About Afghan Medical Journal: The Afghan Medical Journal (AMJ) is an official international open-access peer-reviewed journal, certified by the ministry of higher education, with ISSN 3007-0805 (Online) and ISSN 3007-0791 (Print) numbers, and functions under the oversight of an editorial board of the Kabul University of Medical Sciences (KUMS). KUMS is the first ever medical and higher education institute established in 1932 as a faculty of medicine, in the country with a vision to building healthy and prosperous society through imparting higher medical education and empowerment societies.

The printed version of the journal was established about 7 decades ago and has since published 194 serial issues providing cutting edge knowledge in the medicine and public health. The AMJ specifically encourages the faculty, practitioners and students to make the new knowledge, they obtained through robust research methods, available by publishing in the AMJ for national and global readership for optimal impact. The new knowledge disseminated through the journal informs policies and programs that improve the health and wellbeing of the humans. Online publication of the journal as well as indexing with global online databases will increase its readership and audience multifold and consequently its impact will substantially increase.


A Case Report on Congenital Biliary Atresia with Ventricular Septal Defect

Shafiullah Rashid, Nesar Ahmad Zahier, Fazila Haidari, Ahmad Wahid Waheb, Mohammad Wali Naseri

Introduction: Biliary atresia, an obstructive cholangiopathy with idiopathic etiology is a congenital disorder that eventually destroy liver parenchyma. In some circumstances, it is associated with other abnormalities such as congenital heart diseases, intestinal and spleen anomaly. Diagnosis of biliary atresia is made on clinical manifestations, and specific diagnostic tests. Prolonged pathological jaundice is a critically important sign in newborns that need to be recognized early in order to reduce the chances of further complications. The mainstay of treatment is Kasai procedure (portoenterostomy) and is eighty percent successful if it is performed before or in first two months of life. Case report and clinical discussion: Here, we report a case of a two-month-old baby who had biliary atresia with ventricular septal defect (VSD). The baby had prolonged history of jaundice, pruritus, yellow colored urine, pale stools. He was initially brought to a local clinic for his jaundice where pharmacological treatment was commenced. However, the symptoms persisted and was referred to a hospital where he was placed under blue light phototherapy with no marked improvement in his symptoms. For definite diagnosis and treatment, he was than referred to a multispecialty hospital where diagnostic tests were ordered. HIDA scan showed no uptake of contrast to bile ducts and gallbladder, which is suggestive of congenital biliary atresia. Intraoperative cholangiogram showed definite diagnosis of biliary atresia, which was performed, and Kasai procedure was done successfully. All his family members were healthy with no history of congenital disease. Conclusion: The essential outcome in this case is to consider biliary atresia as a cause of prolonged jaundice in infants and occasionally it is associated with other congenital anomalies. The diagnosis and treatment should be urgent in order to prevent complications.

A Descriptive Study of Sepsis among Children Hospitalized at the Pediatric Department of Maiwand Teaching Hospital

Senior Teaching Assistant Fraidon Frahmand, Teaching assistant Zakerhussain Hussain, Professor Dr. Abdul Rahim Raheen , Professor Dr. Najeebullah Amarkhail

Introduction: Sepsis is a serious and potentially life-threatening condition, particularly in children. It occurs when the body's immune response to infection becomes dysregulated, leading to widespread inflammation, tissue damage, and organ dysfunction. Objective: To describe sepsis among children hospitalized in the pediatric department. Methods: A retrospective analysis of medical records of children admitted with a diagnosis of sepsis between January 2022 and May 2023 was conducted. Data collected on demographics, clinical signs, diseases with sepsis, breastfeeding, types of tests, diagnosis, and antibiotic therapy were collected. The appropriateness of initial antibiotic choice and timely modifications based on clinical signs and established guidelines were evaluated. Results: In the study, 60 patients with sepsis aged 1 to 10 years were included, with 48.8% male and 51.7% female. Of these, 97% were diagnosed with sepsis, while 3% were diagnosed with septic shock. The duration of hospitalization ranged between 1-8 days. In addition to clinical symptoms, sepsis was diagnosed by blood test in 71.7%, urine test in 23.3%, and sputum test in 3% of cases. The discharge rate was 71.7%, while the mortality rate was 3.3%. Conclusions: The study provides valuable insights into the clinical characteristics and management of sepsis and septic shock in children, with a relatively lower mortality rate compared to some other studies. Overall, the significance of early recognition and treatment of sepsis in children and the appropriate use of laboratory tests to aid in diagnosis and guide treatment decisions.

