Journal of the Pakistan Medical Association最新文献

{"title":"Vocabular Therapeutics.","authors":"Sanjay Kalra, Sourabh Sharma, Rahul Chauda, Nitin Kapoor","doi":"10.47391/JPMA.26-18","DOIUrl":"https://doi.org/10.47391/JPMA.26-18","url":null,"abstract":"<p><p>In this communication, we introduce vocabular therapeutics, a novel aspect of health care. Vocabular therapeutics may be defined as the use of language models to assess, and address, internal impediments to healthy behaviour, based upon the choice of vocabulary of an individual (or society). The analysis of words, phrases and sentences, allows modification of \"unhealthy\" beliefs and choices, thus facilitating healthier behaviour. This is based upon the premise that thoughts, words and actions are able to influence each other, finally reaching a state of concordance. Vocabular therapeutics should be considered an integral part of behavioural therapy, lifestyle modification and medication counselling. The concept finds utility in chronic disease care, including obesity management.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"76 3","pages":"455-457"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A schwannoma at the lower cerebellopontine angle mimicking a brainstem glioma on neuroimaging: case report.","authors":"Kui Zhang, Wenhu Li, Kai Zhao, Ninghui Zhao, Chongjing Zhang","doi":"10.47391/JPMA.23017","DOIUrl":"https://doi.org/10.47391/JPMA.23017","url":null,"abstract":"<p><p>This study reports the case of a schwannoma in the inferior cerebellopontine angle (CPA) that mimicked a brainstem glioma in imaging. The patient was a 35-year old male, who presented in February 2023 with dizziness that had persisted for six months and exacerbated on moving the neck. Imaging examinations, specifically cranial magnetic resonance imaging (MRI), revealed a mass in the left brainstem and cerebellar region, measuring approximately 3.7 × 2.6 × 3.8 cm. The mass was irregular in shape, showing slightly long T1 and mixed T2 signals. It locally compressed the fourth ventricle, and after contrast-enhanced scanning, significant heterogeneous enhancement was observed. Magnetic resonance spectroscopy (MRS) indicated that the peak heights of N-acetylaspartate (NAA) and choline complex in the lesion were approximately 0.049 and 0.524, respectively. Due to the extremely similar imaging features to those of a brainstem glioma, it was initially misdiagnosed as glioma. Total surgical resection was performed, and post-operative pathology confirmed it to be a schwannoma. The patient recovered well after the operation, the symptoms disappeared and no neurological deficits remained. This type of schwannoma is extremely rare and is highly likely to be misdiagnosed as a brainstem glioma due to its imaging manifestations. This case emphasises the importance of cautious diagnostic evaluation and surgical management of such rare tumours, providing valuable reference for clinical practice.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"76 3","pages":"443-447"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barovariability.","authors":"Sanjay Kalra, Nishant Raizada, Saptarshi Bhattacharya, Nitin Kapoor","doi":"10.47391/JPMA.26-20","DOIUrl":"https://doi.org/10.47391/JPMA.26-20","url":null,"abstract":"<p><p>Barovariability is defined as the variation or changes that occur in weight, over a specific time frame, in persons living with obesity or overweight. This includes physiological alteration in weight, as well as pathological weight cycling or yo yo phenomenon. Barovariability can be diagnosed by regular weight and body composition monitoring, and may be predicted by artificial intelligence (AI) tools. Barovariability is associated with adverse psychosocial as well as biomedical outcomes. A realistic and rational approach towards weight management can help prevent and mitigate barovariability.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"76 3","pages":"460-461"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paediatric Sialorrhoea.","authors":"Golya Sulaiman, Ahmad Al Ghabban Mahroos, Ahmad Othman, Emad Uddinn Siddiqui","doi":"10.47391/JPMA.22365","DOIUrl":"https://doi.org/10.47391/JPMA.22365","url":null,"abstract":"<p><p>Sialorrhoea is a rare but disturbing symptom associated with increased salivary secretions which may burden the family and the child, and can affect both the patient's and family's psychological well-being, emotionally and physically. The reasons may be abnormal neuromuscular control, swallowing coordination defects etc. Rarely oral, dental and gingival problems like inflammation, caries, malocclusion may also cause increased salivary secretion. We present a unique case of hypersalivation lasting for two weeks without a clear history of dental or oral illness, any drug exposure, or any chronic disease. Management is based on a multidisciplinary team approach, with treatment options ranging from conservative measures like simple observation, neck positioning, behavioural and pharmacological therapies to botulinum toxin or surgery. The patient may need to consult a dentist or orthodontist to assess the extent of secretion and to determine any medical or surgical cause.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"76 3","pages":"432-434"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targetting zombie cells: Potential of senolytics in slowing aging and promoting longevity.","authors":"Kainat Younis, Ayesha Younis, Hafsa Ahsun","doi":"10.47391/JPMA.30998","DOIUrl":"https://doi.org/10.47391/JPMA.30998","url":null,"abstract":"","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"76 3","pages":"486"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of cervical traction with and without EMG biofeedback in patients with cervical radiculopathy- A randomised controlled trial.","authors":"Sana Sabir, Maria Khalid, Kiran Azam Khan, Zainab Noor Qazi, Summaiyah Obaid, Sania Khawar","doi":"10.47391/JPMA.21396","DOIUrl":"https://doi.org/10.47391/JPMA.21396","url":null,"abstract":"<p><strong>Objective: </strong>To find out the effects of cervical traction with and without electromyography biofeedback on range of motion, pain, level of disability and muscle tension.