Are PM’s health cards for benefiting private hospitals?...Rawalpindi, Islamabad and Faisalabad...

KARACHI - Provincial Minister for Health, Dr Sikandar Ali Mandhro has assured the

Jinnah Postgraduate Medical Center (JPMC) administration that the posts or slots of Postgraduate (PG) Doctors will be increased to minimize the pressure on existing doctors, while other genuine demands of institution will also be accepted after approval from competent authority. This he said during inauguration ceremony of 52nd Annual Symposium of JPMC under theme "Prevention is better than Cure" held at Najmuddin Auditorium, JPMC. Additional Secretary Health, Aslam Pechuho, Executive Director, JPMC, Dr Seemin Jamali, Chairperson of Annual Symposium Prof Dr Sughra Parveen and Secretary Prof Dr Haleema Yasmin were also present on this occasion. Dr Mandhro said PG doctor's slots will be enhanced soon, while health professional & deputation allowance, promotions of staff and permission to construct two high-rise

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Inside PMA opposes suspension of senior professors

Advancement in the treatment of adult cancers

Are PM’s health cards for benefiting private hospitals?

ISLAMABAD - The PM's health cards project worth Rs 9 billion in the name of insurance cards under the Prime Minister's National Health Programme has reportedly been handed over to private hospitals instead of public hospitals.At a government run hospital, Pakistan Institute of Medical Sciences, which is the largest hospital in the Federal Capital, the poor patients have to run from pillar to post while keeping these cards in hands, but in vain, as no one is there to attend to them.The health insurance cards issued by the premier are turning out to be nothing more than a piece of paper, as they are not being entertained at the government hospitals.The PIMS administration has neither set up any special counter nor deputed any person to guide these cardholders.The Ministry of National Heath had issued the health insurance cards to some 800,000 families that have a monthly income of less than Rs 2,000. However, only about 12,000 people have succeeded in getting healthcare facilities by utilising these cards.

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ISLAMABAD - The Drug Regulatory Authority of Pakistan (DRAP) conducted raids in different cities. The spokesperson of National Health Services, Regulations and Coordination said that the drug storage system of pharmaceutical stores are not up to the mark. Crackdown was conducted in Rawalpindi, Islamabad and Faisalabad where

low quality medicine stores were sealed.In Rawalpindi, a crackdown was conducted by DRAP at Medicine Distributor at Iqbal Town. In Faisalabad, DRAP conducted a raid at a herbal medicine company. Similarly in Islamabad, raid was conducted on two medical stores in F-8 sector. One of the medical store was sealed too.

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KARACHI - Karachi- Many innocent lives could be saved if modern first-aid and emergency centers are established at main arteries, particularly Superhighway, National Highway and RCD Highway.Presently, seriously injured and emergency patients are rushed to three major hospitals of the city, the Jinnah Postgraduate Medical Center (JPMC), the Civil Hospital Karachi (CHK) and the Abbassi Shaheed Hospital (ASH). However, as these hospitals are situated in the main city area, it takes hours to shift seriously injured and emergency patients from the suburban areas to these hospitals, due to long distances and traffic jams.The medical fraternity of Karachi has been demanding for long to establish at least three emergency centers at the Superhighway, National Highway and RCD Highway. It suggests that the JPMC

should set up its nodal point having first-aid and emergency facilities at the National Highway near Quaidabad, while the CHK should such a center near Baldia on the RCD Road and the ASH near New Sabzi Mandi on the Superhighway. These nodal centers should be directly linked to the main emergency centers of their mother institutions. These nodal centers would help in prompt first aid to the injured and emergency patients and then rushed the patients needing specialized care to the main emergency centers of their mother institutions.The medical fraternity has requested Sindh health minister Dr Sikandar Mandhro to assess the feasibility of this idea and implement it with provision of needed support including funds, infrastructure and manpower. Support from the Motorway police and National


02 MEDICAL NEWS / January 15-31, 2017

KARACHI - The cancer patients attending the Oncology Department of National Institute of Child Health (NICH), and other Government run hospitals suffered a great deal due to non-availability of drugs which help in pain-management of patients with advance stage cancer.The Oncology Department of NICH run by Child Aid Association (CAA), a non-governmental organization, providing totally free of cost treatment and diagnostic facilities to children suffering from cancer coming from all over the country but oncologists and patients suffered a great deal due to non-availability of Morphine Tablets in hospital for management of advance stage patients when no other option left.President, CAA, Prof Dr Nizamul Hasan, informed that morphine tablets and morphine injection used for pain-management of patients suffering advance stage cancer for incurable patients. He explained that morphine tablets are only used on children, when they are suffering from advance stage cancer, while morphine injection is used on adults for pain-management purpose.He said CAA had applied to get registration of morphine tablet for better management of advance stage cancer patients six months ago but local drug inspector refused to do so and asked CAA to apply through proper channel. He said later, Director, Institute of Child Health (NICH), had applied for same but no response had been received yet in this regard. He said oncologists and patients have suffered a great deal due to non-availability of morphine tablets in hospital as well as from private medical store. He said opium and others drugs are available in various areas of Karachi but unfortunately there was too lengthy procedure to get registration of medicines like morphine.Similarly, morphine tablets and injections are also not available in Pharmacy Departments of Civil Hospital Karachi, Jinnah Postgraduate Medical Center and other public sector hospitals. Sources at JPMC, that the morphine tablets and injections are only available in Pharmacy Departments of Aga Khan Hospital and Liaquat National Hospital Karachi. The morphine tablets are only given to cancer patients on the prescription of oncologists.The morphine tablets and morphine injections are even not available in wholesale medicines markets of the city.

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KARACHI - A three-member delegation of Pakistan Medical Association (PMA) left for China to attend Annual Scientific Meeting- 2017. The delegation on the invitation of Dr Rao Keqin, Vice President & Secretary General of Chinese Medical Association (CMA), a delegation of Pakistan Medical Association (PMA) left for China to attend 2017 Annual Scientific Meeting & International, Hong Kong and Macao Medical Association on January 14 to January 15, 2017 in Nanjing (Southern Part of China). The PMA delegation comprises on President PMA Centre, Prof Ashraf Nizami, Secretary General, Dr SM Qaisar Sajjad and Dr Mirza Ali Azhar. The medical associations from all over the world including World Medical Association (WMA) will also participate in this Annual Scientific Meeting. The key topics to be discussed include Role of Medical Associations in the development of medical courses of each country or region, How to strengthen the communication and collaboration among associations of each country and region and building joint medical research and training. In addition, PMA delegates will also visit Chongqing on the invitation of of Chongqing Medical Association.

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MEDICAL NEWS / January 15-31, 2017 03

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KARACHI - Pakistan Medical Association welcomed the decision of Federal Government for proposed establishment of 44 new hospitals throughout Pakistan. Secretary General, Pakistan Medical Association (Centre), Dr SM Qaisar Sajjad, said it is always good to open new hospital in areas where secondary and tertiary care facilities are not available for the poor people of the country. He said PMA welcomed the decision of the government we also want to bring following facts to the planners of the proposed new hospitals. "With the building of new hospitals government should also invest in infrastructure like provision of clean potable water and organized sewerage

system to every citizen of country to prevent them from water born and infectious disease. It will be good if government invest in basic health units and rural health centre and make them functional to provide vaccination to every child," he added. He said water borne and infectious diseases are the main causes of mortality and morbidity in Pakistan He said PMA believes that governments in every province should take special steps to improve the services in existing secondary and tertiary care hospital as majority of them are suffering from resources because of chronic apathy of governments. He said federal


KARACHI - The Health and Medical Services Department of Karachi Metropolitan Corporation (KMC), has started OPD services at Nazeer Hussain Memorial Kidney Centre, Federal B Area, Karachi, while dialysis of patients will commence very soon, it was emerged on Friday. Senior Director Health and Medical Services, KMC, Dr Muhammad Ali Abbasi said OPD facility at Nazeer Hussain Memorial Kidney Center had begun, while dialysis of patients will also commence very soon. He informed that two nephrologists had been deputed for counseling and consultations of patients at Kidney Center. He informed that RO Plant and 15 dialysis machines had been installed at Kidney Center and dialysis of patients will begin after installation electricity power meter. He said a non-governmental organization donated power generator to Kidney Centre administration to ensure uninterrupted power supply during electricity breakdown. Dr Abbasi said Mayor Karachi Wasim Akhtar inaugurated an OPD facility at Kidney Centre at Nazir Hussain Memorial Hospital. He informed that Health and Medical Services Department of KMC donated ten each dialysis machines to Abbasi Shaheed Hospital, Dow University of Health Sciences, Landhi Medical Complex, while five handed over to Chandka Medical College, Larkana. He said that these machines had been distributed to facilitate the poor patients who could not afford expensive treatment. He said the number of kidney patients had been increasing therefore Abbasi Shaheed Hospital, Nazir Hussain Memorial Hospital and Landhi Medical Complex had been activated to facilitate kidney patients. He said the diagnostic centre at Nazir Hussain Memorial Hospital would facilitate people.

