2024-03-28T20:43:16Z
https://annalskemu.org/journal/index.php/annals/oai
oai:ojs2.localhost:article/11
2022-09-12T07:54:36Z
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2079-0694
2079-7192
10.21649/akemu.v14i4.11
doi
dc
Basic Guidelines for Data Analysis Technique(s)
Awais, Syed Muhammad
King Edward Medical University
2010-02-27 00:00:00
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https://annalskemu.org/journal/index.php/annals/article/view/11
Annals of King Edward Medical University; Vol. 14 No. 4 (2008)
eng
Copyright (c) 2010 Annals of King Edward Medical University
oai:ojs2.localhost:article/12
2022-09-12T07:54:36Z
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2079-0694
2079-7192
10.21649/akemu.v15i2.12
doi
dc
The Planning, Organization, Management and Quality Assurance of National Education Systems
Awais, Syed Muhammad
King Edward Medical University
2010-02-27 00:00:00
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/12
Annals of King Edward Medical University; Vol. 15 No. 2 (2009)
eng
Copyright (c) 2010 Annals of King Edward Medical University
oai:ojs2.localhost:article/22
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2079-0694
2079-7192
10.21649/akemu.v15i1.22
doi
dc
The Planning, Organization, Management and Quality Assurance of Health Care Systems
Awais, Syed Muhammad
King Edward Medical University
2010-02-27 00:00:00
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/22
Annals of King Edward Medical University; Vol. 15 No. 1 (2009)
eng
Copyright (c) 2010 Annals of King Edward Medical University
oai:ojs2.localhost:article/40
2022-09-12T07:54:37Z
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2079-0694
2079-7192
10.21649/akemu.v14i3.40
doi
dc
Health and Biostatistics
Awais, Syed Muhammad
King Edward Medical University
2010-02-27 00:00:00
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/40
Annals of King Edward Medical University; Vol. 14 No. 3 (2008)
eng
Copyright (c) 2010 Annals of King Edward Medical University
oai:ojs2.localhost:article/49
2022-09-12T07:54:37Z
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2079-0694
2079-7192
10.21649/akemu.v14i2.49
doi
dc
SCIENCE AND SCOPE OF PEER REVIEW
Awais, Syed Muhammad
King Edward Medical University
2010-02-27 00:00:00
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/49
Annals of King Edward Medical University; Vol. 14 No. 2 (2008)
eng
Copyright (c) 2010 Annals of King Edward Medical University
oai:ojs2.localhost:article/58
2022-09-12T07:54:38Z
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2079-0694
2079-7192
10.21649/akemu.v15i4.58
doi
dc
Introducing the Online Version of Annals of KEMU
Awais, Syed Muhammad
King Edward Medical University
2010-04-20 04:29:27
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/58
Annals of King Edward Medical University; Vol. 15 No. 4 (2009)
eng
Copyright (c) 2010 Annals of King Edward Medical University
oai:ojs2.localhost:article/73
2022-09-12T07:54:38Z
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2079-7192
10.21649/akemu.v15i3.73
doi
dc
Relationship of Accuracy in Decision Making, Wisdom and Publication in Medicine
Awais, Syed Muhammad
King Edward Medical University
2010-04-20 04:29:03
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/73
Annals of King Edward Medical University; Vol. 15 No. 3 (2009)
eng
Copyright (c) 2010 Annals of King Edward Medical University
oai:ojs2.localhost:article/89
2022-09-12T07:54:39Z
annals:ED
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2079-0694
2079-7192
10.21649/akemu.v13i2.89
doi
dc
TRANSFORMATION OF ANNALS OF KEMC INTO ANNALS KEMU
Awais, Syed Muhammad
King Edward Medical University
2010-02-27 00:00:00
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/89
Annals of King Edward Medical University; Vol. 13 No. 2 (2007)
eng
Copyright (c) 2010 Annals of King Edward Medical University
oai:ojs2.localhost:article/99
2022-09-12T07:54:39Z
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10.21649/akemu.v14i1.99
doi
dc
MEDICAL ETHICS AND ISLAM
Awais, Syed Muhammad
King Edward Medical University
2010-02-27 00:00:00
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/99
Annals of King Edward Medical University; Vol. 14 No. 1 (2008)
eng
Copyright (c) 2010 Annals of King Edward Medical University
oai:ojs2.localhost:article/108
2022-09-12T07:54:40Z
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2079-7192
10.21649/akemu.v13i3.108
doi
dc
RESEARCH LEADS TO HUMAN PROGRESSION
Awais, Syed Muhammad
King Edward Medical University
2010-02-27 00:00:00
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/108
Annals of King Edward Medical University; Vol. 13 No. 3 (2007)
eng
Copyright (c) 2010 Annals of King Edward Medical University
oai:ojs2.localhost:article/117
2022-09-12T07:54:40Z
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2079-7192
10.21649/akemu.v13i4.117
doi
dc
RESEARCH AND MEDICAL EDUCATION
Awais, Syed Muhammad
King Edward Medical University
2010-02-27 00:00:00
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/117
Annals of King Edward Medical University; Vol. 13 No. 4 (2007)
eng
Copyright (c) 2010 Annals of King Edward Medical University
oai:ojs2.localhost:article/126
2022-09-12T07:54:40Z
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2079-7192
10.21649/akemu.v16i1.126
doi
dc
Electronic Search for Scientific Literature and Participating in Online Journalism
Awais, Syed Muhammad
King Edward Medical University
2010-06-26 14:36:19
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/126
Annals of King Edward Medical University; Vol. 16 No. 1 (2010)
eng
Copyright (c) 2010 Annals of King Edward Medical University
oai:ojs2.localhost:article/144
2022-09-12T07:54:41Z
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2079-7192
10.21649/akemu.v16i1 SI.144
doi
dc
The Academic Freedom of Teachers and Institutions
Awais, Syed Muhammad
King Edward Medical University
2010-07-03 10:54:47
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/144
Annals of King Edward Medical University; Vol. 16 No. 1 SI (2010): Special Issue
eng
Copyright (c) 2010 Annals of King Edward Medical University
oai:ojs2.localhost:article/184
2022-09-12T07:54:42Z
annals:ED
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2079-0694
2079-7192
10.21649/akemu.v16i2.184
doi
dc
INDEXING OF SCIENTIFIC JOURNALS
Awais, Syed Muhammad
King Edward Medical University
King Edward Medical University
2010-10-16 12:38:29
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/184
Annals of King Edward Medical University; Vol. 16 No. 2 (2010)
eng
Copyright (c) 2010 Annals of King Edward Medical University
oai:ojs2.localhost:article/210
2022-09-12T07:54:43Z
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2079-7192
10.21649/akemu.v16i3.210
doi
dc
QUALITY OF HEALTH CARE
Awais, Syed Muhammad
King Edward Medical University
2011-05-21 03:56:27
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/210
Annals of King Edward Medical University; Vol. 16 No. 3 (2010)
eng
Copyright (c) 2011 Annals of King Edward Medical University
oai:ojs2.localhost:article/232
2022-09-12T07:54:44Z
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2079-7192
10.21649/akemu.v16i4.232
doi
dc
AUTONOMY AND ACCOUNTABILITY
Awais, Syed Muhammad
King Edward Medical University
2011-05-21 15:37:15
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/232
Annals of King Edward Medical University; Vol. 16 No. 4 (2010)
eng
Copyright (c) 2011 Annals of King Edward Medical University
oai:ojs2.localhost:article/259
2022-09-12T07:54:45Z
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2079-0694
2079-7192
10.21649/akemu.v17i1.259
doi
dc
Academic Freedom for University Teachers
Awais, Syed Muhammad
King Edward Medical University
2011-09-18 13:40:53
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/259
Annals of King Edward Medical University; Vol. 17 No. 1 (2011)
eng
Copyright (c) 2011 Annals of King Edward Medical University
oai:ojs2.localhost:article/280
2022-09-12T07:54:46Z
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2079-7192
10.21649/akemu.v17i2.280
doi
dc
What is Curriculum
Awais, Syed Muhammad
King Edward Medical University
2011-09-21 01:47:13
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/280
Annals of King Edward Medical University; Vol. 17 No. 2 (2011)
eng
Copyright (c) 2011 Annals of King Edward Medical University
oai:ojs2.localhost:article/321
2022-09-12T07:54:47Z
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2079-0694
2079-7192
10.21649/akemu.v17i3.321
doi
dc
Problems of Medical Education in Pakistan
Awais, Syed Muhammad
King Edward Medical University
2012-02-27 07:04:34
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/321
Annals of King Edward Medical University; Vol. 17 No. 3 (2011)
eng
Copyright (c) 2012 Annals of King Edward Medical University
oai:ojs2.localhost:article/351
2022-09-12T07:54:48Z
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2079-0694
2079-7192
10.21649/akemu.v17i4.351
doi
dc
Plagiarism in Scientific Journalism
Awais, Syed Muhammad
King Edward Medical University
2012-11-09 22:41:47
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/351
Annals of King Edward Medical University; Vol. 17 No. 4 (2011)
eng
Copyright (c) 2012 Annals of King Edward Medical University
oai:ojs2.localhost:article/364
2022-09-12T07:54:48Z
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2079-0694
2079-7192
10.21649/akemu.v18i1.364
doi
dc
Recent Advances in Medical Education
Awais, Syed Muhammad
King Edward Medical University
2013-05-21 01:29:51
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/364
Annals of King Edward Medical University; Vol. 18 No. 1 (2012)
eng
Copyright (c) 2013 Annals of King Edward Medical University
oai:ojs2.localhost:article/388
2022-09-12T07:54:49Z
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2079-0694
2079-7192
10.21649/akemu.v18i2.388
doi
dc
History of Developments of Computers, Internet and World Wide Web
Awais, Syed Muhammad
King Edward Medical University
2013-05-30 10:42:10
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/388
Annals of King Edward Medical University; Vol. 18 No. 2 (2012)
eng
Copyright (c) 2013 Annals of King Edward Medical University
oai:ojs2.localhost:article/408
2022-09-12T07:54:50Z
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2079-0694
2079-7192
10.21649/akemu.v18i3.408
doi
dc
Relationship of “Education System†with “Information Ageâ€
Awais, Syed Muhammad
King Edward Medical University
2013-06-01 00:18:06
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/408
Annals of King Edward Medical University; Vol. 18 No. 3 (2012)
eng
Copyright (c) 2013 Annals of King Edward Medical University
oai:ojs2.localhost:article/443
2022-09-12T07:54:51Z
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2079-0694
2079-7192
10.21649/akemu.v18i4.443
doi
dc
Clinical Research
Awais, Syed Muhammad
King Edward Medical University
2014-01-17 22:08:10
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/443
Annals of King Edward Medical University; Vol. 18 No. 4 (2012)
eng
Copyright (c) 2014 Annals of King Edward Medical University
oai:ojs2.localhost:article/469
2022-09-12T07:54:52Z
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10.21649/akemu.v19i1.469
doi
dc
Peer Review Ethics of Scientific Papers
Awais, Prof. Dr. Syed Muhammad
Evaluation of the scientific paper by the experts of the scientific topic addressed in the article is known as peer review. Peer review is fundamental to the scien-tific publication process and the quality of publication. The type of review process is generally based on the number of reviewers, authors and institutions blinded to the reviewer identity or not. Peer reviewers are experts chosen by editors to provide written assess-ment of the strengths and weaknesses of written resea-rch, with the aim of improving the reporting of rese-arch by identifying the highest quality material for the journal. The peer reviewers selected for the journal are required to meet minimum standards. The reviewers must have background in original research, publication of articles, formal training, and experience of perfor-ming critical appraisal of manuscripts.
Reviewers will be expected to be professional, honest, courteous, prompt, and constructive. While re-viewing the manuscripts, the reviewers are desired to observe following elements.
1. Identify and comment accurately and constructi-vely on major strengths and weaknesses of study design, methodology, results and interpretation of the data.
2. Comment on any ethical concerns raised by the study, or any evidence of low standards.
3. Provide constructive and professional suggestions for improvement of the manuscript.
4. Write recommendation to editor to make a deci-sion on acceptance (and/or revision) of the manu-script.
5. Treat manuscript as confidential and not retain or copy it. Also, reviewers must not share the manu-script with any colleagues.
6. If reviewers suspect misconduct, they should noti-fy the editor in confidence, and should not share their concerns with other parties unless officially notified by the journal.
The editors should make an effort to educate revie-wers on how to peer review. The editors should routi-nely assess all reviews for review quality and other performance characteristics of the reviewers. Indivi-dual performance data must be kept confidential.
Editors, if possible, after the professional peer review should strongly consider having a statistician review report of original research that is being con-sidered for publication.
King Edward Medical University
2014-05-14 00:00:00
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/469
Annals of King Edward Medical University; Vol. 19 No. 1 (2013)
eng
Copyright (c) 2014 Annals of King Edward Medical University
oai:ojs2.localhost:article/493
2022-09-12T07:54:53Z
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2079-7192
10.21649/akemu.v19i2.493
doi
dc
Definition of Research Misconduct
Awais, Prof. Dr. Syed Muhammad
Unfortunately, a single definition of research miscon-duct does not exist, although most of them include falsification, fabrication and plagiarism. In 2000, re-presentatives of medical councils, professional socie-ties, foundations and industry joined at "a Conference on Misconduct in Biomedical Research" and issued a broader definition that states "Behavior by a Resea-rcher intentional or not that falls short of good ethical and scientific standards".
Britain's largest biomedical charity "The welcome Trust" defines misconduct as;
"Fabrication, falsification, plagiarism or deception in proposing, carrying out, or reporting results of rese-arch or deliberate, dangerous or negligent deviations from accepted practices in carrying out research. It includes failure to follow established protocols if this failure results in unreasonable risk or harms to hum-ans, other vertebrates, or the environment and facilita-ting of misconduct in research by collusion in, or con-cealment of, such actions by others. It also includes intentional, unauthorized use, disclosure, or removal or damage to research related property of another includ-ing apparatus, materials, writing, data, hardware or software or any other substances or devices used in the conduct of research. It does not include honest error or honest differences in the design, execution, interpreta-tion or judgment in evaluating research methods or results or misconduct unrelated to the research process. Similarly it does not include poor research unless this encompasses the intention to deceive".
In 2000, the "White House Office of Science and Technology Policy", issued a federal definition of research misconduct. In April 2002 US National Scie-nce Foundation (NCF) adopted this policy and relea-sed following NSF definition;
"Research Misconduct" means fabrication, falsifi-cation, or plagiarism in proposing or performing resea-rch funded by NSF, reviewing research proposals sub-mitted to NSF, or in reporting research results funded by NSF.
(1) Fabrication means making up data or results and recording or reporting them.
(2) Falsification means manipulating research mate-rials, equipment, or processes. Or changing or omitting data or results such that research is not accurately represented in the research record.
(3) Plagiarism means the appropriation of another person's ideas, processes, results or words without giving appreciate credit.
(4) Research, for purposes of paragraph (a) of this section, includes proposals submitted to NSF in all fields of sciences, engineering, mathematics, and education and results from such proposals.
(5) Research misconduct does not include honest error or difference of opinion.
