Journal of Ayub Medical College

J Ayub Med Coll Abbottabad (JAMC)

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

Past Issues

Guidelines for Authors

JAMC 26(2): April-June 2014




Corruption in healthcare system: An obstacle in achieving optimal outcome
Muhammad Zeeshan Haroon


  TNF-alpha: A risk factor for ischemic stroke
   Faraz Ahmed Bokhari, Tania A. Shakoori, Ambreen Butt, Farkhanda Ghafoor
  Quantitative analysis of macrophages in wound healing of rat skin subjected to loud noise stress
   Aisha Rafi, Muhammad Yunus Khan, Liaqat Ali Minhas
  Rheumatoid arthritis: The importance of evidence based diagnostic reasoning in preventing debilitating    consequences
  Naheed Gul, Mujtaba Quadri
 Stroke after coronary artery bypass surgery with and without cardiopulmonary bypass
  Javed Iqbal, Abdul Ghaffar, Ahmad Shahbaz, Abdul Rehman Abid
 Frequency of dentofacial asymmetries: A cross-sectional study on orthodontic patients
  Nita Kumari Bhateja, Mubassar Fida, Attiya Shaikh
 Isolated inferior oblique myectomy for hypertropia
  Sadia Bukhari, Ghulam Qadir Kazi, Umair Qidwai   
 Efficacy of vancomycin versus linezolid against coagulase-negative Staphylococci in various clinical specimens 
  Muhammad Murad Ehsan, Ghulam Fatima, M. Owais Ismail, Zahida Memon
 Efficacy and safety of subcutaneous lateral internal sphincterotomy for chronic anal fissure
 Muhammad Zubair, Muhammad Saaiq, Syed Aslam Shah

 Outpatient endometrial biopsy with Pipelle vs diagnostic dilatation and curettage 
  Raazia Rauf, Asma Shaheen, Shamsunisa Sadia, Faressa Waqar, Shamsa Zafar, Saadia Sultana, Shumaila Waseem 
 Frequency of albuminuria in diabetic patients presenting with macrovascular complications
 Muhammad Sohail, Fozia Fatima, Sadia Fatima, Shahbaz Ali Khan, Syed Abbas Anwar, Muhammad Adeel Alam, Munir Ahmad Abbasi
 Comparison of primary wound closure with delayed primary closure in perforated appendicitis
  Mukhtar Ahmad, Kishwar Ali, HumeraLatif, SamanNaz, Khalid Said
 Financial costs to institution on patients waiting for gall bladder disease surgery and how to reduce them
  Ahmed Waqas, Shahzad Ahmed Qasmi, Faran Kiani, Ahmed Raza, Khizar Ishtiaque Khan, Shazia Manzoor 
 Current trends in undergraduate medical and dental research: A picture from Pakistan
  Waqar Jeelani, Sanaa Masood Aslam, Asrar Elahi
 Impact of body mass index on left ventricular mass
 Munir Ahmad Rashid, Bilal Ahsan Qureshi, Nisar Ahmed, Mubasher Ali Sherwani
 Knowledge, attitudes and practices of parents regarding antibiotic use in children
 Saad Siddiqui, Mubeen Sultan Cheema, Romana Ayub, Noreen Shah, Ameer Hamza, Sheraz Hussain, Muhammad Hamza Khan, Syed Musa Raza
 Lead erosion in permanent pacemaker: A cumbersome complication
 Bakhtawar Shah, Zahid Aslam Awan, Tahmeedullah, Zahoor Ahmed Khan
 A clinical study of ectopic pregnancy
 Najma Bano Shaikh, Shabnam Shaikh, Farhana Shaikh
 Helicobacter pylori prevalence and histopathological findings in dyspeptic patients
 Khalid Mehmood, Abdul Aleem Awan, Naveed Muhammad, Fariha Hasan, Abdul Nadir
 Vitamin-D status at breast cancer diagnosis: Correlation with social and environmental factors and dietary intake
 Saba Imtiaz, Neelam Siddiqui
 Frequency of gall bladder carcinoma in patients with acute and chronic cholecystitis
 Najamul Haq, Basharat Ali Khan, Muhammad Imran, Adeel Akram, Abdul Basit Jamal, Fatima Bangash
 Prevalence of metabolic syndrome and its component abnormalities among school age Pakistani children
 Amina Zehra Iqbal, Sarah Basharat, Adeel Basharat, Shifa Basharat
 Variation in lung volumes and capacities among young males in relation to height
 Urooj Bhatti, Keenjher Rani, Muhammad Qasim Memon
 Association between psoriasis and coeliac disease related antibodies
 Jauhar Mumtaz Khan, Sibghat Ullah Rao, Muhammad Usman Rathore, Wasif Janjua
 Morphometrical analysis of intervillous space and villous membrane thickness in maternal anaemia
 Nazma Kiran, Alia Zubair, Henna Khalid, Ambreen Zafar


