Vol. 9, Issue 1, JAN – MAR 2015

Journal of Fatima Jinnah Medical College
Vol. 9, Issue 1, JAN – MAR 2015


EDITORIAL

The Consequences of Suboptimal Maternal and Child Feeding.
Looking for Feasible Solution
MUNIR AKHTAR SALEEMI, *RAMEEZA KALEEM**

*Professor & Associate Dean, Faculty of Allied Health Sciences, University of Lahore.
**Assistant Professor & HOD of Dept. of Social & Preventive Pediatrics, FJMU/SGRH, Lahore.

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Malnutrition in Children with Chronic Diarrhea During Early Childhood at A Tertiary Care Hospital, Lahore

AFIFA TANWEER1, GHAZALA PERVEZ ZAMAN2

1Student at the Department of Food and Nutrition, College of Home Economics, Lahore.

2Professor at the Department of Food and Nutrition, College of Home Economics, Lahore.

Correspondence to: Afifa Tanweer, Department of Food and Nutrition, College of Home Economics, Gulberg, Lahore. E-mail: afifatanweer@yahoo.com, Contact number: 0323-4518605

ABSTRACT

Background: There is a two way relationship between disease and malnutrition. The consequences of malnutrition during formative early years can extend long beyond the disease itself, necessitating the interception of this continuous cycle.

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UZMA HUSSAIN, SHAZIA BATOOL, ASIA PARVEEN, ALIA NASIR-UD-DIN
Associate Professor FJMC/ SGRH, Lhr, Registrar, Gynae IV/ SGRH, Lhr, Senior Registrar/ Gynae IV/SGRH, Lhr, Senior Registrar/ Gynae IV/ SGRH, Lhr.
ABSTRACT
Objective: To determine the diagnostic accuracy of Doppler Ultrasonography in diagnosing endometrial
carcinoma in females with post-menopausal bleeding taking histopathology as gold standard.
Introduction: Postmenopausal bleeding (PMB) is one of the most common reasons in patients attending
gynecological OPD. It is a frequent and alarming sign of endometrial cancer though the commonest cause
is an atrophic endometrium. Women with PMB are categorized as those with spontaneous bleeding and
those with bleeding whilst on Tamoxifen or HRT. All these patients should be investigated by TVS,
hysteroscopy and D&C and accordingly should be managed.

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Frequency of Drug Resistance Among Retreatment
Tuberculosis Patients in Gulab Devi Chest Hospital

M. AQEEL UR REHMAN,1 USMAN JAVED IQBAL,2 ZAHEER AKHTER, 3M. JAMIL4

1DMS & Asst. Prof. Pulmonology, 2Demonstrator Cardiac Perfusion, MPH, 3Associate Prof. Pulmonology,
4Medical Officer & DOTS Physician.
ABSTRACT
Objective: Emerging drug resistance is a global challenge. Efforts are underway to detect and treat this
menace. We carried out this study to ascertain the frequency of MDR among Category-II pulmonary TB
patients.

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Frequency of Common Early Complications Following
Omentopexy as Primary Repair in Perforated Doudenal Ulcer

GUL SHARIF, GULAB NOOR, NOOR SARDAR, ZAFFAR IQBAL, SULTAN-E- ROOM, ABDUL WAHAB

For Correspondence: Dr Gulab Noor, CMO Accident and Emergency, Department LRH, Cell:
0333.9366552, Email: afridi404@yahoo.com
ABSTRACT
Objective: To determine the frequency of common early complications following Omentopexy as primary
repair in perforated duodenal ulcer.
Materials and Methods: This was a descriptive study of 6 months duration, carried out from Jan 2014 to
June 2014 in the department of general surgery, Lady reading hospital peshawar. A total of 144 patients
were selected and admitted through emergency. Inclusion and exclusion criteria was set. After detail
history and clinical examination ,all patients were investigated and were prepared for emergency
laparotomy. A detail proforma has been made which contain all information about the patients. SPSS
software (version 17.0) was used for the statistical analysis
Results: Our study shows that 9% patients were in age range < 25 years, 28% patients were in age range 26-50 years, 30% patients were in age range 51-75 years while 33% patients were >75 years. Mean age
was 48 years with a standard deviation of ±5.71. Seventy three percent patients were male and 27%
patients were female. Thirty two percent patients had wound infection and 11% patients had anastomotic
leak.

