Clinical Types of Thoracic Endometriosis

Assistant Prof.Dr Ahmad Shaiq Nadeemy,          Professor Dr Mohammad Saleem Tawana       Department of Thoracic and Cardio-vascular Surgery



The term “endometriosis” is referred to the presence of endometrial tissue outside the uterine cavity. Thoracic endometriosis is the presence of endometrial tissue in one of the thoracic structures. The aim of this review article was to describe clinical types of thoracic endometriosis and to study the relation between clinical manifestations and  anatomopathologic findings of the disease.

Method: English and French literatures were searched via Pubmed using following keywords: Thoracic or pleural or pulmonary or bronchial or diaphragmatic and endometriosis, Pneumothorax or hemothorax or hemoptysis or nodules and endometriosis.

Results: Thoracic endometriosis is a rare disease and its exact prevalence is not known. The pathogenesis is not clear but retrograde menstruation and endometrial implantation in thoracic cavity, microembolization by blood and transcoelomic epithelial metaplasia are the most poplular theories accepted by most of the researchers. Thoracic endometriosis  affects women in their reproductive age. It has mainly four clinical types: catamenial pneumothorax, catamenial hemothorax, catamenial hemoptysis and pulmonary nodules.  The diagnosis is often difficult but history of the patient and cyclicity of the symptoms during menstruation is helpful for diagnosis of the disease. The treatment is hormonotherapy and surgery. The goal of hormonotherapy is the suppression of estrogen secretion by overies. The surgery is performed either by thoracoscopy or thoracotomy. Sometimes gynecologic intervention is also necessary.

Conclusion: Thoracic endometriosis is a rare condition. It has four clinical types which include catamenial pneumothorax, catamenial hemothorax, catamenial hemoptysis and pulmonary nodules.


Arsenic in Rice & Rice Products and Health Hazards

Dr. Mohammad Rafi Rahmani MD

Department of  Pharmacology.


In Afghanistan rice is used too much as the main source of food. the consumed rice in the country is mainly imported rice and on the other hand worldwide rice contamination with arsenic has been a serious problem because continuous consumption of contaminated rice may cause arsenic chronic toxicity (especially in children and pregnant women) and finally the situation would harm health; like skin, bladder and lung cancer, growth abnormalities, neurotoxicity, diabetes, cardiovascular disease, and infertility which is attributed to the presence of arsenic in food. information not found about the "existence of arsenic in rice and rice products available in the markets of Afghanistan," in the official websites of the Ministry of Agriculture and Livestock, Public Health, norms and standards organization, or the World Health Organization, WFP,UNICEF.

Objective:  (1). to discuss the matter and raise the issue with food and health officials and the public awareness about arsenic in rice. (2). Knowing the methods to decrease the toxic level in rice.
Methods : in this study the articles selected from reputable sites, which mainly did in the form of cross sectional survey, epidemiological studies and systematic review. in this study data sources such as Pubmed, WHO, Green facts, Berkeley University of California Research Program, journals and publications of JAMA & FDA reviewed and final results evaluated comprehensively.
Results: (1)- Arsenic is classified as a carcinogenic substance  & arsenic-contaminated rice consumption is carcinogenic.
(2)- Imported rice in the country is suspected for arsenic contamination, there is no evidence or information on safety or the contrary arsenic contamination of rice in the country. (3)- The most important reason causing arsenic is rice, rice grown in water, because water has high arsenic and rice are growing in water and more arsenic is absorbed. 
(1) - Conduct research and assessment for arsenic contamination of imported rice in to the country by the relevant organizations.
(2) Using the methods to decrease the level of arsenic in rice (before cooking, boiling the rice and discard the rice water to make it smooth). 
Conclusion: imported rice in the country is suspected for arsenic contamination and we suggest to conduct research and assessment for arsenic contamination of imported rice in to the country by the relevant organizations.

Descriptive Study of Tuberculous Meningitis 

Associated Prof. Dr. M. Ismael Wardak MD., MPH.

Prof. Dr. Mir Azizullah Akhgar

Department of Infectious Diseases and Tuberculosis


We reviewed the TB-meningitis patients’ recorded history were was admitted to Infectious Diseases Hospital. This is a primary study; the results are concise and reliable so the information containing this article is important for medical students, young doctors, Trainees and specialists.This study is descriptive, in which we reviewed TB meningitis cases admitted to the hospital during a period of one year. The main question of this study:What is the status of TB-meningitis cases admitted to infectious diseases hospital?  We evaluated TBM cases distribution with regards to, gender, season, and residency. In addition we calculated central tendency of CSF and blood examination results variations. With socio-economic point of view we analyzed the data; research results show that tuberculous meningitis cases are more prevalent with individual living with low level socio economic condition. At the time of hospitalization, 30 percent of patients were in coma condition. The primary, concise, and reliable research information is very useful for future investigators at local and national levels; further more sharing the information with undergraduates, post graduates and medical specialists is very important. In general the mortality rate of the patients with meningitis at Infectious Diseases Hospital is estimated 9.66%Besides current diagnostic examinations, we propose defining Adenosine deaminase (ADA) in CSF which is an easy and low cost procedure for diagnosis of TBM disease. Most of TBM cases in the hospital were treated with 4 anti-TB drugs plus two supportive drugs, vit-B6 and dexamethasone.

