{"title":"Coping with the Stress of Obesity.","authors":"Sanjay Kalra, Komal Verma, Ashok Kumar, Nitin Kapoor","doi":"10.47391/JPMA.25-55","DOIUrl":"https://doi.org/10.47391/JPMA.25-55","url":null,"abstract":"<p><p>Coping with chronic disease, such as obesity, is central to effective management. Coping skills enhancement, therefore, should be made part of obesity therapy. The AEIOU model, coupled with the five Bad Bs and five Positive Ps, allows health care professionals to integrate coping skills enhancement in routine care. Analysis and elimination of negative coping mechanisms, initiation and integration of positive skills, ongoing observation and use of opportunities for optimization, and upgradation of one's understanding, allow enhancement of coping skills. This should be considered standard of care in all obesity management programmes.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 7","pages":"1143-1144"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769321","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":"Unveiling awareness: determining the university students' understanding of female reproductive rights through a validated questionnaire.","authors":"Hina Ahmed, Haiqa Ashraf, Fiza Shahbaz","doi":"10.47391/JPMA.20916","DOIUrl":"https://doi.org/10.47391/JPMA.20916","url":null,"abstract":"<p><strong>Objective: </strong>To compare the knowledge of medical and non-medical students regarding female reproductive rights.</p><p><strong>Methods: </strong>The comparative, analytical study was conducted in Lahore, Pakistan, from April to October 2023, and comprised medical students from the Central Park Medical College, Lahore, and non-medical students from the Superior College, Lahore. Using factor analysis, validation of the self-developed questionnaire was done, and five factors were identified: supportive influence, premarital screening and stigma, conscious decision, decision about marriage, and contraceptive choices. The questionnaire's overall reliability was 0.84 using Cronbach alpha value. Data was analysed using SPSS 25.</p><p><strong>Results: </strong>Of the 500 students, 250(50%) were medical students with mean age 20.95±1.776 years, and 250(50%) were nonmedical students with mean age 21.14±1.547 years. There was a statistically significant difference in knowledge level regarding women's reproductive rights between medical and non-medical students (p<0.05).</p><p><strong>Conclusions: </strong>Significant differences were noted in the knowledge level of medical and non-medical students regarding female reproductive rights, underlining the need to create awareness among young adults.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 7","pages":"1100-1108"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769353","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}
Jawed Abubaker, Abdul Sattar Shaikh, Mujtaba Hassan, Ali Ammar, Usman Tauseef, Muhammad Sohaib Arif
{"title":"National Institute Pulmonary Hypertension Registry (NIPHeR): Insights from the first pulmonary hypertension registry of Pakistan.","authors":"Jawed Abubaker, Abdul Sattar Shaikh, Mujtaba Hassan, Ali Ammar, Usman Tauseef, Muhammad Sohaib Arif","doi":"10.47391/JPMA.20192","DOIUrl":"https://doi.org/10.47391/JPMA.20192","url":null,"abstract":"<p><strong>Objective: </strong>To analyse the characteristics, management and outcomes of patients with pulmonary hypertension from a dedicated registry.</p><p><strong>Methods: </strong>The retrospective study was conducted at the Pulmonary Hypertension Clinic of the National Institute of Cardiovascular Disease (NICVD), Karachi from November 2021 to July 2023, and comprised data of patients above eighteen years diagnosed with pulmonary hypertension. Data was retrieved from the National Institute Pulmonary Hypertension Registry (NIPHeR), and was categorised as per the 6th World Symposium on Pulmonary Hypertension 2018 classification into groups 1-5. Patient data was collected using a Proforma. Data was analysed using SPSS 27.</p><p><strong>Results: </strong>Of the 145 patients with mean age 43.10±14.71 years, 92(63%) were females. Group 4 had the most number of patients 50 (34.5%). Dyspnoea and fatigue were the most common complaints, lasting a mean duration of 22.71±29.11 months. The majority 94 (65%) of patients had New York Heart Association Functional Class III or IV, but within 6 months of treatment, the number went down to 72(49.6%). Mortality was reported in 9 (6.2%) cases, and it was significantly associated with Group 4 (p<0.05). Factors significantly associated with increased mortality were Group 4 PH (Pulmonary hypertension associated with pulmonary embolism), an electrocardiographic evidence of right ventricle hypertrophy (RVH) along with severe or persistent right ventricle dysfunction, and use of Endothelin receptor antagonists (ERA) as monotherapy, while there use in combination with phosphodiesterase 5 (PDE5) inhibitors was associated with decreased mortality (p<0.05).