KARACHI - The Civil Hospital Karachi (CHK), management has issued explanation letters to over 103 doctors and transferred four others who remained absent from their duties during Rain-Emergency Day.MS, Civil Hospital Karachi (CHK), Dr Zulfiqar Ali Siyal has issued explanation letters to over 103 doctors who remained absent from duties during Rain-Emergency Day. He further said four other doctors have also been transferred to Emergency Department over their negligence. He said these doctors remained absent from OPDs and Radiology Department duties during rain. He said Additional Medical Superintendent (AMS) Nusheen Qadri, AMS, Afshan Jafri, AMS, Qamar Zaman and Dr Suresh of Jail Ward have been transferred in Causality Department. He said these doctors found to be negligent and hence transferred into Emergency Department.Dr Siyal said PA to MS,CHK, Sajid Qureshi was also transferred in Control Room over misuse of powers and remained absent during rains. He said maintenance of discipline in institution is the top priority of incumbent administration of the hospital. It is pertinent to mention here that Provincial Health Minister Sindh Dr Sikandar Mandhro had declared Rain-Emergency in city hospitals during intermittent rains.

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Medical Fraternity urges ...Continued from page 02


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KARACHI - The Pakistan Myasthenic Welfare Organization in collaboration of Direct Aid Program (DAP) of the Australian Government has opened Plasmapharesis Unit at National Institute of Child Health. Australian High Commissioner to Pakistan, Margaret Adamson, inaugurated the Paediatric Plasmapharesis Facility at NICH, Karachi. Director, NICH Prof Syed Jamal Raza, senior doctors, nurses and paramedical staff attended the event. The Plasmapharesis is a treatment offered for the rapid clinical management of critical ill patients who tend to develop rapid paralysis and respiratory

failure as complication. These medical and neurological disorders are Guillain-Barre Syndrome (GBS), Hemolytic Uremic Syndrome (HUS) with kidney failure, Myasthenia Gravis and certain poisons. Each patient with GBS/HUS usually requires 4-6 sessions and each session is costing from Rs. 50,000-60,000 in private sector. It is likely that 10-15 patients per month may benefit from this treatment facility. This Plasmapharesis unit at NICH will also provide a facility of Cell Separator for Mega Units Platelets required for treatment of children with leukemia, aplastic anemia and dengue fever. This single mega unit of platelets costs

about Rs. 15,000. Australian High Commissioner, Margaret Adamson, said that NICH is doing a remarkable work for the children and is a leading institute of Pakistan for child healthcare. "We are very happy to extend our cooperation and help to NICH through PMWO. Such lifesaving institutional health care facility collaboration will be continued in future for the better care of needy children of Sindh -Pakistan, she added. Director, NICH Prof Syed Jamal Raza paid gratitude to the Australian High Commissioner for providing an advanced healthcare


KARACHI - As many as 6,750 dog bites cases have been reported at Anti-Rabies Clinic, Jinnah Postgraduate Medical Center in 2016 and dog bites are increasing day by day in the city. Executive Director & In-charge of Emergency Department, JPMC, Dr Seemin Jamali, said around 6,750 dog bite victims have been treated and vaccinated at Anti-Rabies Clinic of hospital in 2016. She said each dog bite victim has received vaccination four times during treatment. In 2015, 6,590 dog bites cases treated at Anti-Rabies Clinic, 5,192 in 2014, 3,879 in 2013, 3,450 in 2012, 2780 in 2011, 2,445 in 2010, 2,158 in 2009, 3,552 in 2008, 3,253 in 2007, 2524 in 2006, 2,545 in 2005, 2,932 in 2004, 2,6 74 in 2003, 2,119 in 2002 and 1,769 in 2001, respectively. The majority of dog bite cases were reported from slums areas of North Karachi, New Karachi, Baldia, Orangi, Keamari, Mehmoodabad, Liaquatabad, Federal B Area and Golimar. The children and elderly people generally become victims.

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KARACHI - Chairman Pakistan Tehreek-e-Insaf (PTI) Imran Khan on Thursday performed ground breaking of Shaukat Khanum Memorial Hospital and Research Centre in Karachi.Speaking at the inauguration ceremony, Khan said that SKMCH&RC Karachi will make it possible for the low-income patients across Sindh to get comprehensive cancer care. Former cricketer, Javed Miandad, Business Tycoon Aqeel Karim Dhedi, actor Javed Sheikh and Behroze Sabzwari were also present on the occassion.The PTI chief recalled how difficult it was for him when his mother was battling cancer and they faced expenses for her treatment abroad. He lauded the efforts of all those who helped him. He said in 1990, when Nawaz Sharif was a Chief Minister of Punjab, he also tried to establish a cancer hospital, but he could not make it.He said that it was not an easy task to arrange Rs700 million for the cancer hospitals and he had never thought that this journey to establish the cancer hospitals would be so difficult. Khan said that the construction of a cancer hospital in the city will not only provide the most modern cancer treatment to the people of Sindh, but also help raise healthcare standards and provide training and employment opportunities in the region.For Shaukat Khanum Memorial Trust foundation laying was carried out by a 10-year-old cancer patient Waleed Ahmed from Jamshoro.

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Highway Authority could also be sought for this idea as the proposed nodal centers would mainly care emergency needs of road accident survivors. However, the provincial health department and KMC can take initiative in form of some pilot projects, which could even be set up in the shape of small mobile hospital units.

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KARACHI - The Dow Centre of Excellence, Dow University of Health Sciences (DUHS) and Health Security Partners (HSP) jointly organized an informative CME Session on "Chikugunya" and a Workshop on "Biological Waste Management and Disposal for Clinical and Research Laboratories" at Ojha Campus. The event was a joint venture of Dow Center of Excellence (COE) for Biosafety and Biosecurity and Health Security Partners, USA.The objective of the CME was to increase the understating of laboratory staff and doctors about Chikugunya infection and its prevention. During the CME session Dr Saeed Khan PhD, Associate Professor and Additional Director of DDRRL delivered a very informative lecture on "Chikugunya Virus". He explained the source of infection, symptoms, treatment, prevention and control of this infection. He also highlighted the importance of health hygiene and protection from mosquito's bite which is the

main source of Chikugunya Virus infection. The aim of this workshop and training was to enhance the skills of the healthcare workers how to manage and properly dispose the biological waste. Participants from well-reputed hospitals and universities including Dow Lab, Indus Hospital, Liaquat National Hospital, Jinnah Hospital, Liaquat University of Jamshoro, Chughtai Laboratory, Memon Hospital, Hamdard University, University of Karachi and other institution attended this event. Founding Vice Chancellor, DUHS, Prof Dr Masood Hameed Khan, highlighted the role of Dow University in the prevention of infectious diseases and providing high quality diagnostic and healthcare facilities. He also announced

to establish new research center equipped with modern facilities that will help to stop the spread of different vector borne diseases like Chikugunya, dengue etc. He also offered word of wisdom about the services of Dow University and congratulated the organizers and HSP for successfully organizing the workshop and CME session and urged the importance of organizing such events more frequently.

The theoretical aspects of Biological Waste Management and Disposal were covered during two very informative lectures which were followed by hands-on training session. The workshop elucidated upon several practical and applied aspects. Participants coming from different labs of Sindh also gave their feedback that how they will apply and follow the given information and knowledge in their respective labs. During the session Prof Dr Rana Qamar, Prof Dr Shaheen Sharafat and Dr Yahya Noori also shared their views about this event.