Open Repair of Patent Ductus Arteriosus in Older Children and Adults in Afghanistan: A Case Series

Fahima Negin MD, Sheba Azim MD, Mohammad Sharif Oria MD, Zabiullah Ebrahimi BSc, Megan Olejniczak MD

Patent ductus arteriosus is a common birth defect, indicative of 5-10% of congenital heart anomalies, commonly come to attention in infancy. We present 20 cases of PDA in older children and adults that were surgically repaired in Kabul, Afghanistan. All patients had a detectable murmur and experienced symptoms. All cases were operated using general endotracheal anesthesia. Surgery was performed via a left thoracotomy with intermittent apnea as required for surgical exposure. A remarkable revealing of our series is that we encounter adult PDA patients regularly.

Objective: Prevalence of DKA in patients with type 2 diabetes admitted to the internal service of Ali Abad Teaching Hospital. Method and Material: The research was conducted through the descriptive method in cross-sectional form, which includes all patients who have been admitted to type 2 diabetes in the internal service of Aliabad Hospital for one year. In this study, all patients with type 2 diabetes are included, and type 1 diabetes is not included in this research. Results: In this study, the prevalence of DKA in patients with type 2 diabetes was found to be 5.98 percent, which, from the perspective of gender, is most common in women (60 percent) and between the ages of 60 to 69 years. Conclusion: Approximately 5.98 percent of hospitalized patients with diabetes mellitus type 2 had DKA; it was most common between the ages of 60-69 years, and was most common in women.

Prevalence of endodontic treatment among Stomatology Teaching Hospital adult patients, Kabul University of Medical Sciences (KUMS), Kabul, Afghanistan

Senior Teaching Assistant Dr. Ali Maisam Eshraqi, Teaching Assistant Neghat Ghafoory, Ali Mohammad Alokozay

Background: Endodontic treatment is the entire removal of coronal and radicular pulp tissue and then obturation of the space by specific materials. Normally dental pulp and its surrounding dentin are protected by enamel and cementum. Factors like caries, dental trauma, and restorative procedures may destroy these hard tissues and infect the complex of dentin-pulp, and result in dental pathology and extension of inflammation into peri-radicular tissue. In this condition, endodontic treatment is necessary to be done. Objective: To find the prevalence of endodontic treatment among Stomatology Teaching Hospital adult patients Method and Material: It is a descriptive cross-sectional study that was done during the last four months of 1399. The target information for this research was collected actively from patients in data collection form and the register book and the prevalence of endodontic treatment was found. So that all the patients of the Endodontics and Operative Dentistry department of Stomatology Teaching Hospital were carefully noted and evaluated and the number of teeth that were treated endodontically and their characteristics were noted in the data collection form for research and then the collected data was analyzed. Results: The prevalence of endodontic treatment was found 25 %. The participants were 18-70 years old. According to age, most of the cases were found in the third decade of life (44.96%), 21.6 % in the second decade, and 14 % in the fifth decade. According to gender, 46.4 % of the cases were male and 53.6 % of the cases were female. The most affected teeth were the first permanent molar tooth 39,9 % the and second permanent molar tooth 16,2 %, but the least cases were found in the permanent canine tooth 3,6 % and the third permanent molar tooth 4,3 %. Most cases were found in the lower jaw 52.1 % which is more than in upper jaw teeth. Conclusion: The prevalence of endodontic treatment was 25%, higher than observed in epidemiological studies conducted in other countries. Most of the cases were female. Endodontic treatment was most frequent in the lower jaw and specifically in the first molar and mostly occurred in the third, second, and fifth decades of life.