King Edward Medical University
2014-05-18 23:31:57
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/493
Annals of King Edward Medical University; Vol. 19 No. 2 (2013)
eng
Copyright (c) 2014 Annals of King Edward Medical University
oai:ojs2.localhost:article/512
2022-09-12T07:54:54Z
annals:ED
driver
nmb a2200000Iu 4500
2079-0694
2079-7192
10.21649/akemu.v19i3.512
doi
dc
Peer Review Ethics of Scientific Papers
Awais (S.I.), Prof. Syed Muhammad
Evaluation of the scientific paper, by the experts of the scientific topic addressed in the article is known as "peer review". Peer review is fundamental to the scientific publication process and the quality of the publication. The type of review process is generally based on the number of reviewers, authors and institutions blinded by the reviewer identity or not. Peer reviewers are experts chosen by editors to provide written assessment of the strengths and weaknesses of written research, with the aim of improving the reporting of research by identifying the highest quality material for the journal. The peer reviewers selected for the journal are required to meet minimum standards. The reviewers must have background in original research, publication of articles, formal training, and experience of performing critical appraisal of manuscripts.
Reviewers will be expected to be professional, honest, courteous, prompt, and constructive. While reviewing the manuscripts, the reviewers are desired to observe following elements.
1. Identify and comment accurately and constructively on major strengths and weaknesses of study design, methodology, results and interpretation of the data.
2. Comment on any ethical concerns raised by the study, or any evidence of low standards.
3. Provide constructive and professional suggestions for improvement of the manuscript.
4. Write a recommendation to editor to make a decision on acceptance (and/or revision) of the manuscript.
5. Treat the manuscript as confidential and not retain or copy it. Also, reviewers must not share the manuscript with any colleagues.
6. If reviewers suspect misconduct, they should notify the editor in confidence, and should not share their concerns with other parties unless officially notified by the journal.
The editors should make an effort to educate reviewers on how to "peer review". The editors should routinely assess all reviews for review quality and other performance characteristics of the reviewers. Individual performance data must be kept confidential.
Editors, if possible, after the professional peer review should strongly consider having a statistician review the report of the original research which is being considered for publication.
King Edward Medical University
2014-05-20 23:42:34
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/512
Annals of King Edward Medical University; Vol. 19 No. 3 (2013)
eng
Copyright (c) 2014 Annals of King Edward Medical University
oai:ojs2.localhost:article/525
2022-09-12T07:54:54Z
annals:ED
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2079-0694
2079-7192
10.21649/akemu.v19i4.525
doi
dc
Principles of Transparency and Best Practice in Scholarly Publishing
Awais, Prof. Syed Muhammad
Introduction
The Committee on Publication Ethics (COPE, http://publicationethics.org/), the Directory of Open Access Journals (DOAJ, http://www.doaj.org/), the Open Access Scholarly Publishers Association (OASPA, http://oaspa.org/) , and the World Association of Medical Editors (OASPA, http://oaspa.org/) have collaborated in an effort to identify principles (criteria) of transparency and best practice that set apart legitimate journals and publishers from non-legitimate ones. These criteria are largely derived from those developed by the Directory of Open Access Journals. The principles are available on the Web sites of all the participating organizations since December 19, 2013.
Principles of Transparency
1. Peer review process: All of a journal's content, apart from any editorial material that is clearly marked as such, shall be subjected to peer review, clearly described on the journal's Web site.
2. Governing Body: The full names and affiliations of the journal's editors shall be provided on the journal's Web site.
3. Editorial team/contact information: Journals shall provide the full names and affiliations of the journal's editors on the journal's Web site as well as contact information for the editorial office.
4. Author fees: Any fees or charges that are required for manuscript processing and/or publishing materials in the journal shall be clearly stated in a place that is easy for potential authors.
5. Copyright: Copyright and licensing information shall be clearly described on the journal's Web site.
6. Identification of and dealing with allegations of research misconduct: Publishers and editors shall take reasonable steps to identify and prevent the publication of papers where research misconduct has occurred, including plagiarism, citation manipulation, and data falsification/fabrication, among others.
7. Ownership and management: Information about the ownership and/or management of a journal shall be clearly indicated on the journal's Web site.
8. Web site: A journal's Web site, including the text that it contains, shall demonstrate that care has been taken to ensure high ethical and professional standards.
9. Name of Journal: The Journal name shall be unique and not be one that is easily confused with another journal or that might mislead potential authors and readers about the Journal's origin.
10. Conflicts of interest: A journal shall have clear policies on handling potential conflicts of interest of editors, authors, and reviewers and the policies should be clearly stated.
11. Access: The way(s) in which the journal and individual articles are available to readers and whether there are any associated subscription or pay per view fees shall be stated.
12. Revenue sources: Business models or revenue sources (eg, author fees, subscriptions, advertising, reprints, institutional support, and organizational support) shall be clearly stated on the Web site.
13. Advertising: Journals shall state their advertising policy.
14. Publishing schedule: The periodicity at which a journal publishes shall be clearly indicated.
15. Archiving: A journal's plan for electronic backup and preservation of access to the journal content in the event a journal is no longer published shall be clearly indicated.
16. Direct marketing: Any direct marketing activities, including solicitation of manuscripts that are conducted on behalf of the journal, shall be appropriate, well targeted, and unobtrusive.
King Edward Medical University
2014-05-21 02:28:39
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/525
Annals of King Edward Medical University; Vol. 19 No. 4 (2013)
eng
Copyright (c) 2014 Annals of King Edward Medical University
oai:ojs2.localhost:article/540
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10.21649/akemu.v20i1.540
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AUTHORSHIP OF SCIENTIFIC PAPERS
Awais (S.I.), Prof. Syed Muhammad
In order to avoid disputes and misunderstandings, regarding who will be the author, and in what sequence, these should be determined by the participants early in the research process. Authorship roles can vary from intellectual contribution to the conduction of research work, role in writing the manuscript to reviewing the final draft of the manuscript. All authors are responsible for the quality, accuracy, and ethics of the work, but one author must be identified as the corresponding author who will be accountable if questions arise or more information is needed, and who will take responsibility for the work as a whole. Alternatively, since authors may differ on the nature and magnitude of contributions, each author may be asked to describe their own. This description of author contributions should be printed with the article. The authors are responsible for creating all components of the manuscript. If writers are provided support by the sponsoring or funding institution or corporation to draft or revise the article, the name of the writer and their sponsoring organization must be provided. Their names and contributions will be provided with the acknowledgements. Journals should discourage "honorary" authorship (when authorship is granted as a favor to someone powerful or prestigious who would not have qualified for it otherwise) and should also try to ensure that all those who qualify as authors are listed.
All authors must take responsibility in writing for the accuracy of the manuscript, and one author must be the guarantor and take responsibility for the work as a whole. A growing trend among journals is to also require that for reports containing original data, at least one author (eg, the principal investigator) should indicate that she or he had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. This helps assure that authors, and not funding sources, have final say over the analysis and reporting of their results.
King Edward Medical University
2014-05-22 23:17:21
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/540
Annals of King Edward Medical University; Vol. 20 No. 1 (2014)
eng
Copyright (c) 2014 Annals of King Edward Medical University
oai:ojs2.localhost:article/609
2022-09-12T07:54:57Z
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10.21649/akemu.v20i2.609
doi
dc
STUDY DESIGN AND ETHICS IN SCIENTIFIC PAPERS
Awais (S.I.), Prof. Dr. Syed Muhammad
Good research should be well justified, well planned, and appropriately designed, so that it can properly address the research question. Statistical issues, including power calculations, should be considered early in the study design, to avoid futile studies that produce subject risk without enrollment sufficient to answer the research question. Outcomes should be specified at the start of the study. Research should be conducted to high standards of quality control and data analysis. Data and records must be retained and produced for review upon request. Fabrication, falsification, concealment, deceptive reporting, or misrepresentation of data constitute scientific misconduct.
Documented review and approval from a formally constituted review board (Institutional Review Board or Ethics committee) should be required for all studies involving people, medical records, and human tissues. For those investigators who do not have access to formal ethics review committees, the principles outlined in the Declaration of Helsinki should be followed. If the study is judged exempt from review, a statement from the committee should be required. Informed consent by participants should always be sought. If not possible, an institutional review board must decide if this is ethically acceptable. Journals should have explicit policies as to whether these review board approvals must be documented by the authors, or simply attested to in their cover letter, and how they should be described in the manuscript itself.
Animal experiments should require full compliance with local & national, ethical & regulatory principles, and local licensing arrangements.
Journal recommendations for preferred presentation and analysis of data should be described in the Information for Contributors or Authors. Wherever possible, recommendations should be based on evidence about methods of data presentation that are readable and most likely to be interpreted correctly by readers. Editors should keep themselves informed of this research and adapt their recommendations as it evolves.
King Edward Medical University
2014-09-17 03:21:38
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LESS EXPANSIVE HEALTH CARE REFORMS
Awais, Prof. Syed Muhammad
Health care leaders are always trying to find out how the most famous and best - resourced hospitals in the world do the things. Large scale reforms in US, such as the medical homes, are building integrated care sys-tems to improve quality of health. Evidence from the literature suggests that this may not be how it works in the developing world. But the present literature shows time and again that great ideas often come from un-likely places in the developing countries.
As health systems around the world struggle to do more with less, solutions are coming from developing countries, which have been finding innovative and in-expensive ways to care for their populations.
There's a lot of literature that suggests General Practitioners (GPs) should be at the center of the integ-rated approach, and policy makers may build models around them. This makes sense if we think practical.
Few Teaching Institutions in less developed / less rich countries are now reaching to their patients out-side their teaching hospitals by launching the Commu-nity - Based Chronic Disease Management (CCDM) program with General Practitioners in the core, Com-munity Nurses, Paramedics and Religious Community Leaders. They perform medical assessments, adjust medications, and provide prescriptions and arrange screenings, give preventive education, and coordinate specialist health care services. CCDM engages Gen-eral Practitioners who are the most independent group of health care professionals
As result of CCDM practice, on average, 61% of patients with hypertension achieved a reduction in both systolic and diastolic BP of at least 5 mmHg, dia-betic patients saw an average 15% reduction in A1c levels.
Given that each 5 mmHg reduction in diastolic BP has been shown to reduce the risk of stroke by 34% and ischemic heart disease by 21%, we can imagine the impact of CCDM on care costs and patients' qua-lity of life.
I hope the readers will find this information stimu-lating for reforming health care.
King Edward Medical University
2015-08-03 04:51:41
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Annals of King Edward Medical University; Vol. 20 No. 3 (2014)
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RESPONSIBLE RESEARCH PUBLICATION: INTERNATIONAL STANDARDS FOR AUTHORS
Awais, Prof. Syed Muhammad
Summary
• The research being reported should have been conducted in an ethical and responsible manner and should comply with all relevant legislation.
• Researchers should present their results clearly, honestly, and without fabrication, falsification or inappro-priate data manipulation.
• Researchers should strive to describe their methods clearly and unambiguously so that their findings can be confirmed by others.
• Researchers should adhere to publication requirements that submitted work is original, is not plagiarised, and has not been published elsewhere.
• Authors should take collective responsibility for submitted and published work.
• The authorship of research publications should accurately reflect individuals' contributions to the work and its reporting.
• Funding sources and relevant conflicts of interest should be disclosed.
Reference
1. Wager E &Kleinert S (2011) Responsible research publication: international Standards for authors. A position statement developed at the 2nd World Conference on Research Integrity, Singapore, July 22-24, 2010. Chapter 50 in: Mayer T & Steneck N (eds) Promoting Research Integrity in a Global Environment. Imperial College Press / World Scientific Publi-shing, Singapore (pp 309-16). (ISBN 978-981-4340-97-7).
King Edward Medical University
2015-08-03 05:36:04
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https://annalskemu.org/journal/index.php/annals/article/view/675
Annals of King Edward Medical University; Vol. 20 No. 4 (2014)
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RESPONSIBLE RESEARCH PUBLICATION: INTERNATIONAL STANDARDS FOR EDITORS
Awais, Prof. Syed Muhammad
Summary
• Editors are accountable and should take responsibility for everything they publish.
• Editors should make fair and unbiased decisions independent from commercial consideration and ensure a fair and appropriate peer review process.
• Editors should adopt editorial policies that encourage maximum transparency and complete, honest reporting.
• Editors should guard the integrity of the published record by issuing corrections and retractions when needed and pursuing suspected or alleged research and publication misconduct.
• Editors should pursue reviewer and editorial misconduct.
• Editors should critically assess the ethical conduct of studies in humans and animals.
• Peer reviewers and authors should be told what is expected of them.
• Editors should have appropriate policies in place for handling editorial conflicts of interest.
Reference
Kleinert S and Wager E (2011), Responsible research publication: international standards for editors. A position statement developed at the 2nd World Conference on Research Integrity, Singapore, July 22-24, 2010. Chapter 51 in: Mayer T and Ste-neck N (eds). Promoting Research Integrity in a Global Environment. Imperial College Press / World Scientific Publishing, Singapore (pp 317-28). (ISBN 978-981-4340-97-7).
King Edward Medical University
2015-08-03 22:44:56
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https://annalskemu.org/journal/index.php/annals/article/view/686
Annals of King Edward Medical University; Vol. 21 No. 1 (2015)
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oai:ojs2.localhost:article/698
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Study Design and Ethics
Awais, Prof. Dr. Syed Mohammad
A comprehensive policy on publication ethics has been published by the World Association of Medical Editors (WAME), which addresses all the major areas of ethics which all contemporary science journals should consider
The Annals of King Edward Medical University will publish from time to time different parts of WAME's publication policy for its readers, authors and reviewers.
Study Design and Ethics
Good research should be well justified, well planned, and appropriately designed, so that it can properly address the research question. Statistical issues, including power calculations, should be considered early in study design, to avoid futile studies that produce subject risk without enrollment sufficient to answer the research question. Outcomes should be specified at the start of the study. Research should be conducted to high standards of quality control and data analysis. Data and records must be retained and produced for review upon request. Fabrication, falsification, concealment, deceptive reporting, or misrepresentation of data constitute scientific misconduct.
Documented review and approval from a formally constituted review board (Institutional Review Board or Ethics committee) should be required for all studies involving people, medical records, and human tissues. For those investigators who do not have access to formal ethics review committees, the principles outlined in the Declaration of Helsinki should be followed. If the study is judged exempt from review, a statement from the committee should be required. Informed consent by participants should always be sought. If not possible, an institutional review board must decide if this is ethically acceptable. Journals should have explicit policies as to whether these review board approvals must be documented by the authors, or simply attested to in their cover letter, and how they should be described in the manuscript itself.
Animal experiments should require full compliance with local, national, ethical, and regulatory principles, and local licensing arrangements.
Journal recommendations for preferred presentation and analysis of data should be described in the Information for Contributors or Authors. Wherever possible, recommendations should be based on evidence about methods of data presentation that are readable and most likely to be interpreted correctly by readers. Editors should keep themselves informed of this research and adapt their recommendations as it evolves.
Acknowledgments
The Study Design and Ethics is reproduced from "Policy on Publication Ethics" published by the World Association of Medical Editors (WAME). (www.wame.org)
King Edward Medical University
2015-08-04 01:15:04
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Annals of King Edward Medical University; Vol. 21 No. 2 (2015)
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Definition of a Peer-Reviewed Journal
Awais, Prof. Dr. Syed Muhammad
A comprehensive policy on publication ethics has been published by the World Association of Medical Edi-tors (WAME), which addresses all the major areas of ethics which all contemporary science journals should consider. The Annals of King Edward Medical Uni-versity will publish different parts of WAME’s public-cation policy for its readers, authors and reviewers.
Definition of a Peer-Reviewed Journal
A peer – reviewed biomedical journal is one that regu-larly obtains advice on individual manuscripts from reviewers who are not part of the journal’s editorial staff. Peer review is intended to improve the accuracy, clarity, and completeness of published manuscripts and to help editors decide which manuscripts to pub-lish. Peer review does not guarantee manuscript qua-lity and does not reliably detect scientific misconduct.