KARACHI - The electronic media has come a long way in Pakistan with its reporters omni present on the spot and witnesses traumatic events should have access to regular psychological counseling and medical check-ups to ensure their physical as well as psycho-social safety and productivity. Media houses also need to develop implementation of safety protocols for field reporting and anti-sexual harassment policies for female journalists.These key points were raised at a roundtable discussion on 'Safety of Television Journalists,' under the aegis of Pakistan Press Foundation (PPF) in collaboration with the Open Society Institute (OSI) here.The discussion, attended by television journalists from across Pakistan is part of a series of consultations with electronic, print, radio and digital journalists, as well as, other stakeholders to improve the safety of media professionals.Journalists agreed that they themselves

need to take steps to ensure their safety. Impartiality in reporting, clear distinction between activism and journalism, editorial discretion, cultural sensitivity, and awareness of safety measures were cited as key factors.The role of media houses and owners also came under scrutiny during the discussion as participants said that the issues including inadequate compensation, lack of medical coverage, job insecurity, focus on 'breaking news,' lack of safety equipment, unprofessional and underpaid support staff were some of their biggest failings.TV journalists demanded adequate and timely compensation for district reporters as well; regular arrangement of awareness sessions about hostile environment, first-aid, medical coverage, and provision of proper safety gear. One of the participants suggested use of equipment like drone cameras for the coverage of dangerous assignments such as fires in buildings.


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KARACHI - Sindh Chief Minister Syed Murad Ali Shah has said that polio has become a big challenge for his government but "I have accepted this challenge and would hopefully turn Sindh into a polio free province shortly." He said this while presiding over a high profile meeting on polio here at the New Secretariat. The meeting was attended by Health Minister Dr Sikandar Mendhro, MNA Dr Azra Pechuho, Provincial Polio coordinator Shahnaz Wazir Ali, Chief Secretary Rizwan Memon, IG police AD Khowaja, Additional IG Karachi Mushtaq Maher, Secretary Health Fazal Pechuho, all divisional commissioners, CEO PPHI, PD EPI Fayaz Jatoi, representatives of federal government, representatives of WHO and Unicef and others. Briefing the chief minister, the PD EPI Fayaz Jatoi said that during 2016 some 19 polio cases were detected all over Pakistan, of them eight in Sindh, eight in KPK, two in FATA, one in Balochistan and zero case in the Punjab. He added that out of eight cases of Sindh seven are in rural areas and one in Karachi. The chief minister was told that in 2015 there were 54 polio cases in the country, including 12 in Sindh, 17 in KPK, 16 in FATA, seven in Balochistan and two in Punjab. The chief minister said that it was painful that Punjab, Balochistan, FATA and KPK have improved but Sindh has shown a negligible progress. This shows that there is some problem which we have to address. The campaign which was launched end of September and December 2016 with a target to cover 2.2 million children and 6.1 million children in rural areas of the province. In the city out of 2.2 million some 2.6 children were not available and 1.7 percent refused to intake polio vaccine. On this the chief minister expressed his displeasure saying that it becomes of the responsibility of the district administration to ensure 100 percent coverage. "We all have to take ownership of the anti-polio drive, otherwise Sind would lag behind and I would not allow this to happen. It was also disclosed that the staff in the KMC- managed health facilities are reluctant to participate in polio and EPI activities. LANDHI UC-I and UC -2, SITE UC 9, Baldia UC 2 are at high risk because of lack of health facilities. Apart from it there are non-functional hospitals in UC-4 Gadap Janat Gul Hospital. On this the chief minister's directives the chief secretary directed the KMC administration to ensure proper participation otherwise action would be taken. The chief minister directed the health minister and secretary health to activate Lady Health Workers and utilize their services for eradication of polio out of the province. The chief minister was informed that they were on the protest because of nonpayment of their salaries from the last four months. On this the chief minister ordered finance department to release their funds immediately and pay the salaries.

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SUKKUR - After the long awaited recognition of the Bibi Aseefa Dental College Larkana, it is hoped that the last two batches of the Ghulam Mohammad Mahar Medical College (GMMMC) Sukkur will also get recognition soon. A nine-member team from the Pakistan Medical and Dental Council (PMDC) visited GMMMC and inspected the faculty and facilities available at the college. Shaheed Benazir Bhutto Medical University, Larkana, assistant registrar Dr Altaf Mirani confirmed the visit and said the PMDC team expressed its satisfaction over the faculty and facilities provided at the college. He recalled that the PMDC had refused to recognise the two last batches of the college and also banned fresh admissions.Now all the requirements have been fulfilled and the team seemed satisfied with it, he said, adding that soon they will be able to give good news to the students' parents.

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ISLAMABAD - A delegation of Royal College of Physicians, UK, visited the Higher Education Commission (HEC) and discussed holding of a joint conference on clinical governance, leadership and research to boost medical education and governance in Pakistan.HEC Chairman Dr. Mukhtar Ahmed welcomed the delegation which comprised Dr. Fraz Mir and Mr. Steve. They were accompanied by Vice Chancellor, Pakistan Institute of Medical Sciences Dr. Javed Akram, Dr. Saeed Hamid, and Prof. Akbar Chaudhary. The Chairman shared a roundup of the HEC initiatives as well as achievements with regard to promotion of higher education in the country.He briefed the visiting team about the HEC programmes aimed at creating a research culture in the country. He said since the inception of HEC in 2002, the number of universities has increased highly, adding that HEC pursues a no-compromise policy on quality of education.He said HEC has been striving hard to increase

equitable access to higher education and promote research culture in the country. He said HEC emphasizes relevance of research to the social needs, as relevant research activities will

enable the nation to address its issues itself.The Chairman stressed the need for joint collaboration in the field of medical education, healthcare and health sciences. He underlined the need for collaboration

between Pakistani and UK higher education institutions on the pattern of Pak-US Science and Technology Cooperation Programme. He also shed light on the HEC accreditation services and the role of Pakistan Medical and Dental Council in this regard.The visitors showed interest in exploring opportunities for medical colleges heads to visit the British medical institutions so as to help them update their knowledge. The Royal College of Physicians team discussed with the chairman holding of a joint conference on clinical governance, leadership and research to boost medical education and governance in Pakistan.

LAHORE - The Pakistan Medical Association has reacted strongly to the decision made by the Punjab government to suspend senior professors in the aftermath of the death of Zohra Bibi who breathed her last in the corridors of Lahore's Jinnah Hospital recently.The health department suspended Jinnah Hospital Medical Superintendent Dr Zafar Yusuf, Professors Jawad Zaheer and Tanveer-ul-Islam of the Post Graduate Medical Institute and Lahore General Hospital and Professor Zafar Iqbal of Allama Iqbal Medical College and Jinnah hospital as news of the death of Zohra Bibi on the floors of Jinnah Hospital went viral in the media."There is a strong resentment among medical professionals as very senior and respected professors were held responsible of the death of Zohra Bibi," Professor Dr Ajmal Hasan Naqvi, PMA Lahore Chapter President said

while talking to media persons on Wednesday. According to the professor, the doctors' community completely rejects the attempt of the health department to tarnish the image of respected professors of thousands of doctors and urged the department to take back the decision.The office bearers of the PMA said that the poor healthcare facilities of public sector hospitals increase the doctors' workload manifold. "The government needs to build six more hospitals of the standard of Jinnah Hospital to cater to the mushrooming growth of this city," Dr Naqvi said."The emergencies and ICUs of public sector hospitals are flooded with patients and the staff of emergency ward extremely occupied with their work," he added.The PMA further added that according to the World Health Organization (WHO), only four patients can be treated during a day in one bed of the emergency with an average of 6 hours. As per the standard of WHO, only 400 patients can be treated in the emergency of 100 beds during a day but

it is a matter of fact that four to five thousand patients come to the emergencies of public sector hospitals on a daily basis."The Professor Zafar Iqbal Chaudhry ward in Jinnah Hospital consists of 50 beds but was accommodating more than 100 patients already when Zohra Bibi was brought to his ward. How is it possible to attend all the patients with such limited resources? As per the WHO, there must be 1 bed for a population of 750 but there is only one bed for a population of 6273 in Punjab," Dr Naqvi said and added that the government and bureaucracy are responsible for the death of Zohra Bibi.According to regulations of the Pakistan Medical and Dental Council (PMDC), all private hospitals are bound to provide half of their beds to poor patients. Zohra Bibi was allegedly denied treatment in Arif Memorial Teaching Hospital and Rashid Latif Medical College.A committee constituted by the PMDC will submit its report on the matter on January 13.

