PIPOS Explorer 5

PIPOS EXPLORER
A Bi-Annual Magazine
Volume V (January - June, 2010)
PIPOS
Pakistan Institute of Prosthetic
and Orthotic Sciences
Prof. Dr. Bakht Sarwar
Patron in Chief
Mr. Liaquat Ali Malik

Managing Director
PIPOS EXPLORER
A Bi-Annual Magazine
Mr. Aziz Ahmad
Chief Editor
Mr. Riaz-ud-Din
Volume V (January - June, 2010)
Editor
Ms. Sundas Khalid Khan

Co-Editor
Mr. Waqas Mehmood

Co-Editor
Ms. Hina Arooj

Co-Editor
Mr. Aimal Alam

Co-Editor
VOLUME V (January-June, 2010)
CONTENTS
Editorial.................................................................................................................................. 03
Introduction........................................................................................................................... 05
Collaboration of PIPOS with ICRC ................................................................................... 06
Report on APOS meeting (2010).......................................................................................... 10
Report on seminar at SLSPO................................................................................................. 14
News and Events................................................................................. .................................. 15
Reminiscence........................................................................................................................ 18
PRSP Section......................................................................................................................... 20
Articles Section...................................................................................................................... 22
Students Corner..................................................................................................................... 31
PIPOS
Plot# 6-B, Sector B-3, Phase 5, Hayatabad,
Peshawar, Pakistan.
+92 91 9217150/ 9217520
+92 344 9797980
Email: piposexplorer@hotmail.com
pipos.info@gmail.com
Electronic copy of PIPOS EXPLORER can
be obtained from: www.oppak.com/pipos.html
02
EDITORIAL
ALHAMDO-LILLAH! By the grace of almighty ALLAH and the kind support from PIPOS
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administration; we have been able to publish the 5 consecutive issue of “PIPOS EXPLORER”.
We know that you all have been waiting eagerly for it and at last your curiosity ends here by holding
this issue in your hands.
PIPOS EXPLORER, the only prosthetic/orthotic magazine in Pakistan, has entered an explosive
phase in its growth that has surprised and gratified both its editors and its readers. This magazine is
posted free of cost to all the prosthetists/orthotists, orthopaedic surgeons, orthopaedic workshops,
universities and NGO's throughout Pakistan and is also downloaded by hundreds of users from
the internet.
Although PIPOS EXPLORER has changed both in design and content, it has never changed its
basic aim. Its aim is to provide the latest information regarding PIPOS and prosthetic/orthotic field
to all the people who are helping the physically disabled people. Let me repeat my words once
again “PIPOS EXPLORER is for all those who believe in serving the humanity”.
Dear readers! you all are indeed a part of PIPOS EXPLORER because without your participation
we would have been in wilderness. It is your contributions which makes this magazine an
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exclusive one. The feedbacks for the 4 issue that we received from the readers have really helped us
improving the quality and standard of this magazine. I am very thankful to all those who have sent
us their worthy suggestions and ideas and I hope to receive many more this time too.
Finally, I would like to say thanks to all the members of the editorial board for their hard work,
support and contribution that they extended towards me and the magazine.
Regards,
Riaz ud Din
Editor
03
EDITORIAL BOARD
Sitting Row (L to R) Prof. Dr. Bakht Sarwar (Patron in Chief)

Mr. Liaquat Ali Malik (Managing Director)
Mr. Aziz Ahmad (Chief Editor)
Mr. Riaz-ud-Din (Editor)
Standing Row (L to R) Mr. Waqas Mehmood (Co-Editor)