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SAIQA ZAHEER SHAH, SAIMA AMEER, SAIMA ZAHEER , NEELAM RAHEEL
Department of Diagnostic Radiology, Lahore General Hospital, Lahore, Pakistan.
Department of Obstetrics and Gynecology, Lahore General Hospital, Lahore, Pakistan.
ABSTRACT
Objective: The aim of this study was to determine the Diagnostic Accuracy of Doppler sonography for the
diagnosis of Resistive Index of ovarian carcinoma taking histopathology as gold standard.
Methods: Fifty patients with complex pelvic masses assessed preoperatively with two-dimensional
ultrasound (2DUS), two-dimensional power Doppler (2DPD), color Doppler taking histopathology as gold
standard.

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MOHAMMED ADIL AKHTER1, UJALA NAYYAR2, TAZEEN MAJEED3, UMAR FAROOQ DAR4, KIRAN
NAYYAR5
1Department of Pediatrics, Sir Ganga Ram Hospital Lahore, 2National Committee for Maternal and
Neonatal Health, 3Department of Pathology, Fatma Jinnah Medical College Lahore, 4Department of
Infectious diseases, Institute of Public Health Lahore, 5Oral Pathology, Postgraduate Medical Institute
Lahore. Correspondence to Dr. Ujala Nayyar, Email: uj.nayyar@gmail.com
ABSTRACT
Objective: To access effectiveness of NESTROFT as screening tool for detecting thalassaemia carriers in
extended families of thalassaemia major /intermedia patients.
Patients and Methods: In a cross sectional study total no. of 25 families of index cases of Thalassaemia,
attending Thalassaemia unit of Fatma Jinnah Medical college, Lahore, Pakistan, were visited and 561
samples were collected for CBC, red cell indices, Naked-Eye-Single-Tube-Red-Cell-Osmotic-Fragility-Test
(NESTROFT), Hb Electrophoresis and DNA analysis (if required),without prior iron administration. Average
extended family size was 23.Thisstudy was conducted for duration of 15 months.
Results: 515 NESTROFT tests were valid. 220 NESTROFT were positive and 295 NESTROFT were
negative in detecting Thalassemia trait. Hb electrophoresis was performed as confirmatory test for
Thalassemia trait. Sensitivity of NESTROFT was calculated as 55% and Specificity was 64%. Positive
Predictive Value was 46% and Negative Predictive Value was 64%.

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MUHAMMAD RASHID AYUB, NABEELA RASHID, NAVEED AKBAR HOTIANA
Associate Professor of Pediatrics FMH, Lahore, Associate Professor of Pediatrics SMC, Lahore, Assistant
Professor of Pediatrics FJMC/SGRH Lahore.
Correspondence Author: Dr. Muhammad Rashid Ayub, Department of Pediatrics Fatima Memorial Medical
& Dentistry College, Lahore.
ABSTRACT
Objective: To investigate the spectrum and drug sensitivity of pathogenic bacteria in children presenting
with septicemia.
Methods: A retrospective analysis was performed on the spectrum and drug sensitivity of pathogenic
bacteria in 450 children (age0— 5 years) with septicemia, who were admitted from January to December,2014.