Peer reviewers should be experts in the manu-script’s content area, research methods, or both; a criti-que of writing style alone is not sufficient. Peer revie-wers should be selected based on their expertise and ability to provide high quality, constructive, and fair reviews. For research manuscripts, editors may, in addition, seek the opinion of a statistical reviewer.
Peer reviewers advise editors on how a manuscript might be improved and on its priority for publication in that journal. Editors decide whether and under whi-ch conditions manuscripts are accepted for publication, assisted by reviewers’ advice.
Peer reviewers are sometimes paid for their efforts but usually provide their opinions free of charge, as a service to their profession. Editors should require all peer reviewers to disclose any conflicts of interest, financial or otherwise, related to a particular manu-script and should take this information into account
when deciding how to use their review. Generally speaking, people with a direct financial interest in the results of the manuscripts should not be reviewers.
To be considered peer reviewed, a journal should have obtained external reviews for the majority of manuscripts it publishes, including all original rese-arch and review articles. Some editors request peer re-view for other kinds of articles, such as opinion pieces (commentaries / editorials) and correspondence. To have been peer reviewed, a manuscript should have been reviewed by at least one external reviewer; it is typical to have two reviewers and sometimes more opinions are sought.
Editors of peer-reviewed journals need not send all submitted manuscripts out for review. Manuscripts that seem unlikely to be published in that journal may be returned to authors without external review, to allow authors to submit the manuscript to another jou-rnal without delay and to make efficient use of revie-wers’ and editors’ time.
Editors should state their journal’s peer review policies, including which kinds of article are peer re-viewed and by how many reviewers, in the instructions for authors. Editors should also periodically publish statistics describing their journal’s review process, such as number of manuscripts submitted, acceptance rate, and average times from manuscript submission to rejection letter to authors and, for accepted manusc-ripts, time to publication.
Acknowledgments
The “Definition of a Peer – Reviewed Journal”, is reproduced from “Policy Statements” published by
the World Association of Medical Editors (WAME). (www.wame.org)
King Edward Medical University
2015-11-02 03:55:47
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Annals of King Edward Medical University; Vol. 21 No. 3 (2015)
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20 YEARS OF ANNALS OF KEMU (1995 – 2015)
Awais, Prof Dr. Syed Muhammad
Array
The Annals of KEMU was first published in 1995, and Prof. Abdul Majeed Ch. was the first editor. I was appointed as editor on 15th May 2007, the responsibility which I will be completing on my retirement on 9th December, 2015. A brief report of Annals of KEMU from 15-05-2007 to 09-12-2015 is stated below for kind information of the authors, reviewers and readers of the Annals.
The title of Annals of KEMC was changed to Annals of KEMU, new editorial board was constituted and editorial policy was made and approved on 14th June 2007. According to editorial policy 2007, the editorial process was divided into six (6) steps; 1-Manuscript Submission, 2-Plagiarism Check with “Turnitun”, 3-review of manuscript by two reviewers, 4-acceptance/rewriting/rejection, 5-publication and 6-circulation.
As a result of high quality, the Annals was recognized by PMDC in 2009. The HEC recognized Annals first in category “Z” and later on raised the category to “Y” and in July 2015 to highest category “X”.
Annals of KEMU has been indexed with; 1-Pak MediNet (1996), 2-EMRO Indexus of WHO (1997), 3-Directory of Open Access Journals-DOAJ (2007), 4-ICJME Database(2010), 5-PKP Harvester Database, 6-Open J Gate Database (2010), 7-Google Scholar.
From June 2007 to November 2015, thirty five (35) issues of Annals of KEMU were published. Five hundred and sixty (560) manuscript were received, four hundred and thirty eight (38) manuscripts were accepted and published, forty three (43) were rejected, and four (04) manuscripts were withdrawn by authors. Until December 2015, seventy five (75) manuscripts are in editorial review process.
Total income of the Annals from June 2007 to December 2015 was Rs. 12,52,280/- (Grant from HEC Rs. 6,12,280, collection from authors at rate of Rs. 1,000 for processing each manuscript Rs. 5,60,000 and from advertisements Rs. 80,000. During this period the expenditures of Annals have been Rs. 12,80,215 (publication cost Rs. 11,36,215 and correspondence and circulation Rs 1,44,000). In this way the cost to KEMU treasury has been Rs. 27,935/-.
The credit for the achievements of; maintaining good quality (plagiarism below 19% and approval by two reviewers of same specialty), achieving PMDC recognition and highest HEC rank, having Annals indexed with 7 databases and just cost of Rs. 27, 935 to KEMU treasury for publishing of 35 Issues goes to our able editorial board, authors, reviewers and the staff. I take this opportunity to thank all of them, espe-cially the editorial secretaries, Mr. Asim Saeed and Mr. Muhammad Afzal (Assistant Annals of KEMU), who have worked very hard.
King Edward Medical University
2016-01-08 00:00:00
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Annals of King Edward Medical University; Vol. 21 No. 4 (2015): AKEMU
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Telemedicine: Underutilized Tool of Global Health
Afzal, Dr. Saira
Array
Challenges bring an opportunity for success and each success is followed by a new challenge. Challenges and successes witnessed in the discipline of medicine are numerous. When world was preparing to enter the new millennium twenty years ago many great challenges were faced by medical professionals in-order to implement plans of quality health provision to every human globally. “Health for all” strategy, Millennium Development Goals (MDGs) and many other similar plans are the examples of such great vision to provide health care with equitable distribution, appropriate technology, community participation and acceptance among masses.
Telemedicine is the use of telecommunication and information technologies in order to provide clinical health care at far flung areas with connections through networking. In absence of telemedicine, the equitable access to deliver better health care is difficult especially in remote communities as some health standards could not be implemented on providers and recipients in different places at the same time. Recent advances in telemedicine have created opportunities for health care providers and recipients to overcome the barriers of lack of awareness and deficiency of standard approach towards prevention and management. The experts could extend their teaching and evidence based medical practices in order to increase standards of health care globally. Information technology helps to eliminate distance and communication barriers and can improve access to medical services that are deficient or in distant rural communities. The communities in far-flung areas and isolated populations can receive health care from specialist residing at a distance without patient to the need of travel to visit them.
Telemedicine can also be used to train health workers in field, providing evidence based medical practices, facilitation in standard operating procedures, delivery of medical education, sharing best practices and experiences. Recent advances in mobile techno-logy and the potential for global health elevated telemedicine as a popular force in health care. The special-ties that can be focused during implementation of telemedicine practices include preventive medicine, radiology, pathology, cardiology, mental health services, primary care, emergency care, physical rehabilitation, pediatrics, obstetrics, immunization, nutrition, mother and child health, disaster management, epidemic control, health system monitoring and management and many others.
Telemedicine in developing countries like Pakis-tan is a tool of global health. Pakistan is an over populated country where people are, by the large, deprived of proper medical facilities especially those living in far flung areas. The implementation of telemedicine can facilitate the patients and educate the health care providers for the purpose of improving patient care. In Pakistan, biometric verfication by Pakistan Telecommunication Authority (PTA) has declared mobile phone users in the country; according to which the figure for mobile phone users is estimated to be near 114.7 million. Thus big resource is available that can be channelized to improve health and prevent disease through telemedicine across the country and beyond geographical boundaries.
According to World Health Organization (WHO), the use of telemedicine in provision of health care is not simply about technology, but a means to reach an out-come, such as better decisions for provision of prevention and management, vulnerable populations received high quality and safer care, more awareness about health making people to have better choices for their health, better surveillance of communicable and non-communicable disease, government become more responsible and aware of health needs of populations. More-over equitable, appropriate, acceptable, effective and efficient monitoring of resources at Healthcare Centers.
The satisfaction of patients and health care provi-ders were found positive over time. According to Care Hill more than 80% of consumers find their health care to be satisfactory. Telemedicine is occasionally blamed of being driven by commercial rather than public health interests. However in spite of this criticism, telemedicine is linking the rich communities with poors globally.
Nevertheless, telemedicine is an effective tool for surveillance, monitoring, standardization, research, and implementation. There is no alternative to telemedicine. There are several telemedicine networks linking the industrialized and developing world, this is an area that is likely to grow in the future. Global health strategies have to focus on underutilized tool for better access to health care.
King Edward Medical University
2016-02-10 13:09:34
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Annals of King Edward Medical University; Vol. 22 No. 1 (2016): AKEMU
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Community Oriented Prevention and Rehabilitation of Burns
Afzal, Dr. Saira
“Anything that’s human is mentionable, and anything that is mentionable can be more manageable. The people around can help us know that we are not alone.† Fred Rogers
     In spite of the efforts of public health physicians to prevent burn injury through fire prevention, awareness campaigns and educational programs, still burn injuries continue to present a significant social and financial burden through patient mortality, morbidity, and long  term disability. Life after burns is a continuous struggle to improve quality of life in society, seeking employment to remain functional, acceptance in community without any stigmatization and medical support to combat health problems. Cost of medical care and rehabilitation is enormous and can be avoided through community oriented prevention of burns and later on effective rehabilitation in particular community. The causes and types of burn injuries determine prevention and rehabilitation plans. Especially when burns are associated with violence, terrorism conflicts and fights. The conflicts include inter racial differences; inter religious assassinations, revengeful traditions, attempted murders, honor killings, domestic violence and terrorism in a community.1
     The use of acid to produce facial burns in women was witnessed in many rural communities in developing countries.2 The first recorded acid attacks in developing countries occurred in Bangladesh in 1967, followed by India in 1982, and Cambodia in 1993. Since then, research has witnessed an increase in the amount and severity of acid attacks in the region. However, this can be traced to significant underreporting in the 1980s and 1990s, along with a general lack of research for this phenomenon during that period.3 Acid attacks were reported in many parts of the world. Since the 1990s, Bangladesh had been reporting the highest number of attacks and highest incidence rates for women with 3,512 Bangladeshi people acid attacked between 1999 and 2013.3 Although acid attacks occur all over the world, including in Europe and the United States, this type of gender based violence is concentrated in rural communities of India, Bangladesh and Pakistan where the implementation of regulations needs further exploration. In Pakistan, the majority of these attacks occurred in the summer. According to a report, up to 150 attacks on women occurred every year. They also reported that the attacks were often the result in rise of domestic abuse, and the majority of victims were female.4 The gender violence increased the morbidity rates in burns survivors.
     The efforts to produce community oriented prevention and rehabilitation of the adult burn survivors and to measure their health outcomes, preventing social isolation, providing social support and better quality of life after burn injury are almost negligible. WHO working groups states that quality of life is an individual perception of their position in life in context of culture and values system which they live in relation to their goals, expectations, standard and concerns.5 Eventual outcome depends on injury severity, individual physical characteristics of patient’s motivation, and social support by family and friends.5 It was documented that large number of people living with burn scars need social support more than healthy people for better quality of life.6
     There is a dire need for better understanding of multifaceted determinants of burn injuries and quality of life in adult survivors in the context of society norms and cultural pressures in community settings, in order to plan better preventive strategies to combat this public health problem. Prevention efforts are urgently needed to reduce the rate of these unacceptably high burn injuries, and should be developed on a local level in response to risk factors identified in individual areas. Community oriented prevention and rehabilitation of burns is a cost effective strategy. Community participation, use of appropriate technology, accessibility and equitable distribution of preventive and rehabilitative services are its components. Thus efforts should be directed to decrease sufferings of the burn survivors in society and social support systems should be developed to improve quality of life of burn victims through community oriented prevention and rehabilitation of burns.
King Edward Medical University
2016-05-21 13:38:23
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Annals of King Edward Medical University; Vol. 22 No. 2 (2016): AKEMU
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Publish or Perish
Khan, Prof. Dr. Farid Ahmad
It gives me immense pleasure and pride to write the editorial for the annals of my beloved alma mater. Within the realms of this great institution, I spent the best years of my youth burning the midnight oil mastering the science and art of healing both the body and soul of ailing humanity and striving hard to diligently absorb the words and works of my teachers, all maestros in their fields. Coming so close to suffering and death on such a regular basis humbled me greatly; it also incited me to do more to alleviate the anguish of my fellow humans.
     It is this “more†that I wish to stress upon, for I am sure every colleague in my field does his or her bit in maintaining the nobility and probity of our profession to the utmost. â€More†in this context means progression and progression is analogous with research; exploring new horizons not yet ferreted out but carrying great potential to benefit and ensure the survival of our species. Research always stems from a curious mind and curiosity is inherent to the nature of mankind. Unfortunately, the version of pedagogy pervasive in our system seems to fear curiosity. After all, it is sup-posed to have killed the proverbial cat, so instead, rote learning is promoted. I think both students and teachers even at the elementary level should be trained to segregate impudence from the innocuous and fruitful quest to delve into the unknown.
     Just as the most avid readers go on to become the greatest writers, studying the work and research of others acts as a stimulus to do so ourselves. Making research journals available should be a priority of every institution. Moreover, research should be made an integral part of the curriculum in colleges and universities. Problem based and project based learning, especially in groups should be encouraged. Opinions sequestered from a multitude of minds encourage critical and lateral thinking, providing a nidus for generating many new hypotheses, which of course require research to prove their validity.
     With the world on hand at the click of a button, research today is more tangible than ever. I personally believe that being computer savvy will help as promoting and inculcating research as part of our culture. Since research is a prerequisite to the development of a country, monetary or other incentives can be quite effective in luring and encouraging both the researcher and his subjects, when the zest to instigate research is lacking per se.
     However, within the precincts of research also lie innumerable dark secrets. Adolph Hitler was a great protagonist and promoter of research to satisfy his own whims and vices. To pursue and fulfill Hitler’s fantasy of creating a perfect and superior Caucasian race, replete with blond hair and blue eyes, the infamous Nazi doctor, Josef Mengele carried out inhumane experiments on concentration camp prisoners, especially twins. That was research in its most hideous form; not to benefit humanity, but to filter it out.
     Today universities all over the world are ranked according to their research statistics. As Arrivistes striving to enter the clique of internationally acclaimed institutions, we need to adopt the “The Publish or Perish†phenomenon rampant in the West. However, merely putting on a supercilious patina of carrying out research is not enough. Choosing the right topic relevant to the incumbent problems, communicating effectively to assert our opinions and inferences as well as selecting the right journal to publish it in, are important to promote and uphold our perspective. Only after it has proved its credibility will research be able to permeate the current system and alter it to the benefit of humanity.
King Edward Medical University
2016-05-21 13:38:23
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Annals of King Edward Medical University; Vol. 22 No. 2 (2016): AKEMU
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Professionalism in Medical Journalism and Role of HEC, PM&DC
Jawaid, Shaukat Ali
Array
The art of medical writing and science of scientific publishing has made tremendous progress during the last two decades. The revolution in information technology while on one hand has brought lot of ease and benefits, it has also created tremendous pressure and problems for the medial editors who are trying to come up to the expectations of authors who are very keen to see their manuscript published soon after submission.1,2
     One can be a good physician or a good surgeon but it does not mean that he/she can also be a good Editor as one has to learn this art. That is why starting with the International Committee of Medial Journal Editors (ICMJE)3,4 which was formed in 1978 and later World Association of Medical Editors formed in 19955 have been working to improve the professional skills of medial editors by regularly organizing conferences, Hands on Workshops as well as seminars to train the editors. Their websites offer lot of useful information and training material. American Medial Writers Association (AMWA),6 European Medical Writers Association (EMWA)7 and European Association of Science Editors (EASE)8 founded in 1982 have also been doing a commendable job helping the authors and researchers. They too organize their annual conferences and training workshops on regular basis. Then came the various regional bodies like Eastern Mediterranean Association of Medical Editors (EMAME) and Asia – Pacific Association of Medial Editors (APAME) which have been busy in promoting the discipline of medical journalism in their respective regions.9,10 Numerous countries in these regions have also formed their own associations of medical journal editors to improve the professional capacity of their member editors in their respective countries. Pakistan which had taken an active part in establishing the EMAME in 2003 did not lag behind and established Pakistan Association of Medial Editors (PAME) in 2010. Since then it has not only hosted EMMJ5 Medical Journals Conference in 2010 which was attended by thirty four foreign delegates and guest speakers from eighteen countries but has also organized three national conferences and a large number of Hands on Workshops all over the country.11
     PAME organized training course for medical journal editors at Karachi on July 14, 2012, at PIMS Islamabad on September 15, 2012, at Khyber Medical University at Peshawar in Khyber KPK on September 16, 2012 and at University of Health Sciences Lahore on April 25, 2013. PAME organized yet another training course for medical journal editors at University of Health Sciences Lahore on March 4-5th 2016. All this was aimed at to build up the professional capacity of editors of biomedical journals published from Pakistan.