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March 9-11, 201733rd PSG Annual Congress by Pakistan Society of Gastroenterology & GI Endoscopy at PC Hotel, Karachi

February 3-5, 2017International Conference on Bridging the Gap in Primary Health Care at Ziauddin University Clifton Campus

9 International Fetal Alcohol Syndrome Day

12 World Oral Health Day21 World Alzheimer’s Day20 World Retina Week25 World Pharmacist Day26 World Retina Day29 World Heart Day

8 World Sight Day10 World Mental Health Day12 World Arthritis Day12 World Bone And Joint Week15 World Handwashing Day16 World Food Day17 World Spine Day17 World Trauma Day20 World Osteoporosis Day24 World Polio Day29 World Stroke Day

1 Lung Cancer Awareness Month9 World Quality Day14 International Diabetes Day17 World Chronic Obstructive

Pulmonary Disease Day 26 World Anti-Obesity Day

1 World Aids Day3 International Day of Disabled Persons5 World Patient Safety Day

1-7 World Breastfeeding WeekAUGUST

SEPTEMBER

OCTOBER

NOVEMBER

DECEMBER

16 World Hypertension Day20 World Head Injury Day21 World Down Syndrome Day24 World Tuberculosis Day

2 World Autism Awareness Day7 World Health Day17 World Haemophilia Day24 World Immunization Week25 World Malaria Day

5 World Asthma Day8 World Thalassemia Week10 World Move For Health Day12 World Chronic Fatigue And

Immune Dysfunction Syndrome12 International Nurses Day17 World Hypertension Day28 International Day of Action

for Women’s Health31 World No Tobacco Day

1 World Milk Day1 International Children Day5 World Environment Day 14 World Blood Donor Day19 World Sickle Cell Day26 International Day Against Drug

Abuse And Illicit Drug Trafficking

11 World Population Day28 World Hepatitis Day

MARCH

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Introduction:The first parenteral iron of ferrous hydroxide was infused subcutaneously and intramuscular but it was found that due to lose carbohydrate bounding of iron causes side effects.After these findings researchers worked on different combinations of carbohydrate and iron to invent such iron which had a strong binding carbohydrate ,reducing release of free iron during infusion that accounted for a low incidence of adverse reactions e.g high molecular weight iron dextran, low molecular weight iron dextran, ferric gluconate, iron sucrose.In the past few years, a new parenteral iron compounds have been released for use in IDA patients named as Iron Isomaltoside 1000. The i-matrix structure allows Isomaltoside to bind the iron molecules in a linear

chain for a controlled release of iron.Several studies have been published on a safety profile of iron Isomaltoside 1000 as a conventional and total dose infusion.Taking advantage of its pH 5-7 and less dilution i.e. 100mg/ml, we compared the safety and efficacy of iron Isomaltoside 1000 in intramuscular and intravascular routes of administration.Methods:Study design and settingThis single blind clinical experience was conducted on antenatal and posts partum patients that have hemoglobin in between 6g/dl to 10.98 g/dl and that requires parenteral iron therapy to raise their hemoglobin. The patient selected randomly who visited Sind government hospital liquatabad antenatal OPD regularly for admissions and follow-up visits and those who were

admitted in ward after post-partum. Before any intervention, administered medication and its complications were thoroughly explained for their guardians and informed written consent was obtained from them.Participants:240 women were recruited using convenience

sampling. They were randomly allocated in two groups of 120 patients by using block randomization method. Subjects with a history of allergy to iron, severe asthma, arthritis, infection, fever and hepatitis and those who are not willing to participate were excluded from the study (table 1).

Intervention: Nurse , blinded to the intervention, was present by the side of the patients during the whole procedure and not only recorded the routine nursing observations and evaluations, but also any abnormal conditions until the patient recovered to her pre-procedure state. Venipuncture was performed for all patients to ensure blindness of the nurses and physicians. The first group of patients received IV iron Isomaltoside 1000 (200 mg, maximum dose upto 800mg Infusion by 1oo/ 500 milliliter normal saline), and the second took an IM dose (200 mg/day; maximum dose upto 800mg regularly). Patients with an open airway and adequate oxygen saturation, who were on IV infusion, able to drink liquids, and respond to all the levels of consciousness were considered eligible for discharging from the obstetrics and gynea department. For IM route, Z track technique was used with all the international guidelines.Outcome:The data regarding demographic characteristics, duration of the procedure, efficacy, side effects, and time until obstetrics and gynea department discharge were gathered for all participants. At the end of the procedure, a specialist, who was blinded to the intervention, rated the efficacy of medicine in pain management as excellent (no pain during the whole procedure), moderate (slight pain without interfering in the procedure), and poor (pain that interfered in the procedure). The patients' status was followed for at least one hour in the recovery room and the incidence of any adverse effects was recorded. Continued on Page 09

Dr. Anees Zehra JafriHead of obstetrics and gyneacology DepartmentSind Government Hospital Liquatabad, Karachi, Pakistan

Coordinators:Dr Massoma Zahid, Dr Nadia Sheikh, Dr Naseem Rashid, Dr Rizwana Begum, Ns Rubina, Ns Sumaira.


Women with anaphylactoid reactions were categorized as "patient with iron hypersensitivity". In the absence of any side effects, the subjects were classified as "stable and comfortable".Statistical analysisThe sample size calculation was performed based on detection of clinically significant differences in the incidence of side effects. With considering a = 0.05 and 80% power, 232 patients were needed to be enrolled. The collected data were entered to SPSS version 20.0 (SPSS Inc., Chicago, IL, USA) and described by using mean and standard deviation, graphs and tables. Variables without normal distribution and ordinal ones were analyzed through Mann-Whitney U test. Chi-square test was also performed to compare qualitative variables between the two groups. For assessment of any difference between IV and IM groups related to efficacy, side effects, duration of the procedure, time to raise hemoglobin levels and time to discharge we used generalized linear model adjusted for baseline characteristics. P values less than 0.05 were statistically considered significant.

ResultsThe mean hemoglobin of IV and IM groups were 7 ± 1 g/dl and 9 ± 1 g/dl, respectively (p < 0.001). In IM procedure patient get it over in 2 ± 1 minute whereas in IV procedure it will take 1.5 ± 0.5 hour in completion of 100ml infusion (figure 1).

ConclusionIt was concluded from overall experience that IM route of administration of iron Isomaltoside 1000 is safe, effective and convenient for patient, doctors and paramedical staff. This route is economical for patient whereas possibility of side effects are much lesser in IM as compare to IV route due to slow rate of absorption. Iron Isomaltoside 1000 if induce

IM, produces less side effects due to its Ph 5- 7 and 1ml dilution. The results to achieve target hemoglobin are also satisfactory via IM rout of administration.

Acknowledgments:The authors appreciate the insightful cooperation of the staff of obstetrics and gyneacology Department of Sind Government Hospital Liquatabad, Karachi, Pakistan.

Conflict of interest:None

Funding support:None

Figure 1: Comparison between IM and IV time to complete the procedure

Figure 2: Comparison between IM and IV to rise in hemoglobin after 25 days of infusion

A randomized Clinical experience ...Continued from page 08

KARACHI - The multinational pharmaceutical giants seem to be moving out of Pakistan and as they are either bought over by the local companies or have reduced their manufacturing operations to a considerable level owing to inefficient capacity utilization and price freeze.In statistical terms, the exit of the pharmaceutical company throws a huge investment down the drain and creates a gap of some $18 million in the medicinal market, while affecting more than 1,000 households directly in terms of unemployment, job insecurity and unused capacity.In a complete contrast, the pharmaceutical industry of India is at its peak. Recently, it invited Japan's pharmaceutical industry to locate their production units in India, which has become an ideal choice for multinational companies to set up their ventures, either wholly owned or in joint partnership with Indian companies.Unfortunately, most of the manufacturing and production facilities in Pakistan are underused and have become noncompetitive in relation to the industry benchmark followed in the region. Being on the verge of total collapse, the pharmaceutical industry needs government support more than ever.

