Journal of Ayub Medical College Abbottabad 27(1)

Journal of Ayub Medical College

J Ayub Med Coll Abbottabad (JAMC)

ISSN 1025-9589 (Print), ISSN 1819-2718 (Online)

JAMC 27(1): January-March 2015

CONTENTS

EDITORIAL
Why aren’t we conducting cohort studies? Fatima Mukhtar	1
ORIGINAL ARTICLES
Outcomes following “Double Knot” suspension arthroplasty for basal joint arthritis of the thumb Mustafa Javed, Tarek Nazar, Andrew M Collier	3
Prevalence of uncorrected refractive errors in adults aged 30 years and above in a rural population in Pakistan Ayesha S Abdullah, Muhammad Zahid Jadoon, Mohammad Akram, Zahid Hussain Awan, Mohammad Azam, Mohammad Safdar, Mohammad Nigar	8
**XmnI Polymorphism and disease severity in patients with beta thalassemia from northern Pakistan** Tamoor Bin Hanif, Suhaib Ahmed, Jaleel Anwar, Syed Kazim Abbas Kazmi	13
Childhood bladder stones-endemic disease of developing countries Bhamar Lal, Jai Pal Paryani, Shafique-ur-Rehman Memon	17
Cryopreservation of oocytes Shandana Jadoon, Muhammad Adeel	22
Total lymphocyte count as a substitute to CD4 count in management of HIV infected individuals in resource limited society Muhammad Yousuf Daud, Rizwan Aziz Qazi, Naila Bashir	29
Relationship of adiponectin level with lipid profile in type-2 diabetic men with coronary heart disease Sadaf Durrani, Jasmin Shah, Mudassir Ahmad Khan, Muhammad Rasul Jan	32
A survey of death adjustment in the Indian subcontinent Mohammad Samir Hossain, Muhammad Irfan, Yatan Pal Singh Balhara, Noor Ahmed Giasuddin, Syeda Naheed Sultana	36
Intra operative frozen examination of sentinel lymph node in breast cancer Lubna Mushtaque Vohra, Rubina Gulzar, Omema Saleem	40
Pain associated with liver biopsies through percutaneous approach under sono-graphic guidance-A cross sectional pilot study in a tertiary care hospital Muhammad Akbar Baig, Wajiha Javed	45
Medical expulsive treatment of distal ureteral stone using Tamsulosin Hussain Ahmad, Waqar Azim, Muhammad Akmal, Badar Murtaza, Arshad Mahmood, Amir Nadim, Khubaib Shahzad	48
Emergency contraception: An overview among users Shazia Amir Khan, Humaira Hafeez, Rabiya Akbar	51
Comparison of peak expiratory flow rate and lipid profile in asymptomatic smokers and non-smokers Fozia Fatima, Sadia Fatima, Muhammad Munir Noor, Munir Ahmad Abbasi, Raheel Jahangir Jadoon, Muhammad Sohail, Muhammad Junaid Shah, Sana Ullah	55
*Severity of thrombocytopenia in patients with Plasmodium vivax* malaria; A single center study** Muhammad Hafeez, Faisal Rashid Lodhi, Zaheer Akhtar, M Zafar Ali, Anjum Aijaz	61
Morbidity and mortality assessment in acute hepatitis-E Lubna Kamani, Saeed Sadiq Hamid, Faisal Wasim Ismail, Syed Waqas Haider, Safia Awan, Ashfaq Ahmed,Wasim Jafri	64
Factors associated with increased red blood cells transfusion requirements in patients with Hodgkin and Non-Hodgkin lymphoma Sheeraz Ali, Mussadique Ali, Farhana Badar, Abdul Basit, Abdul Hameed	70
Audit of surgical emergency at Lahore General Hospital Sadaf Khalid, Afsar Ali Bhatti, Burhanulhuq	74
Comparison of peritoneal closure Vs non-closure during Caesarean section Amera Takreem	78
Spectrum of central nervous system tumours–A single center histopathological review of 761 cases over 5 years Javaria Ahsan, Shohaib Naiyar Hashmi, Iqbal Muhammad, Hafeez Ud Din, Ahsan Masood Butt, Sajid Nazir Bhatti, Muhammad Azhar	81
Frequency and outcome of necrotizing enterocolitis in preterm neonates Syed Sajid Hussain Shah, Munazza Saleem, Tahir Mehmood, Tausif Ahmed	85
Cost of primary health care in Pakistan Muhammad Ashar Malik, Wahid Gul, Saleem Perwaiz Iqbal, Farina Abrejo	88
Early experience of endovascular treatment of peripheral vascular disease Tariq Ashraf, Kamal Yousuf, Muhammad Tariq Karim	93
Students’ perception about the clinico-anatomical conferences as a teaching methodology Kanwal Saeed, Marina Baptist, Fatima Mukhtar	96