     Journalology has now emerged as an important discipline with numerous subspecialties. Publishing a good quality peer reviewed journal is an uphill task which requires a team work. Publishing a medical journal is not economically viable for many institutions and organizations. The problems are further compounded with the non-availability of good Peer Reviewers, willing and interested Editorial Board Members which play a vital role in improving the contents and quality of a journal. If this was not all, the issues like plagiarism, scientific misconduct and upholding professional ethics has made the job of the editors more difficult. Institutions like Committee on Publication Ethics (COPE) UK has come up with very informative Flow Charts to guide the editors on dealing with scientific misconduct including plagiarism, duplicate and redundant publication etc., but it has not made the life of medical journal editors easy.12 It is extremely important that one should opt for professionalism, seeks help and assistance from the respective government institutions, organizations to find a solution to the various problems with the medical journal editors are facing. It was in this context that PAME in its Third National Conference held at UHS Lahore from April 1 – 2, 2016 had devoted a special session to  “Professionalism and Medical Journal Editors†where representatives of Higher Education Commission (HEC) and Pakistan Medical and Dental Council (PM&DC) were also invited. However, it was unfortunate that none of them came to attend the meeting thus deprived themselves to update on latest developments and problems faced by Editors.
     Some of the issues concerning both these institutions which were highlighted during the conference were as under:
 Pakistan Medical and Dental Council
• Its website is not updated regularly.• List of PM&DC recognized journals is not update and lacks lot of information and there is no mention of Publication Ethics.
• There is a communication gap between the PM& DC and the Editors. Not enough time is given when asking for some documents or holding meeting of Journals Evaluation Committee.
• Communications sent to the PM&DC remain unanswered and it makes no differentiation between those journals who fulfill all the requirements, are published regularly and those who do not follow the laid down criteria.
• Communications received from the Journals Committee of PM&DC from time to time have a threatening tone and they need to show respect to the Editors.
• PM&DC wants the journals to submit plagiarism report but provides no help or assistance to the journals in this regard.
 Higher Education Commission
• Communications received from Quality Assurance Department regarding meeting of Journal Evaluation Committee does not give enough time.
• In the past HEC used to provide the facility of checking manuscripts for plagiarism using the Turnitin software but now it has been restricted to medical universities only.
• HEC website is also not updated regularly.• Communication gap between the HEC and Medial Journal Editors also needs improvement.
     It will be unfair not to mention the generous grant the Higher Education Commission has been providing to its recognized biomedical journals for the last many years but it will be much better if it is replaced by providing much needed services and software facilities.
     Pakistan Association of Medical Editors with its meager resources has been doing a commendable job to help improve the professional capacity of Editors through various ways. Its website also contains some useful material for the training of the new editors.11 Regulatory bodies like PM&DC and HEC working in close collaboration with PAME can work wonders and go a long way in improving the standard of biomedical journals published from Pakistan. Commission on Iranian Medical Journals based in Ministry of Health in Islamic Republic of Iran apart from providing financial assistance also provides software for checking plagiarism, helps the journal in preparing their websites, helps them provide facilities of XML which has helped a large number of Iranian Medical Journals to go to PubMed Central and has thus increased their visibility and readership manifold. The number of medical journals published from Iran was ninety in 2005 which has now increased to over four hundred. Seventy two of these Iranian Medical Journals are visible on PubMed, PubMed Central and Medline while twenty are covered by ISI Thompson Reuter known for Impact Factor.13 On the contrary only about half a dozen medical journals from Pakistan are covered by Medline, PubMed and PubMed Central and only four medical journals from Pakistan has an Impact Factor.14
     Our regulatory bodies can learn from Iran and that is what the HEC should be doing in Pakistan. Instead of offering any financial grants it can better utilize the same resources to provide facilities for checking plagiarism, software to prepare XML files for submission to PubMed Central, organizing training workshops for Editors and support staff on Open Journal System, electronic publishing, peer review, publication ethics etc. PAME has the professional capacity to help PM&DC and HEC to realize these objectives. What is missing is the proper liaison and understanding between Medical Journal Editors and these regulatory bodies like PM& DC and HEC. A study presented at the PAME Third National Conference by the author had also heighted some basic and serious deficiencies in the journals which are recognized by PM&DC as well as HEC because the members of their respective Journal Evaluation Committees are not fully conversant with the latest developments in the field of medical journalism. These committees need to be further strengthened by inducting competent, knowledgeable professional editors and PAME has time and again offered its help and assistance in this regard. Even once the PM&DC had also issued a notification making PAME President an exoffico member of the Journals Evaluation Committee but no meeting was ever held.15
     To improve the present situation and find a workable, feasible, practical solution to the various problems being faced by the medical journal editors in Pakistan is not an uphill task. The objective of every one, the editors and regulatory bodies like PM&DC and HEC are the same i.e. improvement in the quality of contents, standard of medical journals so that we can increase our contribution to the world medical literature and promote research culture in Pakistan. Intentions of everyone are good but what is lacking is cooperation, coordination and bridging the communication gap. It is never too late and let us makes a new beginning in our relationship. The role of the regulatory bodies is to facilitate and not to create hurdles and discourage those who are working under difficult circumstances with meager resources and facilities available.
King Edward Medical University
2016-09-06 12:42:29
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Annals of King Edward Medical University; Vol. 22 No. 3 (2016): AKEMU
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Revamping Health Professionals Education for Stronger Health Systems
Tariq, Dr. Saira
Array
With an emerging transformation in global health from ‘diseases’ to ‘Health Systems’, there is increased recognition that Health Systems need to be resilient and receptive to the accelerated demographic and epidemiological transition, posing unconventional health challenges. Health System strengthening is also crucial for progressing towards Universal Health Coverage which is an intrinsic attribute of health related SDGs (2030).
In light of contemporary threats to health security, Health systems are becoming more complex and placing supplementary demands on the Health Workforce which is one of the key components of health systems. Pakistan has been categorized as one of 57 countries that are facing an HRH (Human Resource for Health) crisis i.e. that its health workforce is below the threshold level defined by WHO, required to deliver the essential health interventions to attain the Sustainable Development Goals (UN) by 2030.1 The crisis is complex and is related not just to the quantity but the quality, efficiency and effectiveness of the health work-force.
In a series of studies about Health Professionals education, the landmark 1910 Flexner Report2 triggered revolutionary reform in Health Professionals education by consolidating modern science into the curricula at universities, equipping the health professionals with the knowledge that contributed to enhanced life expectancy and improved quality of life in the 20th century. Marking the centenary of the reform initiative, the Lancet Commission on ‘Education of Health Professionals for the 21st Century’ accented the fact that professional medical education especially in developing countries, has not kept pace with emerging challenges because of obsolete and inert curricula that has led to production of valueless and ill equipped graduates who have not been able to address the contextual challenges effectively.3
According to the commission some of the impinging issues include weak leadership to improve health system performance, persistent mismatch of competencies to individual patient and population needs, limited technical focus without broader contextual understanding, predominant clinical orientation at the expense of primary health care, intermittent episodic encounter
of the patient with clinic rather than a ‘continuum of care’ approach etc.
The Commission draws attention to ‘three generations’ of Health Professional education reform in the past century starting with a science based curriculum in the first generation (start of the 20th century) followed by problem based instructional innovation (mid-century). Authorities emphasize that a third generation of reform is now required that employs a systems approach for improving health system performance and adapts core professional competencies to specific contexts while drawing on global knowledge. They maintain that actualization of this vision will require a series of instructional and institutional reforms, which should be guided by transformative learning which is the highest of three successive levels, moving from in-formative to formative to transformative learning. In-formative learning is about acquisition of knowledge and skills with the objective to produce experts. Formative learning is about socializing students around values to produce professionals. Transformative learning is about developing leadership attributes; its purpose being production of enlightened and cultivated change agents. Effective education builds each level on the previous one. As a valued outcome, transformative learning involves three fundamental shifts: from fact memorization to searching, analysis, and synthesis of information for decision making; from seeking professional credentials to achieving core competencies for Effective teamwork in health systems; and from non-critical adoption of educational models to innovative adoption of global resources to address local priorities.3
Pursuance of these reforms requires leadership from within the academic and professional communities, increased investments and stewardship followed by shared learning by supporting evaluation and strengthening of research to build the knowledge base about which innovations work in which settings. It is critically important to subscribe to the vision and recommendations of the Commission for development of cadres of skilled, competent and motivated health professionals who can in due course, be agents of change within their domains and work towards addressing the daunting health challenges of our times.
(Adapted from The Lancet Commission on ‘Education of Health Professionals for the 21st Century, 2010)
King Edward Medical University
2016-12-14 20:55:22
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https://annalskemu.org/journal/index.php/annals/article/view/1435
Annals of King Edward Medical University; Vol. 22 No. 4 (2016): AKEMU
eng
Copyright (c) 2016 Annals of King Edward Medical University
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The Opioid Epidemic: What Pakistan can Learn from the US
Ilyas, Asif M
Array
In the United States of America, we are in the midst of a social pandemic, referred to as “The Opioid Epidemic.” This is a problem not unique to America, but because it plagues America it illustrates the problem’s multifactorial nature and also highlights that any country, regardless of affluence, can fall victim to this problem. The problem with opioid abuse is not a new one in America and can be traced at least as far back as the Civil War, where soldiers suffering from various war-related injuries were treated liberally with morphine resulting in widespread addiction, referred to at the time as “Soldier’s Disease.” However, despite growing awareness of the problem over time and despite several social and political initiatives to combat it, including establishment of both the Food and Drug Ad-ministration (FDA) and the Drug Enforcement Agency (DEA) that were charged with controlling opioid prescribing among other responsibilities and the late First Lady Nancy Reagan’s famous “Just Say No” campaign in the 1980’s, opioid abuse has persisted in America.
Opioid abuse represents both abuse of prescribed opioids such as morphine, oxycodone, hydrocodone, codeine, etc; but also abuse of illegal opioids such as cocaine and heroin. The current epidemicis unique in that it draws heavily from abuse of prescription opioids. The modern “Opioid Epidemic”can be traced back to approximately the year 2000. At that time, hospital patients’ pain scored on a visual analog scale from 1 – 10 was designated the “fifth vital sign” after temperature, heart rate, blood pressure, and respiratory rate; warranting aggressive management. It is this singular event that a direct line can be drawn from when both patients began consuming more opioids and physicians began prescribing more. It was also at approximately this time, that the pharmaceutical industry came out with several long-acting opioids such as Oxycontin (Purdue Pharma – Stamford, Connecticut, USA). What resulted was a rising expectation by patients and society of aggressive and generous receipt of opioids and liberal prescribing by physicians. The result was an explosion of opioid prescriptions. Here are our current facts to consider.1
- American represents 5% of the world’s population but consumes 80% of the world’s opioids.
- 260 plus opioid prescriptions are written annually, 3 times more than in 1999.
- 1.9 million Americans are addicted to prescription opioids.
- 4 out of every 5 heroin users started their addiction with prescription opioids.
- 78 people die daily from an opioid-related over-dose.
Fortunately, this has resulted in a pro-active response from both the American medical community and the political establishment. The American Attorney General, Dr. Vivek Murthy, recently took the unprecedented step to write a personal letter to all prescribing physicians in America engaging them to under-stand the problem, encouraging them to curb inconsiderate opioid prescribing, and recommended directing those patients with signs of addiction to receive early active treatment. Many states have also taken aggressive steps such as mandating opioid prescribing restrictions and requiring medical students and physicians to receive mandatory opioid prescriber training. Similarly, in our institution, we have studied our patients’ opioid consumption and physician prescribing habits. Within the Orthopaedic Surgery department, we noted that on average patients were consuming 8 opioid pills on average after upper extremity surgery, yet physicians were prescribing 25 opioid pills on average, resulting in an inadvertent 3 fold over-prescribing pat-tern.2 The results of this study surprised us all and has led us to establish prescription guidelines and pre-scribe opioids post-operatively more discriminately.
Pakistan is not immune to this problem. In some ways, it is more susceptible to it due to limitations in resources, greater poverty and illiteracy, and the active and ever increasing opioid production in Afghanistan making its way to Pakistan. A survey report published by the UN Office on Drugs and Crime in 2013 found that more that 6.7 million Pakistanis are estimated to have used opioid (including both heroin and opioids) in 2012 alone.3 Although there is variability with consumption throughout the country, with Balochistan having the highest prevalence of users, all regions were involved. Punjab, due to its large share of the population, has the highest number of opioid abusers with 2.9 million. Moreover, approximately 80% of users in Punjab who inject opioids admit to sharing syringes regularly.
Fortunately, there is much Pakistan can learn from America’s challenges with opioid abuse. These lessons include: avoiding the trap of aggressively treating pain under the guise of good patient care, active education of physicians and medical students on the risks of opioid addiction and learning best opioid prescribing habits, curbing the influence on the pharmaceutical industry on opioid consumption, and keeping pressure on public officials to fight illegal opioid entrance into the country. Ultimately, it will be the medical community, and in particular leaders like those at the King Edward Medical University, that will have to both face this problem and ultimately address it heads on.
King Edward Medical University
2016-12-14 20:55:22
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Annals of King Edward Medical University; Vol. 22 No. 4 (2016): AKEMU
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Endemic Crimean Congo Hemorrhagic Fever in Pakistan
Afzal, Dr. Saira
Array
“In times of stress and danger such as come about as the result of an epidemic, many tragic and cruel phases of human nature are brought out, as well as many brave and unselfish ones.”
