Dera Ghazi Khan, Pakistan
Dera Ghazi Khan, Pakistan

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Ayub M.,Durham University | Ayub M.,Esk and Wear Valleys NHS Foundation Trust | Ayub M.,Lanchester Road Hospital | Poongan I.,Esk and Wear Valleys NHS Foundation Trust | And 7 more authors.
Child Psychiatry and Human Development | Year: 2012

A severe earthquake occurred in Kashmir in 2005. The epicentre was close to Muzzafarabad. We collected data on over 1,100 children 18 months after the earthquake to look at symptoms of PTSD and behavioural and emotional problems using well established questionnaires. We found that 64.8% of children had significant symptoms of PTSD. Girls were more likely to suffer from these symptoms. The proportion of children suffering from emotional and behaviour difficulties was 34.6%. This percentage was not different from other studies of children from Pakistan within areas which were not affected by the earthquake. The rate of emotional symptoms was higher in girls while hyperactivity was more frequent in boys. This pattern is similar to other studies from across the world. © Springer Science+Business Media, LLC 2011.


Naeem F.,Lahore Institute of Research and Development | Ayub M.,Esk and Wear Valleys NHS Foundation Trust | Ayub M.,Lanchester Road Hospital | Masood K.,Sheikh Zayed Medical College | And 6 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.


Babar M.I.,Sheikh Zayed Medical College | Ahmad I.,Sheikh Zayed Medical College | Rao M.S.,Sheikh Zayed Medical College | Iqbal R.,Paediatrics Unit | And 2 more authors.
Journal of the College of Physicians and Surgeons Pakistan | Year: 2011

Objective: To determine the frequency of clinical features of Celiac disease (CD) and Celiac crisis in children. Study Design: Case series. Place and Duration of Study: Paediatrics Unit, Sheikh Zayed Medical College and Hospital, Rahim Yar Khan, from September 2009 to September 2010. Methodology: Forty children aged between 4 to 13 years of either gender, presenting with complaints of recurrent diarrhea, abdominal distention, severe emaciation and dehydration were included. The information about breast feeding, weaning diets, age of introduction of wheat diets, onset of diarrhea, characteristics and frequency of stools, growth, vaccination status, symptoms in 1st degree relatives, restriction of Gluten diet in the past and anthropometric measures were recorded. Serological tests against anti-Tissue Transglultaminase (anti-tTG) antibodies were obtained in all cases. Upper gastrointestinal endoscopies were performed and multiple biopsies were taken from distal parts of duodenum. Results: Among the forty children, twenty four (60%) were females and 16 were males (40%). The mean age was 6.35 ± 2.83 years. Thirty five (87.5%) parents were cousins. Breast feeding was not exclusively given and the Gluten containing weaning diets were given as early as 3.5 months of age. Thirty (75%) children presented with typical sign and symptoms of CD. Celiac crisis presented with profuse diarrhea, severe dehydration; abdominal distention; pedal edema, carpopedal spasm due to tetany; wasted muscles; head drop and inability to stand. The serum TtG antibodies in thirty-eight cases (95%) were above the cut off level of 7u/ml ranging from 35-99 u/ml. The histopathology of specimens from distal duodenum revealed lesions of M3 type in thirteen (32.5%) and M2 type in eighteen cases (45%). All cases recovered and improved on follow-up after strict adherence to gluten-free diet (GFD). Conclusion: Majority of children with Celiac disease presented with typical symptom, while Celiac crisis was characterized by severe dehydration, weakness and calcium deficiency signs. Most were the product of consanguineous marriages and were given Gluten - containing weaning foods as early as the 4th month of life. © 2011. College of Physicians & Surgeons Pakistan.


Maqbool A.,Sheikh Zayed Medical College | Hameed O.,Sheikh Zayed Medical College | Athar Z.,WMC | Rafi A.,Sheikh Zayed Medical College
Medical Forum Monthly | Year: 2013