Prevalence of Febrile Seizures in Children Admitted to Ataturk Children’s Hospital in 2022

Professor Dr. Zemary Hassain, Professor Dr. Abdul Rahim Raheen

Introduction: Febrile seizures are seizures that occur in the presence of fever and absence of central nervous system infection, metabolic disturbances. Febrile seizures are a major problem in pediatric emergency services and hospitals, and if not treated promptly and appropriately, they can cause a number of complications, disabilities, and even deaths. Having sufficient knowledge and information about this disease can greatly help in preventing and protecting against it. Objectives: To determine the prevalence of febrile seizures in children under five years of age admitted to Ataturk Children's Hospital in 2022. Research Method: This is a Descriptive Cross-sectional study that was conducted in 2022 at Ataturk Children's Hospital. Results: The prevalence of febrile seizures was 15%. In terms of gender, 420(68.9%) were boys and 190(31.1%) were girls. In terms of age, 155 (25.4%) were between 6-12 months, 233 (38.2%) were 13-24 months, 141 (23.1%) were 25-36 months, and 81 (13.3%) were over 36 months old. The highest number of cases occurred in the 13-24-months age group. In terms of clinical presentation, 374 (61.3%) were simple febrile seizures, and 236 (38.7%) were complex febrile seizures. In terms of underlying diseases, respiratory diseases accounted for the highest number of cases 276(45.2%), followed by gastrointestinal diseases 209(34.3%), urinary tract infections 122(20%), and other diseases 3 (0.5%). Conclusion: The prevalence of febrile seizures was 15%, with the highest number of cases occurring in boys and in the 13-24-month age group. According to clinical descriptive respiratory diseases were the most common underlying cause of fever.

Background: Upper gastrointestinal bleeding (UGIB) is a common emergency medical condition that may require hospitalization, resuscitation and results in high patient morbidity. Upper gastrointestinal bleeding is approximately four times as common as bleeding from the lower gastrointestinal tract. Well-known causes of UGIB include duodenal ulcers (DU), Gastric ulcers (GU), erosive mucosal disease (EMD), esophageal varices due to portal hypertension, and Mallory Weiss syndrome. Upper GI bleeding usually presents with hematemesis and melena. Objective: This study aims to find the prevalence of upper gastrointestinal bleeding. Method and Materials: This is a descriptive cross-sectional study. The data collected from the Ali Abad Teaching Hospital archive included 921 patients' documents admitted to the medical ward from 21/3/2021 till 20/3/2022. We did the data entry and analysis through SPSS software. Results: This study found that the prevalence of upper gastrointestinal bleeding is 3.9%, with the mean age of cases being 36 years. In addition, the prevalence of upper gastrointestinal bleeding in male patients was 47.2%, and in female patients, it was 52.8%. Conclusion: In our study, the prevalence of upper gastrointestinal bleeding was 3.9%, with most cases being female patients.


Professor Ghulam Rahim Awab,

In 1932, the first medical faculty was established as initial higher education center in Afghanistan. That era of country, the establishment of this academic repository as a medical nucleus was profound foundation for improvement as ever. In 1980 faculties of pediatric and Stomatology added and the name changed to Kabul Medical Institute and in 2004 renamed as Kabul Medical University.

Congenital Cutis Laxa with Pulmonary Tuberculosis and Micropenis: A Case Report

Mohammed Akbar Ibrahimi MD, Khesrow Ekram MD, Abdul Ghafar Hamdard MD, Mohammad Sharif Sediqi MD, Turyalai Hakimi MD

Cutis laxa is an infrequent connective tissue illness that mostly affects the skin and is brought on by faults in the elastic fiber network. The crotch, palms, and neck are frequently where loose skin is most obvious. Examining the skin makes it quite simple to identify the symptoms of cutis laxa. Family histories can be used to identify the kind of cutis laxa. We describe a unique case of Cutis laxa in a 2-month-old child with extremely loose skin and enlarged skin folds all over his body, along with pulmonary TB, sepsis, an umbilical hernia, and micropenis. Clinical signs were noted after delivery, and a clinical physical examination with the parents involved helped to make the diagnosis of these defects (second-degree cousins). After the management of pulmonary tuberculosis and sepsis, he was discharged from the hospital in good condition.

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