Ms. Sundas Khalid Khan (Co-Editor)
Ms. Hina Arooj (Co-Editor)
Mr. Aimal Alam (Co-Editor)
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ABOUT PIPOS
Pakistan Institute of Prosthetic and Orthotic Sciences (PIPOS) previously known as PETCOT, is the only
unique institute of its kind in the field of prosthetics and orthotics in Pakistan. PIPOS was established
in 1981 under bi-lateral assistance cooperation program between Pakistan and Germany and has
transitioned into a centre of excellence awarding B.Sc (Hons) degree in prosthetics and orthotics
from the University of Peshawar. PIPOS has been awarded as Category-II accreditation for training
and education in the field of Prosthetics and Orthotics by ISPO (International Society for Prosthetics
and Orthotics) based in Copenhagen, Denmark. Each year 12 students including both locals and
foreigners are trained in the field of Prosthetics and Orthotics. The students after graduation
undergo an exam here in Pakistan conducted by a delegation of ISPO. After passing the exam;
students are awarded a Category II certificate of orthopaedic technologist. Along with the provision
of B.Sc (Hons) degree, PIPOS is also providing all types of Prosthesis (Artificial
limbs) and Orthosis (Braces) for almost every kind of physical disability. For this
purpose institute maintains a model production centre providing assessment,
rehabilitation services to thousands of people annually. Each year more than 6000
orthopaedically disabled patients including amputees are fitted with the artificial
limbs and supports in PIPOS rehabilitation centre located at Hayatabad, Peshawar.
PROSTHETICS: It is the branch of orthopaedic science that deals with the study of
design, manufacture, and use of prosthesis (Artificial limbs) as a replacement for
a patient's limb loss caused through amputation or congenital limb loss. The aim of
this replacement is to provide an artificial limb, which looks and functions in a
manner, close to the natural limb as modern technology allows. The professionals
in this field are called a Prosthetist.
ORTHOTICS: It is the branch of orthopaedic science that deals with the

rehabilitation of weakened or disabled segment of the body, to prevent physical
deformities from progressing or to relieve pain through orthosis (Mechanical
supporting device).The professionals in this field are called as Orthotist.
COLLABORATION OF PIPOS WITH NATIONAL AND INTERNATIONAL ORGANIZATIONS
National Level:
Chal Network, AFIRM (Armed Forces Institute for Rehabilitation Medicine), PPL (Pakistan Petroleum
Limited), ERRA ( Earthquake Reconstruction and Rehabilitation Authority), PSRD (Pakistan Society for
the Rehabilitation of Disabled, Lahore), Al Khidmat Foundation Quetta, UET Peshawar, DOW Medical
university Karachi, MARDEA ( Medical Rehabilitation of the Disabled in Earthquake Affected Area).
International Level:
ISPO (International Society for Prosthetics and Orthotics), ICRC (International Committee of Red
Cross), WHO (World Health Organization), HI (Handicap International, France), DRI (Direct Relief
International, USA), The Parkwood Institute USA, University of Stathclyde Glasgow, Nippon
Foundation Japan, APOS (Alliance of Prosthetic and Orthotic Schools, Asia), George Brown College for
Prosthetics and Orthotics, Toronto, Canada.
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COLLABORATION OF PIPOS WITH ICRC

Pakistan Institute of Prosthetic and Orthotic Sciences (PIPOS) is the only unique institute of its
kind in the field of Prosthetic and Orthotic sciences in Pakistan. Since 1981, PIPOS has struggled
a lot to provide quality services in the field of Prosthetics (Artificial limbs) and Orthotics
(Orthopaedic supporting devices) to the patients.
PIPOS has always been among the first ones to help the people of Pakistan in every misfortune,
crises and natural disasters. PIPOS through its prosthetic and orthotic services has always helped
the disabled people and tried to alleviate the suffering and the consequences of their disability
and to accelerate their reintegration into society.
PIPOS is also committed to provide education in the field of prosthetics and orthotics according
to the international standards.
For this purpose PIPOS has developed linkages with many national and international
organizations and universities. Through all these collaborations and linkages PIPOS has
succeeded in its purpose to a great extent and is proud and confident to say that it is the only
institute in Pakistan providing high quality prosthetic and orthotic education and rehabilitation
to its people.
Among many of the collaborators, the ICRC is
currently the most active and leading one.
The International Committee of the Red Cross (ICRC)

is an impartial, neutral and independent organization
whose exclusively humanitarian mandate is to
protect the lives and dignity of victims of war and
internal violence and to provide them with
assistance.
Collaboration of the ICRC with PIPOS started in Oct,
2004 with the aim to assist the patients from the
conflict area of North & South Waziristan Agency and
also Afghan refugee in the camps. After the
earthquake 2005, ICRC supported PIPOS in terms of
training in Polypropylene (PP) Technology in Feb
2006. In this regard the ICRC donated the material
and components of PP technology for 300 Prosthesis
to PIPOS. Moreover, Two (Ortho & Physio) expatriate
of ICRC are in PIPOS to insure the quality of the
appliances and strengthen the hand skills of PIPOS
rehab staff in PP technology. ICRC PRP team members at PIPOS
L-R: Mr. Philip Morgan (Ortho prosthetist), Mr. Fazal Muhammad
(Ortho prosthetist), Mrs. Jantien Faber (Physiotherapist), Mr.
On 23rd Dec, 2009 PIPOS and the ICRC signed a 5 years Yaqoob Jan (Physiotherapist),
memorandum of understanding (MoU) with an Mr. Naseem Gul (Assistant)
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intention to assist PIPOS to grow to a centre of excellence contributing quality services to

physically disabled people.
With this Vision PIPOS and the ICRC are working together on different projects. Some of them are
as follow:
The Physical Rehabilitation Program