KARACHI - The University of Karachi's plan to set up a medical college and a hospital on its premises is facing a delay since 2014.The KU administration had signed an MOU with the Panjwani Foundation to establish a medical college and hospital on the university premises last year."Students have to acquire medical degrees including MBBS and BDS from Jinnah Sindh Medical University, public sector institutions and private medical colleges directly affiliated with the Pakistan Medical and Dental Council (PMDC), but the KU has yet to start classes despite announcement of the program in 2014," Yasir Ahmed said, a student at JSMC said."The city's population has increased manifolds, but medical colleges and hospitals in the public sector have shrunk and the government

has been depriving us of professional education in the city." he concluded.It was in the mid of 2015, when the VC wrote a letter to the director of Panjwani Foundation and Trust, Nadira Panjwani, for taking steps to immediately initiate the project. An agreement had to be signed for the timeframe for the construction and the launch of MBBS programme after the construction of the medical college.The KU's syndicate committee had approved the project and construction site, which spreading over seven acres of land located opposite to the

varsity's main the campus.Panjwani Foundation and Trust had vowed to provide a grant worth Rs25 million to the university to meet miscellaneous needs for the proposed hospital and college. The KU administration had to provide the same amount from their funds for the project.It was in 2014 when a row between public sectors universities and Pakistan Medical and Dental Council on the affiliation and recognition of private medical colleges resulted in the PMDC's decision to invoke affiliation of various universities including KU.

KARACHI - Thirteen more dengue fever cases were reported in Karachi city, taking the patients toll to 30 in the city since January 1st. As per weekly report issued by Prevention and Control Program for Dengue in Sindh, as many as 13 new dengue fever cases surfaced in Karachi from January 08, to January 14, 2017, while a total 37 dengue fever cases were reported in Sindh province so far, out of which 30 in Karachi, three in Hyderabad, two each in Mithi or Tharparkar and Umer Kot. In Karachi, out of the 13 dengue fever cases, three were reported from District Central, one from District South, two from District West, six from District East and one from District Korangi.

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new study by Johns Hopkins researchers suggests that a specialized area of the

mosquito brain mixes tastes with smells to create unique and preferred flavors. The findings advance the possibility, they say, of identifying a substance that makes "human flavor" repulsive to the malaria-bearing species of the mosquitoes, so instead of feasting on us, they keep the disease to themselves, potentially saving an estimated 450,000 lives a year worldwide.A report on the research appeared online in the journal Nature Communications. Malaria is an infectious parasite disease of humans and animals transmitted by the bite of the female Anopheles gambiae mosquito. In 2015, experts estimate it affected 214 million people, mostly in Africa, despite decades of mosquito eradication and control efforts. There is no malaria vaccine, and although the disease is curable in early stages, treatment is costly and difficult to deliver in places where it is endemic."All mosquitoes, including the one that transmits malaria, use their sense of smell to find a host for a blood meal. Our goal is to let the mosquitoes tell us what smells they find repulsive and use those to keep them from biting us," says Christopher Potter,

Ph.D., assistant professor of neuroscience at the Johns Hopkins University School of Medicine.Because smell is essential to mosquito survival, each mosquito has three pairs of "noses" for sensing odors: two antennae, two maxillary palps and two labella. The maxillary palps are thick, fuzzy appendages that protrude from the lower region of the mosquito's head, more or less parallel to its proboscis, the long, flexible sheath that keeps its "feeding needle" under wraps until needed. At the very tip of the proboscis are the labella, two small regions that contain both "gustatory" neurons that pick up tastes and olfactory neurons for recognizing odorants.To better understand how An. gambiae mosquitoes that cause malaria receive and process olfactory information from so many sensory regions, Potter's team wanted to see where olfactory neurons from those regions go to in the brain.They used a powerful genetic technique - never before accomplished in mosquitoes, according to Potter - to make certain neurons "glow" green. The green glowing label was designed to appear specifically in neurons that receive complex odors through proteins called odorant receptors (ORs), since OR neurons are known to help distinguish humans from other warm-blooded animals in Aedes aegypti mosquitoes, which carry the Zika virus.

"This is the first time researchers managed to specifically target sensory neurons in mosquitoes. Previously, we had to use flies as a proxy for all insects, but now we can directly study the sense of smell in the insects that spread malaria," says Olena Riabinina, Ph.D., the lead author of the study and a postdoctoral fellow now at the Imperial College London. "We were pleasantly surprised by how well our genetic technique worked and how easy it is now to see the smell-detecting neurons. The ease of identification will definitely simplify our task of studying these neurons in the future."As expected, Potter says, the OR neurons from the antennae and maxillary palps went to symmetrical areas of the brain called antennal lobes, just as they do in flies. But Potter was quite surprised when he saw that the OR neurons from the labella went to the so-called subesophageal zone, which, he says, had never before been associated with the sense of smell in any fly or insect; it had only been associated with the sense of taste."That finding suggests that perhaps mosquitoes don't just like our smell, but also our flavor," says Potter. "It's likely that the odorants coming off our skin are picked up by the labella and influence the preferred taste of our skin, especially when the mosquito is looking for a place to bite."

Potter says the finding potentially offers researchers one more way to repel mosquitoes. The antennae and maxillary palps are more specialized for picking up long-range signals, while the labella come into direct contact with our skin. In fact, Potter says, before injecting their needlelike proboscis, mosquitoes use the labella to probe about on a victim's skin. "We don't really know why they do that, but we suspect that they're looking for sensory cues that hint at easy access to a blood vessel," he says. "This suggests that a combination of repellants could keep mosquitoes from biting us in two ways. One could


Novel study identifies an area of the mosquito brain that mixes taste and smell

A female Anopheles gambiae mosquito with olfactory neurons on the antennae, maxillary

palp and labella labeled in green.

Olena Riabinina and Courtney Akitake, Johns Hopkins Medicine

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GENEVA - According to WHO billions of dollars and millions of lives can be saved through effective tobacco control. Policies to control tobacco use, including tobacco tax and price increases, can generate significant government revenues for health and development work, according to a new landmark global report from WHO and the National Cancer Institute of the United States of America. Such measures can also greatly reduce tobacco use and protect people's health from the world's leading killers, such as cancers and heart disease.But left unchecked, the tobacco industry and the deadly impact of its products cost the world's economies more than US$ 1 trillion annually in healthcare expenditures and lost productivity, according to findings published in The economics of tobacco and tobacco control. Currently, around 6 million people die annually as a result of tobacco use, with most living in developing countries.The almost 700-page monograph examines existing evidence on two broad areas:. The economics of tobacco control, including tobacco use and growing, manufacturing and trade, taxes and prices, control policies and other interventions to reduce tobacco use and its consequences; and. The economic implications of global tobacco control efforts."The economic impact of tobacco on countries, and the general public, is huge, as this new report shows," says Dr Oleg Chestnov, WHO's Assistant Director-General for Non-communicable Diseases (NCDs) and mental health. "The tobacco industry produces and markets products that kill millions of people prematurely, rob households of finances that could have been used for food and education, and impose immense healthcare costs on

families, communities and countries."Globally, there are 1.1 billion tobacco smokers aged 15 or older, with around 80% living in low- and middle-income countries. Approximately 226 million smokers live in poverty.The monograph, citing a 2016 study, states that annual excise revenues from cigarettes globally could increase by 47%, or US$ 140 billion, if all countries raised excise taxes by about US$ 0.80 per pack. Additionally, this tax increase would raise cigarette retail prices on average by 42%, leading to a 9% decline in smoking rates and up to 66 million fewer adult smokers."The research summarized in this monograph confirms that evidence-based tobacco control interventions make sense from an economic as well as a public health standpoint," says the monograph's co-editor, Distinguished Professor Frank Chaloupka, of the Department of Economics at the University of Illinois at Chicago.The monograph's major conclusions include:. The global health and economic burden of tobacco use is enormous and is increasingly borne by low- and middle-income countries (LMICs). Around 80% of the world's smokers live in LMICs.. Effective policy and programmatic interventions exist to reduce demand for tobacco products and the death, disease, and economic costs resulting from their use, but these interventions are underused. The WHO Framework Convention on Tobacco Control (WHO FCTC) provides an evidence-based framework for government action to reduce tobacco use.. Demand reduction policies and programmes for tobacco products are highly cost-effective. Such interventions include significant tobacco tax and price increases;

