Journal of Islamabad Medical & Dental College <p>The Journal of Islamabad Medical &amp; Dental College (JIMDC) is a new quarterly Journal of Islamabad Medical &amp; Dental College. <strong>Its is recognized By Pakistan Medical and Dental Council (PMDC</strong>) <strong>and Higher Education Commission of Pakistan</strong>. It includes original research papers, reviews, case reports<strong>,</strong> and short communication related to health, medicine and dentistry. Submitted manuscripts must be original, written in English, and will be accepted for publication with the understanding that it has not been submitted simultaneously to any other journal, not published or under consideration elsewhere and has not been published previously. The manuscripts will be reviewed through double-blind peer review process.&nbsp;</p> Islamabad Medical and Dental College en-US Journal of Islamabad Medical & Dental College 2227-3875 <p><img style="border-width: 0;" src="" alt="Creative Commons License"><br>This is an Open Access article distributed under the terms of the Creative Commons Attribution-Non Commercial License (<a href=""></a>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</p> Ibn-e-Sina’s “Canon of Medicine” <p>Perhaps the most famous philosopher-scientist of a thousand years hence was Ibn-e-Sina (Avicenna) who was born near Bukhara in 980 AD. While his writings on astronomy, Islamic theology, mathematics as well as poetry gained fame, it is for his contribution in medicine that he is remembered.</p> Syed Irfan Ahmad Copyright (c) 2020 Journal of Islamabad Medical & Dental College 2020-12-31 2020-12-31 9 4 233 234 10.35787/jimdc.v9i4.629 Symptom Analysis of Confirmed Covid-19 Patients Managed at Allied Hospitals of Rawalpindi Medical University, Pakistan <p><strong>Introduction</strong></p> <p>Coronavirus can cause respiratory disease ranging from mild upper respiratory tract illness to severe pneumonia, severe acute respiratory distress syndrome, and death. The purpose of this research was to study the symptoms of confirmed Coronavirus disease (COVID-19) cases and their relationship with gender and age groups.</p> <p><strong>Materials and Methods</strong></p> <p>This observational cross-sectional study was conducted at Rawalpindi Institute of Urology and Transplantation (RIUT) that is the COVID-19 management center of Rawalpindi Medical University, Rawalpindi during the month of March 2020. Consecutive sampling methodology was used, and all real-time polymerase chain reaction (RT-PCR) confirmed patients of COVID-19 were included. Data regarding age, gender, and symptoms with onset was recorded and analyzed.</p> <p><strong>&nbsp;Results</strong></p> <p>Thirty-five patients, 22 (62.9%) males, and 13 (37.1%) females were included. Seven (20%) patients were ≥60 years old, and 12 (34.8%) ≥40 years old. 21 (60%) were symptomatic and the rest of them were asymptomatic. The mean duration of symptoms was 2.8±1.1 days. Fever (13, 61.9%), persistent cough (12, 57.1%), sputum (6, 28.6%), shortness of breath (4, 19%), anorexia (3, 14.3%), fatigue (3, 14.3%), myalgia (1, 4.8%), were presenting symptoms. Cough, anorexia, and fatigue were significantly more frequent in the patients ≥40 of age. Anorexia and fatigue were common in the age groups ≥40 and ≥60 years. Myalgia was significantly frequent in patients aged ≥60 years.</p> <p><strong>Conclusion</strong></p> <p>Fever, persistent cough and shortness of breath are commonest symptoms of COVID 19 patients. COVID-19 can be asymptomatic in many cases.</p> Javeria Malik Muhammad Khurram Arsalan Manzoor Mughal Noman Ahmed Chaudhary Qaiser Aziz Muhammad Mujeeb Khan Muhammad Shahzad Manzoor Copyright (c) 2020 Journal of Islamabad Medical & Dental College 9 4 235 241 10.35787/jimdc.v9i4.607 Histomorphometric Variations of the Placenta in Normal and Hypertensive Pregnancies <p><strong>Background</strong>: Pregnancy-induced hypertension is a leading cause of deleterious changes in the placenta resulting in decreased blood supply towards the placenta. The objective of the current study was to analyze the histo-morphometric variations in the placenta of women with or without known pregnancy-induced hypertension.