</p><p><strong>Methods: </strong>The randomised controlled trial was conducted at the Fauji Foundation Hospital, Rawalpindi, Pakistan, from July 2021 to July 2022, and comprised patients aged 30-50 years having radicular symptoms persistent for 1-6 months, and underwent cervical traction. The subjects were randomly allocated to Group A with electromyography biofeedback, and Group B without electromyography biofeedback. Both the groups received conventional therapy including hot pack, transcutaneous electrical nerve stimulation, cervical mobilisation and isometrics. The frequency of the treatment was 2 sessions per week over 6 weeks. Data was collected at baseline, after 2, 4 and 6 weeks. Data collection tools included visual analogue scale, neck disability index, inclinometer and electromyography biofeedback. Data was analysed using SPSS 21.</p><p><strong>Results: </strong>Of the 44 patients, 22(50%) were each of the two groups. In Group A, there were 16(72.7 %) females and 6(27.3 %) males with mean age 43.72+6.71 years. Group B had a similar gender distribution while the mean age was 43.95+5.58 years. In both the groups, neck pain and cervical range of motion improved significantly postintervention (p<0.05), but Group A values were significantly better than Group B (p<0.05). Cervical disability and muscular tension were not significantly different in both intragroup and intergroup comparisons (p>0.05).</p><p><strong>Conclusions: </strong>Cervical traction with added electromyography biofeedback effectively lowered cervical pain intensity and improved cervical range compared to cervical traction alone. Electromyography biofeedback showed no additional benefits in managing disability and muscular tension.</p><p><strong>Rct registration number: </strong>Clinical Trials. govt with ID: NCT05352464.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"76 3","pages":"308-315"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pakistan's national hepatitis strategic framework (2024-2030).","authors":"Hassan Mahmood, Ahmed Sabry Alaama, Muhammad Shahid Jamil, Shabana Saleem, Safdar Kamal Pasha, Atiya Aabroo, Saeed Akhter, Ammara Naveed, Saeed Hamid, Aamir Ghafoor Khan, Abid Ghori, Zulfiqar Dharejo, Tariq Hayat, Mehreen Awan, Shoaib Kurd, Muhammad Salman, Shah Zaman, Muhammad Farooq, Zaeem Zia, Muhammad Khawar Aslam, Ambreen Arif, Huma Qureshi","doi":"10.47391/JPMA.31929","DOIUrl":"https://doi.org/10.47391/JPMA.31929","url":null,"abstract":"<p><strong>Objective: </strong>The framework sets ambitious targets to reduce new chronic hepatitis C virus infections, lower hepatitis B virus prevalence among children, and decrease hepatitis-related mortality.</p><p><strong>Methods: </strong>The framework outlines five strategic objectives: 1. Strengthening leadership and governance. 2. Improving prevention and access to care. 3. Building laboratory capacity. 4. Enhancing strategic information use. 5. Improving access to testing, care and treatment services.</p><p><strong>Results: </strong>By implementing these strategic objectives, the framework aims at driving progress towards global health goals, and reduce the burden of hepatitis B and C.</p><p><strong>Conclusion: </strong>The National Hepatitis Strategic Framework 2024-30 provides a comprehensive roadmap for national efforts to combat hepatitis, leveraging evidence-based strategies to achieve meaningful impact.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"76 3","pages":"400-416"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"40% PCV dose and its cost saving potential.","authors":"Raafey Imran, Momina Jalal, Muhammad Danial Tarar","doi":"10.47391/JPMA.31084","DOIUrl":"https://doi.org/10.47391/JPMA.31084","url":null,"abstract":"","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"76 3","pages":"488"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histopathological spectrum of oral squamous cell carcinoma in Naswar users: Correlation with duration, age and site.","authors":"Fatima Iqbal, Nasiha Bashir, Hoor Maryam, Sajjad Ahmad","doi":"10.47391/JPMA.23254","DOIUrl":"https://doi.org/10.47391/JPMA.23254","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the relationship of clinico- pathological parameters with the histopathological spectrum of oral squamous cell carcinoma in a high-risk population.</p><p><strong>Methods: </strong>The prospective, cross-sectional study was conducted from January 2019 to September 2022 in the Khyber Pakhtunkhwa province of Pakistan, and comprised histologically confirmed cases of oral squamous cell carcinoma with a history of consumption of Naswar from different hospitals. The duration of use, age, site and histopathological features were recorded, and their association was explored. Data was analysed using SPSS 19.</p><p><strong>Results: </strong>Of the 80 patients with mean age 56.98±12.94 years at diagnosis, 59(73%) were males and 21(26%) were females. Buccal mucosa was the predominant site of involvement 28(35%). Histologically, the most common presentation was well-differentiated squamous cell carcinoma 63(78.7%). The association of age and duration of use is more appropriate with the histopathological pattern of oral squamous cell carcinoma was statistically non-significant (p>0.05).</p><p><strong>Conclusion: </strong>There was no significant association of age and prolonged Naswar use with histopathological patterns of oral squamous cell carcinoma.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"76 3","pages":"387-391"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Person Centred Primary Care Diabetes.","authors":"Sanjay Kalra, Madhur Verma, Nitin Kapoor","doi":"10.47391/JPMA.26-19","DOIUrl":"https://doi.org/10.47391/JPMA.26-19","url":null,"abstract":"<p><p>This opinion piece highlights the importance of person centred philosophy in primary care. The authors define, describe and detail the concepts of person centred and responsible person centred care. They call for equal emphasis on evidence-based treatment, empathic delivery, experiential learning, ethical guidelines and environmental constraints.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"76 3","pages":"458-459"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}