Objective: To assess number, type and diameter of accessory foramen transversarium (AFT) in the cervical spine. Study Design: Descriptive observational study. Place and Duration of Study: This study was conducted at Anatomy department, Sheikh Zayed Medical College, Rahim Yar Khan and Wah Medical College, Wah Cantt., district Rawalpindi. Duration of this study was two years. Materials and Methods: The study included 45 sets of cervical spine (315 human cervical vertebrae). Direct measurements were taken with vernier calipers sensitive to 0.01 mm. The data were collected on a designed collection sheet. Number, type and diameter of AFT were assessed, recorded and analysed. Results: Out of 315 human cervical vertebrae, the numbers of AFTs were mostly observed in the lower cervical vertebrae; C4, C5 and C6 showed AFTs present as 13.33%, 35.55% and 51.11%. AFTs were 33 on right side and 46 on left side. AFT type I was the most common present in 52 vertebrae (16.50%). The mean AFT diameter on right side was 2.13± 0.53 mm and on left side it was 2.29± 0.73 mm. Conclusion: The incidence of AFT was higher in our population and AFTs were more in the lower cervical vertebrae. Studying the number, type and diameter of AFTs is of clinical significance in understanding the possible neurovascular variation and their course. Such variations should always be suspected when examining transverse processes having an unusual pattern of foramina transversaria.


Hameed O.,Sheikh Zayed Medical College | Athar Z.,WMC | Maqbool A.,Sheikh Zayed Medical College
Medical Forum Monthly | Year: 2013

Objective: To assess morphological variations of superior articular facets of atlas vertebrae. Study Design: Descriptive observational study. Place and duration of study: This study was conducted at the Anatomy Department, Sheikh Zayed Medical College, Rahim Yar Khan and Wah Medical College, Wah Cantt., district Rawalpindi. Duration of this study was two years. Materials and Methods: The study included 60 dried human atlas vertebrae of unknown age and sex. The instruments were hand lens, lead pencil and markers. Morphological parameters of presence of a notch/ constriction, presence of a groove, tendency of separation, pressure facets and shape of 120 superior articular facets (SAFs) were examined and noted. Results: In superior articular facets notch/constriction on medial border was 13.33%, lateral border 15% and on both borders 40%. The SAFs without notch/constriction were 31.67%. Grooves on right, left and bilateral facets were 11.67%, 23.33% and 46.67% respectively. No groove was present in 18.33% SAF. The tendency of separation on right and left facets (right 50%, left 48.33%) showed no significant difference. Incomplete separation (right 6.66%, left 8.33%) and complete separation (right 3.33%, left 5%) was slightly more frequent on left side as compared to the right SAF. The pressure facets were present on 5% on right side, 6.66% on left side and 51.66% SAF on both sides. Regarding the shapes of SAF, dumb-bell was the most frequent (34.17%) followed by oval (31.67%) figure of eight (20.83%) and kidney shape (13.33%). Conclusion: The knowledge of quantitative anatomy of superior articular facets of atlas vertebrae will prove useful for the surgeons who perform operative procedure in this region and will help in avoiding complications.


Maqbool A.,Sheikh Zayed Medical College | Athar Z.,WMC | Hameed O.,Sheikh Zayed Medical College
Medical Forum Monthly | Year: 2014

Objective: To assess the prevalence and morphometry of arcuate foramen and comparison with native foramen transversarium in atlas vertebrae of Pakistani population. Study Design: Descriptive/observational study. Place and Duration of Study: This study was conducted at Anatomy department, Sheikh Zayed Medical College Rahim Yar Khan and Wah Medical College Wah Cantt. during a period of two years from Jan 2012 to Dec. 2013. Materials and Methods: The study included 150 dried human atlas vertebrae. Prevalance of complete arcuate foramina (CAFs) in atlas vertebrae were noted and its anteroposterior and superoinferior diameters were measured by vernier calipers with accuracy of 0.01 mm. Size and shape of CAFs were compared with native foramina transversaria (NFTs). Results: Out of 150 atlas vertebrae, 13 (8.66%) showed CAF. The mean anteroposterior diameter of the right CAF was 6.71 mm and that of left was 6.76 mm. The mean superoinferior diameter was 5.07 mm on the right and on left side it was 5.22 mm. The mean cross-sectional area of CAFs was 26.74 mm2 and 27.77 mm2 for the right and left sides respectively. The mean cross-sectional area of the right NFTs was 34.86 mm2, while the mean area for the left was 35.31 mm2. Conclusion: This study provides information on the morphometry of arcuate foramen and ipsilateral native foramina transversaria (NFTs) and their implications. The observation that CAFs are smaller than ipsilateral NFTs suggests that they are an important cause of vertebral artery compression syndromes and needs careful investigations. Knowledge of CAF may help the surgeons undertaking procedures in the CI region.