William Crawford Gorgas
Crimean Congo hemorrhagic fever is endemic in certain parts of world. It is a zoonotic disease and reservoirs are domestic and wild animals. It spreads by vector Hyalomma tick or contact with infected animals or people or infected secretions. The clinical disease spectrum includes fever with flu like symptoms, hemorrhages and mortality rate of 10 – 40%. The incubation period is 1 – 3 days after a tick bite or 5 – 6 days following exposure to infected blood or tissues. The flu – like symptoms may resolve after one week. In up to 75% of cases, however, signs of hemorrhage appear within 3–5 days of the onset of illness in the form of skin bruises, nose bleeds, vomiting, and black stools. The liver becomes swollen and tender. Patients usually begin to show signs of recovery after 9 – 10 days from when symptoms presented.1 10 – 40% of the cases result in mortality by the end of the second week of illness and may be attributed by hemorrhagic shock, hypovolemia, septacaemia, acute kidney failure, and acute respiratory distress syndrome.2
Pakistan has witnessed severe outbreaks in 2009 and 2010. In 2009, epidemic of Crimean Congo hemorrhagic fever was reported from Baluchistan. In September 2010, an outbreak was reported in Pakistan’s Khyber Pakhtunkhwa province. Poor diagnosis and record keeping has caused the extent of the epidemic to be uncertain, though some reports indicate over 100 cases, with a case – fatality rate above 10%. Crimean – Congo haemorrhagic fever is declared endemic in Pakistan. Human infections caused by the Crimean-Congo haemorrhagic virus have been occurring throughout the year and in wide geographic areas of the country. The seasonal spike has been reported this year and guidelines for prevention in public and health care providers are formulated. However, clear and rational policies from law enforcement agencies to avoid spread from endemic foci to other non-endemic areas through transportation of animals or contact with infected cases especially during Eid festivals are still needed. The transportation of animals is greatly increased during Eid festival in Pakistan and risk of epidemic is also increased. Law enforcement and Agricultural regulations require de-ticking farm animals before transportation or delivery for slaughter. Protocols for safety during slaughter and disposal of infected wastes should be formulated and implemented. In the case when feverish patients with evidence of bleeding are reported, emergency preparations for resuscitation or intensive care are required urgently. Moreover guidelines regarding suspected cases quarantine, body secretions and wastes isolation and disposal in health care facilities and standard precautions for laboratory workers, nursing staff and doctors should be adopted.
Surveillance and laboratory diagnosis for early detection of cases, infection control measures in health care facilities and risk communication should be strengthened especially in high risk areas in the country. Seroprevalence of antibodies against Crimean Congo hemorrhagic virus in our community is still unknown.
Preventive steps are simple but awareness in masses about Crimean congo hemorrhagic fever is the most important step. Some of the important steps for prevention are:
• Use a repellent containing 20% – 30% DEET or 20% Picaridin. Re-apply according to manufacturer’s directions.
• Wear neutral – coloured and light – weight clothes, long – sleeved shirts and full pants. Tuck pants into socks for further protection.
• Apply a permethrin spray or solution to clothing and gear.
• When walking through grass lands avoid tall grasses and shrubs.
• Carefully examine body, clothing, gear, and animals for ticks.
• Apply sunscreen first followed by the repellent and preferably 20 minutes later.
• Avoid coming into contact with the blood or tissues of animals. Healthcare practitioners should take appropriate infection control measures to prevent infection. Standard operating procedures to handle infectious materials and suspected cases should be displayed in clinical settings.
• Laboratory staff should wear protective gear and waste disposal should be according to the protocols.
There is no effective commercially available vaccine or chemoprophylaxis against Crimean-Congo Hemorrhagic Fever. Thus efforts should be directed to prevent this disease by awareness in masses. Moreover, seroprevalence in general public as well as in specific groups including health care providers, laboratory workers, butchers, veterans and surgeons should be detected by screening and later on confirmed by Enzyme Linked Immunosorbant Assay (ELISA). Early case detection, quarantine of susceptible cases and adoption of standard protocols during management of patients can decrease the spread of this deadly virus.
King Edward Medical University
2016-09-06 12:42:29
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https://annalskemu.org/journal/index.php/annals/article/view/1480
Annals of King Edward Medical University; Vol. 22 No. 3 (2016): AKEMU
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Copyright (c) 2016 Annals of King Edward Medical University
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Forensic Medicine V/S Forensic Pathology. (A Difference That Everyone Should Know)
Malik, Prof. Dr. Arif Rasheed
King Edward Medical University http://annalskemu.org
In the past, several futile attempts were carried out at different forums to change the name of subject of Forensic Medicine to Forensic Pathology.
In that scenario, it is pertinent to seriously review that matter to have crystal clear concept about the subject of Forensic Medicine and to critically evaluate the effects of changing its name to Forensic Pathology particularly keeping in view the in vogue Medicolegal System in our set up.
I will try my level best to present here a factual ground reality base picture.
Let’s start with definition of Forensic Medicine, “as branch of medicine which deals with the application of principles of medical knowledge for the purpose of law, both civil and criminal, to furthering of the justice”.
It also deals with legal aspects of medical practice and doctor patient relationship and medical ethics.
Traditionally, it includes pathological anatomy and Forensic Toxicology.
Forensic Pathology is defined as the special branch of pathology dealing with the medicolegal investtigation of death.
A simple comparison of the definitions of two entities have made it clear that Forensic Medicine is broader/wider/more comprehensive subject and more in parlance with the present medicolegal system in our country than Forensic Pathology.
Our medicolegal system has a similarity with the continental medicolegal system, hence designated as modified continental medicolegal system where the role of investigating agency (police) and doctor (medical officer) is well defined in the following legal frame work.
This crucial point will be more evident by just briefly observing the following rules and regulations governing the present medicolegal system of our country.
1. Criminal procedure code, sec. 174, 174A, 176. (part relevant to medical man is reproduced below) 174. (1).
(3) When there is any doubt regarding the cause of death, or when for any other reason the policeofficer considers it expedient so to do, he shall, subject to such rules as the Government may prescribe in this behalf, forward the body, with a view to its being examined, to the nearest Civil Surgeon, or other qualified medical man appointed in this behalf by the Government, if the state of the weather and the distance admit of its being so forwarded without risk of such putrefaction on the road as would render such examination useless.
176. (1) When any person dies while in the custody of the police, the nearest Magistrate empowered to hold inquests shall, and, in any other case mentioned in section 174, clauses (a), (b) and (c) of subsection (1), any Magistrate so empowered may hold an inquiry into the cause of death either instead of, or in addition to, the investigation held by the policeofficer, and if he does so, he shall have all the powers in conducting it which he would have in holding an inquiry into an offence. The Magistrate holding such an inquiry shall record the evidence taken by him in connection therewith in any of the manners hereinafter prescribed according to the circumstances of the case.
(2) Whenever such Magistrate considers it expedient to make an examination of the dead body of any person who has been already interred, in order to discover the cause of his death, the Magistrate may, cause the body to be disinterred and examined.
2. Qisas and Diyat ordinance 1990/Criminal amendment act 1997.
Authorised Medical Officer 299 C: It means a medical officer/ medical board howsoever designated, authorised by Provincial Government.
3. Health Department, Government of the Punjab, instructions regarding postmortem and medicolegal examinations 2009.
4. Police ordinance 2002.
5. Police rules, i.e., 25.19 (medicolegal opinion), 25.21 (dying declarations), 25.22 (medical examination of women), 25.34 (Disinterment of bodies) clause 5, 25.36 (postmortem examination when and by whom held, 25.37 (post-mortem examinations), 25.38 (unidentified bodies), 25.43 (procedure in poisoning cases), 25.47 (report of medical officer).
A simple review of above relevant portions of the laws makes it clear that in our set up medico-legal examinations (of living and dead) are conducted by medical officers who are trained and taught the subject of Forensic Medicine in the 3rd year MBBS as depicted in the curricula issued by the PM&DC, Islamabad. The dead body is shifted to the nearby authorized medical man for autopsy. It is pertinent to mention that the autopsy rate is very high (about 1000 medico-legal autopsies are being conducted annually in the Forensic Medicine department of KEMU, Lahore, Pakistan).
The subject of Forensic Medicine is a state subject. The existing facilities are extremely deficient. There is no forward planning in spite of severe threat of terrorism leading to mass disaster. The paramedical staff required to work in the city morgues is not only deficient but is also untrained.
Now compare this situation with the states where Forensic or medico-legal autopsies are conducted by Forensic Pathologist who are medical persons highly qualified in the subject of pathology and then trained in Forensic Pathology. The facilities are enormous and mortuary staff is very well trained. The autopsy rate is low. These Forensic pathologist do not conduct medico-legal examinations of living cases of assault (physical and sexual), poisoning or alcohol intoxication etc. This task is done by the clinical Forensic Medicine examiner or Forensic physicians or by police surgeons as in U.K.
Hence, it is evident that Forensic Pathology is a limb or branch of Forensic Medicine, how can it replace Forensic Medicine. If there are intentions to introduce it as a subject in the curricula first it should be decided whether it will be a undergraduate or post-graduate entity, then its curriculum/syllabus should be prescribed then mode of training should be categorised.
Mere changing the name of Forensic Medicine to Forensic Pathology is a mockery with the medical science and leads to provide the opportunity to the civilized world to laugh on us. So, if we start to produce subject specialist of Forensic Pathology today, it will take a decade to have first batch of Forensic Pathologist as shown below:-
MBBS, five years,
House job, one year,
Post graduate qualification like PhD or MD or FCPS or M.Phil in Histopathology or morbid anatomy, four to five years then training in Forensic Pathology for one to two years).
So it is advisable not to open Pandora box leading to complete collapse and disarray of our medicolegal system.
What will be the service structure of that Forensic Pathologist? Will that come under teaching cadre or specialist cadre? So thorough discussions/deliberations required but my considered opinion is that this settled issue may not be unsettled because of reasons already mentioned.
The existing rules and laws mentioned above shows that medical officer conduct medico-legal examinations how the Forensic Pathologist will act as authorized medical officer when he is a specialist not an ordinary medical officer.
Therefore, prima faciae, to change the name of subject (Forensic pathology instead of Forensic Medicine) keeping all other modalities as such will lead only to deterioration and mockery. It will be an unjusttified step in all aspects, i.e., academically, legally and ethically. So, It is suggested that bring the change keeping in view the latest advancements in medical sciences, please do not bring the change by just changing the name.
King Edward Medical University
2017-03-11 10:23:05
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Annals of King Edward Medical University; Vol. 23 No. 1 (2017): AKEMU
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Cervical Cancer Screening
Wasim, Prof. Tayyiba
King Edward Medical University http://annalskemu.org
Cervical cancer is the fourth most common cancer in women in the world and second commonest cancer in less developed countries. It is estimated that 528, 000 cases are reported ever year with 80% reported in underdeveloped countries.1 It is one of the few cancers which have a well defined, approachable and early detectable pre cancerous stage which takes 10 – 15 years to transform into invasive disease. Exposure to HPV infection especially 16 & 18 along with risk factors of early age in first intercourse, multiple sexual partners, and smoking and low socio economic status all make women more vulnerable to cervical cancer.2 According to recent PDHS survey, women in Pakistan marry at a median age of 19.5 years and 8% of teenage pregnancy happen.3 Extra marital sex is prevalent although not talked about much. In Pakistan incidence of cervical cancer is reported to be 3.6% of all cancers with screening coverage of 1.9%.4
Effective screening program of Pap smear has resulted in decline of incidence and mortality in the developed world. The standard practice is to screen women using cytology every 3 years starting from 21 – 65 years.5 In contrast, this program is a failure in the developing countries because of lack of laboratory infrastructure, trained cytologist, cost and follow up visit requirement especially in rural areas. The menace of disease is visible when it is already spreaded adding the threat to human life and burden to health care system.
The visual inspection of cervix with acetic acid (VIA) has been advocated as an alternative screening method to Pap smear in developing countries. It comprises of application of 5% acetic acid to the cervix and visualization of acetowhite area. It is simple, cheap, and easy to perform, does not require lab infrastructure and can be learnt easily. WHO guideline6 suggests VIA as recommended screening method in developing countries. VIA has been evaluated in large number of clinical trials in India, Bangladesh and Africa in terms of sensitivity, specificity, positive & negative predictive value in detecting CIN and has been found a reliable screening test.7-10 HPV DNA testing is now the recommended screening test according to recent AS-CO guideline.11 Screening in developing countries has been addressed in this guideline for the very first time and VIA has been suggested for basic settings.
Effective treatment approaches in the form of Cryotherapy, LEEP/LETTZ and cold knife conization are present for cervical premalignancy. Screen and treat approach at single visit is now recommended by WHO in low and middle income countries.6
More than 2 million women worldwide have cervical cancer. Despite evidence that cervical cancer has declined in certain regions of the world and that survival in women with this cancer has improved, far too many women die from this cancer every year in developing countries due to lack of effective screening programmes. Primary prevention in the form of HPV vaccine was introduced 10 years ago but it is still not widely used in resource poor countries due to its cost.12 Interventions that do not require massive capital investment are available and need to be explored in low resource settings, where access to early detection of cervical cancer is generally limited. It is hoped that decision makers are enlightened about possible alternative strategy in the form of visual inspection of acetic acid for cervical cancer screening that could improve the lives of women by early detection, destigmatize this disease in community, and ensure that they remain on the healthcare agenda. A three prong strategy including sexual health education, screening and HPV vaccination should be global health priority to reduce burden of this highly preventable cancer.
King Edward Medical University
2017-03-11 10:23:05
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Annals of King Edward Medical University; Vol. 23 No. 1 (2017): AKEMU
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10.21649/akemu.v23i1.1514
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dc
Qualitative Research and Clinical Methods
Tarin, Dr. Ehsanullah
King Edward Medical University http://annalskemu.org
I am honored for being an alumnus of KEMC, and am delighted to write this editorial for the Annals. I have, ever since done my research and taught qualitative methods, felt that clinical methods are quite akin to qualitative research. Then, why only few clinical researchers use qualitative methods? A witness to this assumption is the research published in the Annals. In this treatise, I try to identify some parallels between the two types of methods and argue for the clinicians to invest in learning qualitative research methods to practice clinical methods well.
Qualitative research is to identify and interpret issues from the perspective of participants, their experience of: illness or disability, using health service, and to appreciate the meanings they give to the behaviour, events or objects in the context of their social and cultural norms. In this type of research, the emphasis is on exploring the associations and understanding the phenomenon in its holism; and not, like in quantitative research, from an outsider’s perspective and for certain specific aspects.1 It requires participants with specific characteristics, selected purposely that can best inform the research topic. More participants, identified inductively during data collection, are added to develop full and multiple perspectives about the cases.2
No preset data collection tool is used, instead qualitative researcher guided by a research question acts as an instrument, since the line of enquiry he changes during data collection as new understanding is gained and/or the situation changes.3 The data for research is derived from the observation, interviews or verbal interactions, focus group discussions, document reviews, life histories etc. and the researcher asks why, how and under what circumstances things occur; and not just what, where and when. It is recorded in words or pictures and log book is used to record notes arising from interviews, observations, extracts from documents etc.
In health care settings patients are the subjects for clinical methods. The clinician, even prior to any verbal communication, observes the patient, e.g. for his gait and appearance. If in a bed or examination couch, his posture could give some clue to the illness. Inspection, a clinical method, is like systematic observation, which is qualitative method, should be holistic. In my third year during bedside teaching, Professor (late) Rashid Ahmed Qureshi said, “patient has come to you as a whole and not his stomach in a tray”, when a student straight went to examine abdomen of a patient with acute abdomen. History taking, another clinical method, is like conducting semi structured in depth interview – a qualitative research method. In both disciplines, we are told, “not to ask leading, but follow up and probing questions”; and Professor (late) Alamgir Khan, while teaching clinical methods, would add, “if a good history is taken, you will establish diagnosis in over 65% of cases”. Likewise, as part of history taking, documents related to patient’s illness history and treatment are reviewed similar to document review in qualitative research.
The two approaches however differ in how the data is analysed. In clinical practice, diagnosis is established based on the pathophysiological knowledge or patient’s clinical condition is discussed in clinicopathological conference.4 On the other hand, qualitative research employs meaning based data analysis, whereby the qualitative data is transformed into some form of explanation, understanding or interpretation of people and situation that is investigated.5,6
In conclusion, the history, the observation and the review of document related to patient are since obtainned using qualitative methods, the clinician trained in these methods could not only conduct these methods well but also interpret the data to identify and detect obstacles to the change in clinical condition and the reasons why improvement does or does not occur.7 Finally, while it is heartening that research forums are organised in the institutions affiliated with KEMU, in order the research is richer, the researchers’ skills in qualitative research methods should be built.