Prevention of Aspiration in Anesthesia Induction    

Asist.Prof.Dr. Zainulabuddin

Department of Anesthesia 


Background:Full Stomach is a risk for aspiration in patients who need surgery  


  1. Which patient is at the rick of Aspiration?
  2. What is the effect of premedication on Aspiration Pneumonia?
  3. Is there any restriction for drinking or eating before surgery in General Anesthesia?

Method&Material:In this method we collected information from different web sites and references.There are different Ideas.

Usually Experts find out different factors in complication of Aspiration Pneumonia such as full stomach  and surgery in emergency setting.

Result: Emergency patients are at the high risk of Aspiration because of full stomach, acute abdomen, pregnancy, diabetic patients and patients with reflective reaction.

Conclusion:Anti-acid should be advised to patients before Anesthesia: Advice of anti-acid 15-30/min before induction of Anesthesia helps in increase pH of stomach contents above 2.5. 

Sodium citrate should be advised to patient PO.

Patients can take 150ml of water before anesthesia.

Suggestion:For Emergency patients with full stomach we should apply N.G tube.

Selective patients during night time should avoid taking food 4 /hour before Anesthesia.

Missing of First permanent Molar Prevalence

Asst. Prof. Dr. Sayed Shoaib Ghafari

Department of pediatric dentistry


Background: First permanent molar is the first permanent tooth which erupts in the oral cavity.

This is the largest permanent tooth which exists one in each quadrant, thus the total number of first permanent molars is four. This tooth has wide occlusal surface containing fissures and cusps. This characteristics of the tooth paves the ground to dental caries. This tooth erupts at six years of age which is the starting time of mixed dentition namely there are primary and permanent teeth, so capitation of primary teeth affects permanent teeth. Misdiagnosis of this tooth with primary tooth and less care of treatment of this tooth, are the factors that destruct this tooth very soon.

Objective: Finding the prevalence of missing first molar in children aged 8-17.

Method: observational cross sectional study

Results: This study was conducted on 100 children aged 8-17 who lost their first permanent molar. As a result of this study, the high percentage  of missing tooth (31%) was at age of 17 and the lowest percentage (1%) was at age of 8th. Therefore the peak of its prevalence is in second decade of life. Also it has been found that lower right quadrant of first molar constitutes 52% loss which shows highest prevalence than other 3 quadrants. Also among females, it was found 55 % which is higher than male.

Conclusion: As it was found in this research, first molar was missed more in second decade of life rather than first decade. The tooth erupts in 6-7 of age. Also right lower first molar due to having deep pits and fissures are prone to dental caries, besides having vital role in mastication and lack of knowledge of parents cause early loss of it.

Suggestions: As this tooth erupts 6th year of age the parents should be educated, and should know its importance in arch. Dentist should try to treat and save this tooth.

Value of Ultrasound in Diagnosis and Determination of Treatment Type of Intussusception in Children

Dr. Mohammad Tahir Aien

Department of Medical Imaging and Radiation Sciences


Background: Intussusception is an emergency medical condition in which a part of the intestine invaginates into another section of intestine. Imaging has important role in diagnosis and treatment of this pathology. From various modalities of imaging, ultrasound is the safest and most sensitive diagnostic modality in detection of intestinal intussusception.

Objective: 1-Introducing ultrasound as a safe,  accurate, effective and rapid modality in with high level of sensitivity and specificity in diagnosis of intussusception which can prevent high expenses as well as exposure of patients to x-ray by barium enema. 2- Use of   color Doppler to evaluated the status of arterial circulation of the affected bowel loops and determining type of treatment as soon as possible. 3- Presenting new methods for diagnosis of intussusception for doctors and medical students.

Method: This study was performed as an article review. In this review 22 articles from international journals and related textbooks were taken as the references. These articles were from well-known websites such as , ,  and

Results: Application of radiologic procedures especially ultrasonography and color Doppler have important role in diagnosis of intussusception. Ultrasound has excellent sensitivity and specificity in diagnosis of intussusception.