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NAVID QURESHI, IMTIAZ HUSSAIN, FAROGH ZAHRA
1Associate Professor Histopathology, Fatima Jinnah Medical College/ Sir Ganga Ram Hospital, Lahore.
2Senior Registrar Surgical Unit I, Sir Ganga Ram Hospital, Lahore. 3Assistant Professor Surgical Unit I, Sir
Ganga Ram Hospital, Lahore.
Correspondence: email: navidqureshi@hotmail.com. Cell no.: +923008448530
ABSTRACT
Objective: The objective of this study was to prove the efficacy of thyroid FNAC in cases benign nonneoplastic
lesions and malignant lesions.
Study Design: Cross Sectional Survey
Setting: Department of Pathology (Histopathology Section), Fatima Jinnah Medical College, Lahore
Subject and Methods: Fine Needle Aspiration Cytology (FNAC) was used as a diagnostic procedure in
the Department of Pathology (Histopathology Section), Fatima Jinnah Medical College, Lahore, for the
past fifteen years. We have collected the data for past 4 years, (from 2003 to 2007), of FNAC and
correlated with Histopathology. We included 130 cases, in which FNAC was done followed by surgery.
Results: In this study diagnostic accuracy of FNAC in cases of benign lesions was 86.95%, and it was
13.05% in cases of neoplastic lesions.

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USMAN ISMAT BUTT, WASIM HAYAT KHAN, AHSAN ULLAH GHILZAI, SHAHZAD BASHIR,
MAHMOOD AYYAZ, ASIF SAJID, SAID UMER, ANILA CHUGHTAI
Department of Surgery, National Hospital and Medical Centre, DHA Lahore.
Correspondence to: Dr. Ahsan Ullah Ghilzai, Email: ahsankhan73@yahoo.com, Cell: 0300-4359316
ABSTRACT
Objective: To observe the presence of intra-abdominal adhesion in previously non-operated abdomen.
Design: A prospective observational study.
Setting: The National Hospital and Medical Centre, Lahore.
Patients: 150 patients were included in this study.
Main outcome measures: Intra-abdominal adhesions were noted with the help of laparoscope.
Results: There were 48 males and 102 females. Out of the 150 patients adhesions were seen to be
present in 53 patients, the majority of whom were females.

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RABAIL JAVED1, FARKHANDA GHAFOOR2, ASMA MUNIR3, ATIYA MAHBOOB4, MUHAMMAD ASIM5
1Research Officer NHRC (PMRC), Shaikh Zayed Medical Complex, 2Senior Research Officer NHRC
(PMRC), Shaikh Zayed Medical Complex, 3Demonstrator, Department of Haematology, Shaikh Zayed
Medical Complex, 4Professor and Head of Dermatology Dept, Shaikh Zayed Medical Complex,
5Statistician NHRC (PMRC), Shaikh Zayed Medical Complex, Lahore,
Correspondence: NHRC 2nd Floor Federal Post Graduate Medical Institute, Sheikh Zayed Medical
Complex, Lahore. Mobile: 009-23214312913, Email: rabailjaveed@hotmail.com
ABSTRACT
Objective: To find the trends of fertility hormone profile among teenagers.
Study design: Retrospective analytical study.
Method: Recorded data in NHRC lab (year 2006- 2011) was statistically analyzed for different fertility
hormones including leutinizing hormone (LH), follicular stimulating hormone (FSH), prolactin, testosterone,
progesterone and cortisol, in teenager boys and girls (13-19 years).

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AQUILA FAZIL, HINA MASOOD, GUL E RAANA, MARIAM MALIK
Department of Gynae Unit 1, Sir Ganga Ram Hospital, Fatima Jinnah Medical College, Lahore, Pakistan
ABSTRACT
Background: In a developing country like Pakistan, there is a great need to save mother and neonatal life.
Government has launched many programs but due to lack of knowledge and approach of health care
delivery system to people, we lose many lives daily. Lack of adequate knowledge, negative attitude and
inadequate birth preparedness results in loss maternal and neonatal life. Birth preparedness is a plan of
the process of childbirth and it involves choice of place of birth, arrangement for transportation, blood
donors and knowledge of health facility.