</p> <p><strong>Methods</strong>: Cross-sectional study was carried out in the Gynecology and obstetrics section of Nazeer Hussain Medical Complex, Hyderabad in collaboration with Isra University, Hyderabad from March 2019 to August 2019. A total of <strong>100 </strong>placentae were selected and divided into two groups (control and study groups) based on the presence or absence of hypertension in pregnancy. The observations of the control group placenta were compared with the study group placentas. All placentae were observed for morphometric and histological changes. SPSS ver. 22 was used to analyze the collected data.</p> <p><strong>Results</strong>: There was an increase in the mean weight of placentae among the control group as compared to the group having known hypertension cases and the difference was statistically significant (p-value &lt;0.05). The fetoplacental weight ratio was increased among the hypertension group when compared to the statistically insignificant control group (p-value &lt;0.05). Various gross (infarction, calcification) and histological changes (hyalinised villi, intervillous hemorrhage, decreased villous vascularity) were observed in the placentae of the hypertensive group as compared to the normal group.</p> <p><strong>Conclusion: </strong>The findings of the study concluded that Preeclampsia/PIH poses harmful and serious histo-morphometric variations in the placental tissues that affect fetal outcome.</p> Rizwan Ali Talpur Samia Siddiqui Sehar Khowaja Naila Noor Muhammad Saqib Baloch Mansoor Mukhtar Qazi Copyright (c) 2020 Journal of Islamabad Medical & Dental College 2020-12-31 2020-12-31 9 4 242 248 10.35787/jimdc.v9i4.540 Nephroprotective Effects of L-Arginine against Chemotherapy Induced Acute Kidney Injury in Wistar Rats <p>Background: L-arginine is a nitric oxide precursor that decreases oxidative stress and regulates the blood flow by modifying the tone of vessels and also prevent ischemic renal tissue injuries. The objective of this study was to evaluate the protective role of L-arginine in cisplatin-induced acute renal injury through assessment of renal, oxidative stress, and inflammatory markers in albino Wistar rats.<br>Material and Methods: A quasi-experimental study was conducted at the Department of Physiology and Postgraduate Research Laboratory, Isra University, Hyderabad, Pakistan from April to September 2019. Thirty male Albino Wistar rats were selected through non-random purposive sampling and divided equally into three different groups: Group A (control group), Group B (cisplatin group), and Group C (cisplatin plus arginine group). Blood samples from rats were collected through cardiac puncture, followed by renal histopathological analysis under light microscope. The severity of tissue damage was observed using a graded scale from ‘0’ (no damage) to III (severe damage). Data was analyzed using SPSS version 24.0., with one-way ANOVA and Post hoc Tukey analysis used for comparison of different variables.<br>Results: There was a statistically significant decline in the bodyweight and rise in absolute kidney weight of group B in comparison with the other two groups (P &lt;.05). Moreover, a significant rise in serum renal markers was observed in group B (P &lt;.05), with a statistically significant decline in these markers in group C compared with group B (P &lt;.05). Marked histological alterations (glomerular and tubular damage) were observed in renal tissues of group B as compared to group C.<br>Conclusions: The present study concludes that L-arginine exerts anti-oxidative, anti-inflammatory, and nephroprotective effects against renal tissue damage caused by Cisplatin.</p> Kumayl Abbas Meghji Tariq Feroz Memon Imtiaz Ahmed Sehar Gul Memon Naila Noor Ali Abbas Copyright (c) 2020 Journal of Islamabad Medical & Dental College 2020-12-31 2020-12-31 9 4 249 255 10.35787/jimdc.v9i4.535 Psychological impact of COVID-19 pandemic on mental health of general population of Pakistan <p><strong>Background:</strong> Most of the ongoing research on COVID-19 is related to development of an effective vaccine and treatment for this illness, while psychological impact on mental health remains underexplored. The objective of this study was to determine the psychological impact of COVID-19 pandemic on the mental health of the general population of Islamabad.