Hussian M.,Sheikh Zayed Medical College | Arain A.Q.,Shaheed Zulfiqar Ali Butto Medical University | Chiragh S.,Post Graduate Medical Institute
Journal of the Pakistan Medical Association | Year: 2016

Objective: To evaluate the anti-dyslipidaemic effects of pioglitazone in diet-induced non-diabetic hyperlipidaemic rats and to compare them with gemfibrozil. Methods: This comparative animal study was conducted at the Postgraduate Medical Institute, Lahore, Pakistan, from July to September 2011, and comprised Sprague Dawley albino rats divided into three equal groups. Initially all three groups were given high-lipid diet containing cholesterol 1.5g, coconut oil 8ml and sodium cholate 1.0g per 100g of rat chow to induce hyperlipidaemia. From 4th to 8th week, Group A (control) was given 0.5ml of distilled water, Group B was given pioglitazone 10mg/kg body weight, and Group C was given gemfibrozil 10mg/kg body weight as single morning dose by oral route for a period of 04 weeks in addition to hyperlipidaemic diet. Serum lipid levels were estimated at zero, 4th and 8th week. Blood sugar level was estimated at 4th week to exclude diabetic rats.SPSS 17 was used for data analysis. Results: Of the 27 rats, each group had 9(33.33%) rats. At the start of the study, the mean weight was 254.44±14.67g in Group A, 255.11±14.66g in Group B and 252.22±14.18g in Group C. It was 352.22±16.79g, 332.22±17.19 and 328.11± 12.92 at the 8th week. The mean total cholesterol at 0 week was 71.4±4.88 mg/dl in Group A, 71.9±7.03 in Group B and 73.4±5.27 in Group C. At the 8th week, the values were 161.8±9.2 mg/dl, 100.8±7.0 and 95.0±6.6. The mean low-density lipoproteincholesterol levels in the respective groups were 30.2±4.9mg/dl, 32.2±7.0 and 33.6±6.0 at 0 week; 77.8±8.4, 85.1± 15.3 and 86.9± 6.3 at the 4th week and 113.9± 10.1, 60.4± 9.2 (p≤ 0.001) and 54.8± 6.6 (p≤ 0.001) at the 8th week.The mean serum high-density lipoprotein cholesterol at the 8th week was 11.4± 1.7 mg/dl, 19.7± 2.4 (p≤ 0.001) and 19.2± 2.5 (p≤ 0.001) in the three groups, respectively. Conclusion: Treatment with pioglitazone improved serum lipid profile of non-diabetic hyperlipidaemic rats equivalent to that of gemfibrozil. © 2016, Pakistan Medical Association. All rights reserved.


Dixon P.H.,Imperial College London | Trongwongsa P.,Imperial College London | Abu-Hayyah S.,Imperial College London | Ng S.H.,Imperial College London | And 5 more authors.
Journal of Medical Genetics | Year: 2012

Background: NLRP7 (NALP7) has been identified as the major gene involved in the inherited predisposition to recurrent molar pregnancies, a rare recessive condition in which affected individuals have complete hydatidiform moles of diploid biparental origin (BiCHM). The role of NLRP7 in other types of molar pregnancy and reproductive wastage has not been conclusively demonstrated. The purpose of this study was to clarify this by identifying NLRP7 variation in two clinically well-defined groups of patients: women with recurrent BiCHM, and women with three or more recurrent complete hydatidiform moles of proven androgenetic origin (AnCHM). Methods: Fluorescent microsatellite genotyping of molar tissue was used to establish a diagnosis of recurrent BiCHM (four novel cases) or recurrent AnCHM (nine women with multiple CHM). These two groups were subsequently screened for mutations in NLRP7 using DNA sequencing. Additional screening for non-pathological variants was performed in 21 previously published cases of recurrent BiCHM. Taqman genotyping was used to determine the frequency of novel NLRP7 variants in two control cohorts of Caucasian and Asian women with no adverse reproductive outcomes. Results: Of the four novel cases with recurrent BiCHM, two were homozygous for mutations in NLRP7 while one was a compound heterozygote for a nonsense mutation and a pathological variant. No NLRP7 mutations or pathological variants were identified in the fourth case. None of the women with AnCHM carried any mutations or pathological variants of NLRP7. A single case of AnCHM was found to be heterozygous for a novel variant (R413Q). Conclusion: NLRP7 mutations do not represent a major cause of AnCHM.


