Journal of the Pakistan Medical Association最新文献

{"title":"Reason for joining the medical profession: Passion or parental pressure.","authors":"Rohma Malik, Urwa Ashfaq, Beshair Aziz, Allahdad Khan, Ayesha Zafar, Muhammad Farhan Jamil","doi":"10.47391/JPMA.20903","DOIUrl":"https://doi.org/10.47391/JPMA.20903","url":null,"abstract":"<p><strong>Objective: </strong>To determine the factors that influence medical students' decision to pursue a career in medicine, and to assess their level of satisfaction with their decision.</p><p><strong>Methods: </strong>The descriptive, cross-sectional study was conducted at the Nishtar Medical University, Multan, Pakistan, from July to October 2023, and comprised first year medical students of the 2023-24 academic session. Data was collected using a questionnaire-based survey form. Data was analysed using SPSS 23.</p><p><strong>Results: </strong>Of the 174 students with mean age 20.1±1.4 years, 93(53.4%) were males with mean age 19.9±1.5 years, and 81(46.6%) were females with mean age 20.3±1.2 years (p>0.05). For 121(69.5%) students, 'parental pressure' was the primary factor, followed by 'passion' for 41(23.6%), 'inspired by others' 3(1.7%), 'noble profession' 2(1.1%), 'monetary gains' 3(1.7%) and 'just by chance' 4(2.3%). There were 26(14.9%) subjects who had conducted thorough research before deciding to pursue the profession. For 85(48.9%) students, personal interest played a minor role in career selection. Overall, 88(50.6%) students were completely satisfied with the decision, 12(6.9%) had concerns, and 74(42.5%) were dissatisfied.</p><p><strong>Conclusions: </strong>A significant number of students entered the medical profession under parental pressure. Only about half of the students were satisfied with their decision.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 3","pages":"525-527"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722472","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":"Intramedullary Spinal Cord Metastasis in Spinal Ependymomas.","authors":"Zanib Javed, Raheema Sadiq, Hania Fatima, Muhammad Shahzad Shamim","doi":"10.47391/JPMA.25-22","DOIUrl":"https://doi.org/10.47391/JPMA.25-22","url":null,"abstract":"<p><p>Drop metastasis, or intramedullary spinal cord metastasis (ISCM), is a rare condition accounting 0.9%-5% of CNS or spinal metastases. It arises from tumour cell dissemination through cerebrospinal fluid (CSF), often affecting the thoracic and lumbar spine. Clinical features include rapidly progressive neurological deficits, limb weakness, sensory loss, and pain. Diagnosing drop metastasis is challenging and MRI with gadolinium remains the gold standard modality for investigation. Surgical resection followed by radiotherapy remains the primary treatment option, whereas chemotherapy serves a palliative role in cases of recurrence or disseminated metastases.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 3","pages":"509-511"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722240","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":"Progesterone role in the development of intracranial meningioma: A new frontier.","authors":"Junaid Hasan, Mariam Ali, Ahsan Shabbir","doi":"10.47391/JPMA.21128","DOIUrl":"https://doi.org/10.47391/JPMA.21128","url":null,"abstract":"","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 3","pages":"520"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722376","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":"Clinico-pathological features of oral squamous cell carcinoma and oral potentially malignant disorders: A comparative study from a tertiary care hospital of Karachi.","authors":"Samreen Khan, Muhammad Mohiuddin Alamgir, Uzma Bukhari, Muhammad Shuja Farrukh, Areeba Shafiq","doi":"10.47391/JPMA.20599","DOIUrl":"https://doi.org/10.47391/JPMA.20599","url":null,"abstract":"<p><strong>Objective: </strong>To compare the clinicopathological features of oral squamous cell carcinoma and oral potentially malignant disorders.</p><p><strong>Methods: </strong>The analytical, cross-sectional study was conducted at the Dow University of Health Sciences, Karachi, from July 2022 to April 2023, and comprised cases of oral squamous cell carcinoma in group A and those of oral potentially malignant disorders in group B. Data, including detailed clinical history, radiological findings and histopathology reports, was collected using a predesigned questionnaire. Data was analysed using SPSS 21.</p><p><strong>Results: </strong>Of the 90 patients, 45(50%) were in group A; 34(75.6%) males and 11(24.4%) females with mean age 49.44±11.53 years. The remaining 45(50%) patients were in group B; 35(77.8%) males and 10(22.2%) females with mean age 50.82±13.34 years (p>0.05). The most common oral habit reported in both the groups was tobacco in smokeless form; 33(73.3%) in group A and 37(82.2%) in group B. The most reported site in group A was the buccal mucosa of the cheek 29(64.4%), followed by the tongue 14(31.1%). Most cases in group A were of moderately differentiated tumours 38(84%), and 21(46.7%) were in advanced stage IV at the time of presentation. Majority of the cases in group B showed mild dysplasia on histology 29(65%).</p><p><strong>Conclusions: </strong>There were no significant differences patients of oral squamous cell carcinoma and oral potentially malignant disorders except that oral cancer cases presented in the advanced stage at the time of diagnosis.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 3","pages":"443-446"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722556","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 narrative review on the role of traditional Chinese medicine (TCM) in treating coronary artery disease.","authors":"Andong Zhang, Xiangpu Liu, Xuying Li, Na Duan, Bin Huang","doi":"10.47391/JPMA.11610","DOIUrl":"https://doi.org/10.47391/JPMA.11610","url":null,"abstract":"<p><p>Coronary artery disease is one of the leading types of cardiovascular disorders globally, and is a significant contributor to mortality. Its prevalence is increasing annually, underscoring the need for innovative therapeutic strategies to enhance patient outcomes and quality of life. Despite the availability of numerous pharmacological treatments, there remains a critical need for novel interventions. Traditional Chinese medicine, with its centuries-old history, offers promising alternatives. The current narrative review was planned to examine 10 prominent Chinese herbal medicines currently in use, including Salvia miltiorrhiza, Hawthorn, Schisandra berry, Ginseng, Ginkgo biloba, Astragali radix, Reishi mushroom, Licorice root, Dang gui, and Cinnamon bark. While each of these traditional medicines holds potential for managing coronary artery disease, further large-scale clinical trials are warranted to draw more definitive conclusions.