bans on tobacco industry marketing activities; prominent pictorial health warning labels; smoke-free policies and population-wide tobacco cessation programmes to help people stop smoking. In 2013-2014, global tobacco excise taxes generated nearly US$ 269 billion in government revenues. Of this, less than US$ 1 billion was invested in tobacco control.. Control of illicit trade in tobacco products is the key supply-side policy to reduce tobacco use and its health and economic consequences. In many countries, high levels of corruption, lack of commitment to addressing illicit trade, and ineffective customs and tax administration, have an equal or greater role in driving tax evasion than do product tax and pricing. The WHO FCTC Protocol to Eliminate Illicit Trade in Tobacco Products applies tools, like an international tracking and tracing system, to secure the tobacco supply chain. Experience from many countries shows illicit trade can be successfully addressed, even when tobacco taxes and prices are raised, resulting in increased tax revenues and reduced tobacco use.. Tobacco control does not harm economies: The number of jobs dependent on tobacco has been falling in most countries, largely due to technological innovation and privatization of once state-owned manufacturing. Tobacco control measures will, therefore, have a modest impact on related employment, and not cause net job losses in the vast majority of countries. Programmes substituting tobacco for other crops offer growers alternative farming options.. Tobacco control reduces the disproportionate health and economic burden that tobacco use imposes on the poor. Tobacco use is increasingly concentrated among

the poor and other vulnerable groups.. Progress is being made in controlling the global tobacco epidemic, but concerted efforts are needed to ensure progress is maintained or accelerated. In most regions, tobacco use prevalence is stagnant or falling. But increasing tobacco use in some regions, and the potential for increase in others, threatens to undermine global progress in tobacco control.. The market power of tobacco companies has increased in recent years, creating new challenges for tobacco control efforts. As of 2014, 5 tobacco companies accounted for 85% of the global cigarette market. Policies aimed at limiting the market power of tobacco companies are largely untested but hold promise for reducing tobacco use.Dr Douglas Bettcher, WHO Director for the Prevention of NCDs, says the new report gives governments a powerful tool to combat tobacco industry claims that controls on tobacco products adversely impact economies. "This report shows how lives can be saved and economies can prosper when governments implement cost-effective, proven measures, like significantly increasing taxes and prices on tobacco products, and banning tobacco marketing and smoking in public," he adds.Tobacco control is a key component of WHO's global response to the epidemic of NCDs, primarily cardiovascular disease, cancers, chronic obstructed pulmonary disease and diabetes. NCDs account for the deaths of around 16 million people prematurely (before their 70th birthdays) every year. Reducing tobacco use plays a major role in global efforts to achieve the Sustainable Development Goal of reducing premature deaths from NCDs by one-third by 2030. -PR


target the antennal neurons and reduce the likelihood that they come too close, while another could target the labellar neurons and make the mosquitoes turn away in disgust - before sucking our blood - if they got close enough to land on us."The two-part genetic system Potter devised to generate the glowing neurons will make it much easier for his and other laboratories to mix and match genetically altered

mosquitoes to generate new traits, he says. His group has already created a strain of An. gambiae mosquitoes whose OR neurons glow green upon activation. Scientists can thus see which neurons light up in response to a specific smell."Using this method, we hope to find an odorant that is safe and pleasant-smelling for us but strongly repellant to mosquitoes at very low concentrations," says Potter.His group was also able to compare the brains of male and female mosquitoes.

Since only females use their sense of smell to find humans and males feed only on nectar, it was previously thought that males had just a rudimentary sense of smell. The Potter group found instead that males have the same level of complexity in their brains to detect odors as females but have fewer olfactory neurons. "It appears that males might just have a scaled-down version of a female's sense of smell. So they can still smell everything a female smells, just not as

well," Potter says.His group plans to study other types of neurons to better understand how signals from the mosquitoes' three types of olfactory receptors interact to influence their behavior. For example, why is lactic acid not attractive on its own but highly attractive when mixed with carbon dioxide?"We'd like to figure out what regions and neurons in the brain lead to this combined effect," says Potter. "If we can identify them, perhaps we could also stop them from

working."Other authors of the report include Darya Task, Elizabeth Marr and Chun-Chieh Lin of the Johns Hopkins University School of Medicine; and Robert Alford and David O' Brochta of the University of Maryland, College Park.This work was supported by grants from the Johns Hopkins Medicine Discovery Fund, the Johns Hopkins Malaria Research Institute, and the National Institute of Allergy and Infectious

Altering the ‘Flavor ’ of ...Continued from page 10

team of researchers at the Research Institute

of the McGill University Health Centre (RI-MUHC) has found an epigenetic modification that might be the cause of 15% of adult cancers of the throat linked to alcohol and tobacco use. This is a first in the field of epigenetics and the researchers are hopeful that the discovery can blaze a path in the development of new, targeted, more effective treatments that could arise over the next few years. "This discovery was absolutely unexpected since it seemed highly improbable that the kind of alterations of the epigenome that we had previously found in other types of tumours in children and young adults could also

target an epithelial tumour like throat cancer that occurs only in adults," explains Dr. Nada Jabado, a researcher at the RI-MUHC and one of the principal authors of the study published in Nature Genetics.Head and neck cancers, also called oropharyngeal cancers or throat cancer often have devastating consequences. Standard treatments involve surgery, radiotherapy or chemotherapy. Unfortunately, the side effects of these treatments are significant and relapses are common. That's why oncologists are searching to develop more effective treatments that will be less harmful and have fewer deleterious effects. The discovery of this epigenetic

modification opens new treatment possibilities. In fact, some promising drug molecules are already on the market for other illnesses and could possibly be tested for head and neck cancers as well as other cancers like multiple myeloma and lung cancer.Dr. Jabado, who is also a pediatric hemato-oncologist, has hopes that this discover will have positive repercussions for pediatric cancers as well. "Now that we've identified this cohort of patients, we can move quite quickly since in the case of adults, as opposed to children, there are more patients and lots of clinical trials. The medicines could then be tested on children afterward."About the discoveryDr. Jabado's work focuses

on epigenetics in pediatric cancers, and more specifically on the mutations of histone H3. Histones are proteins that package the structure of our DNA and regulate the expression of our genes. For this group of researchers, collaboration between scientists and access to the vast genomic databases of patients around the world is essential. They were particularly intrigued by a 2015 publication by the Tumor Cancer Genome Atlas Consortium (TCGA) on head and neck cancer that mentioned one of the genes that regulates H3."We made use of the same data but took a completely different approach. Instead of concentrating on genetic mutations, we looked at the effect of these mutations on histone H3 proteins. That's when we discovered that the histone H3 protein was abnormal or incorrectly modified in about 15% of patients with head and neck cancer. The data were there, but this fact had gone unnoticed," explains Dr. Jacek Majewski, a researcher at McGill University and one of the principal authors of the study."It's crucial to have access to public data, because it allows us to advance faster and go further in our analyses. In our case, this discovery revealed a sub-group of patients who might benefit from a therapy that targets the epigenome. This could improve the treatment of more than one in five patients suffering from devastating oropharyngeal

cancer," points out Dr. Jabado. "We are currently collaborating with two big groups specializing in head and neck cancer with the goal of finding treatments."EpigeneticsThe body is composed of a large number of different types of cells (neurons, skin cells, fat cells, immune system cells, etc.) Even though they differ, all these cells have the same DNA or genome. Scientists have only recently discovered that their differences can be explained by epigenetics, i.e. what triggers activity in each cell.To illustrate her research, Dr. Jabado compares the genome to notes of music and our epigenetics to a musical score. "Using the same scale, you can create many different melodies. Like a sheet of music that dictates which notes to play and in which order, epigenetics organizes and provides meaning to our genes. If an error makes its way into the score, there's going to be a problem with the music."Epigenetics can provide explanations for why environmental factors, like tobacco or alcohol, can induce changes in the expression of our genes without actually modifying our DNA.Article: Impaired H3K36 methylation defines a subset of head and neck squamous cell carcinomas, Nada Jabado et al., Nature Genetics, doi:10.1038/ng.3757, published online 9 January2017.