The main objective of this program is to assist in fitting physically disabled people primarily
from NWFP and FATA with orthopaedic appliances: Prostheses (Artificial limbs), Orthoses
(Orthopedic mechanical devices that rehabilitate the weakened or disabled segment of the
body, prevent the deformity from progressing further or relieves the pain), mobility aids (Wheel
chairs, Crutches) as well as physiotherapy treatments.
It is the basic right of every disable to get access to rehabilitation services. Due to poor
economic conditions a majority of the population does not have access to physical
rehabilitation. The MoU between PIPOS and ICRC has given a great benefit to the people of NWFP
province of Pakistan, as
under this program the
major part of patient's
rehabilitation in PIPOS is
financially sponsored by
the ICRC. The patients
(who are part of the ICRC
target group) of far flung
areas are also provided
free accommodation and
food by the ICRC. In 2009,
2351 patients received
prosthetic and orthotic
services which were mainly
sponsored by the ICRC.
Home Care Project (HCP)

The ICRC has carried out a home care project in NWFP since 2007 to reintegrate spinal cord
injured patients into the community. This project has registered 300 patients from Peshawar,
Mardan, Charsadda and Nowshera who are suffering from spinal cord injuries. It provides
patients with treatment in their home environment, thereby helping them to preserve their
dignity and optimize their functional independence. Assistance includes physiotherapy
assessment and treatments, gait training, orthotic devices, wheelchairs, walking aids, toilet
chairs and other equipments.
The orthotic devices for these patients are manufactured in PIPOS.
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Renovation of PIPOS Rehabilitation Area

To provide high quality rehabilitation services to
patients it is essential to have a world class
infrastructure. For this purpose the ICRC
renovated the rehabilitation area for PIPOS. In
this new infrastructure every room has been air-
conditioned and well furnished. Separate male
and female gym with two casting rooms for
females and four casting rooms for males have
been built. A well organized reception, separate
waiting room for male and female patients have
also been developed. The moulding,
modification and machine rooms have been
arranged according to international standards.
Tools and Machinery Donation
The ICRC also donated different tools and machinery used in the field of prosthetics and
orthotics. The assembling hall has been set up with separate tables for every
prosthetist/orthotist having all the tools available on their tables. Different physio equipments
have also been donated to the male and female gym.
Training of On Job Rehab Staff
In order to maximize the likelihood of a successful outcome in relation to clinical management
of the patient, it is necessary to perform a good examination, evaluation, and diagnosis. This is
only possible if the professionals are having an updated practical and theoretical knowledge.
In this regard ICRC expatriates are providing
training to the on job prosthetists/orthotists,
physiotherapists and bench workers. All this is
helping them in updating the knowledge and
bringing the rehabilitation facilities at PIPOS
according to international requirements and new
research.
In this regard the bench workers and P&O's were
also provided three months training at ICRC
Muzaffarabad center.
The main focus of ICRC expatriates is to strengthen the knowledge of PIPOS rehab staff in
physical rehabilitation, assessment, prescription and manufacturing appliances according to
the polypropylene technology. This is because PP appliances are cheap and easy to fabricate as
compared to conventional appliances. The cheapness and easy fabrication of polypropylene
appliances will help the P&O services of PIPOS to become sustainable. This sustainability is
important because an individual amputee or physically disabled person has a permanent
disability and needs access to functioning rehabilitation center for rest of his/her life.
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Introduction of PMS
The Patient Management System (PMS) has been
introduced in the reception and two
receptionists were provided training for its
operation.
The PMS was developed as a tool to manage the

activities of a physical rehabilitation center.
The PMS include the following (most important

features):
! Possibility to uses the PMS with two
languages: English and national language
! Possibility to customized PMS according to
center specificities (name, location,
fabrication \techniques, etc)
! It covers patient personal information, prosthetic/orthotic/wheelchair/walking aids
information (including fabrication, repair history, follow-up), physiotherapy treatment,
and information on patients seen in outreach programs.
! Complete history of patient can be viewed on one screen.
Scholarships for Students

The ICRC also provided scholarships to two students of Kashmir that were affected in earth
quake. The scholarships cover all their tuition and hostel expenses.
Clinical Placement of Final Year Students