</p><p><strong>Conclusions: </strong>The importance of early diagnosis and appropriate management of pulmonary hypertension cannot be overemphasized. The National Institute Pulmonary Hypertension Registry could serve as a vital tool for understanding regional trends and guiding future clinical practice and research in pulmonary hypertension.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 7","pages":"1058-1066"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769336","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":"Giant renal angiomyolipoma (RAML): A case report and literature review.","authors":"Ahsan Nasim, Adeena Azam, Amna Faheem Mufti, Hafiz Usman Azeem","doi":"10.47391/JPMA.21576","DOIUrl":"https://doi.org/10.47391/JPMA.21576","url":null,"abstract":"<p><p>Renal angiomyolipoma is a benign, rare type of tumour which consists of mature adipose tissue, thick-walled blood vessels, and smooth muscle cells. This tumour can grow to a large size, and is then defined as giant. We are describing the case of a 34-year-old female with a giant renal angiomyolipoma, measuring 32cm x 28cm x 6cm, which caused her pain and constipation. The mass was removed successfully, and partial nephrectomy was done. The patient had an uncomplicated postsurgical clinical course, and renal function was preserved. Renal angiomyolipoma is a hamartomatous, benign mass with variable components. It can occur sporadically or in association with genetic syndromes such as tuberous sclerosis. Symptoms include abdominal pain and constipation. Potentially dangerous sequelae include retroperitoneal haemorrhage and shock. The treatment for these tumours is surgery with open nephrectomy. Other treatment modalities have also been developed. Diagnostic workup should be done for genetic syndromes whenever necessary.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 7","pages":"1131-1134"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769330","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":"Myofascial pain syndrome: A diagnostic challenge for dental practitioners.","authors":"Robia Ghafoor, Nighat Naved","doi":"10.47391/JPMA.11560","DOIUrl":"https://doi.org/10.47391/JPMA.11560","url":null,"abstract":"<p><p>This case report describes the unusual presentation of chronic temporomandibular joint (TMJ) dysfunction in a young girl and highlights the effectiveness of a multidisciplinary approach in managing her condition. A 15-year-old female presented to the dental clinics at the Aga Khan University Hospital with a one-year history of restricted mouth opening, severe bilateral preauricular pain, and audible TMJ clicking. The pain, initially dull had progressed to spontaneous, sharp, and radiating discomfort unresponsive to conventional analgesics. A significant psychosocial stressor was identified as the precipitating factor. Clinical examination revealed marked tenderness across multiple craniofacial and cervical muscles, with features consistent of myofascial pain syndrome. A comprehensive management plan was implemented, involving pharmacologic therapy (antiinflammatories and muscle relaxants), non-pharmacologic strategies (TENS, moist heat, cervical manipulation), and psychological support. A bilaminar occlusal splint was fabricated and adjusted periodically. Over 15 sessions, her VAS pain score improved from 8/10 to 5/10, followed by complete resolution of symptoms and improved mouth opening to 45 mm within six weeks.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 7","pages":"1118-1121"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769335","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}
Aqsa Eeman, Muhammad Afaq Khan, Hamza Ashraf, Haider Ashfaq
{"title":"Overcoming mental health care barriers for postpartum depression in developing countries: Zuranolone as a game changer.","authors":"Aqsa Eeman, Muhammad Afaq Khan, Hamza Ashraf, Haider Ashfaq","doi":"10.47391/JPMA.22362","DOIUrl":"https://doi.org/10.47391/JPMA.22362","url":null,"abstract":"","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 7","pages":"1171-1172"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769285","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":"Causal beliefs of conversion disorder: A cross-sectional study.","authors":"Sara Latif, Aisha Sitwat","doi":"10.47391/JPMA.20605","DOIUrl":"https://doi.org/10.47391/JPMA.20605","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate causal beliefs pertaining to conversion disorder among clinical sample, caregivers and the general public.</p><p><strong>Methods: </strong>The cross-sectional, quantitative, mixed-sample study was conducted from January to December 2023 after approval from ethics review board of the University of the Punjab, Lahore, Pakistan, and comprised patients diagnosed with conversion disorder in group A, their caregivers in group B, and members from the general community at large in group C. Data was collected using self-designed demographic information questionnaire and the Conversion Disorder Causal Belief Questionnaire. Data was analysed using SPSS 24.