Prevalence of co-morbid depression in diabetic population Khizran Mir,Kinza Mir,Irsa Malik, Quratulain, Anum Shehzadi	99
Comparison of operative time and length of hospital stay in laparoscopic cholecystectomy in acute verses chronic cholecystitis Shireen A.A Ramzanali Damani, Sadiqa Haider, Hazrat Bilal, Sughra Perveen	102
Frequency and severity of steatosis in patients with chronic hepatitis-C Adil Naseer Khan, Khalid Said, Kishwar Ali, Humera Latif, Rahid Gul	105
Trends in complete denture impressions in Pakistan Fahim Vohra, Haroon Rashid, Ayesha Hanif, Siti Mariam Ab Ghani, Shariq Najeeb	108
*Acinetobacter* infections as an emerging threat in intensive care units Uzma Tahseen, Muhammad Tahseen Talib	113
Microbiological pattern of ventilator associated pneumonia Shamshad Ali, Khalid Waheed, Zafar H Iqbal	117
Dry tap: A diagnostic alert for underlying bone marrow pathology Saqib Qayyum Ahmad, Rizwan Yusuf, Nadeem Zafar, Nadir Ali	120
Prevalence of congenital heart disease in rural communities of Pakistan Syed Faiz-ul-Hassan Rizvi, Ghulam Mustafa, Asadullaha Kundi, Mushtaq Ahmed Khan	124
Frequency of different valvular lesions of rheumatic heart disease presenting to a tertiary care hospital Javaid ur Rehman, Zahid Irfan Marwat, Zahoor Ahmad, Islam Shah, Asifullah Khattak, Sheikh Fahad Falah	128
Clinico-pathological pattern, classification and staging of urinary bladder carcinomas - A five years experience at a tertiary care hospital in central Punjab Amjad Naeem, Nadia Naseem, Sadia Anwar, Seema Butt,Abdul Hanan Nagi	131
Postoperative complications with glycine and sterile distilled water after transurethral resection of prostate Muhammad Tousif Pasha, Musharraf Ali Khan, Yasir Jamal, Fazle Wahab, Hamza Ashraf, Naeemullah	135
Treatment of distal ureteric stones-Comparative efficacy of transureteral pneumatic lithotripsy and extracorporeal shock wave lithotripsy Bakhtawar Gul Wazir, Akhtar Nawaz Orakzai, Ahmad Nawaz	140
Emergency peri partum hysterectomy-A life saving procedure Anisa Fawad, Ansa Islam, Humaira Naz, Talat Nelofar, Aziz-un-Nisa Abbasi	143
Effect of epidural analgesia on labor and its outcomes Sadia Anwar, Muhammad Waseem Anwar, Attiya Ayaz, Nargis Danish, Sajjad Ahmad	146
Rate and indications of elective and emergency caesarean section; A study in a tertiary care hospital of Peshawar Mohammad Naeem, Muhammad Zia Ul Islam Khan, Syed Hussain Abbas, Ayasha Khan, Muhammad Adil, Muhammad Usman Khan	151
The emergent concern of seropositive status of hepatitis-B virus and hepatitis-C virus in the pregnant females attending a tertiary care hospital Kaweeta Kumari, Naresh Kumar Seetlani, Rehana Akhter	155
Non-compliance to anti-hypertensive medication and its associated factors among hypertensives Arshia Bilal, Mehwish Riaz, Noor-ulain Shafiq, Mariam Ahmed, Sadaf Sheikh, Sobia Rasheed	158
The quantitative evidence of malarial transmission and its associates in Bahawalpur, Pakistan Syed Arif Ahmed Zaidi, Farkhanda Kokab, Ijaz Ahmad Bukhari, Jamal Abdul Nasir	164
Causes of fever in adults in Thall and surrounding areas Sajid Ali Shah, Javed, Altaf Hussain, Safdar Ali, Haroon-ur-Rashid, Sheraz Ahmad	168
Radiological outcome of transpedicular screws fixation in the management of thoracolumbar spine injury Mian Iftikhar ul haq, Shahbaz Ali Khan, Ahsan Aurangzeb, Ehtisham Ahmed, Sajid Nazir Bhatti, Ali Noman	171
Elective percutaneous coronary interventions-acomparision of efficacy of clopidogrel and prasugrel Shahzeb, Nasir Ali, Abdul Hadi, Ibrahim shah, Adnan Mehmood Gul, Jabar Ali, Mohammad Hafizullah	174
Inspiration for smoking among medical students of Abbottabad, Pakistan Fahad Saqib Lodhi, Rehan Farooqui, Muhammad Munir Noor, Saadia Irum	178
Non-ligation of indirect hernial sac in children Kishwar Ali, Haider Kamran, Irfan Khattak, Humera Latif	180