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FAZAL AHMED, WASEEM MUHAMMAD
Associate Professor of Surgery, Kohat Institute of Medical Sciences, Administrator Health Ways Hospital,
Kohat.
Correspondence Author:- Dr. Waseem Muhammad, Administrator Health Ways Hospital, Kohat.
Email:- waseem_kt@hotmial.com
ABSTRACT
Background: Surgery is associated with innate risks. Post-operative Ileus is one of the most frequent
complication post-operatively following bowel surgery. The peristaltic movements of the intestine recover
within 12hours completely. The effect of Epidural anesthesia and General anesthesia both on
postoperative ileus has been proved many years ago . Hence the two mode of anesthesia were compared
in our research. Study design is Comparative. Patients having acute appendicitis were selected as it is the
commonest emergency procedure. Moreover increase sample size helped to reduce sample bias.

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UZMA AHSAN*, NADIA ALI AZFAR, LAMEES MAHMOOD MALIK
*Assistant Professor Dermatology Sharif Medical and Dental College, Lahore. Email:
docuzmayusuf@hotmail.com.
ABSTRACT
Introduction: Patients with end stage renal disease (ESRD), frequently present with intractable pruritus. In
the recent past, many newer therapies have emerged for its treatment with variable results. We studied the
antipruritic efficacy and safety of Montelukast sodium, (a leukotriene receptor antagonist), and compared it
with Gabapentin in patients on hemodialysis.
Materials and Methods: The study was conducted in the Department of Dermatology, Sharif Medical and
Dental College Lahore. It was a Quasi experimental study, 60 patients on hemodialysis, with refractory
pruritus were enrolled in each group .Patients were given 10mg of tab Montelukast sodium daily and
300mg of Gabapentin thrice a week for four weeks. Severity of pruritus was assessed using pruritus
scoring by Duo.
Results: Pruritus sev

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SAIF-UR-REHMAN, FAHAD NAZIR, MUHAMMAD IMRAN, MUHAMMAD SALEEM
Department of Orthopedics, Sir Ganga Ram Hospital, Lahore
Correspondence to: Dr. Saif-ur-Rehman, Post-Graduate Resident, Orthopedic Department, Sir Ganga
Ram Hospital Lahore. Email: drsrehman@outlook.com
ABSTRACT
Objective: To determine the correlation between forearm plus little finger length and the actual femoral
length in orthopedic patients presenting with femoral shaft fractures at a teaching hospital in Punjab.
Design: Descriptive cross-sectional study.
Place and Duration of Study: This study was conducted in the department of Orthopedic Surgery, Sir
Ganga Ram Hospital, Lahore from November 2014 to June 2015.
Patients and Methods: 30 patients of both genders, aged between 18-70 years having femoral shaft
fractures undergoing intramedullary nail fixation at Department of Orthopedic Surgery, Sir Ganga Ram
Hospital, Lahore were included in this study. A written informed consent was obtained from every patient.

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FAZAL AHMED, WASEEM MUHAMMAD
Associate Professor of Surgery Kohat Institute of Medical Sciences , Administrator Health Ways Hospital,
Kohat.
Correspondence Author:- Dr. Waseem Muhammad, Administrator Health Ways Hospital, Kohat.
Email:- waseem_kt@hotmial.com
ABSTRACT
Background: Rectal prolapse is an uncommon condition.Increased abdominal pressure is the main
causative factor. Failure of conservative measures should be followed by surgical corrective procedures
like Sclerotherapy followed by more aggressive surgery, including abdominal posterior rectopexy ,
abdominal or perineal bowel resection, transanal suture rectosacropexy , and posterior sagittal
Anorectoplasty procedures have been described. Our study was conducted to observe the results of
Sclerotherapy in young children.