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 3","pages":"462-468"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722594","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":"Intra rater reliability of Y balance test in medical students.","authors":"Muhammad Mustafa Gul, Sidrah Shabbir, Muhammad Burhan, Muhammad Mahmood Alam, Muhammad Waseem Akhtar, Muhammad Shahbaz","doi":"10.47391/JPMA.11010","DOIUrl":"https://doi.org/10.47391/JPMA.11010","url":null,"abstract":"<p><p>The cross-sectional study was planned to assess the Ybalance test's intra-rater reliability among a sample of 59 medical students. The subjects took six trials under supervision, and the reliability of the results improved, with intra-class correlation values >0.75, indicating high reliability. Though the study had a cross-sectional design, it provided insightful data for focussed assessment. The Ybalance test was found to be an easy and reliable technique for evaluating dynamic balance.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 3","pages":"480-481"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722234","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":"Pregnancy-associated spontaneous coronary artery dissection: A challenging scenario in limited-resource setting.","authors":"Hassan Abdullah, Ayesha Rafique, Asad Jamil Awan, Muhammad Muzaffar Mahmood","doi":"10.47391/JPMA.11299","DOIUrl":"https://doi.org/10.47391/JPMA.11299","url":null,"abstract":"<p><p>Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome (ACS). We report a case of SCAD in a patient who had her Caesarean section three weeks earlier. This report describes the management, emphasising the need to keep a high index of suspicion to avoid mismanagement, such as inadvertent thrombolysis which may prove disastrous in such situations. The practical aspects of performing percutaneous coronary intervention in patients with SCAD are also discussed.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 3","pages":"482-484"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722374","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":"The promise and pitfalls of AI in medicine: A balanced perspective.","authors":"Kinzah Imtiaz, Anzah Imtiaz Waggan","doi":"10.47391/JPMA.21535","DOIUrl":"https://doi.org/10.47391/JPMA.21535","url":null,"abstract":"","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 3","pages":"524"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722490","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":"How safe and effective is oral analgesia for hip fracture patients? A prospective cohort study.","authors":"Zehra Abdul Muhammad, Tashfeen Ahmad","doi":"10.47391/JPMA.20532","DOIUrl":"https://doi.org/10.47391/JPMA.20532","url":null,"abstract":"<p><strong>Objective: </strong>To assess the safety and pain reduction profile of routinely prescribed oral analgesics in patients of hip fracture surgery.</p><p><strong>Methods: </strong>The single-centre, prospective, cohort study was conducted from June 2022 to July 2023 at the Aga Khan University Hospital, Karachi and comprised adult patients of either gender with hip fractures. The analgesics prescribed at the time of hospital discharge and 1-week follow-up were recorded along with pain and adverse effects till the 2-week post-discharge follow-up. Pain was recorded using the visual analogue scale, with the target score set at 3/10. The relationship between covariates to pain or adverse events was assessed. Possible analgesic-related deaths/adverse events, absolute risk and agespecific death rates were also calculated. Data was analysed using SPSS 19.</p><p><strong>Results: </strong>Of the 133 patients, 80(60.1%) were females and 53(39.8%) were males. The overall median age was 73 years (interquartile range: 16 years). The median pain score was 4 (interquartile range: 2) and 2 (interquartile range: 2) at 1-week and 2-week follow-up, respectively. Adverse events were experienced by 83(62.4%) patients, while 1(0.75%) patient was lost to follow-up at both follow-ups. Of the remaining 132(99.2%) patients, 106(80.3%) were aged >60 years, and 26(19.6%) were aged <60 years. Sub-optimal analgesia at 1-week follow-up with high adverse events was observed after combining acetaminophen with analgesics like ibuprofen (100% and 50% of 2), diclofenac (55% and 50% of 20), meloxicam (50% and 50% of 4), celecoxib (71.4% and 42.8% of 7), tramadol (60% and 57% of 35), pregabalin (100% and 50% of 2), or gabapentin (50% and 50% of 2) respectively. There were 7(5.3%) deaths of which 5(71.4%) were analgesic-related. All 5 of 132 (3.78%) potentially analgesic-related deaths occurred among >60 years of age. Thus, in 106 patients with age >60 years, 5(4.7%) died, and the age-specific death rate was 4,717/100,000 population. The odds of adverse events increased with comorbidity (p=0.02). Pain score was significantly related to adverse events (p=0.007).</p><p><strong>Conclusion: </strong>Combining acetaminophen with other analgesics did not improve analgesia, but did increase adverse events. The risk of adverse events and mortality were higher with comorbidity and older age.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 3","pages":"434-442"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722010","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":"Is central venous catheter placement overrated for inotropic support: A voice from low-resource setting.","authors":"Zofishan Anwar, Madiha Ismail","doi":"10.47391/JPMA.21424","DOIUrl":"https://doi.org/10.47391/JPMA.21424","url":null,"abstract":"","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 3","pages":"522"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722244","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}