7th Annual Medical Symposium was held at Muhammad Medical College, Mirpurkhas on 19th -20 August 2009. A large number of delegates attended the Symposium both from within Mirpurkhas region and from other cities. Many scientific papers were presented by the research scholars and a number of State-of-Art Lectures were delivered by experts in various medical fields. The theme of the Symposium was “Standardizing Medical Education- necessary and/or desirable?”

On the first day of Symposium, the proceedings began with recitation from Holy Quran. This was done by Associate Professor in Biochemistry of the college, Dr. Shamsul Arfeen Khan. Chairman Organizing Committee Professor Syed Zafar Abbas then briefly went into the history of medical symposia held on a regular basis yearly at Muhammad Medical College, Mirpurkhas. He talked about various ups and downs ad also on the quality and quantity of papers presented at the previous symposia which were later appreciated at various national and international fora. Associate Professor of Surgery at Muhammad Medical College, Mirpurkhas Dr.Rehmatullah Soomro then took the charge as stage secretary and welcomed Dr. Shah Bux Laghari- Consultant Orthopedic Surgeon from East London, UK as the chief Guest of the Students Session. He then invited student of third year, Mr. Numan Majeed to present his groups work which was titled “Assessment of Exam Anxiety in Medical Students”. This survey was done at many private and public medical colleges in Sindh and Punjab including Muhammad Medical College and suggested that at least 50% of all students felt pressurized and thought that they could do better in exams but get anxious and / or depressed. There was a significant variation in responses among different medical colleges, and students agreed that stress management courses / classes may help them perform better in exams. Miss Azra Parveen of final year Muhammad Medical College, then presented her paper on work done with her colleagues on “Survey of Muhammad Medical College students about their experiences in dissection hall”. This group also looked at the choices of students for future career and found that most students would prefer career in Surgery or Gynae and Obs. Most students (80%) said they felt reasonably prepared by their teachers when they first went in dissection hall. Miss. Rabia Hameed and her group of fourth year presented their work on “Knowledge, attitude and practice of women regarding family planning at Mirpurkhas”. She said that 71% woman had adequate knowledge but only 48% were practicing a form of family planning. 68% women of those who did not practice it, expressed their wishes to practice family planning. Various social and perceived religions reasons were put forward as causes of non-practice. Miss Ambreen Shahni presented her group’s work on “Obstructed Labour in emergency caesarean sections”. They found a significantly high mortality and morbidity as a result of this avoidable situation. Miss. Anum Hameedi presented her group’s work on “Causes of acute abdomen presenting at Muhammad Medical College Hospital”. Urological causes appeared to be the commonest among this group (37%). Mr. Abdul Mannan of final year talked on behalf of his colleagues on the findings of their work on “Top 10 surgical presentations at the department of surgery”. They found that urological diseases constitute 61% of all surgical admissions at Muhammad Medical College Hospital. Miss. Salma Farooque of final year presented her groups work on “Practice of blood transfusion at Muhammad Medical College Hospital” and found that blood loss or anaemia associated with complicated cirrhosis was the commonest indication for this procedure. Their group found that if strict care is taken in transfusing blood, complications were very rare. Commonest blood group found was 0 positive (41.4%) in this region. Miss. Aisha Idrees of final year presented her groups work on “Frequency and distribution of cancers at a rural tertiary centre”. Unlike described in most textbooks and traditional medical teaching, they found that primary liver cancer was by far the commonest primary cancer presenting to this hospital (33.8%). Alarmingly 1/4th of all patients who were diagnosed with a malignant disease, were aged 50 or under. Mr. Muhammad Rizwan Javed of final year presented his group’s work on “Decompensated Cirrhosis – do weekend admissions fare worse than weekday admissions?”. They said that, although patients were older and more ill at presentation if presented on weekend, there was a trend of higher mortality in this group. Mr. Muhammad Umar Baqa and his group of final year did a similar study on “Acute upper GI bleed – do weekend admissions do better than weekdays admissions?" Again although their study was small, and weekend admitted patients were older and had higher co morbidity rates, they showed a trend of higher mortality. Miss. Fatima Muhammad of fourth year, from Jinnah Medical and Dental College, Karachi, presented her survey of the “Practice of respecting patient’s rights by medical students and senior doctors”. She found that a significant minority of students felt that learning practical clinical skills was more important than respecting patient’s rights to refuse such requests. A minority of students felt brave enough to challenge their senior teachers if they saw them violating patients rights. She felt that more emphasis on ethics and consent taking should be given in medical education at undergraduate and post-graduate levels. Mr. Faizan Saeed of final year, Muhammad Medical College, presented his group’s extensive work of “All cause admissions at a teaching hospital, and their departmental breakdown”. They studied 2655 patients’ records, and found that cirrhosis with its complications not only constituted highest number of admissions to the hospital (22%), but they were also the group of patients with highest mortality (33%).

