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Professor, Consultant Pathologist, American Board Certified Pathologist, Fellow College of American Pathologists. Areas of interest Fine Needle Aspiration Cytology, Cytology, Cancer, Ethics, Islam, Humanity

Cavernous Hemangioma of the Scrotum

Nosheen Nabi, Saadia Tahir, Ashok Kumar Tanwani and Ahmareen Khalid

Pakistan Institute of Medical Sciences Islamabad, Pakistan


Abstract: Scrotal hemangiomas are rare benign neoplasms of the scrotum. Its diagnosis is often missed on ultrasonography. As the incidence of malignant neoplasm of testis is more than the benign neoplasms so radical orchidectomy is usually performed as a management because of suspicion of malignancy and the diagnosis is finally made on the histopathological examination. Reporting these cases emphasise in keeping it in the differentials of testicular neoplasms so that testis are preserved by not performing the orhidectomy thus preventing hypogonadism and infertility.

Key Words: Scrotum, testicular tumors, hemangiomas.

History of Science & Medicine: Brief Introduction of Az-Zaharawi’s Contributions in Science

Compiled by Iqra Butt

Department of Pathology, Pakistan Institute of Medical Sciences (PIMS), Islamabad



History is full of description of great Muslim scientists and great patrons of sciences and research; however there is serious lack of awareness that keeps world not acknowledging their efforts and contributions to modern day sciences. Acknowledgment of their contributions will help nullifying the deliberate defamation of Islam and Muslims.

One of the great Muslim Scientists is Abū al-Qāsim Khalaf ibn al-‘Abbās al-Zahrāwī (936–1013), (Arabic: أبو القاسم خلف بن العباس الزهراوي‎‎), popularly known as Al-Zahrawi (الزهراوي), Latinized as Abulcasis (from Arabic Abū al-Qāsim), was an Arab Muslim physician and surgeon who lived in Al-Andalus. He is considered the greatest medieval surgeon to have appeared from the Islamic World, and has been described as the father of surgery. His greatest contribution to medicine is the Kitab at-Tasrif, a thirty-volume encyclopedia of medical practices.[2] His pioneering contributions to the field of surgical procedures and instruments had an enormous impact in the East and West well into the modern period, where some of his discoveries are still applied in medicine to this day.

Al-Zahrawi was born in the city Az-Zahra, northwest of Córdoba, Andalusia. The nisba (attributive title), Al-Ansari, suggests origin from the Medinian tribe of Al-Ansar. He lived most of his life in Córdoba. It is also where he studied, taught and practiced medicine and surgery until shortly before his death in about 1013, two years after the sacking of Az-Zahra. A few details remain regarding his life, aside from his published work, due to the destruction of Az-Zahra during later Castillian-Andalusian conflicts. His name first appears in the writings of Abu Muhammad bin Hazm (993 – 1064), who listed him among the greatest physicians of Moorish Spain. But we have the first detailed biography of al-Zahrawī from al-Ḥumaydī’s Jadhwat al-Muqtabis (On Andalusian Savants), completed six decades after al-Zahrawi’s death.

Editorial: Quackery is still rampant!

Anwar Ul Haque

Azad Jammu & Kashmir Medical College, Muzaffarabad, Azad Kashmir


Quackery is an unscientific, unproven and non established method of patient management. It may or may not have ulterior motives! If there are ulterior motives then it also constitutes a fraud! Quackery had been in practice all over the world since time immemorial. First documented evidence of effective check on Quackery is by Abbasi Khalifa Walid who is also known to have built first modern hospital about 1300 years back. After death of one patient apparently from maltreatment he constituted a medical board composed of competent well reputed physicians of that era and personally headed the board. After through examination the board would issue medical license without which no one was allowed to practice medicine in the vast Muslim land in which sun never set! Those were the most glittering and glorious centuries of history when the West was in dark ages! (Please see “History of Science: History of Medical Licensing” in this issue of IJP.

Chronic Bacterial Prostatitis: Current Microbiological Spectrum and Sensitivity Pattern

1Mohsin Shakil and 2Mumtaz Ahmad Khan

1Urologist, Abbas Institute of Medical Sciences, Muzaffarabad

2Microbiologist, Abbas Institute of Medical Sciences, Muzaffarabad


Introduction: The incidence of Prostatitis is increasing considerably worldwide. Clinical diagnosis of Prostatitis is mostly based on signs and symptoms. Laboratory diagnosis relay on microscopy culture of expressed prostatic secretion (EPS). Studies regarding bacterial prostatitis are limited in Pakistan. This study determines microbiological profiles and resistance patterns of infecting organisms in prostatitis in a general hospital.

Objective: To determine the bacterial agents and their antibiotic sensitivity pattern from EPS samples of patients presenting symptoms of chronic prostatitis.