Mannan A.,Services Institute of Medical science | Anwar S.,Sheikh Zayed Medical College | Qayyum A.,Social Security Hospital | Tasneem R.A.,Services Institute of Medical science
Singapore Medical Journal | Year: 2011

Introduction: This was a retrospective study conducted to assess the nature, presentation, mode of insertion, diagnosis and management of foreign bodies in the urinary bladder. Methods: Between January 1998 and December 2007, 20 patients with foreign bodies in their urinary bladder were treated at our centre. The records of these patients were reviewed and analysed for their symptoms, mode of insertion, diagnosis, management and complications. Results: A total of 20 foreign bodies were recovered from the urinary bladders during the study period. These included JJ stents with calculi, intrauterine contraceptive devices with stones, a rubber stick, ribbon gauze, encrusted pieces of Foley catheter, proline thread with calculus, a suture needle, broken cold knives, the ceramic beak of a paediatric resectoscope, a knotted suprapubic tube, a hair clip, a nail, an electrical wire and a hairpin. The common presenting features were dysuria and haematuria. The diagnosis was established radiologically in most of the cases. The circumstances of insertion were variable; iatrogenic in 16 (80.0 percent) cases, sexual stimulation in two (10.0 percent), accidental insertion by a child in one (5.0 percent) and physical torture in one (5.0 percent). 17 (85.0 percent) foreign bodies were recovered endoscopically, and cystolithotomy was required in three (15.0 percent) patients. Conclusion: The instances of foreign bodies in the urinary bladder are uncommon. A diagnosis is usually made radiologically. Iatrogenic foreign bodies were found to be the most frequent type of insertion encountered. Endoscopic retrieval is usually successful, with minimal morbidity.


PubMed | Shaheed Zulfiqar Ali Butto Medical University, Post Graduate Medical Institute and Sheikh Zayed Medical College
Type: Journal Article | Journal: JPMA. The Journal of the Pakistan Medical Association | Year: 2016

To evaluate the anti-dyslipidaemic effects of pioglitazone in diet-induced non-diabetic hyperlipidaemic rats and to compare them with gemfibrozil.This comparative animal study was conducted at the Postgraduate Medical Institute, Lahore, Pakistan, from July to September 2011, and comprised Sprague Dawley albino rats divided into three equal groups. Initially all three groups were given high-lipid diet containing cholesterol 1.5g, coconut oil 8ml and sodium cholate 1.0g per 100g of rat chow to induce hyperlipidaemia. From 4th to 8th week, Group A (control) was given 0.5ml of distilled water, Group B was given pioglitazone 10mg/kg body weight, and Group C was given gemfibrozil 10mg/kg body weight as single morning dose by oral route for a period of 04 weeks in addition to hyperlipidaemic diet. Serum lipid levels were estimated at zero, 4th and 8th week. Blood sugar level was estimated at 4th week to exclude diabetic rats.SPSS 17 was used for data analysis.Of the 27 rats, each group had 9(33.33%) rats. At the start of the study, the mean weight was 254.4414.67g in Group A, 255.1114.66g in Group B and 252.2214.18g in Group C. It was 352.2216.79g, 332.2217.19 and 328.11 12.92 at the 8th week. The mean total cholesterol at 0 week was 71.44.88 mg/dl in Group A, 71.97.03 in Group B and 73.45.27 in Group C. At the 8th week, the values were 161.89.2 mg/dl, 100.87.0 and 95.06.6. The mean low-density lipoproteincholesterol levels in the respective groups were 30.24.9mg/dl, 32.27.0 and 33.66.0 at 0 week; 77.88.4, 85.1 15.3 and 86.9 6.3 at the 4th week and 113.9 10.1, 60.4 9.2 (p< 0.001) and 54.8 6.6 (p< 0.001) at the 8th week.The mean serum high-density lipoprotein cholesterol at the 8th week was 11.4 1.7 mg/dl, 19.7 2.4 (p< 0.001) and 19.2 2.5 (p< 0.001) in the three groups, respectively.Treatment with pioglitazone improved serum lipid profile of non-diabetic hyperlipidaemic rats equivalent to that of gemfibrozil.

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