Evaluation of toxic heavy metals in ayurvedic syrups sold in local markets of Hazara, Pakistan Bibi Hajra, Iftikhar Qayum, Shaukat Orakzai, Fida Hussain, Uzma Faryal, Aurangzeb	183
Performance of two different clinical scoring systems in diagnosing distal sensory polyneuropathy in patients with type-2 diabetes Fehmeda Farrukh Khan, Ahsan Numan, Khadija Irfan Khawaja, Ali Atif, Aziz Fatima, Faisal Masud	187
Early response of local steroid injection versus mini incision technique in treatment of carpal tunnel syndrome Abdus Saboor, Alamzeb Khan, Sikandar Aziz Afridi,Inam Ullah Khan, Sajid Nazir Bhatti, Ehtisham Ahmed, Gul Muhammad, Rao Suhail Khan, Shahid Sultan, Fahad Saqib Lodhi	192
Comparison of efficacy of spinal anaesthesia and sub-fascial local anaesthetic inguinal field block for open inguinal hernia repair-A single institutional experience Natasha Shafique, Haroon Ur Rashid, Muhammad Ijaz Raja, Mohammad Saeed	197
Working environment in job satisfaction among health professional working at a tertiary care hospital of Pakistan Imrana Aziz, Ramesh Kumar, Anita Rathore, Manohr Lal	201
Survival analysis of dialysis patients in selected hospitals of Lahore city Zahid Ahmad, Isaac Shahzad	205
Demographic and clinical characteristics of patients referred to psychiatric unit in a tertiary care hospital Abdul Wahab Yousafzai, Attique ur Rehman Jehangiri,Mehrunissa Kazim, Mubashir Shah	208
Comparison of single verses multiple session band ligation for the treatment of bleeding oesophageal varies Ali Hyder, M Akif Dilshad, Shahid Sarwar, Altaf Alam, Anwaar A Khan, Arshad Kamal Butt	212
Propolis as an antibacterial agent against clinical isolates of MDR-Acinetobacter baumannii Abdul Hannan, Alia Batool, Muhammad Usman Qamar, Fizza Khalid	216
Risk characterization of maternal and neonatal tetanus in view of tetanus vaccination campaigns in Pakistan Ejaz A Khan, Rownak Khan, Muhammad Tariq Iqbal, Quamrul Hasan, Saadia Farrukh, Muhammad Safdar Rana, Wasiq Mehmood Khan	220
SYSTEMATIC REVIEW
Enhanced immunization coverage through interventions for childhood cluster diseases in developing countries Sheh Mureed, Ratana Somronghtong, Ramesh Kumar, Abdul Ghaffar, Robert S Chapman	223
CASE REPORTS
Pyrexia-induced Brugada phenocopy Nauman Khalid, Lovely Chhabra, Jeffrey Kluger	228
A young girl with fits Imran Ahmed, Ejaz Ahmed, Badshah Hussain Zaidi, Jawad Khaliq Ansari, Shazia Nisar	232
Ureteric Angiomyolipoma causing unilateral pelvi-ureteric junction obstruction Iftikhar Ali Khan, Durre Shahab, Asad Rehman, Imran Jamil, Saeed Akhter	234
Onion peel appearance in balos concentric sclerosis-A variant of multiple sclerosis Saeed Arif, Muhammad Waseem Wali, Atiq ur Rehman Slehria, Hina Khalid, Hamza Malik	236
Unexpected sudden death in a young man with myopericarditis Rafaqat Hussain, Laszlo Halmai, Eduardas Subkovas	239
ALT changes and adverse events of Telbivudine in hepatitis-B patients-An experience of 11 patients Zeeshan Ali, Neeta Maheshwary, Uffaq Zara, Siddiqi Ahson, Muhammad Athar Khan	241
Retained gauze piece resulting in right renal complex cyst diagnosed after 4 years of pyelolithotomy Ayra Arshad, Nayyab Zehra, Ahmed Hassaan Malik	243
*Community acquired methicillin sensitive Staphyloccus aureus* cerebral abscess in a previously health gentleman mimicking signs of cavernous sinus thrombosis-A unique presentation** Ishma Aijazi, Fadhil M Abdulla, Ahmad Elbagir Ibrahim	245
Coexistence of Graves’ disease and toxic adenoma: A rare presentation of Marine-Lenhart syndrome Enver Avci, Huseyin Narci	248
SPECIAL COMMUNICATION
Dedicated breast cancer management centres with facilities for full image-guided assessment and image-guided surgery in the developing areas of Pakistan - A long overdue necessity Saeed Ahmad, Alaa Eldin Ginawi, Samer Sabbagh	251
PICTORIAL
An unusual complication of chest intubation Munir Ahmad Abbasi	255
Mucinous cyst adenocarcinoma Sadaf Khalid	256