Participants also discussed the role of other stakeholders like press clubs, journalists' unions, the government, law-enforcement agencies in improving safety standards.Press clubs need to weed out non-journalists from their member base as such individuals' compromise the credibility and safety of actual journalists. Press clubs should also open or resume induction of new members to increase unity and ensure safety of journalists. Regular medical camps also need to be arranged by press clubs for journalists, and there shouldn't be nepotism or favoritism in the selection of journalists for training.The government was cited as another key stakeholder that can improve and ensure journalists' safety. Implementing labor laws, monitoring safety measures in media houses, investigating attacks on media, and passing effective safety bills are some of the areas where the government can play a key role.

Regular counseling essential ...Continued from page 06


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buildings comprises on 200 apartments will be given after approval of Chief Minister and other authorities concerned. He assured his full support and cooperation to hospital administration in order to improve patient care. He appreciated the efforts of organizer for organizing Annual Symposiums at JPMC every year and said such events will help to build capacity of doctors and other support staff. Executive Director, JPMC, Dr Seemin Jamali, in her welcome speech, appreciated the professional ability of existing faculty, doctors, nursing staff, paramedics, technical and support staff. She requested the health minister to regulate the capacity building programmes and promotions, grant health-professionals allowance and deputation allowances. She appealed to Dr Sikandar Ali Mandhro to sanction at least 100 more slots of Postgraduate (PGs) to minimize the work pressure on the existing doctors. She said this will not only boost the morale of the work force of JPMC but will also go a long way in larger public interest.

Plenary Session: Speaking at the Plenary Session, Ex-Senator, Javed Jabbar, said mismanagement has destroyed the national institutions otherwise Pakistan has full potential to emerge as leading country in every field. He said 70 per cent sewerage water of city unfortunately released into the Arabian Sea without treatment causing environmental pollution. lamented that Population Welfare Department and National Programme for Family Planning and Primary Health care are being run through two separate department instead one since last two decades which shows that how serious authorities concerned with our nation. Pediatric Oncologist, Dr Shamvil Ashraf said 40 per cent cancer cases are avoidable through preventive measures. He advised the people to avoid tobacco, do exercise, increase intake of fresh-fruit and Prof Dr Ejaz Vohra, and Prof Dr Sadiqa Jafari were also addressed the Plenary Session. Prof Dr Iqbal Afridi supervised the session. In the end, Shields were distributed to Ex-Senator Javed Jabbar, Dr Shamvil Ashraf, Prof Dr Dr Ejaz Vohra, and Prof Dr Sadqa Jafri by Executive Director JPMC Dr Seemin Jamali.

- Day 2The second day at the 52nd Annual Symposium of Jinnah Post Graduate Medical Centre (JPMC) with the theme "Prevention is better than cure" continued at Najmuddin Auditorium of JPMC.Chairperson of Annual Symposium, JPMC, Prof Dr Sughra Parveen, said different scientific sessions were held on second day of symposium which includes two sessions of surgery, two of medicines, one session of ENT, one of Anesthesia, one of Paramedics and Nursing and a session of Basic Medical Science (BMS).

She said sessions were addressed by Guest Speakers Prof Dr Abdul Majeed from Lahore, Prof Dr Shahab from Karachi, Prof Dr Saeed Qureshi from Karachi and other prominent speakers were also addressed the sessions. She said each session was headed by a Chairman, Co-chairman and Convener. She informed that five research papers were presented in each session, while poster presentations were also held. She said a large number of faculty members, doctors, nurses and paramedical staff attended the sessions.

- Day 3The third day at 52nd Annual Medical Symposium of Jinnah Postgraduate Medical Centre (JPMC), in which over all 12 different sessions were held each addressed by a guest

speaker. The two sessions of Basic Medical Sciences Institute (BMSI) were held on the third day of symposium under this year's theme "Prevention is better than cure". First session of BMSI was addressed by Prof Naveen Faridi on the topic of "Gliomas. A Practical Approach Towards Diagnosis while the second session of BMSI was addressed by Prof Khalid Zafar Hashmi on the topic of Immune Thrombocytopenia, Dr Rana Muzafar on topic" Molecular Techniques in diagnosis" and Dr Saba Jamal on "Leukemia classification".The first session of BMSI was chaired by Prof. Sirajuddoula Syed and the second session was chaired by Prof Khalid Zafar Hashmi.The dentistry session was addressed by Dr Syed Abrar Ali, Prof Dr Noor Ul Wahab, Dr Babar Ashraf and others. Dentistry session was chaired by SM Kafi Iqbal.The Haematology/ Infectious Disease session was addressed by Dr Farheen Karim, Dr Aneela and Dr Mahmood Zeeshan, chaired by Prof. M.A. Shah.The first session of Gynecology was addressed by Prof Haleema Hashmi on the

topic Prevention and Management Strategies of Ca Endometrial and Prof Sadia Aziz on the topic of Screening, Primary Prevention and Treatment Options of Ca Cervix. The session was chaired by Prof Rahat Qureshi.The second session of Gynecology was addressed by Dr Tanveer Zubairi on the topic "Role of Radiology in Infertility" and Dr Ilyas Khan spoke on "Science of Breast Feeding". The second session was chaired by Prof Rubina Izhar.The first session of Psychiatry/ Neurosurgery/Neurology was addressed by Prof Rashid Jooma on the topic "Prevention of Head Injuries" and Dr Shaukat Ali addressed on " Approach to encephalopathy and coma" while in the second session Dr Shifa Naeem spoke on "Promotion of health and Prevention

of Psychiatric Illness" and Dr Wasay Jaleel addressed on " Prevention of Psychiatric Disorders". Both the sessions were chaired by Prof Junaid Ashraf and Prof Haroon Ahmed respectively.The General Surgery session was chaired by Prof Asad Ullah Khan and was addressed by Prof Abul Fazal and Prof Syed Muhammad Raza on the topic of "Metabolic Surgery in Pakistan; Challenges and Possible Solutions".The Pulmonology & Intensive Care session was addressed by Prof Javaid A. Khan and Dr Javaid Hussain on "Tobacco

Control- Current Challenges for Pakistan. Nephro-Urology session was chaired by Prof. Masood Shaikh, in which he addressed on "Role of Laparoscopy in Urology". The session of Dermatology was chaired by Prof. Azam Jah.

- Day 4

25,000 people die in road-accidents in Pakistan every year Eminent Neurosurgeon, Prof Dr Rashid Jooma revealed that an estimated 25,000 to 26,000 people die from road-accidents in Pakistan each year and majority of motorcyclists have become victims of such accidents. He shared these statistics while addressing the concluding ceremony of 52nd Annual Symposium of Jinnah Postgraduate Medical Center (JPMC) was held at Najmuddin Auditorium. Executive Director Dr Seemin Jamali, Prof Nadeem Rizvi, Prof Dr Iqbal Afridi, Prof Raza Rizvi and other present on this occasion.



Prof Rashid Jooma, who is also Head of Road Traffic Injury and Research and Prevention Centre (RTIRPC), said according to the World Health Organization (WHO) approximately 25,000 to 26,000 die from road accidents in Pakistan every year. He explained that generally bikers have become victims of such accidents. He informed that 9,192 deaths had been reported in Karachi last eight years due to road accidents out of which 3,901 were motorcyclists. He said non-implementation on traffic laws and low use of helmets are some major reasons behind high number mortalities from road related accidents in the country.

He said highest number of injuries or road-accidents were reported at JPMC followed by the Civil Hospital Karachi and Abbasi Shaheed Hospital.Head of Orthopedic Department, JPMC, Prof Dr Anisuddin Bhatti, while addressing the sessions on topic "Born with deformity" said treatment centres for child born with clubfoot has been increased three to 29 throughout Pakistan . He said earlier treatment of children born with foot defects were only available in Indus Hospital Karachi, Jinnah Postgraduate Medical Center and a hospital in Lahore. He demanded of the federal and provincial governments to increase health budget as per WHO recommendation in order to facilitate the poor

patients in better way. The session of Ophthalmology was held on fourth day of symposium. The session was chaired by Prof Dr Javed Niazi, Co-chairman Dr Vasder Hirani and Dr Rabia Chaudhry was the moderator of session. Prof Prof. Alyscia Cheema was the guest speaker of session. The session of Clinical Oncology was held on fourth day of symposium

with theme " Standards of Peer Reviewed Radiation, treatment and Planning". The session was chaired by Prof Dr Syed H. M Zaidi, Co-chairman Prof Ahmed Usman, and Dr Mariam Gul was the moderator of session. Dr Adnan Jabbar and Dr Bilal Qureshi were the guest speakers of session. The sessions on General Medicines III and Orthopedics were also held in which guest speakers highlights different aspects in treatment of patients.