<br><strong>Material and Methods:</strong> This cross-sectional study was conducted among the general population of Islamabad, during a period of two months from 15th May to 15th July 2020. A total of 278 participants were given a structured questionnaire based on Hospital Anxiety and Depression Scale (HADS) scoring system to calculate depression and anxiety. The possible scores for depression and anxiety ranged 0-21. A cut off value of 8 and above was used to identify anxiety and depression with higher scores indicating increased severity.<br><strong>Results:</strong> The mean age of the participants was 33.42 ± 9.67 years and 148 (53.2%) were males. Among these, 238 (85.6%) were residents of urban area, and 167 (60.1%) were married. Most of the participants were graduate 102 (36.7%). Thirty-six (12.9%) participants had a known patient of COVID-19 in their family or friends. Most of the participants 196 (70.5%) had no comorbidity. The mean anxiety score was noted to be 6.47 ± 5.51 and mean depression score was 6.65 ± 4.17. Presence of any comorbidity showed a highly significant association with anxiety and depression score (P &lt; .01).<br><strong>Conclusions:</strong> There was no significant psychological impact of COVID-19 on mental health of the population of Islamabad. However, people with comorbidities showed a significantly raised anxiety and depression status on the HADS score.</p> Muhammad Afzal Hameed Mumtaz Durrani Muhammad Imran Sohail Copyright (c) 2020 Journal of Islamabad Medical & Dental College 2020-12-31 2020-12-31 9 4 256 261 10.35787/jimdc.v9i4.592 Comparison of Quality of Life in Breast Cancer Survivors with Lymphoma Survivors <p><strong>Background:</strong> Breast cancer diagnosis and its subsequent treatment, especially surgical removal of the breast(s) cause changes in physical appearance that can be devastating to the Quality of Life (QOL) of cancer survivors. The objective of this study was to assess the effect of surgical intervention on the QOL of breast cancer survivors by comparing it with QOL of Lymphoma survivors.<br><strong>Material and Methods:</strong> This was a cross-sectional study, conducted in the Departments of General Surgery and Oncology at Pakistan Institute of Medical Sciences (PIMS) Islamabad, Pakistan from 1st June to 31st December, 2019. Six months’ post treatment patients of breast cancer (n=166) and lymphoma (n=50) were included. A standardized questionnaire was used to assess the Quality of Life in Cancer Survivors (QOL-CSV). Chi square and independent t-test were applied to determine the association of QOL among lymphoma and breast cancer survivors. Linear regression model was applied to determine the confounding variables.<br><strong>Results:</strong> All participants responded moderately in reporting overall quality of life in lymphoma survivors (LS) as compared to Breast cancer survivors (BCS) group (100% vs 86.7%; P = .007). Physical wellbeing parameters revealed a better mean score of 75.86 ±10.53 for LS group than the BCS group (P &lt; .001). Psychological wellbeing mean score was similar for both groups (P = .46). Distress associated with illness and treatment was dealt better by LS than BCS group (P &lt; .001), whereas spiritual wellbeing was markedly better in BCS group (P &lt; .001). Fear of recurrence and spread was poor amongst the BCS than LS, while the LS group performed worse in social factors (mean value of 26.88±6.67) (P &lt; .001).<br><strong>Conclusions:</strong> Both lymphoma and breast cancer negatively affect the quality of life of the patients, especially the psychological, social and spiritual wellbeing. However, surgical intervention in breast cancer patients led to considerable worsening of the quality of life with respect to physical and social wellbeing and increased distress of illness and fear factor.