 Treatment of chronic hepatitis-C with standard interferon and ribavirin
 Shakeel Ahmad Jadoon, Habib Ahmad Jadoon, Hasan Shahzad Nazar


 Endoscopic findings in patients presenting with oesophageal dysphagia
 Adil Naseer Khan, Khalid Said, Mukhtar Ahmad, Kishwar Ali, Rania Hidayat, HumeraLatif


 Comparison of perinatal outcome in growth restricted fetuses retaining normal umbilical artery Doppler flow to  those with diminished or severely reduced/absent end-diastolic flow
 Tariq Saeed Siddiqui, Aisha Asim, Shafqut Ali, Tahir Saeed Siddiqui, Asima Tariq


 Laparoscopic cholecystectomy: Experience at a tertiary level hospital
 Muhammad Tanveer Sajid, Syed Mukarram Hussain, Riaz Anwar Bashir, Quratul Ain Mustafa, Muhammad Ahmed, Abdul Halim, Irfan Shukr,   Muhammad Ahmed


 Problems of group dynamics in problem based learning sessions
  Zafar Ahmed
 Frequency of modifiable risk factors in stroke patients
 Muhammad Zuhaid, Salman, Javed Akhtar Chawla, Umer Farooq, Aamir Ahmad, Saminullah Khan, Momina Asfandiyar


 Functional status of vascular endothelium in diabetes mellitus
  Muhammad Saboor, Moinuddin, Muhammad Ajmal, Samina Ilyas


 Giant ovarian cyst–An unusual finding
 Mukhtar Mehboob, Samina Naz, Muhammad Zubair, Muhammad Ashraf Kasi
 Impact of prosthodontic treatment on the oral health related quality of life in a maxillectomy patient with multiple impairments
 Muhammad Faheemuddin, Nazia Yazdanie, Muhammad Sohaib Nawaz
 Fibroma of the tendon sheath-A rare hand tumour following repetitive trauma to the palm
Muhammad Yousaf
 Role of isotretinion in cancer prevention and management in malignancies associated with xeroderma pigmentosum
 Sajid Zaman, Jawad A Gillani, Nabeela, Rauf Khattak, Iqbal, Noor ul Ain, Zanaib, Fayyaz
 Ureteral triplication and contralateral duplication with vesicoureteral reflux
  Sohrab Naushad Ali, Aymon Naushad Ali, Niqad Ahmad, Mian Naushad Ali


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Current Issue

Hypothyroidism presenting as Hoffman Syndrome

Hypothyroidism presenting as Hoffman Syndrome

A 40 year old male presented with features suggestive of myxedema in the form of hoarseness of voice, fatigability, constipation, cold intolerance, non-pitting bilateral ankle edema and proximal muscle weakness from last 1.5 years. He was not a known diabetic and hypertensive. On examination, he had bilateral calf muscle hypertrophy with normal tone (photograph) along with percussion myoedema and delayed tendon jerk relaxation. His thyroid profile showed T3 0.2 ng/ml, T4 10 ng/ml and TSH 135 mU/ml. Anti-microbial antibody and  anti-thyroglobulin titers were 210 AU/ml and 425 U/ml respectively. Ultrasound thyroid showed atrophy. CPK was 450 U/l. Electromyogram revealed polyphasic action potential consistent with hypothyroid myopathy. Nerve conduction velocity was normal. Muscle biopsy revealed atrophy of muscle fibers with increased inter-fiber ground substance. In this patient having features of myxedema and bilateral calf muscle pseudohypertrophy, a diagnosis of Hoffman syndrome was made and the patient responded to L-thyroxin therapy.
    In hypothyroidism skeletal muscle atrophy usually occurs in the form of diffuse myalgia, weakness, stiffness with slowness of both contraction and relaxation phases of deep tendon reflexes.  However calf muscle pseudohypertrophy, myoedema and wasting are rarely encountered. Prominent muscle pseudohypertrophy in adults is known as Hoffman syndrome. Definitive diagnosis is made on muscle biopsy. Therapy with thyroxin corrects these muscle abnormalities.


Professor, Department of Medicine, Govt Medical College/GND Hospital, Amritsar, India, 143001.

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