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Current Issue

mucinous cyst adenocarcinoma

A 16 year old young unmarried girl presented to us in the surgical outpatient department with the complains of increasing abdominal girth since last 8 weeks. Imaging studies showed a giant abdominal pelvic mass probably of ovarian origin. Cancer antigen-125 and alpha fetoprotein were raised while carcinoembryonic antigen were normal. These huge disseminated tumors (12x13 cm) displaced her uterus, compressed her abdominal contents and extended up to her diaphragm with massive ascites and peritoneal metastatic seedlings. Bilateral salpingoopherectomy and omentectomy were done. The histopathological diagnosis was a well differentiated mucinous cyst adenocarcinoma.

Giant mucinous cyst adenocarcinomas are very rare. This type can account for 5-10% of all ovarian muncinous tumors. Mucinous cystadenoma is an epithelial tumor most often found in the ovaries. They also frequently occur in extra ovarian sites. Mucinous cystadenomas have origins from inclusions and invaginations of the ovarian celomic epithelium and persistence of Müllerian cells, or from Wolffian epithelium and teratomas. They often occur in the fourth and fifth decades, accounting for 25% of the ovarian tumors, 5% are bilateral and 15% are malignant. Mucinous (25%) and serous (75%) cystadenomas account for 8 to 15% of all ovarian tumors. The epithelium of the cysts is usually cylindrical and mono- or multi-stratified, and cuboidal epithelium is due to the pressure inside the cyst. The classical cells show clear cytoplasm and a hyperchromatic nucleus at the base. Extra-large benign and malignant cysts of the ovary are uncommon and involve diagnostic and management challenges and determinations of cancer antigen (CA)-125 can help to identify epithelial tumors of the ovary.

Dr. Sadaf Khalid

Department of General Surgery, Lahore General Hospital, Lahore-Pakistan.

Email: woven.dreamz@gmail.com