</p><p><strong>Results: </strong>Of the 300 subjects, 100(33.3%) were in group A with mean age 25.76±7.7 years, 100(33.3%) were in group B with mean age 43.22±11.4 years, and 100(33.3%) were in group C with mean age 32.42±12.02 years. Majority of the participants were females 215(72%), educated 276(92%) and working 281(94%). There were significant differences across all the groups in psychogenic, somatogenic, sociocultural, interpersonal and paranormal beliefs regarding conversion disorder. Group A had significantly higher levels of agreement on all domains (p<0.05) except for somatogenic myths compared to group B (p>0.05), and psychogenic facts compared to group C (p>0.05). Comparisons between groups B and C revealed significant differences in psychogenic facts, sociocultural facts and interpersonal myths (p<0.05).</p><p><strong>Conclusions: </strong>Causal beliefs about conversion disorder varied across clinical sample, their caregivers and the general public, where the clinical sample agreed more with both myths and facts about the cause of conversion disorder.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 7","pages":"1072-1076"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769314","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":"Comparison of intralesional triamcinolone acetonide alone and with 5-fluorouracil for the treatment of keloids.","authors":"Sadia Bhatti, Sadaf Ahmed Asim, Madiha Sajid, Tayyaba Iqbal, Fozia Shaikh, Hira Fatima Waseem","doi":"10.47391/JPMA.20767","DOIUrl":"https://doi.org/10.47391/JPMA.20767","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the efficacy of intralesional triamcinolone acetonide alone and in combination with 5 -fluorouracil in the management of keloids.</p><p><strong>Methods: </strong>The prospective cross-sectional study was conducted at the Dermatology outpatient department, Ojha campus, Dow University of Health Sciences, Karachi, from April to September 2023, and comprised patients with keloids who were divided into group A receiving intralesional triamcinolone acetonide 40mg/ml alone, and group B receiving a combination of triamcinolone acetonide 40mg/ml and 5-fluorouracil 50mg/ml. The medication was given monthly for 6 months, and efficacy was assessed using the Vancouver Scar Scale on each visit before the injection. Data was analysed with SPSS version 26.</p><p><strong>Results: </strong>Of the 66 patients, 33(50%) were in group A; 19(57.6%) females and 14(42.4%) males with mean age 34.39±9.81 years. There were 33(50%) patients in group B; 20(60.6%) females and 13(39.4%) males with mean age 33.75±11.51 years. In group B, good to excellent response was seen in 31 (95%) cases compared to 23 (70%) in group A. Side effects such as atrophy (3 cases, 9.1%) and telangiectasia (2 cases, 6.1%) were more prevalent in Group A compared to atrophy (1 case, 3%) and telangiectasia (1 case, 3%) in Group B.</p><p><strong>Conclusion: </strong>Intralesional triamcinolone acetonide in combination with 5-fluorouracil was found to be more effective with faster response and less side-effects compared to triamcinolone acetonide alone.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 7","pages":"1082-1085"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769320","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":"Empowering women: Urging immediate breast reconstruction awareness in Pakistan.","authors":"Urwah Noor, Muhammad Shumas","doi":"10.47391/JPMA.21511","DOIUrl":"https://doi.org/10.47391/JPMA.21511","url":null,"abstract":"","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 7","pages":"1164"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769325","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}
Safa Saleem, Samia Sarmad, Muhammad Jawad, Sameed Liaqat, Muhammad Ahad, Wardah Rauf
{"title":"Physical therapy rehabilitation of Cohen syndrome in Pakistan.","authors":"Safa Saleem, Samia Sarmad, Muhammad Jawad, Sameed Liaqat, Muhammad Ahad, Wardah Rauf","doi":"10.47391/JPMA.21053","DOIUrl":"10.47391/JPMA.21053","url":null,"abstract":"<p><p>Cohen Syndrome is a rare genetic disorder. It is caused by the mutation of VPS13b gene which is present on chromosome number 8. It was first described in 1973. Here is a case report of a male child who presented to Paediatric Physical Therapy and Neuro Rehabilitation Department of The University of Lahore Teaching Hospital, Lahore, on July 25, 2021, with developmental delay due to hypotonia, typical facial gestalt, neutropenia, intellectual disability and speech delay. His genetic testing confirmed the diagnosis of Cohen syndrome. He received an intensive and holistic physical therapy programme for 3 years (July 2021 till July 2024) which helped him reach his developmental milestones. This study shows that with efficient goal setting, early intervention along with enriched environment and family centred approach can help the child achieve age-appropriate milestones.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 7","pages":"1122-1124"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769286","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}