King Edward Medical University
2017-03-11 10:23:05
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https://annalskemu.org/journal/index.php/annals/article/view/1514
Annals of King Edward Medical University; Vol. 23 No. 1 (2017): AKEMU
eng
Copyright (c) 2017 Annals of King Edward Medical University
oai:ojs2.localhost:article/1557
2022-09-12T07:55:39Z
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10.21649/akemu.v23i2.1557
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Antibiotic Stewardship: Battle to Defeat Superbugs
Afzal, Muhammad Faheem
King Edward Medical University http://annalskemu.org
The practice of medicine has been transformed by antimicrobials. However, overuse and misuse of anti-microbials is one of the major global health problems. Longer and expensive hospital stays are expected for those patients who are suffering from multi-drug resistant organisms.1
Antibiotic stewardship is an emerging concept and may be defined as coordinated interventions to imp-rove and measure the appropriate use of antimicrobials with selection of the optimal antimicrobial drug regimen, duration, dose, and route of administration.” Antibiotic stewardship program (ASP) is aimed to tar-get the antibiotic related optimal clinical outcomes, minimal toxicity and adverse events, cost reduction for infections, and curtail the selection for antimicrobial resistant strains.Centre for disease control and prevention (CDC) has described core elements of hospital ASP, the essentials of these are leadership commitment, accountability, drug expertise, action, tracking, reporting, and education.2 This program has larger impact on infection rates, resistance patterns, costs and clinical outcomes in many studies.3, 4
Pakistan, being the developing country, is facing the problem of antimicrobial resistance at large due to irrational use of antimicrobials. Review of data on drug use in Pakistan shows the excessive and irrational drug use in Pakistan with higher use of antimicrobials and injections and choice of more expensive drugs with inadequate dispensing, compared to the lower middle income countries. The injudicious use of anti-microbials attribute towards antimicrobial resistance and emergence of new mutant strain.5-8
In Pakistan, there is need to conduct drug utilization to identify appropriate usage of drugs in terms of medical, social and economic aspects. To overcome the problem, strategies to decrease unnecessary anti-biotic prescription like “Antibiotic Stewardship Programs” must be implemented.9 In Pakistan, Medical microbiology and Infectious diseases society of Pakis-tan (MMIDSP) has taken initiative to develop indigenous ASP and training program. The ASP should be the part of undergraduate curriculum to sensitize our future doctors. The regulatory authorities should also be active in monitoring the judicious use of antimicrobials. The masses should have easy access to the quality health care services, so as to minimize the irrational antimicrobial use.
King Edward Medical University
2017-05-25 10:19:42
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https://annalskemu.org/journal/index.php/annals/article/view/1557
Annals of King Edward Medical University; Vol. 23 No. 2 (2017): AKEMU
eng
Copyright (c) 2017 Annals of King Edward Medical University
oai:ojs2.localhost:article/1653
2022-09-12T07:55:43Z
annals:ED
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2079-0694
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10.21649/akemu.v8i1.1653
doi
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Determination of Cause of Death after Autopsy- “A Dilemma”
KHALIL, I U R
AZIZ, K
MEMON, M U
Determination of the cause of death after autopsy is the fundamental responsibility of the autopsy surgeon, yet very little has been written about the criteria that need to be satisfied to make this decision. This issue causes confusion in courts where both autopsy surgeons and lawyers fail to appreciate the philosophy of causation. It is generally assumed and believed by the lay public including lawyers that the cause of death will be easy to establish after detailed autopsy. However, things are not always as simple as they seem. Leaving aside the cases where the lesion observed at autopsy is incompatible with life (e.g. decapitation) what infect usually happens in coming to a conclusion is that a cause of death discovered at autopsy, which accords with the medical history and circumstances, is elevated to the cause of death. The autopsy surgeon makes a subjective decision that a certain autopsy finding is capable of leading to death, and that is consistent with the deceased’s medical history and circumstances of death. Furthermore, a conclusion about the cause of death is retrospective and cannot be tested. These problems emphasize the need to discover all the pathological processes present in the deceased before considering them in relation to the medical history and the circumstances of death.
Causation Philosophy and Problems. One group of academicians believes that the cause is not
only sufficient but is necessary for the effect: A is always followed by B, and B never occurs unless A occurred. Others disagree and advocate that it is the sum total of the conditions in which an event occurred: It is not correct to isolate one of the conditions in which an event occurred as
the exclusive cause. To the One, The statement “The rising of the sun causes daylight”, would have been reasonable, since the rising of the sun is always followed by daylight, and daylight never comes about unless the rising of the sun has occurred. To Others, the statement is, in fact, incomplete because daylight could not occur unless there is an atmosphere. So one must include an atmosphere in the statement about what causes daylight because it is one of the conditions in which the event occurs.
The restrictiveness of the first group can be seen in the commonest cause of death in the western world:
coronary atherosclerosis. The development of the coronary atherosclerosis is not always followed by death, and death does not occur only when coronary atherosclerosis has developed. Yet clearly it is a reasonable proposition that coronary atherosclerosis has been the pathological basis for an enormous number of deaths. It seems that the first approach is suited more to those cases where the cause of death is incompatible with life. This is not to say that other’s approach is necessarily the answer. Take the example of a heavy smoker who dies of carcinoma of the lung. One of the conditions in which the death occurred is smoking, but there are more: a person may smoke because of the effect of advertising, because of parents, because of particular personality trait. The autopsy surgeon (and in some cases, courts) have to make a practical decision that cause stops somewhere. In general, the line is drawn at the “Medical Cause” of death, but as the example shows, this is often unsatisfactory: because smoking is increasingly noted again on death certificates in western world. Autopsy surgeons have some instinctive understanding of these issues but there are a particular sort of cases where the difficulties are even greater.
King Edward Medical University
2016-07-19 09:00:38
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https://annalskemu.org/journal/index.php/annals/article/view/1653
Annals of King Edward Medical University; Vol. 8 No. 1 (2002): AKEMU
eng
Copyright (c) 2016 Annals of King Edward Medical University
oai:ojs2.localhost:article/1654
2022-09-12T07:55:43Z
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10.21649/akemu.v8i1.1654
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Biochemistry: A Historical Overview
HAMEED, A
AZIZ, K
Biochemistry in the earlier times was a neglected field, has become the most flourishing scientific realm in agriculture, medicine and industry and the scientific research has been swayed in the direction of Biochemistry. The history of Biochernistiy is not so old one as in the beginning it was not recognized as separate entity. Initially Biochemistry was associated with development of science of chemistry
in late 18th century and of Biology in 19th century .So biochemistry often described as study of chemistry of life is a multifaceted science that include the study of all forms of life and utilizes basic concepts derived from Biology, Physics, Chemistry and Mathematics to achieve its goals. It is until the years of early 19th century that Biochemistry began to emerge as an independent scientific discipline.
Biochemical research, which arose in the last century with isolation and characterization of naturally occurring organic compounds, is today integral component of most biological research.
King Edward Medical University
2016-07-19 09:00:38
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https://annalskemu.org/journal/index.php/annals/article/view/1654
Annals of King Edward Medical University; Vol. 8 No. 1 (2002): AKEMU
eng
Copyright (c) 2016 Annals of King Edward Medical University
oai:ojs2.localhost:article/1695
2022-09-12T07:55:45Z
annals:ED
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"170911 2017 eng "
2079-0694
2079-7192
10.21649/akemu.v8i3.1695
doi
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Mental Health Services Rooted in Primary Care: Why is this so relevant for Pakistan
MIRZA, I Q
World Health Report 2001, Mental health: New Understanding, New Hop & was launched on 10th October 2001. World Health Organization devoted this first report of the 21 century to highlight the burden of mental disorders, as it is envisaged that these will present a major public health challenge in the future. The report highlights much that is already common knowledge for mental health professionals, that is mental illness is common, 1 in 4 or 25% of the population will suffer from a mental health problem during their lives. World Health Report 2001 makes ten recommendations to improve mental health with three “scenarios for action” according to varying level of national resources. The recommendations include provisions of service in primary care, involving communities and care in the community. In addition, the report emphasis the need for availability of essential psychotropic drugs, the importance of educating the public, supporting research, establishing national policies and programmes, linking with other sectors and developing human resource.
King Edward Medical University
2017-09-11 07:36:37
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https://annalskemu.org/journal/index.php/annals/article/view/1695
Annals of King Edward Medical University; Vol. 8 No. 3 (2002): AKEMU
eng
Copyright (c) 2017 Annals of King Edward Medical University
oai:ojs.pkp.sfu.ca:article/1760
2017-12-05T03:39:14Z
annals:ED
oai:ojs.pkp.sfu.ca:article/1761
2017-09-21T08:20:59Z
annals:ED
oai:ojs.pkp.sfu.ca:article/1938
2017-11-14T10:38:58Z
annals:ED
oai:ojs.pkp.sfu.ca:article/1940
2017-11-15T08:12:03Z
annals:ED
oai:ojs.pkp.sfu.ca:article/1947
2018-02-20T06:22:53Z
annals:ED
oai:ojs2.localhost:article/2005
2022-09-12T07:55:57Z
annals:ED
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"171205 2017 eng "
2079-0694
2079-7192
10.21649/akemu.v23i3.2005
doi
dc
Granulomatous Mastitis Mimics Breast Carcinoma- A Diagnostic Concern
Bajwa, Rakhshindah
Extensive research has been done to investigate and treat malignant conditions of the breast. Benign breast lesions are, however, more common than breast malignancies. Patients presenting with acute mastitis or abscess rarely undergo fine needle aspiration cytology and biopsy, since diagnosis is usually based on clinical grounds. Breast cancer and infection may be present in the same patient; acute mastitis can raise suspicion of inflammatory carcinoma.
King Edward Medical University
2017-09-21 13:00:42
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/2005
Annals of King Edward Medical University; Vol. 23 No. 3 (2017): AKEMU
eng
Copyright (c) 2017 Annals of King Edward Medical University
oai:ojs2.localhost:article/2186
2019-05-25T08:58:39Z
annals:ED
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nmb a2200000Iu 4500
"180220 2018 eng "
2079-0694
2079-7192
10.21649/akemu.v23i4.2186
doi
dc
Open Peer Reviews and Blind Peer Reviews: Merits and Demerits
Afzal, Saira
The peer review process is essentially the quality control mechanism. Scientific discoveries and advancements have far reaching implications especially in health and medical publications. The quality assurance mechanism in medical journals has to be stringent and flawless. The peer review systems are continuously being criticized, debated and updated. It may be open peer review or blind peer review, both have advantages and disadvantages. Open peer review is performed for scientific quality after publication. It is also known as transparent peer review and public peer review.
King Edward Medical University
2017-11-15 13:13:20
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/2186
Annals of King Edward Medical University; Vol. 23 No. 4 (2017): AKEMU
eng
Copyright (c) 2017
oai:ojs2.localhost:article/2298
2019-05-24T08:50:38Z
annals:ED
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"180320 2018 eng "
2079-0694
2079-7192
10.21649/akemu.v24i1.2298
doi
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Voluntarism: A Way Forward for Health Care Delivery In Developing World
Volunteer is a term which refers to the provision of services by choice or free will of a person, organization or group of individuals with no financial gain in full awareness and appreciation (1). It is an international phenomenon in which the individuals provide their time and services free of cost to an organization for the benefit of others (2). It is vital for the sustainability and smooth functioning of the nonprofit and community organizations that the participation on volunteer basis should be regular and ongoing (3). This is worth mentioning that in United States during the year of 2000, 15.5 billion hours were contributed by 83.9 million volunteers which is equal to an amount of USD 39.2 billion wages for the employees (4). During the year of 2006, there were 5.2 million volunteers in Australia contributing around 623 million hours to the non-profit segment. This contribution value is equal to a wage of 15 billion AUD$ (5).
King Edward Medical University
2018-03-20 07:35:49
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https://annalskemu.org/journal/index.php/annals/article/view/2298
Annals of King Edward Medical University; Vol. 24 No. 1 (2018): AKEMU
eng
Copyright (c) 2018
oai:ojs2.localhost:article/2345
2019-05-23T08:48:03Z
annals:ED
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nmb a2200000Iu 4500
"180417 2018 eng "
2079-0694
2079-7192
10.21649/akemu.v24i1.2345
doi
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Innovative Ways to Promote Children’s Mental Health: Developing Accessible and Sustainable School Mental Health Services in Pakistan
Imran, Nazish
According to World Health Organization (WHO), approximately 10-15% of children and adolescents worldwide suffer from mental health problems.(1) The WHO also highlights that “Lack of attention to mental health of children & adolescents may lead to mental disorders with lifelong consequences, undermines compliance with health regimens and reduces the capacity of societies to be safe and productive”. (2) More than half of all mental disorders have an onset in childhood and adolescence with suicide being the third leading cause of death among adolescents. (1), (3) Child & adolescent mental health thus needs to be considered & emphasized as an integral component of overall health & growth of young population. Youth with positive mental health have positive self-efficacy beliefs, are productive and able to tackle developmental challenges adequately.
King Edward Medical University
2018-03-20 07:35:49
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/2345
Annals of King Edward Medical University; Vol. 24 No. 1 (2018): AKEMU
eng
Copyright (c) 2018
oai:ojs.pkp.sfu.ca:article/2412
2018-06-23T08:52:49Z
annals:ED
driver
oai:ojs.pkp.sfu.ca:article/2417
2018-09-11T07:20:39Z
annals:ED
driver
oai:ojs.pkp.sfu.ca:article/2500
2018-09-27T05:32:37Z
annals:ED
driver
oai:ojs2.localhost:article/2502
2019-05-22T08:55:13Z
annals:ED
driver
nmb a2200000Iu 4500
"180927 2018 eng "
2079-0694
2079-7192
10.21649/akemu.v24iS.2502
doi
dc
Counseling in Medical Institutions; Challenges and Solutions
Afzal, Saira
It is really hard to imagine the spectrum of challenges faces by Medical Students. The lack of organized counseling and relevant policy in Medical Institutions has worsened the existing situation for students facing problems in learning, adjustment in medical institutions and coping with increased stress of studies. The progress in lifelong learning notion is seriously hampered in practical situation for the young brilliant and energetic minds who face multi facet problems and challenges, and cannot find the way out on their own.
King Edward Medical University
2018-09-27 10:02:52
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https://annalskemu.org/journal/index.php/annals/article/view/2502
Annals of King Edward Medical University; Vol. 24 No. S (2018): AKEMU
eng
Copyright (c) 2018
oai:ojs2.localhost:article/2517
2018-09-28T19:02:09Z
annals:ED
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nmb a2200000Iu 4500
"180620 2018 eng "
2079-0694
2079-7192
10.21649/akemu.v24i2.2517
doi
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Medical Professionalism in Pakistan: Taking Inspiration from the Pakistani Motto
Medical professionalism is considered to be a very important component in medical education and embodies a social contract of a doctor to the community he serves. The social contract, as defined by Cruess, is ''a contractual relationship with a series of obligations and expectations based on mutual trust between the society and medicine'' . Each society has different moral and social norms and hence it become rather clear that medical professionalism and its attributes will vary from society to society. Much work has been done in the west to define attributes related to medical professionalism. However,Western frameworks of medical professionalism may not be suited to the cultural values of non-Western countries. It has been brought to attention now that not all the attributes of medical professionalism as defined by West are compatible with the Eastern culture. For example Al-Eraky demonstrated that there is influence of Islamic values and norms in the Arabic society and for that he purposed a 4-gate model of p r o f e s s i o n a l i s m , w h i c h h a d f o u r t h e m e s (domains),that is: dealing with self, dealing with tasks, dealing with others and dealing with God(taqwa and ehtasab) It must be pointed out that not all the Muslim countries demonstrated then domains of faith in Allah and religion as an integral part of professionalism. For an example, thought Turkey is an Islamic State, the attributes lacked the
'faith' discipline in defining professionalism.