</p> Mumtaz Ahmad Khan Shaista Zaffar Namrah Mahmood Copyright (c) 2020 Journal of Islamabad Medical & Dental College 2020-12-31 2020-12-31 9 4 262 268 10.35787/jimdc.v9i4.587 Nosocomial Blood Stream Infections in Pediatric Intensive Care Unit of Fauji Foundation Hospital, Rawalpindi Pakistan <p><strong>Background:</strong> Nosocomial blood stream infections with bacterial organisms are one of the most common problems faced by health care professionals in admitted patients, since these infections complicate the treatment and affect the outcome. The objective of this study was to determine the frequency of most common bacterial organisms in nosocomial blood stream infections in children admitted in Pediatric Intensive Care Unit of a tertiary care hospital at Rawalpindi, Pakistan.<br><strong>Material and Methods:</strong> This cross-sectional study was carried out from 6th July 2017 to 6th January 2018 in the Pediatric Intensive Care Unit (ICU), Fauji Foundation Hospital, Rawalpindi, a tertiary care hospital. A total of 385 patients, aged 14 days to 12 years, admitted in the ICU were monitored from the time of admission till their blood culture reports were positive for bacterial growth along with signs of clinical sepsis Blood samples for culture were collected aseptically and the bottles were incubated for 7 days. Patients were monitored from time the blood culture yielded growth of bacterial pathogens till final blood culture report with antibiotics sensitivity against the pathogen became available. Data was analyzed using SPSS Version 20. Effect modifiers like age, duration of admission and gender were controlled by stratification and chi-square test was applied for comparison with P-value less than .05 considered as statistically significant.<br><strong>Results:</strong> Pseudomonas aeruginosa and Salmonella typhi were the most common bacterial organisms (n=83; 21.6% each) causing nosocomial blood stream infection, followed by Escherichia coli (n=77; 20%) and Klebsiella (n=67; 17.4%), respectively. Effect modifier, like gender (stratified and compared by Chi-square test) had a statistically significant relationship with frequency of most common bacterial organisms in nosocomial blood stream infections (P=.001). However, effect modifiers like age and duration (hours) of admission to PICU had a non-significant relationship with frequency of bacterial organisms in nosocomial blood stream infections (P&gt;.05).<br><strong>Conclusions:</strong> There is a high frequency of common bacterial organisms in nosocomial blood stream infections in children with predominance of gram-negative bacteria including Pseudomonas aeruginosa and Salmonella typhi. Thus, early initiation of appropriate antibiotic therapy can help in decreasing mortality, significantly in hospitalized patients.</p> Iqra Ayaz Hira Hameed Wajeeha Amber Talal Zafar Copyright (c) 2020 Journal of Islamabad Medical & Dental College 2020-12-31 2020-12-31 9 4 269 274 10.35787/jimdc.v9i4.533 Comparison of Clipless and Clipped Laparoscopic Cholecystectomy at Nishtar Hospital Multan, Pakistan <p><strong>Background:</strong> Laparoscopic cholecystectomy has become the procedure of choice in the management of gall stone diseases which is commonly performed using titanium clips. Harmonic scalpel is an option for the clipless surgery. The objective of the study was to compare the efficacy of clipless cholecystectomy using harmonic scalpel and clipped conventional laparoscopic cholecystectomy.<br><strong>Material and Methods:</strong> This randomized controlled trial was conducted at Nishtar Hospital Multan, Pakistan from October 1st 2019 to March 31st 2020. Total 188 patients of gallstone related cholecystitis were enrolled in the study. Patients were divided by simple randomization into two equal groups for clipless and the conventional clipped laparoscopic cholecystectomy, respectively. Age, gender, duration of cholecystitis, duration of procedure, hospital stay, usefulness in difficult procedures and biliary leakage were recorded for all the patients. Data was compared between the two groups by applying Student t-test on quantitative variables and Chi square test on the qualitative variables.