Conclusion: Ultrasound is considered as a safe, reliable and cost effective method for diagnosis and treatment of intussusception with high level of sensitivity and specificity. Color Doppler ultrasound can effectively determine the status of arterial circulation of the affected bowel loops and can avoid the unnecessary surgery.


  1. Performing ultrasonography in all children with abdominal colic pain, vomiting and bloody diarrhea.
  2. Availability of ultrasound machine with linear transducer and color Doppler in all hospitals especially children hospitals. 
  3. Training of doctors in the field of radiology and medical imaging should be taken in consideration in order to early diagnose the patients especially intussusception patients and treat them on time to prevent serious complications.

Key words: Intussusception- Ultrasound- Reduction of intussusceptions

Incidence  of  Chest  Pain  in GERD

Pro. Dr. Abdul  sami  Ahmadi

Depaetment of  internal  medicine


Background: Gastroesophageal reflux disease (GERD)is a common disease that affects 20 % adults weekly and 10% daily .

it defines as a reflux of stomach contents in upper has  specific and non specific symptoms and sign,specific symptoms such as heart burn and regurgitation. none specific symptoms such as asthma,chronic cough ,sore throat,laryngitis and dysphagia.

Aims:incidence of chest pain in GERD.

Methods and materials:first all available medical literature was reviewed ,important points were noted and then ,discussed ,and  final results were drawn.

Result and conclusion:

  1. None cardiac chest pain was seen in 10% of GERD. none cardiac chest pain a non specific symptom.
  2. Males are effected more than females due to elevated use of narcotics,alchol and spicy foods.
  3. It affects adults  more than other ages. patients suffering from chest pain require long time therapy with PPI.

Suggestion: equipped endoscopic centre.

A Case-Control Study of 1253 Twin Pregnancies From a 1982-1987 Perinatal Data Base.

Assistant Prof.Dr.Zubaida Zewak

Department of  Obstetrics and Gynecology


In one regional perinatal network between 1982-1987, 101,506 women delivered infants greater than 500 g, of which 1253 were twin pregnancies (1.2%). This latter group was compared statistically with a 5% random sample of the singletons (N = 5119). The results showed that the women with twin pregnancies were slightly older, had a higher parity, gained more weight during the gestation, and had a heavier body weight at delivery. Twin pregnancies were complicated by increases in hypertension (odds ratio 2.5; 95% confidence interval 2.1-3.1), abruption (odds ratio 3.0; 95% confidence interval 1.9-4.7), and anemia (odds ratio 2.4; 95% confidence interval 1.9-3.0). There was no increased risk of pyelonephritis, placenta previa, or diabetes mellitus in mothers with twins. The twin pregnancies delivered earlier and the infants were smaller, had lower Apgar scores, and were at increased risk for congenital anomalies. Fetal and neonatal mortality rates were significantly increased in the twin infants; the perinatal mortality rates for twin A and twin B were 48.8 and 64.1, respectively, compared with 10.4 per 1000 births for the singleton controls. When the twin infants A and B were of similar weight, they had a similar perinatal mortality (odds ratio 1.0; 95% confidence interval 0.6-1.8). For infants less than 2500 g, twins A and B had lower fetal and neonatal mortality rates than did singletons, but twins heavier than 2500 g were at increased risk of perinatal death.


Chromosome Abnormalities

Assistant Prof. Shahla Hamidi

Department of  Biology


With the creation of chromosomal analysis techniques, the chromosomal abnormalities such as: Down syndrome, klinefelter’s turner and Trisomic syndromes has been known.At least 20,000 chromosomal abnormalities exist in informative banks which are usually rare, but overall it has a big allotment in mortality.

Chromosomal abnormalities have a big part in Spontaneous Abortions and malformations in childhood and adulthood.

Aim To find information about chromosomal abnormalities, reasons, involving factors of individuals and the ways to prevent of individuals from involving of it

Method  In this research which have been done like a library, it has been used from the medical journals, internet sites and other new and reliable sources of the world.

Results  Researches show that the factors that cause chromosomal abnormalities, with malformation in number or structure of chromosomes, are important reasons for congenital problems and   spontaneous abortions.

Final result

Abnormal chromosome is the most frequent cause of spontaneous abortion, accounting for at least 50 percent of them. Studies of preimplantation embryos cultured in laboratories for in vitro fertilization reveal that 20 percept of them have abnormal chromosomes, yes only 0.5 to 0.7 percent of newborns have abnormal chromosomes.


All the members of the society must have least information about this subject so they could serve in part of medication of this abnormality.