King Edward Medical University
2018-09-11 13:03:57
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https://annalskemu.org/journal/index.php/annals/article/view/2517
Annals of King Edward Medical University; Vol. 24 No. 2 (2018): AKEMU
eng
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oai:ojs2.localhost:article/2591
2018-11-14T04:36:41Z
annals:ED
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nmb a2200000Iu 4500
"181114 2018 eng "
2079-0694
2079-7192
10.21649/akemu.v24i4.2591
doi
dc
Artificial Intelligence and Educational Leadership.
Artificial Intelligence (AI) is mimicking of human cognition by computer / I.T equipment that can sense, reason, comprehend, discover meaning, generalize and learn from experience. Computer learns from data over time and allows us to use large amount of new complex data and can perform administrative and clinical healthcare functions. IMELF 2018 organized by RCPSC has innovative theme of “Leadership in the Face of Artificial Intelligence” Machine learning is a new concept and computer can recognize speech, process and analyze digital images, pictures, video to extract computer data.
King Edward Medical University
2018-11-14 09:12:42
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/2591
Annals of King Edward Medical University; Vol. 24 No. 4 (2018): AKEMU
eng
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oai:ojs2.localhost:article/2690
2019-04-09T08:23:29Z
annals:ED
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nmb a2200000Iu 4500
"190305 2019 eng "
2079-0694
2079-7192
10.21649/akemu.v25i1.2690
doi
dc
Current and Future Prospects of Mesenchymal Stem Cells in Regenerative Medicine
Butt, Ghazala
As stem cells have revolutionized all the fields of medicine in the present era so is the field of regenerative medicine which is the most recent and emerging branch of medical science and in which stem cells may prove to be a new armamentarium in treating different chronic and disabling diseases.
King Edward Medical University
2019-03-05 09:25:45
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https://annalskemu.org/journal/index.php/annals/article/view/2690
Annals of King Edward Medical University; Vol. 25 No. 1 (2019): AKEMU
eng
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oai:ojs2.localhost:article/2850
2019-06-22T05:49:28Z
annals:ED
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"190622 2019 eng "
2079-0694
2079-7192
10.21649/akemu.v25i2.2850
doi
dc
Reflection and Growing Minds
Fatima Naumeri
In the unpredictable and dynamic health system, there is a growing need to incorporate reflection and reflective practice into all levels of medical education, as it is an essential tool for improving medical competencies.
King Edward Medical University
2019-06-17 09:50:09
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/2850
Annals of King Edward Medical University; Vol. 25 No. 2 (2019): AKEMU
eng
Copyright (c) 0
oai:ojs2.localhost:article/2941
2019-08-07T06:13:26Z
annals:ED
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nmb a2200000Iu 4500
"190807 2019 eng "
2079-0694
2079-7192
10.21649/akemu.v25iS.2941
doi
dc
Current Challenges in Globalization of Medical Education; Looking through the Lens of Health Reforms
Globalization of medical education is a need of the hour. Medical profession has faced many challenges and different institutions developed various strategies to cope with these challenges. In the past, the training model in medical education used was “Apprenticeship Model”. Then medical education evolved further to implement process and product based models. Now all over the world, outcome based or competency based model is the preferred way of trainings in medical profession. Accreditation Council for Graduate Medical Education (ACGME) Model in the US and CanMEDS Model of Canada are well known models internationally for imparting medical education.
King Edward Medical University
2019-08-07 11:13:26
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/2941
Annals of King Edward Medical University; Vol. 25 No. S (2019): AKEMU
eng
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oai:ojs2.localhost:article/2948
2019-08-08T08:32:15Z
annals:ED
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"190808 2019 eng "
2079-0694
2079-7192
10.21649/akemu.v25iS.2948
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Community Driven Development in context of Health Promotion
Afzal, Saira
King Edward Medical University
The use of information technology has revolutionized the health care systems and health promotion models. Information technology including use of artificial intelligence in preventive medicine has enabled the mankind living at various places to become active co-creators of their own health rather than passive recipients of health care. New prevention models are being developed on new technologies involving artificial intelligence to genomics.1 Quality of health care services is greatly enhanced by the integration of preventive models, curative services and artificial intelligence. Artificial intelligence, accountability and social prescribing lies at the heart of all health reforms. Promoting health by social prescribing where medical professionals and doctors advise non medical solutions, such as life style modifications, quit smoking plans, sleep hygiene, mental health prevention tools, and referring patients to community services for better control on their physical, mental and social health.2
King Edward Medical University
2019-08-07 11:13:26
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https://annalskemu.org/journal/index.php/annals/article/view/2948
Annals of King Edward Medical University; Vol. 25 No. S (2019): AKEMU
eng
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oai:ojs2.localhost:article/3060
2019-10-15T03:33:01Z
annals:ED
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nmb a2200000Iu 4500
"191015 2019 eng "
2079-0694
2079-7192
10.21649/akemu.v25i3.3060
doi
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Social Media: An Emerging Tool in Medical Education
Zahid Kamal
King Edward Medical University/Mayo Hospital, Lahore
Nazish Imran
King Edward Medical University/Mayo Hospital, Lahore
Social Media are “all websites and applications that enable users to create and share content, to interact with other users or to find people with similar interests to one's own”.1 Students of twenty first century are “digital natives” and use social media daily necessitating the need for its incorporation in teaching and learning in medicine. Furthermore, global interconnectivity means future doctors need to learn and master the skill of social media use.
Social media broadly encompasses multiple platforms, including social networking sites [SNS] like Facebook, Twitter, LinkedIn; Media sharing sites [MSS] like YouTube; blogs; Wikis; video and text messaging services such as Skype, WhatsApp; and Learning management systems [LMSs] (including Moodle, Blackboard) etc.
King Edward Medical University
2019-10-11 12:04:23
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/3060
Annals of King Edward Medical University; Vol. 25 No. 3 (2019): AKEMU
eng
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oai:ojs2.localhost:article/3138
2020-01-09T05:48:43Z
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"200109 2020 eng "
2079-0694
2079-7192
10.21649/akemu.v25i4.3138
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Universal Health Care: Reaching out to the Vulnerable and Poor Communities
Saira Afzal
King Edward Medical University
Unsa Athar
King Edward Medical University, Lahore
Faiza Aziz
King Edward Medical University, Lahore
Universal Health Care (UHC) has been recognized all over the world as an unparalleled standard for the provision of extensive health services particularly to the impoverished and economically poor sectors of the community. Through appropriate affordable and acceptable technology UHC demands the delivery of essential health care to the community with equity and participation. Immunization tremendously improving overall health globally as one of the vital components of UHC that aids to eliminate major infectious diseases. Government of Pakistan instituted Pakistan Nursing Council that registers and regulates Lady Health Visitors (LHVs) in order to provide essential health services and accomplish health for all in the urban and rural slum areas. Family Planning and Immunization are the two main subjects of Lady Health Visitors duty since 1951. After diploma of two-year, role of LHVs is to manage normal labor and delivery cases, administer vaccines, counsel and educate regarding family planning, treat common diseases in children and women, identify disease complications and carry out an efficient referral to concerned specialist. For the provision of UHC, it is essential to properly train the community health workers all over the world. Attainment of adequate training of Lady Health Visitors directly influence the provision of preventive, curative and rehabilitative services to the community.
King Edward Medical University
2019-12-30 10:13:20
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/3138
Annals of King Edward Medical University; Vol. 25 No. 4 (2019): AKEMU
eng
Copyright (c) 0
oai:ojs2.localhost:article/3266
2020-05-14T08:46:40Z
annals:ED
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nmb a2200000Iu 4500
"200514 2020 eng "
2079-0694
2079-7192
10.21649/akemu.v26i1.3266
doi
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An update on preventive measures of COVID-19 in Pakistan
Arshad, Amber
Afzal, Saira
Throughout the human history, multiple disease outbreaks have affected millions of people around the globe. Such pandemics with high morbidity and mortality rates affected the countries in the worst possible ways1. The first deadly virus pandemic was reported in 1918 known as Spanish flue involving H1N1 influenza virus affecting 500 million people around the globe and death toll raised from 17 million to 50 million. In 2009 the world again faced another H1N1 Swine flu pandemic during 2009-2010 with 6.8 billion people under effect and almost 5 million deaths.
Similarly world is facing another problem of COVID-19 since December 2019.It started as an epidemic in the city of Wuhan , China and considered as the one of the greatest threat to the human health and health economics. The virus has crossed multiple geographical boundaries and declared pandemic by World Health Organization, affecting almost every country in the world. There is a need to take urgent and forceful actions to change the course of the disease. The countries like China, Japan, South Korea, Iraq, and other European countries2,3 have demonstrated that the virus can be suppressed and controlled. But this picture has another side. COVID-19 is just like any other flu disease. The mortality rate is still low and if every country steps up its preventive strategies and implement the action plans to control the disease, soon this pandemic will be over. World Health Organization calling COVID-19 a pandemic is not a huge surprise as more than 100 countries are involved and its spread is multiplied on daily basis. However, it is a preventable contagious disease. Due to exaggeration by the media, panic among the public and myths about the disease has affected economic status of many countries.
Pakistan's southern Sindh province is the worst-affected with the virus and 15 people have been tested positive till Feburary 2020. Most countries are using ‘Containment strategies’. Pakistan has also increased health screening on airports and boarders. As cases are being reported on daily basis, Pakistan Government needs to step up the game and design proper control strategies for COVID. More work should be done on Pandemic preparedness, outbreak detection and response. Proper allocation of Resources must be done to control the current situation. WHO has warned countries to get ready for the accelerated phase during which rapid increase in the COVID-19 cases will occur. In Pakistan, significant steps have been taken for surveillance, social distancing, isolation and quarantine and every effort has been made by public health and preventive medicine experts for early diagnosis and prompt treatment.
King Edward Medical University
2020-03-17 11:31:27
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/3266
Annals of King Edward Medical University; Vol. 26 No. 1 (2020): AKEMU
eng
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oai:ojs2.localhost:article/3609
2020-07-09T05:23:57Z
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"200709 2020 eng "
2079-0694
2079-7192
10.21649/akemu.v26iSpecial Issue.3609
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The Journey from Medical Nihilism to Pandemic Preparedness for COVID-19: A Global Health Challenge
“Nihilism is a well-known phenomenon of attitude among the mass population with extreme skepticism believing that nothing in the world has a material
existence or value. It is often times associated with extreme symptom or sign of pessimism and a radical skepticism that condemns existence.”
King Edward Medical University
2020-06-23 11:28:23
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/3609
Annals of King Edward Medical University; Vol. 26 No. Special Issue (2020): AKEMU
eng
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oai:ojs2.localhost:article/3691
2020-07-21T08:11:30Z
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nmb a2200000Iu 4500
"200721 2020 eng "
2079-0694
2079-7192
10.21649/akemu.v1i1.3691
doi
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This glorious premier institution “a Living Legend” of medical education - the KEMC
NAGI, A H
This glorious premier institution “a Living Legend” of medical education - the KEMC is the second oldest of its kind in the whole of subcontinent. It has been producing medical graduates of very high standard and not only became a primary source of medical teachers and specialists for other institutions of Lahore, but also for all major medical institutions of the country. Its ALUMNI not only stop at the boundaries of Pakistan hut are heading the various departments of basic and clinical sciences in some institutions of India, Bangladesh and of course it is well known that the graduates of this great institution are holding the highest positions both at institutional i.e. academic and private sectors in USA, Canada U.K. and Australia. In other words they are definitely benefiting the welfare of mankind both in their health care and in the diffusion of knowledge. They are therefore comparable with their own graduates. It would not he out of place to say that the KEMCOLEANS have proven even superior to graduates of many universities of most developed countries. From time to time these Alumni visit their alma mater and a small percentage of them decides to settle here and serve their own institution. Such are the fortunate Ones who got the taste of an advanced training abroad as well as being on the faculty of their own great aIma mater. - KEMC. Lahore.
King Edward Medical University
2020-07-17 09:19:40
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/3691
Annals of King Edward Medical University; Vol. 1 No. 1 (1995): AKEMU (Inaugural)
eng
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oai:ojs2.localhost:article/3915
2020-09-29T08:19:03Z
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"200929 2020 eng "
2079-0694
2079-7192
10.21649/akemu.v26i2.3915
doi
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COVID-19 Crisis: Pulmonary and Extra-Pulmonary Complications would Last for Long Time in Foreseeable Future
Afzal, Saira
Nasir, Mehreen
COVID-19 is currently one of the greatest problems the world is facing. A viral disease by nature, it emerged in city of China named Wuhan. Within few months it turned to be a global health emergency. It is an acute respiratory infection whose impact on world is somewhat similar to that of Spanish flu of 1918.1 To date, this infection has killed approximately 600,000 people in 216 countries and the number is rising.2 This virus affects multiple organs with varying degree of severity including respiratory, gastrointestinal, neurological, cardiovascular and hematological systems. This article will provide insight about the multiple organ complications of COVID-19 and the prognosis with different organ involvement.
King Edward Medical University
2020-08-10 08:01:38
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/3915
Annals of King Edward Medical University; Vol. 26 No. 2 (2020): AKEMU
eng
Copyright (c) 2020
oai:ojs2.localhost:article/4158
2020-12-02T06:15:31Z
annals:ED
driver
nmb a2200000Iu 4500
"201202 2020 eng "
2079-0694
2079-7192
10.21649/akemu.v26i3.4158
doi
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Post COVID-19 Pandemic Effects in Pakistan; Infodemic and Resilience
Afzal, Saira
Nasir, Mehreen
Junaid, Khunsa
The fateful year of 2020 will go down the annals of history as the year of the pandemic 2020 originating from the city of Wuhan in China, the COVID-19 virus spread to more than 215 countries worldwide with astoundingly swift pace. As on 12th September 2020, the virus has infected more than 27 million people worldwide and taken more than 0.9 million lives.1 From clinical point of view, the virus does not cause any illness or causes only mild but wide ranging symptoms in most of the affectees. However, in some cases, the effects of this virus, accentuated by existing morbidities like cancer, diabetes, hypertension etc., become much more devastating and fatal. The virus is highly contagious and spreads swiftly among the communities with many researchers categorizing it as an air-borne pathogen which can enter a person's respiratory system simply on inhaling the infected air.2
King Edward Medical University
2020-10-28 10:40:14
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/4158
Annals of King Edward Medical University; Vol. 26 No. 3 (2020): AKEMU
eng
Copyright (c) 2020
oai:ojs2.localhost:article/4391
2021-03-17T11:39:06Z
annals:ED
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"210317 2021 eng "
2079-0694
2079-7192
10.21649/akemu.v27i1.4391
doi
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COVID-19 Vaccines
Afzal, Saira
Nasir, Mehreen
The fateful year of 2020 will go down the annals of history as the year during which global pandemic COVID-19 spread across the globe causing widespread confusion, panic, chaos and mayhem. As this respiratory disease-which primarily affects lungs and, in case of complications, many other organs of body-spread rapidly across the world, scientists and biologists began their hectic efforts to develop proto-cols for treatment and prevention of this disease. As is the case with all other viral diseases, the best tool that can save humanity from this ongoing pandemic is a potent vaccine. Realizing the urgency of the matter at hand and the enormous potential of revenue generation, a number of companies started this race of developing vaccine at an accelerated rate. From securing funding from research to gaining approval of regulatory authorities after clinical trials, it norm-ally takes a long time to develop a vaccine. However, owing to the great global demand and willingness of governments to provide generous funding, vaccines for COVID-19 have been developed at a much faster pace than ever before.