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SYED HASNAIN ABBAS, IMTIAZ HUSSAIN, SHAHID MANZOOR, MUNAZZA ZAFAR, M. ZUBAIR
AHMED
1Senior Registrar, Paediatric Surgery Department, Jinnah Hospital, Lahore 2Senior Registrar Surgical Unit
I, Sir Ganga Ram Hospital, Lahore. 3Associate Professor, Radiology Department, Qaid-e-Azam Medical
College/ Bahawal Victoria Hospital, Bahawalpur. 4Women Medical Officer, Radiology Department,
Bahawal Victoria Hospital, Bahawalpur 5Professor of Neonatal & Paediatric Surgery Department, Bahawal
Victoria Hospital, Bahawalpur.
Correspondence: email:hansum96@gmail.com. Cell no.: +923444088776
ABSTRACT
Objective: To determine the outcome of combination of low dose oral Prednisolone with oral propranolol
for the treatment of infantile hemangioma.
Study Design: Experimental Study
Setting: Department of Neonatal & Pediatric Surgery, Plastic Surgery, Dermatology and Ophthalmology,
Bahawal Victoria Hospital, Bahawalpur.
Duration of Study: 7th January 2013 to 6th July 2013.
Subjects and Methods: Seventy three cases fulfilling inclusion criteria were registered through Outpatient
Departments of Neonatal & Pediatric surgery, plastic surgery, Dermatology and Ophthalmology, Bahawal
Victoria Hospital, Bahawalpur. Diagnosis were confirmed by consultant pediatric Surgeon (assistant
professor and above having 5 years experience) clinically and by Color Doppler ultrasonography (clustered
dilated, tortuous blood vessels with Sluggish blood flow) by consultant radiologist (assistant professor and
above having 5 years experience). Demographic history including age (in years) and sex (male or female)
were taken. Approval from the hospital ethical committee was taken. Written informed consent was taken
from the parents/guardians of the patients after discussing the risks and benefits of the drugs.
All the patients received treatment with oral prednisolone in a dose of 1mg/kg/day and propranolol in a
dose of 0.5 mg/kg/day twice a day (BID) and increase up to 1.5mg/kg/day BID within three days with close
monitoring of heart rate, blood pressure and blood glucose as an inpatient. Treatment was given for 3
months to all patients then titer down for two weeks before cessation of treatment. In case of early
response i.e, before 3 month, drugs were titer down for two weeks before cessation.
The follow up of the patients were performed at 7th day after initiation of treatment, then 1st month and
finally at 3rd month. Heart rate, blood pressure, random blood sugar and treatment compliance was
checked during each visit along with outcome parameter i.e. response which was categorized as excellent,
good, moderate, slight improvement or no effect taking good to excellent response as acceptable outcome
by measuring the size of IHs in terms of maximum dimensions in millimeters by using 100 mm horizontal
scale on photograph taking by using 12 mega pixel digital camera. All the information was collected on a
specially designed proforma (attached).

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Scelerotherapy with 5% Phenol in Almond Oil in Treatment of Rectal Prolapse in Children: Experience of District Head Quarter Hospital Kohat

FAZAL AHMED, WASEEM MUHAMMAD

Associate Professor of Surgery Kohat Institute of Medical Sciences , Administrator Health Ways Hospital, Kohat.

Correspondence Author:- Dr. Waseem Muhammad, Administrator Health Ways Hospital, Kohat.

Email:- waseem_kt@hotmial.com

ABSTRACT

Background: Rectal prolapse is an uncommon condition.Increased abdominal pressure is the main causative factor. Failure of conservative measures should be followed by surgical corrective procedures like Sclerotherapy followed by more aggressive surgery, including abdominal posterior rectopexy , abdominal or perineal bowel resection, transanal suture rectosacropexy , and posterior sagittal Anorectoplasty procedures have been described. Our study was conducted to observe the results of Sclerotherapy in young children.

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SADIA AFZAL RANDHAWA, SHAMSA HUMAYUN
Department of Obstetrics and Gynecology, Unit 3, Sir Ganga Ram Hospital Lahore.
For Correspondence: Dr Sadia Afzal Randhawa, Senior Registrar Gynae Unit 3, Sir Ganga Ram Hospital,
Lahore. Email: drsadiahsan@yahoo.com
ABSTRACT
Introduction: EMERGENCY PERIPARTUM HYSTERECTOMY is a life saving procedure performed after
spontaneous vaginal delivery or caesarean section, or in the immediate post partum period. Although rare
in modern obstetrics, it still remains a life saving procedure in cases of intractable hemorrhage where
conservative measures fail, although it itself is still associated with significant maternal mortality and
morbidity even in developed countries.

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