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Rahim Yar Khan, Pakistan

Ayub M.,Durham University | Poongan I.,Tees | Masood K.,Sheikh Zayed Medical College | Gul H.,Fatima Jinnah Medical College | And 5 more authors.
Child Psychiatry and Human Development

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. Source

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

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. 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

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

Mannan A.,Services Institute of Medical science | Anwar S.,Sheikh Zayed Medical College | Qayyum A.,Deparment of Urology | Tasneem R.A.,Services Institute of Medical science
Singapore Medical Journal

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. Source

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

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. Source

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