<br><strong>Results:</strong> Mean operation time was more for clipped (28.35±7.92 minutes) as compared to clipless cholecystectomy (21.15±4.47 minutes) (P &lt; .001). Mean hospital stay was 2.37±0.60 days in clipped surgery group and 1.71±0.74 days in clipless surgery group (P &lt; .001). Biliary leakage was reported in 2 (2.1 %) patients of the clipped group and 1 (1.1%) patient of the unclipped group (P = .561). Clipless procedure was found to be more useful in difficult cases (n=8; 8.5%) as compared to the clipped cholecystectomy (P = .004).<br><strong>Conclusions:</strong> The results in the current study show that clipless surgery is a better option as compared to the clipped conventional laparoscopic cholecystectomy, as it is associated with a shorter operating time and hospital stay along with better usefulness in difficult cases.</p> Abdul Manan Irfan Ahmad Ashar Ahmad Tariq Jamil Muhammad Usman Muhammad Afzal sajid Copyright (c) 2020 Journal of Islamabad Medical & Dental College 2020-12-31 2020-12-31 9 4 275 279 10.35787/jimdc.v9i4.548 Common Radiological Findings in Children with Suspected Foreign Body Inhalation <p><strong>BACKGROUND: </strong>Foreign body inhalation is an emergency situation, affecting children mostly in first decade of life. An aspirated solid or semisolid object may lodge in the larynx or trachea may cause complete obstruction. Lesser degrees of obstruction or passage of the obstructive object beyond the carina can result in less severe signs and symptoms. Chronic debilitating symptoms with recurrent infections might occur with delayed extraction, or the patient may remain asymptomatic. Many aspirated foreign bodies are unexpectedly discovered, go undetected, or are misdiagnosed. In many cases with suspected foreign body radiological findings may reveal other findings e.g. emphysema, atelectasis, air trapping.</p> <p><strong>OBJECTIVE: </strong>To determine the frequency of common radiological findings among children with suspected foreign body inhalation.</p> <p><strong>MATERIAL AND METHODS: </strong>This cross-sectional descriptive study was conducted at Department of ENT, Khyber Teaching Hospital, Peshawar, from April 2017 to October 2017. In this study a total of 141 patients were observed. All patients were subjected to detailed history and clinical examination. X ray chest (AP and lateral views) of all the patients was performed to detect common radiological findings (Radio-opaque Foreign Body (FB), Pneumonia, Emphysema, atelectasis and Air Trapping). The demographic details like name, age, gender, address and contacts were recorded on a pre-designed proforma.</p> <p><strong>RESULTS: </strong>In this study mean age was 8 years with SD ± 3.563.&nbsp; Sixty percent children were male while 40% children were female. Sixteen percent children had Radio opaque FB, 13% children had pneumonia, 28% had emphysema, 18% children had atelectasis while 25% had Air trapping.</p> <p><strong>CONCLUSION: </strong>Our study concludes that the frequency of Radio opaque was 16%, pneumonia 13%, emphysema 28%, atelectasis 18%, Air trapping 25% among children with suspected foreign body inhalation.</p> <p><strong>KEY WORDS: </strong>radiological findings, suspected foreign body inhalation, Pneumonia, Emphysema, atelectasis and Air Trapping</p> Muhammad Junaid Mansoor Alam Fawad Sahibzada Sajid Ali Khalid Saeed Hamid Mukhtar Copyright (c) 2020 Journal of Islamabad Medical & Dental College 2020-12-31 2020-12-31 9 4 280 284 10.35787/jimdc.v9i4.608 Mastalgia: Risk Factors and Treatment Strategies Used at Two Breast Clinics in Pakistan <p><strong><u>Introduction</u></strong><strong><u>:</u></strong><strong>&nbsp;&nbsp; </strong>Mastalgia is a common cause of fear and anxiety in patients especially in south east asia due to high prevalence of&nbsp; breast cancer . Mastalgia is one of the commonest symptom with which women consult a breast clinic.</p> <p><strong><u>Objective:&nbsp; </u></strong>Aim of this study is to determine risk factors associated with&nbsp; &nbsp;mastalgia,its association with&nbsp; &nbsp;various breast disorders, and various&nbsp; management strategies used for &nbsp;its treatment.</p> <p><strong><u>Study Design: &nbsp;</u></strong>Prospective Descriptive &nbsp;Study</p> <p><strong><u>Duration and place of study: </u></strong>&nbsp;This study was carried out at CMH Rawalpindi &nbsp;and Thall over a period of six months &nbsp;from January&nbsp; to July 2017.