Materials and Methods: The cross-sectional study was carried out in the Microbiology department, Abbas Institute of Medical Sciences, Muzaffarabad from January 2015 to March 2016. A total of 298 samples of prostatic secretions from patients suspected with prostatitis were cultured by a semi-quantitative method. The isolated bacteria were identified by colony morphology, Gram’s staining, motility and biochemical tests. Antibiotic sensitivity was done according to the CLSI guidelines 2015 by disc diffusion method. WHONET Version 5.6 was used for compilation and calculation of data.

Evaluation of Surveillance System of Acute Flaccid Paralysis in Azad Jammu & Kashmir: 2011 to 2015

1Dr. Syed Nadeem-ur-Rehman, 2 Dr. Uzma  Hafeez and 3Dr. Tamkeen Ghafoor

1Provincial Technical Officer FELTP-Pak, Provincial Disease Surveillance & Response Unit, Directorate General Health, Muzaffarabad, AJ&K, 2Assistant Professor, Department of Community Medicine, AJK Medical College, Muzaffarabad, AJ&K, 3Faculty FELTP-Pakistan, National Institute of Health, Islamabad



Background: The last case of wild polio virus transmission occurred in AJ&K in October 2000.This study was conducted to describe the characteristics of patients reported with acute flaccid paralysis and to evaluate the performance of the surveillance system during 2011-2015 using indicators recommended by the World Health Organization.

Methods: This retrospective study was conducted at directorate of Expanded Program on Immunization AJ&K during May 2016. Records were reviewed of children aged younger than 15 years with acute flaccid paralysis. Data analysis was performed using Microsoft Excel 2007.

Clinical Manifestations of Dengue in a Recent Outbreak in Muzaffarabad

*Abdul Khalid Awan, Imtiaz Ahmed, Ashfaque Ahmed, Khusheed Lone, Robina Rafique, Manzoor Haidri and Muhammad Riaz

*Assistant Professor Medicine, Azad Jammu & Kashmir Medical College, Muzaffarabad



Objective: Assessment of clinical manifestations of dengue fever in area of Muzaffarabad during first ever outbreak of dengue fever.

Design: Prospective, cross sectional

Material & Methods: Patients who were diagnosed as suffering from dengue fever were included in the study. Clinical manifestations of all patients were recorded in study Performa designed for the study. All routine laboratory investigations including Blood complete examination including platelet counts, total leukocyte count and hematocrit, Blood Sugar, Urea, Creatinine, Serum Electrolytes, LFTS and Urine examination were performed in all patients. The diagnosis of dengue fever was confirmed with serological tests (NS1 Antigen or IgM/IgG Anti-dengue virus antibody titers).

Results: In most patients, typical diagnostic clinical findings on physical examination were high fever (1020 to 1040 F), suffused conjunctivae (45%) and facial flushing (82%) including external ears. The other prominent feature was diffuse erythematous rash (18%) over extremities and truck. The early features at presentation were facial flushing and suffused conjunctivae while rash appeared after 3-4 days of febrile illness in most patients. There was only small percentage (5%) of patients with insignificant cervical lymphadenopathy.

Comparison of Ultrasound Therapy and Local Steroid Injection for Treatment of Carpal Tunnel Syndrome using Electrodiagnostics

Omer Jamshed Khan1, Naveed Mumtaz2 and Wafa Munir Ansari3

1 Combined Military Hospital, Muzaffarabad, 2 Combined Military Hospital, Lahore, 3 Azad Jammu & Kashmir Medical College, Muzaffarabad


Introduction: To determine the efficacy of ultrasound therapy as compared to intra lesional steroid injection in Carpal Tunnel Syndrome (CTS) using visual analogue scale (VAS) and electrodiagnostic parameters.

Study Design: Randomized Controlled Trial

Duration and Setting: 4months’ study at carried out at Armed Forces Institute of Rehabilitation Medicine.

Methods: Patients diagnosed with CTS on Nerve Conduction Studies (NCS) /Electromyography (EMG) were divided into two groups, A and B. Group A received ultrasound therapy for 5 days a week for a 4-week period. Group B received local steroid injections. Major outcome measures were VAS scores and electrodiagnostic parameters which were checked after before and after 4 weeks of treatment for both groups.

Adult Burkitt Lymphoma: An Unusual Presentation

Shahzad Ali Jiskani, Asfa Zawar and Lubna Naseem

Department of Pathology, Pakistan Institute of Medical Sciences, Islamabad

Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad


Abstract: Burkitt lymphoma is a disease of young population; especially children. It rarely occurs and presented in elderly group. World Health Organization (WHO) divided Burkitt lymphoma in endemic, sporadic and immunodeficiency – associated. The non–endemic variant occurs in children with abdominal involvement. We report a sporadic case presented at the age of 61 years old male with irregular thickening of parietal peritoneum and omentum without involving any lymph nodes.