; systemic lupus erythematosus.


Bhutto A.R.,Jinnah Postgraduate Medical Center
JPMA. The Journal of the Pakistan Medical Association | Year: 2012

To determine the correlation of hepatic venous waveform changes with severity of hepatic dysfunction and grading of oesophageal varices. A cross-sectional analytical study was conducted at Jinnah Postgraduate Medical Centre, Karachi, Medical Unit-III, Ward-7 from January 2009 to December 2009. Cirrhotic patients with portal hypertension were included in study. Patients presented with acute variceal bleeding, previous treatment with beta blockers or nitrates, sclerotherapy endoscopic band ligation, portal vein thrombosis, severe clotting defects, hepatic encephalopathy grade III or IV and noncirrhotic portal hypertension; were excluded from the study. Upper G I endoscopy was carried out in all patients after informed consent. Oesophageal varices were classified according to Baveno III while hepatic function was assessed and grouped by Child-Pugh classification. Colour Doppler ultrasound was carried out on all patients. Their waveforms were classified as monophasic, biphasic triphasic and the correlation of these hepatic vein waveforms with Child-Pugh class and size of oesophageal varices was evaluated. Statistical significance was defined as P?0.05. Total of 65 patients who met the inclusion criteria and included in the study with mean age of 47.39 +/- 10.91 (range 23-70) years. Among these 51 (78.5%) were males while 14 (21.5%) were females. On the basis of hepatic function 32 (49.2%) patients presented in Child-Pugh Class A, 23 (35.4%) with Class B and 10 (15.4%) patients had Class C. Hepatic venous waveform was triphasic in 5 (7.7%), biphasic in 18 (27.7%), and monophasic in 42 (64.6%) cases. The relationship of these waveforms had significant relation with hepatic dysfunction (p < 0.012) while insignificant with grading of oesophageal varices (p 0.29). Upper GI endoscopy revealed large grade varices in 37 (56.9%) patients, 17 (26.2%) patients had small grade varices while no varices were found in 11 (16.9%) patients. Hepatic venous waveform pressure changes have significant relation with severity of hepatic dysfunction but insignificant relation with grading of oesophageal varices. Further studies using a combination of various Doppler parameters are required to create indices with a better predictive value.


Malik U.U.,University of Karachi | Siddiqui I.A.,Jinnah Postgraduate Medical Center | Hashim Z.,University of Karachi | Zarina S.,University of Karachi
Clinica Chimica Acta | Year: 2014

Background: Oxidative stress is associated with many diseases including cancer. Oral squamous cell carcinoma (OSCC) is a prevalent cancer involving oral cavity. We evaluate the activity of paraoxonase 1 (PON1) in serum samples of subjects suffering from OSCC along with malondialdehyde (MDA) levels, a marker for oxidative stress. Antioxidant status in OSCC may reflect the role of oxidative imbalance in the disease. Methods: Forty-five patients suffering with OSCC and 30 healthy controls were selected for the study. Serum paraoxonase (PON) and arylesterase (ARE) activities were measured in subjects suffering from OSCC and their healthy counterparts. To examine the status of lipid peroxidation, MDA concentrations were estimated and a correlation was determined between PON activities and MDA concentrations. MDA expression in cancer and normal adjacent tissue was studied through immunohistochemical (IHC) analysis. Total reactive oxygen species (ROS) level was determined in serum from normal and diseased subjects. Our results revealed that both PON and ARE activities of PON1 were significantly decreased in OSCC patients. Serum MDA concentrations were inversely correlated to PON activity. Immunohistochemical analysis showed a higher expression of MDA in cancerous tissue. Total ROS levels were found to be significantly elevated in cancer subjects. Conclusions: Along with other antioxidants, PON levels may act as an indicator of oxidative stress in cancer. © 2013 Elsevier B.V.


Lateef M.U.,Jinnah Postgraduate Medical Center
Asia-Pacific journal of public health / Asia-Pacific Academic Consortium for Public Health | Year: 2010

The objective of the study was to estimate the magnitude of road traffic fatalities occurring in Karachi, Pakistan. A 2-source capture-recapture model was applied to obtain a reliable estimate of the magnitude of the problem. A conservative adjusted estimate of fatalities generated, using data from 2 sources matched by at least name, gender, age, and location. In 2008, police reported 616 fatalities whereas hospitals recorded 1092 fatalities due to road traffic crashes. The capture- recapture analysis estimated at least 1375 fatalities. Police data show 55% deficit from the estimated figure and 43.6% deficit from the observed one, whereas hospital data show 20.6% deficit from the estimation. Road traffic crashes and resulting fatalities and injuries are a much more substantial health problem than is evident from official statistics. The capture-recapture analysis can be used as a tool to provide affordable and reliable estimates in developing countries where routine official statistics suffer from underreporting.


Kumar A.,Jinnah Postgraduate Medical Center
Journal of Ayub Medical College, Abbottabad : JAMC | Year: 2010

Hepatitis B (HB), Hepatitis C (HC) and their risk factors are amongst the major health problems in developing countries including Pakistan. This study aimed to screen for HB and HC among people who visited General Practice clinics and also to identify the differences of screening positive cases by age and sex. This was a retrospective study conducted in Tando Muhammad Khan city, one of the rural districts of Sindh. All together we reviewed 5989 laboratory reports of people for hepatitis B and C on consecutive basis from two laboratories. A pre-designed and structured perform was used to collect the required information. Chi-squared test and univariate analysis was calculated to assess the difference in HB and HC proportion by age groups and sex. One-fourth of reports were positive for at least one entity whereas 8% and 17% of reviewed reports of adults (> 18 years and above) were screened positive for HB and HC respectively. Positive screened tests were higher among older age group compared to young age group (HB: older age group = 56.6% vs. younger age group = 43.4%; OR = 1.07) and (HC: older age group = 58.3% vs. younger age group = 41.7%; OR = 1.08). In the same way, positive screened tests were higher among men compared to women (HB: men = 67.0% vs. women = 33.0%; OR = 1.2) and (HC: men = 62.0% vs. women = 38.0%; OR = 1.3), A large proportion of people were screened positive for HB and HC inthis study. Prevention and screening are suggested at larger scale for urgent planning and implementation of intervention strategies in this regard. Further research is also recommended to explore this important health issue at large scale.


Saeed N.,Jinnah Postgraduate Medical Center
Journal of Ayub Medical College, Abbottabad : JAMC | Year: 2010

In standard or conventional cholecystectomy gallbladder is approach through a subcostal incision of 7-10 Cm. New technique and procedures have evolved, aiming at decreased tissue damage, pain, hospital stay and complications. This study was conducted to assess cholecystectomy through 5 Cm mini-laparotomy. This study was conducted at Department of General Surgery, Ward-26, Jinnah Postgraduate Medical Centre, Karachi from January, 2008 to January, 2009. Both sexes irrespective of age were included in this study. Ninety cases were females and 10 were male. Mean age of the patients was 48 years. Mini-cholecystectomy was performed on patients and results evaluated as percent and frequency. This study included 100 patients with cholelithiasis. Mini-cholecystectomy was possible in 95% cases, and in 5 cases incision had to be extended to conventional cholecystectomy. The average operating time was 50 minutes and postoperative hospital stay was 2-days and postoperative complications like minor biliary leal haemorrhage and wound infection was seen in 10 cases. Mini-cholecystectomy is a safe procedure with shorter operative time, fewer complications, better prognosis, and less of postoperative hospital stay. It may be recommended as a procedure of choice where laparoscopic facilities are not available.

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