</p> <p><strong><u>Materials and Methods:</u></strong> All &nbsp;women &nbsp;presenting to breast surgery clinic with complaints of breast pain, heaviness, and tenderness were included in the study. Patients were initially evaluated&nbsp; at the time of presentation, treatment initiated&nbsp; and then were evaluated after six months of treatment.</p> <p><strong><u>&nbsp;</u></strong></p> <p><strong><u>Results: </u></strong>A total of 93 women &nbsp;presented to our clinic during this period. Cyclical mastalgia was noted in 39.8% (n=37) women while 60.2% (n=56) had non cyclical mastalgia. In 41.9%(n=39) patients no underlying pathology was noted ,49.5%(n=46) patients &nbsp;had benign disorders while 8.6%(n=8) had malignancy. Increased BMI ,lack of exercise were associated with onset of mastalgia while use of OCP was associated with low risk of mastalgia. Of all 45.1%(n=42) responded to measures like reassurance, dietary and lifestyle modifications while 54.9%(n=51) were treated with&nbsp; pharmacological therapy .Those having malignancy were treated according to the underlying malignancy.</p> <p>&nbsp;</p> <p><strong><u>Conclusion:</u></strong>&nbsp; Careful and thorough evaluation of mastalgia is necessary to rule out any underlying pathology.</p> <p>&nbsp;</p> <p><strong><u>&nbsp;</u></strong></p> sohail saqib Copyright (c) 2020 Journal of Islamabad Medical & Dental College 2020-12-31 2020-12-31 9 4 285 290 10.35787/jimdc.v9i4.561 A Cadaveric Morphometric Study of Lumbar Vertebrae in Zimbabwean Adult Males <p><strong>Background: </strong>The occurrence of vertebral fractures and spinal cord injuries in developing countries in Africa is high with an annual incidence rate of 12.1 to 57.8 per million; 82.8% of these occurring in males and the most common causes being vehicle crushes (41.4%) and falls (34.9%)<sup>1</sup>. Treatment of vertebral fractures is aimed at stabilising a segment and then restoring its mobility thereby preventing nerve damage<sup>2</sup>. Violation of the pedicle walls during transpedicular screw fixation may occur if the screw diameter is too large or there is wrong placement<sup>3</sup>. Prevalence of pedicle wall violation using the “free hand” technique was reported to be 1.4%<sup>4</sup>.</p> <p><strong>Objective: </strong>To document the dimensions of the pedicles of lumbar vertebrae in the Zimbabwean population.</p> <p><strong>Study design</strong>: A descriptive cross-sectional study.</p> <p><strong>Place and duration of study: </strong>The study was conducted in the Gross Anatomy Laboratory of the Department of Anatomy, University of Zimbabwe College of Health Sciences, Harare. The duration of study was 6 months (from June 2019 to December 2019).</p> <p><strong>Material and Methods: </strong>A total of 15 adult male cadaveric specimens were taken from the Department of Anatomy at University of Zimbabwe. The lumbar vertebrae were dissected and their Pedicle Transverse Diameter (PTD), Pedicle Vertical Diameter (PVD) and the chord length were measured using a vernier calliper. Statistical calculations were performed using SPSS version 20.</p> <p><strong>Results: </strong>There was no significant difference between the pedicle dimensions of the right and left sides (P &gt; 0.05). PTD steadily increases from vertebral level L<sub>1</sub> to L<sub>4</sub> followed by an abrupt increase at L<sub>5</sub>. PVD gradually decreases from L<sub>1</sub> to L<sub>5</sub> level. The chord length increases from a minimum at L<sub>1</sub> to reach a maximum at L<sub>3</sub> and then again decreases to L<sub>5</sub> level.</p> <p><strong>Conclusion: </strong>Pedicle dimensions for the Zimbabwean population differ from those reported in previous studies for other population groups.</p> <p><strong>Key words: </strong>Chord length, Lumbar vertebrae, Pedicle dimensions.</p> Maimoona Khan Copyright (c) 2020 Journal of Islamabad Medical & Dental College 2020-12-31 2020-12-31 9 4 291 297 10.35787/jimdc.v9i4.479 Mucoepidermoid Carcinoma: A Demographic and Histopathological Profile <p>Background: To find the frequency and clinico-pathological presentation of mucoepidermoid carcinoma (MEC).