King Edward Medical University
2021-02-04 09:29:19
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/4391
Annals of King Edward Medical University; Vol. 27 No. 1 (2021): AKEMU
eng
Copyright (c) 2021
oai:ojs2.localhost:article/4440
2021-07-07T09:49:51Z
annals:ED
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"210409 2021 eng "
2079-0694
2079-7192
10.21649/akemu.v27i2.4440
doi
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A Hospital-Acquired Infection: A Public Health Problem
Prof. Saira Afzal
King Edward Medical University, Lahore
Khunsa Junaid
King Edward Medical University, Lahore
Faiza Aziz
King Edward Medical University, Lahore
hospital-acquired infection, also known as nosocomial infection or hospital associated-infection, is defined as any infection that develops within 48 hours after hospitalization. It may develop either from out-patient clinic, indoor hospital setting, nursing homes, diagnostic laboratories or any other clinical settings. It may also occur either in epidemic or endemic form but endemic hospital-acquired infections are most common. According to an estimation, more than 1.4 million patients get affected globally by hospital-associated infections both in developed and underdeveloped countries. At any times, the prevalence of nosocomial infections differs between 3.5 to 12% in developed countries. However, the prevalence of nosocomial infections in developing countries is 5.7% to 19.1% and the average prevalence is significantly higher in contrast to developed countries.
In accordance with a recent multicenter study conducted in Europe, the prevalence of hospital-associated infection is 51% in intensive care unit patients and the cumulative incidence is 17 episodes per 1000 patient-days among high-risk adults in developed countries. Though, in developing countries, the prevalence of nosocomial infections in intensive care unit patients is significantly greater (88.9%) with 42.7 episodes per 1000 patient-days that are nearly three times greater in contrast to high-income countries.
King Edward Medical University
2021-03-02 13:11:01
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/4440
Annals of King Edward Medical University; Vol. 27 No. 2 (2021): AKEMU
eng
Copyright (c) 2021 Annals of King Edward Medical University
oai:ojs2.localhost:article/4613
2021-11-04T05:18:13Z
annals:ED
driver
nmb a2200000Iu 4500
"211104 2021 eng "
2079-0694
2079-7192
10.21649/akemu.v27iSpecial Issue (Jul-Sep).4613
doi
dc
Antibiotics Resistance and Stewardship
Since Alexander Fleming has discovered antibiotics (penicillin) in 1928 a new era of treatment of many diseases has started. Treatment of lots of diseases takes a new step, which in turn improves morbidity as well as mortality. In old ages, a human had to face many epidemics and pandemics of infectious diseases like typhus, cholera, HIV/AIDS, small-pox, measles, Spanish flu, tuberculosis, etc.
King Edward Medical University
2021-08-25 00:00:00
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/4613
Annals of King Edward Medical University; Vol. 27 No. Special Issue (Jul-Sep) (2021): AKEMU
eng
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oai:ojs2.localhost:article/4817
2021-12-03T06:23:30Z
annals:ED
driver
nmb a2200000Iu 4500
"211203 2021 eng "
2079-0694
2079-7192
10.21649/akemu.v13i1.4817
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Current Status of Organ Transplantation (Cultural, Ethical, Psychological & Trading Dimensions)
AKRAM, M
Organ transplantation has become an effective means of restoring health and saving lives. Demand for transplantation is increasing, but there is concomitant deficit of organs from the traditional cadaveric pool. The results of living donor specially kidney transplantation is better than those of cadaveric transplantation.
King Edward Medical University
2010-02-27 00:00:00
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/4817
Annals of King Edward Medical University; Vol. 13 No. 1 (2007)
eng
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oai:ojs2.localhost:article/4825
2022-04-23T11:39:47Z
annals:ED
driver
nmb a2200000Iu 4500
"220202 2022 eng "
2079-0694
2079-7192
10.21649/akemu.v27i4.4825
doi
dc
Misinformation and Misconceptions About COVID-19 Vaccination in Pakistan: The Need to Control Infodemic
A unprecedented global public health and economic disaster have emerged from the spread of SARS-CoV-2, the COVID-19 causal agent. The World Health Organization (WHO) has labeled the outbreak a pandemic on March 11, 2020. The spread of this infectious disease has created a humanitarian and economic crisis throughout the world. Vaccination has been shown to be effective in preventing such pandemics 1. To prevent the spread of COVID-19, researchers developed COVID-19 vaccines in record time with the assistance of pharmaceutical industries. By December 2020, many candidate vaccines had demonstrated safety and efficacy in phase III trials,
with efficacy rates as high as 95%. The public's acceptance of vaccination is critical to the success of any immunization program2. Public suspicion about vaccines reduces their acceptance rate. It is well known that conspiracy theories and religious beliefs are linked to vaccine hesitation. During the 2009 pandemic, studies revealed low vaccine acceptance rates (17–67%)2,3,4. Contrary to developed countries, developing countries' vaccination refusal and hesitancy is more common, as preventable diseases like polio persist5. Vaccine hesitancy is one of the top ten global health threats in 2019, according to the World Health Organization (WHO)6,7.
King Edward Medical University
2021-12-06 15:01:32
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/4825
Annals of King Edward Medical University; Vol. 27 No. 4 (2021): AKEMU
eng
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oai:ojs2.localhost:article/4989
2023-10-31T06:58:26Z
annals:ED
driver
nmb a2200000Iu 4500
"231031 2023 eng "
2079-0694
2079-7192
10.21649/akemu.v28i1.4989
doi
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System within System: World Health Organization Building Blocks and Public-Private Partnership in Healthcare sector of Pakistan
Afzal , Saira
Arshad, Amber
"Health systems" (also called "health care systems" and "healthcare systems") are organizations that provide health care services to target populations by integrating
people, institutions, and resources. A health care system is nothing more than a collection of interdependent pieces and their relationships. People, organizations,
and behaviors whose primary goal is to promote, restore, or maintain health are part of a "health system." This system relies on the interdependence of its various
components. Numerous components that make up a health care system, like patients, families, communities, health departments, health care professionals, and
organizations responsible for funding health care are just a few examples. The duties and functions of each component are intertwined. WHO proposes supporting
and building a health care system based on the following framework, the Six Health System Building Blocks? It is possible to produce more equitable and long-lasting gains in health services and outcomes by enhancing the six components of the health system and 1 managing their interrelationships .
King Edward Medical University
2022-03-01 00:00:00
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/4989
Annals of King Edward Medical University; Vol. 28 No. 1 (2022): AKEMU
eng
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oai:ojs2.localhost:article/5079
2023-01-20T04:21:40Z
annals:ED
driver
nmb a2200000Iu 4500
"220803 2022 eng "
2079-0694
2079-7192
10.21649/akemu.v28i2.5079
doi
dc
The Sustainable Development Goals: A Way Forward for Pakistan
Afzal, Saira
Junaid, Khunsa
The Sustainable Development Goals (SDGs) were adopted globally in September 2015 as a set of universal and transformative goals and targets to be implemented by 2030. The 17 development goals include 169 concise, global, and applicable to all countries; developing and developed—the SDGs address three interconnected dimensions: social, economic, and environmental. Health is interconnected with social, economic, and developmental/environmental determinants. 1 The SDGs include 244 indicators related to the five Ps: People, Planet, Prosperity, Peace, and Partnership. The SDGs are more comprehensive and people-centered than the MDGs, with the commitment to & quot; leave no one behind, & quot; i.e., reach vulnerable populations. Among the SDGs, Goal 3 directs countries to & quot; Ensure healthy lives and promote well-being for all ages & quot;; SDG3 includes 13 targets, four of which address implementation. 2 Thirteen SDGs are related to health and well-being and may be informed by less than 169 indicators. SDG 3 addresses chronic diseases, tobacco, alcohol, narcotics use, mental health, road safety, and pollution. However, health is not solely a component of Goal 3. Throughout the majority of the SDGs, some targets have a direct or indirect effect on health gains and thus require special consideration when developing strategies, policies, and plans to achieve the health goal and monitor progress. 2,3
King Edward Medical University
2022-06-01 00:00:00
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/5079
Annals of King Edward Medical University; Vol. 28 No. 2 (2022): AKEMU
eng
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oai:ojs2.localhost:article/5079
2022-11-23T03:20:18Z
annals:ED
oai:ojs2.localhost:article/5179
2022-11-24T06:35:53Z
annals:ED
oai:ojs2.localhost:article/5179
2023-01-20T04:20:13Z
annals:ED
driver
nmb a2200000Iu 4500
"221021 2022 eng "
2079-0694
2079-7192
10.21649/akemu.v28iSpecial Issue (Jul, Sep).5179
doi
dc
Critical Appraisal of Published Research Papers: A Reinforcing Tool for Evidence-Based Medicine
Critical appraisal ensures that an article is completely evaluated, identifies the study's strengths and weak-nesses, and helps clinicians utilize appropriate inter-ventions. The method of critical appraisal may be very time consuming and demands a careful reading of the whole article 1,2 especially methodology and statistical analysis. The Global Burden of Disease Study (GBD) is now the most important global observational epidemiological research conducted. It describes global, national, and regional mortality and morbidity from key diseases, injuries, and risk factors.
King Edward Medical University
2022-09-01 00:00:00
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/5179
Annals of King Edward Medical University; Vol. 28 No. Special Issue (Jul, Sep) (2022): AKEMU
eng
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oai:ojs2.localhost:article/5253
2023-02-25T04:04:22Z
annals:ED
driver
nmb a2200000Iu 4500
"230225 2023 eng "
2079-0694
2079-7192
10.21649/akemu.v28i4.5253
doi
dc
Children of Disaster: Helping Children Recover from the Trauma of Pakistan Floods
Pakistan is amongst the world's most vulnerable countries to natural disasters and climate change, but the country was not prepared for a disaster of such scale- the unprecedented floods of 2022. The floods submerged nearly a third of the country, affected more than 33 million people and have taken more than 1700 lives, approximately 600 of them children.1 Government declared 72 out of 160 districts to be disaster zones and earlier estimates put the cost of destruction at more than $10 bn.1 The situation is still evolving, with flood waters stagnant in many areas, and more than 8 million displaced people now facing a health crisis. The disaster after the disaster is looming.
King Edward Medical University
2022-12-01 00:00:00
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/5253
Annals of King Edward Medical University; Vol. 28 No. 4 (2022): AKEMU
eng
Copyright (c) 2023
oai:ojs2.localhost:article/5335
2023-07-04T07:54:32Z
annals:ED
driver
nmb a2200000Iu 4500
"230704 2023 eng "
2079-0694
2079-7192
10.21649/akemu.v29i1.5335
doi
dc
Role of Non-Governmental Organizations as Developmental Partners in Health Care
Afzal, Saira
Nasir, Mehreen
NGOs, or non-governmental organizations, are a kind of non-profit private sector provider of the health system. Global health issues include health inequity. Inequity exists in healthcare, vaccinations, and research for developing nations. There are disparities
in healthcare access even between nations. NGOs typically focus on underprivileged groups or specific diseases that the government sector frequently ignores. But maintaining financial stability is a significant problem for NGOs. Donors account for the majority of an NGO's funding. The availability of health care can be expanded through NGOs. By 2030, the World Health Organization hopes to have
universal health coverage.
King Edward Medical University
2023-03-20 00:00:00
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/5335
Annals of King Edward Medical University; Vol. 29 No. 1 (2023): AKEMU
eng
Copyright (c) 2023
oai:ojs2.localhost:article/5423
2023-11-03T09:40:17Z
annals:ED
driver
nmb a2200000Iu 4500
"230927 2023 eng "
2079-0694
2079-7192
10.21649/akemu.v29i2.5423
doi
dc
The Invisible Killer: Investigating the Lack of Research on Smog in Pakistan
Afzal, Saira
Smog, a combination of smoke and fog, is a major public health hazard in Pakistan, although it has gotten little attention and research. Despite the negative impacts of smog on the population, there is a dearth of studies and data on the subject, making it difficult for politicians and public health professionals to properly comprehend the issue and design effective solutions. Smog hurts public health
in Pakistan, with research attributing it to an increase in respiratory infections and mortality. However, a paucity of study makes it difficult to completely comprehend the scope of the problem and its impact on the community. The purpose of this article is to highlight the critical need for additional study and data collection on the issue of smog in Pakistan and its effects on public health. We also emphasize the need for the government to prioritize this issue and take steps to alleviate the consequences of smog on the population.
King Edward Medical University
2023-06-15 00:00:00
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/5423
Annals of King Edward Medical University; Vol. 29 No. 2 (2023): AKEMU
eng
Copyright (c) 2023
oai:ojs2.localhost:article/5546
2024-01-16T06:54:38Z
annals:ED
driver
nmb a2200000Iu 4500
"240109 2024 eng "
2079-0694
2079-7192
10.21649/akemu.v29iSpl3.5546
doi
dc
Empowering Women in Healthcare: Breaking Barriers, Building Leaders
Afzal, Saira
Khan, Ramsha Mushtaq
In Pakistan, women comprise over 70% of the health workforce yet confront multifaceted challenges limiting their advancement and well-being.1 Pakistan ranks the second lowest in the world for women’s labor force participation, and deep-rooted gender biases permeate the workplace.2 Concrete action is imperative to transform the status quo and empower women across health system levels.
King Edward Medical University
2023-09-15 00:00:00
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/5546
Annals of King Edward Medical University; Vol. 29 No. Spl3 (2023): AKEMU - Special Issue 3 (Jul, Sep)
eng
Copyright (c) 2023
oai:ojs2.localhost:article/5602
2024-03-14T11:47:51Z
annals:ED
driver
nmb a2200000Iu 4500
"231231 2023 eng "
2079-0694
2079-7192
10.21649/akemu.v23i4.5602
doi
dc
Primary Healthcare System Reforms in Pakistan to Achieve Universal Health Coverage
Afzal, Saira
Chief Editor, Annals of KEMU/ Chairperson, Department of Community Medicine, KEMU
Junaid, Khunsa
Assistant Professor, Department of Community Medicine, Akhtar Saeed Medical & Dental College, Lahore
Primary health care (PHC) is crucial for a country's health system, serving as the first point of contact for patients and providing clinical management at a local level. Primary health care (PHC) aims to achieve physical, psychological, and social well-being, facilitating fair interaction with the patient.1 It is the cornerstone of global health systems and requires efficient resource allocation, sustainable financing, and a strong primary healthcare system. Primary health care (PHC) principles include universal access, equitable care provision, prevention, health promotion, and community participation. Balancing social and medical aspects is essential in PHC service provision to meet the needs of its users.2 Primary health care doctors in the UK, Ireland, Australia, and New Zealand provide first-contact care, saving time and money by preventing patients from going to the hospital. This model is increasingly being adopted in countries like Qatar, Saudi Arabia, and the United Arab Emirates.3 Qatar has a government-led Primary Care Health Cooperation, Saudi Arabia invests in primary care, and United Arab Emirates recognizes the importance of preventive medicine for a healthy life. Strengthening primary health care and achieving universal health coverage are crucial global health policy initiatives, aiming to provide accessible, affordable, and high-quality health services to all individuals.4
King Edward Medical University
2023-12-15 00:00:00
application/pdf
https://annalskemu.org/journal/index.php/annals/article/view/5602
Annals of King Edward Medical University; Vol. 29 No. 4 (2023): AKEMU
eng
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