The chief guest of the session, Dr. Shah Bux Laghari then praised the quality of papers and acknowledged the hard work put in by students to come up with the data so badly needed by health authorities. He then gave a State-of-Art Lecture on “Open fracture and Compartment Syndrome”. He threw light on various aspects of this problem, especially its early diagnosis and management. At the end of his talk, he was presented with symposium shield and Ajrek by Prof. Ghulam Ali Memon. This was followed by another State-of-Art Lecture by Dr.S. Qamar Abbas, Deputy Director St. Clare Hospice, UK and Lecturer in Cambridge University. He talked upon “Communication Skills”. He emphasized upon the importance of communicating politely with patients and treating team well. He threw light on some of the modern concepts in this regard.

After lunch and prayers break, Dr. Shah Bux Laghari opened the Poster Hall. 41 scientific posters were on display and were presented by various students and doctors on their work done mostly at Muhammad Medical College Hospital, Mirpurkhas.

The guests did a detailed round of all the posters and engaged presenters in discussion on various aspects, showing keen interest in them.

On second day of symposium, the program started with State-of-Art lecture by Dr. S. Qamar Abbas of UK on “Forgotten rights of the patients”. He emphasized on the fact that patients are the centre place of any health care setup and their rights must be respected as they may not be able to exercise them because they may be vulnerable at the time they seek medial help. He gave quotations from Hippocrates oath and Ibne Sena’s work on them. He urged doctors to treat their patients the way they wish themselves to be treated. The second State-of-Art lecture was delivered by Prof. Abdul Sattar Memon, Dean Faculty of Surgery at LUHMS on “Ruptured Amoebic Liver Abscess - 22 years experience”. He gave an excellent update and overview on the topic and presented his study done on 36 patients over 22 years. His results indicated that patients treated with laprotomy in such situation fare a lot worse than those treated conservatively with intravenous antibiotics and needle aspiration under ultrasound guidance. Both the worthy presenters were presented with symposium shields and traditional Ajraks. Prof. S. Zafar Abbas Chairman Scientific Committee of the symposium then presented brief summary of work produced by Muhammad Medical College students and doctors in symposium 2009. He gave a brief history, first of Muhammad Foundation Trust of over 11 year period, and then of symposia held regularly for last 7 years on yearly intervals. The audience, which was packed with doctors and notables of Mirpurkhas, Lahore, Rawalpindi, Nawabshah, Karachi, Hyderabad and other cities, then heard a brief summary of 41 papers that were being presented by students and doctors of Muhammad Medical College Hospital in this symposium. Prof. Dr. Syed Razi Muhammad Managing Trustee of the Trust then gave his theme speech on the symposium. He quoted from various studies done at Muhammad Medical College, compared them with national and international data, and concluded that the medical curriculum for under and post graduate doctors in different countries can not be the same as more emphasis has to be put on more prevalent diseases locally. Prof. Ghulam Ali Memon then continued and gave his invited talk on Ameloblastoma. His presentation was full of examples and illustrations which made the topic look easy to the audience. He was presented with symposium shield. He then went on and as one of the hosts, gave vote of thanks to all participants of the symposium and also thanked the workers and students of the college who worked hard day and night and made the symposium a great success.

Prof. Syed Razi Muhammad took all senior guest professors to first open the exhibition hall by Professor Tayyab of Lahore, and then poster hall by Professor Ataullah Mazhar of Rawalpindi accompanied by Prof. Muntaz Memon of LUHMS. The symposium was attended by a large number of Pharmaceutical companies, who put on several hospitality suites and stalls. They informed the doctors of their products. The guests then had a break for prayers and lunch. After this the delegates divided themselves to attend either the “Physicians Hour” or ‘Society of Surgeons - Mirpurkhas Chapter’s Annual Meeting”. A large numbers of delegates came to attend this meeting from Mirpurkhas, Hyderabad Chapter and from Karachi Chapter. “Physician’s Hour” was started off with an invited lecture by Prof. Noor Muhammad Memon on Myocardial Infarction. He described various aspects of the diagnosis of the problem, especially with the help of ECG, and also the current management. Dr.Zulfiqar Shaikh of Community Health Sciences presented the data of his recently concluded study on problems other than the clinical ones faced by patients in having appropriate treatment of myocardial infarction. He showed that only 10% of all patients were able to travel to hospital in severe chest pain via an ambulance, even which in most cases was not so well equipped. Very few were given aspirin or any other treatment by attending physicians before they were transferred to a hospital. Dr. Abdul Qadir Khan presented his study of 100 consecutively admitted patients with Organophosphate poisoning. Majority of his study patients had a suicidal intention – mostly females. There was 3% mortality.