<br>Materials and Methods:<br>In this study, we included all the malignant salivary gland tumors. Among these the frequency of mucoepidermoid carcinoma was considered. Age, gender, histopathological grading and anatomical site of tumor were included in data analysis.<br>Results:<br>Out of 60 malignant salivary gland tumors reported to the histopathology department, 30 tumors were diagnosed as mucoepidermoid carcinomas. The patient’s age having mucoepidermoid carcinoma ranged from 6 to 88 years, mean age of 44.9±19.2SD. The male patients were 23 in number while female were 7. Out of 30 cases, 73.3% patients had tumor in parotid gland, while13.3% patients in submandibular gland . Other tumors were in palate, retromolar area, and in posterior 1/3rdof tongue (13.3%). According to histopathological grading 26.6% cases of MEC were of high grade, 26.6 % were intermediate grade and 36.6% were low grade.<br>Conclusions:<br>According to this study, the frequency of MEC was 50% among all salivary gland tumors. MEC was mostly found in parotid gland and histopathologically low grade type was the most common.</p> zainab niazi Copyright (c) 2020 Journal of Islamabad Medical & Dental College 2020-12-31 2020-12-31 9 4 298 302 10.35787/jimdc.v9i4.460 Effect of Novel COVID-19 Infection on Different Organs of Human Body: A Narrative Review <p>The COVID-19 infection creates a drastic effect on vital organs of human body including heart, liver, brain and lungs. This infection can cause mild to severe organ injuries resulting in death of the patient. The novel corona virus damages host cells through ACE-2 receptors. Therefore, proper care should be taken to protect vital organs during diagnosis and treatment of COVID-19 infection.</p> abdul qadir Hayat Copyright (c) 2020 Journal of Islamabad Medical & Dental College 2020-12-31 2020-12-31 9 4 303 306 10.35787/jimdc.v9i4.532 Two Case Reports of Hereditary Sensory Autonomic Neuropathy Type IV <p>Hereditary Sensory Autonomic Neuropathy type IV (HSAN-IV), previously known as congenital insensitivity to pain and anhidrosis (CIPA), is an uncommon condition that presents in infancy with repeated episodes of fever, loss of pain sensations and self-mutilation. We are reporting two patients from two different families. Both patients had history of recurrent fever, anhidrosis, and pain insensitivity and self-mutilation behavior. Both had delayed motor developmental milestones with cognitive impairment. Clinical diagnosis of HSAN type IV was made on the basis of history, clinical examination and excluding other possible causes. Diagnosis of this rare disease is commonly delayed and patients ultimately develop complications. As there is no definitive treatment, these patients and their families should receive proper education and counselling for rehabilitation</p> QURAT-UL-AIN KHALID Copyright (c) 2020 Journal of Islamabad Medical & Dental College 2020-12-31 2020-12-31 9 4 307 310 10.35787/jimdc.v9i4.595 Intraparotid Facial Nerve Schwannoma in a 40-Year-Old Male with Hearing Loss – A Case Report <p>Schwannoma is a benign tumor of axonal nerve sheath. Head and neck area, particularly parotid gland is an uncommon site for Schwannoma, however it can rarely arise from the intraparotid part of facial nerve and present as either a symptomless mass or facial paresis. Its diagnosis before surgical intervention is important for the conservation of parotid gland and facial nerve. On clinical examination and imaging studies, it can be misdiagnosed easily. FNAC is a helpful tool for its diagnosis. This entity should not be ignored while dealing with parotid masses. We present a case of a patient who came with the complaint of a parotid mass. Magnetic imaging resonance (MRI) scan suggested a parotid tumor which proved to be a spindle cell neoplasm on Fine Needle Aspiration Cytology (FNAC). A definite diagnosis of schwannoma of intraparotid facial nerve was made on histopathological examination of the excision sample.</p> Nosheen Nabi Qudsia Ishaq Muhammad Tahir Aslam Shah Copyright (c) 2020 Journal of Islamabad Medical & Dental College 2020-12-31 2020-12-31 9 4 311 314 10.35787/jimdc.v9i4.616 Histopathology Images Department of Pathology Copyright (c) 2020 Journal of Islamabad Medical & Dental College 2020-12-31 2020-12-31 9 4 i ii