Intelligence and Intelligence Quotient

Assistant Prof .Mohammad Sarwar Alborz MD, PGD

Department of Epidemiology and Biostatistics


Background:IQ (Intelligence Quotient) as IQ or cognitive intelligence is the ability to measure numerical, logical or mathematical one. It is a measure of the relative intelligence of a standard test, mental age to chronological age measures(IQ= MA/CA × 100), Where MA(Mental Age), CA(Chronological Age).

IQ is ability to learn and understand new things, ability to deal with new situations an environmental manipulation or analysis is thinking.

Psychologists agree that: IQ of only 10 to 25 percent to achieve success and continue to be dependent on anything, including the EQ.

In business, law, medicine, education, professional relationship between IQ and success isnegative or zero.

The divisions cent of IQ regular 70% Middle, 12% higher than the average, 2% a very high IQ, and only 1 percent of the population as gifted individuals are grouped and the rest fall in the category of low intelligence and mental retardation.

In the IQ test, you should try to answer 39 questions in 40 minutes. The questions will go from easy to hard.At the end of the test according to your age, you can see at the schedule of the IQ y.

Now the IQ test is used less and do more EQ(Emotional Quotient) or EI(Emotional Intelligence), because they believe that EQ can determine a person's ability to cope with stressful situations.

Emotional intelligence (EI) is the ability to monitor one's own and other people's emotions, to discriminate between different emotions and label them appropriately, and to use emotional infoIQ can word concepts such as power, mathematical and logical reasoning ability measure.
When a person is capable of creative skills and emotions, IQ falls.

In fact, it has been shown that some people with high IQ scores, but they do not have good personal relationships are socially awkward.

That is a true reflection of the recognition of the other tests and mental abilities needed to show him, came to the EQ. rmation to guide thinking and behavior. Our self with some of the celebrities to compare.

Aim: To determine Intelligence concept and Intelligence Quotient

Method and Material: This study done as literature review during year 2014.

Results: IQ is ability to learn and understand new things, ability to deal with new situations an environmental manipulation or analysis is thinking

Psychologists agree that: IQ of only 10 to 25 percent to achieve success and continue to be dependent on anything, including the EQ.

The divisions cent of IQ regular 70% Middle, 12% higher than the average, 2% a very high IQ, and only 1 percent of the population as gifted individuals are grouped and the rest fall in the category of low intelligence and mental retardation.

In the IQ test, you should try to answer 39 questions in 40 minutes. The questions will go from easy to hard.

Conclusion: The divisions cent of IQ regular 70% Middle, 12% higher than the average, 2% a very high IQ, and only 1 percent of the population as gifted individuals are grouped and the rest fall in the category of low intelligence and mental retardation.

In the IQ test, you should try to answer 39 questions in 40 minutes. The questions will go from easy to hard


Create appropriate environment to improve IQ.

Classification of people according there IQ to assign in different fields and positions.

Comparison of Early Childhood Caries incidence between Branchial Asthmatic Children and Non-asthmatic children

Assistant Prof.Dr.Ehsanullah Naseri                 

Dept. Pediatric Dentistry


Background: Branchial asthma is a diffused chronic obstructive disease of air way which results from swelling of mucosa and increased secretions and contraction of smooth muscles of lung bronchioles.Early childhood caries occurs in early childhood period. Relation between these two diseases is due to increased respiratory rate, decreased saliva and consuming inhalers. Thus, these factors play fundamental role in progressing ECC in asthmatic children rather than non-asthmatic ones.

Goal: Comparison of ECC incidence between asthmatic and non-asthmatic children aged 2-6.

Method: This study was conducted as case control study. 40 asthmatic children were as case and 120 non-asthmatic children of the same age were as control group. These patients had come to Maiwand Teaching Hospital. Demographic characteristics of both groups were studied and Caries rate incidence was compared in different ages of both group. Quantative  variables were indicated by mean, standard deviation and Qualititve data was indicated by percentage.

Results: The mean of age in case group  3.7 -+1.5 (2-6) and in control group 4.3_+1.4 (2-6) were found. 62.5% were boys in case group and 34.2 % were boys in control group. Early  childhood Caries in 29 children of case group (58%) and in 82 children of control group (68.3) were found. It was found more found caries rate in children aged 2-3 with ( P= 0.01 in case group rather than control group children from the prospect of age. Besides, it was found more caries rate in girls rather than boys namely 42.5 Vs 37.5.

Conclusion: As a result of the study, there was not found a considerable association between bronchial asthma and dental caries.

Suggestions: Considering the world’s literatures on the issue which show contradictory results and besides our research result didn’t approve bronchial asthma and dental caries association. Thus, this is suggested to be conducted more researches on this issue from different prospective in a huge Afghan nations.