Health Fair at JPMCA Public Health Fair (Health Mela) was held at Jinnah Postgraduate Medical Center (JPMC), where scores of patients were provided consultation and diagnostics facilities free of cost. The Public Health Fair was organized in connection with three-day 52nd annual Symposium Jinnah

Postgraduate Medical Center (JPMC). A large of number doctors, nurses and paramedical staff attended the health fair event. The Physiotherapy, Eye Testing, Blood Sugar and Cholesterol Testing, Nutrition Assessment, PharmEvo Uric Acid Testing, Blood Group Testing, Prevention of Obesity and Dental Checkup facilities have been provided to dozens of people during Health Fair begun from 09:00am and continued till 02:00pm. Organizer of Health Fair said health experts have provided free consultation and counseling to citizens in various stalls during the health fair. He said diagnostic facilities have been provided free of cost to dozens of people during the event. He said basic aim of organizing health fair in one of the major hospital of Karachi to raise awareness in general public about diseases.


52nd Annual Symposium ...Continued from page 13

KARACHI -The Services, General Administration and Coordination Department, Government of Sindh has posted Dr Muhammad Toufique, Senior Medical Officer (BS-20) as Director Health Services, Karachi in place of Dr Abdul Waheed Panhwar, retiring from government service on January 31,2017.According to the notification, Dr Muhammad Toufique, Senior Medical Officer (BS-20), Medical Superintendent, Services Hospital, Karachi, is transferred and posted with immediate effect and until further orders as Director Health Services, Karachi

vice Dr Abdul Waheed Panhwar, Senior Medical Officer (BS-20), retiring government service on January 31,2017.Similarly, Dr Mehmood Qureshi, Senior Medical Officer (BS-19), presently working as Focal Person, Expended Programme on Immunization at Provincial Expended Programme on Immunization Cell, Sindh Karachi is transferred and posted with immediate effect and until further orders as Medical Superintendent, Services Hospital, Karachi vice Dr Muhammad Toufique, Senior Medical Officer transferred.

KARACHI -The Chikungunya viral fever continues to affect citizens in different parts of Karachi as now Chikungunya viral fever cases being reported from Orangi Town. Director Health Services, Karachi, Dr Abdul Wahid Panhwar, confirmed presence of Chikungunya viral fever cases in UC-15 of Orangi Town Karachi following Saudabad and Lyari Town. He said cases were being reported in Urban Health Center (UHC) Orangi Town. He informed that the intensity of Chikungunya viral fever was low in Lyari Town and Orangi Town as compared to Saudabad but efforts were under way to fully control the spread

of viral fever in the city. He said Health Services Department of Karachi has decided to launch vector control strategy in Karachi in the lights of expert opinion of Entomologists and Educationists. He informed that preparation is underway to launch a comprehensive vector control strategy in the city in order to save citizen from vector-borne diseases in future. He further informed that vector control strategy will be launched in collaboration with Karachi Metropolitan Corporation, Health Department Government of Sindh, all district administrations and other department concerned.

Dr Panhwar informed a total 637 Chikungunya fever cases were reported in Karachi since a month out of which 532 from Saudabad, 41 from Lyari Town and 64 from Orangi Town so far. He informed that blood sample of nine people belongs to Orangi Town had been sent to National Institute of Health (NIH), Islamabad, for investigation out of which six were tested positive. He said 29 people were tested positive so far out of total 637 reported cases. Health Experts said Chikungunya is a viral disease transmitted to humans by infected mosquitoes. It causes fever and severe joint pain.

Those poor people do not dare to enter private hospitals due to high cost of healthcare facilities there, and they prefer to go to government hospitals whenever they fall ill.Instead of benefiting from these cards, the holders are facing inconvenience at public hospitals, which means that the government intends to give the mega healthcare project to some private hospitals.When this reporter contacted National Health Ministry Director Dr Faisal, he said that PIMS is not on the list of hospitals where these health cards could be utilised. He said that right private hospitals of Islamabad had been placed on its panel.

government should provide necessary assessment to provincial health ministry in this regard.He urged the planners of 44 hospitals that construction of buildings may not be difficult with people lining up to get commission in the process but the main task is to train human resource for proposed hospitals for which government has not proposed any plan. He said new hospitals will need thousands of nurses, paramedics, midwives, medical technicians and doctors for which government should make a program before the completion of buildings and procurement of expensive instruments the human resource should be trained and appointed in proposed hospitals. Dr Qaisar Sajjad said all branches of PMA will be more than happy to help government if the planners are serious about the training and development of human resource for these hospitals. He hoped that government will come out with detail plans about construction and commissioning of these hospitals soon.

facility for children of Sindh, Karachi The National Institute of Child Health (NICH) Karachi, the premiere pediatric institute of the country has achieved another mile stone in establishing Plasmapharesis facility as a part of our vision to develop sub-specialties and offer such services which are very expensive and not easily accessible to the poor and under privilege children.

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NICH gets Pediatric Plasmapharesis ...Continued from page 05


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KARACHI - An estimated 8,000 babies are born with foot disabilities in Pakistan every year, a most common genetic nutrition birth defects that causes one or both feet to turn inward and downward, this was revealed by Prof Dr Anisuddin Bhatti.Prof Anisuddin Bhatti, who is also Head of Orthopedic Department, Jinnah Postgraduate Medical Center (JPMC), said around 8,000 babies are born with foot defects, also known clubfoot, in the

country each year. He explained that clubfoot is one of the most common genetic nutrition birth defects that causes one or both feet to turn inward and downward. He said if it is neglected or left untreated it causes permanent disability.He said infants with feet defect can be easily treated using the ponseti method technique which is very cost-effective, cheap and correction which has 95 percent success rate than any other program. He explained that ponseti

method technique can be applied on children from three months to 15 years age. He informed that Ponseti International Association is an international organization working on early, non-surgical intervention of clubfeet management. He said presently organization is working in big number of countries including in Pakistan.Prof Bhatti said technique for clubfeet treatment is being practiced all over Pakistan by Orthopedic

Surgeons. He said at present 29 clubfeet treatment centers are working in Pakistan out of which 20 are in Sindh province. He informed that there are seven Clubfoot Clinics are operating in Karachi including in Jinnah Postgraduate Medical Center, Indus Hospital Karachi, Abbasi Shaheed Hospital, Civil Hospital Karachi and others. He said training of Orthopedic Surgeons and Post Graduate (PG) doctors are also underway so far a total 60 orthopedic surgeons

and 100 PGs had completed two weeks and six months training , respectively. Approximately 250,000 infants are born with foot disabilities in each year worldwide out of which 80 percent such cases are reported from developing countries and if these newborn children remain untreated, it cause permanent disabilities humiliation, affectee remain less productive human and have meager opportunity to live a decent life and yet, it is easily and cheaply treated without surgery.

Printed at Clifton Printers, BC-11, Block-9, Clifton-5, Karachi - 75600 and published by Hassan Mahmod for MEDICAL NEWS, KARACHI.Phones: 021-35834932 & 35833172, Founder Ayaz Mahmood.


KARACHI - The pharma industry in Pakistan which is controlled through a strict regulatory regime, remains well below its total production capacity and operational potential. As per its current standing, pharma industry continues to fall at an alarming rate, down from 16 per cent to 8 per cent per year. With a meagre 0.5 per cent market share in international trade in medicinal and pharmaceutical products, the market size of pharmaceuticals in Pakistan is below USD 3 billion. Comprising a negligible portion of the country's exports to the world, pharmaceutical exports from Pakistan constitute less than USD 100 million per annum in the global market worth USD 1 trillion.The pharmaceutical industry in India has emerged as the world's third largest producer mainly by adding contract manufacturing to its production a few decades earlier. Today, the market value of contract manufacturing in India is estimated at 50 per cent of its total domestic pharmaceutical production, which translates to approximately US$ 5.3 billion. Because of its investment friendly environment and a substantial 40 per cent lower cost of operations and production, leading multinational companies consider India for their outsourcing needs. However, the current state of the Pakistan's pharmaceutical sector is quite the opposite and similar to the year of 2016, the outlook of the sector looks bleak in 2017 as well.

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