The ICRC and PIPOS are making arrangements for the clinical placements of the final year
students in the ICRC centers of Muzaffarabad and Quetta. During this clinical placement the
students would effectively apply the knowledge and skill learned at PIPOS by independently
performing patients clinical assessments, diagnosis, prescription, material selection,
fabrication, fitting and gait training.
Report prepared by: Riaz ud Din
Student of PIPOS/Editor of PIPOS EXPLORER
References:
Information and patient data obtained from Mrs. Jantien Faber (Team leader, ICRC PRP in Peshawar)
and Mr. Fazal Muhammad (Field officer, ICRC PRP, Peshawar)
Information obtained from ICRC SUPPORT FOR LIFE DVD.
www.icrc.org, accessed on 14/3/10
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APOS
Alliance of Prosthetic and Orthotics Schools Asia
APOS MEETING 2010, SRI LANKA

Introduction:
The Alliance of Prosthetic Orthotic Schools (APOS) Asia, is a group of training institutions and
their supporters in Asia who have developed a series of activities to provide mutual support,
challenge and interaction to promote the profession of prosthetics and orthotics in the region
and beyond.
The initiative was taken in 2003 by the Cambodia School of Prosthetics and Orthotics (CSPO) and
supported by the Nippon Foundation. Annually, the alliance has promoted the development of
staff exchange programs, annual meetings and the sharing of resources.
The core membership comprises of the four prosthetics and orthotics schools, three out of which
(Cambodia, Sri Lanka, Thailand) are directly supported by the Nippon Foundation, Japan and
the fourth school is from Pakistan.
APOS was initially managed by the international staff/leadership of the four founding schools,
the president of International Society for Prosthetics and Orthotics (ISPO), the Nippon
Foundation and the Cambodia Trust. However in 2009, the leadership was handed over to a
regional board from the four core schools, plus the school in Vietnam (VIETCOT). The founders
will maintain a presence as an advisory group from February 2009, eventually phasing out in 3-5
years. The newly formed APOS board had its first meeting in Thailand and the second meeting
was conducted in Sri Lanka in Feb, 2010.
APOS Meeting Proceedings:

st
The Meeting of APOS board was held in Sri Lanka from 19 February to 21 February, 2010. Twenty-
five Participants attended the meeting. These participants were from core member schools that
are PIPOS, SLSPO, VEITCOT, CSPO and SSPO, as well as, associate school like Mobility India, JSPO
(Jakarta School of Prosthetics and Orthotics) Indonesia, and upcoming school of Bangladesh. Mr.
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Dan Blocka specially came to join the meeting on third day (21 February) for demonstration of
Google Apps.
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Participants of APOS Meeting 2010 at SLSPO (Sri Lanka School of Prosthetics and Orthotics) Sri Lanka
The Agenda of the meeting was to monitor the objective of APOS, set the criteria for staff
exchange programs and mentoring of some specific topic in member schools and monitoring the
activities of repository group.
The first day was allocated for the meeting of APOS sub groups. In the first session, APOS board
and Advisory group (Dr. Bakht Sarwar and Mary Scot) met together. At the same time task
officers and repository task officers were meeting in their respective groups.
Oil Lamp lighting ceremony
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The Formal session was started on next day with registration of participants followed by elegant
ceremony of oil lamp lighting. Dr. Panagla from Ragama Rehabilitation Hospital, Advisory group
and APOS Board, Lise Hjelstoms (School Manager, SLSPO) lit the lamp.
Lise Hjelstoms, Uzma Jabeen(PIPOS) and Dr. Panagla delivered their speeches on behalf of
SLSPO, APOS board and Ragama Rehabilitation Hospital, respectively.
In Second session of the day, presentations were made about the objective Monitoring and APOS
budget. Representatives from Laos, Indonesia, Thailand, India, Pakistan and Cambodia
presented progress of their schools. Delegate from Bangladesh came with proposal of upcoming
school.
The final session of the second day mainly consisted of discussion about proposed criteria for
staff exchange and Mentoring topics. Mr. Teap Odom (CSPO, Cambodia) and Mr. To Sicheun
(CSPO, Cambodia) facilitated this session.
The Third and Last day was mainly about the activities of repository group. Mr. Aziz Ahmad
(PIPOS) coordinator repository group coordinated the meeting on 3rd day. Mr. Dan Blocka (ISPO)
and Mr. Thanit (SSPO, Thailand) did the demonstrations about the use of web page
(www.google.com/a/apos-aisa.org) and http://www.apos-asia.org/mod/system_home/.
The repository development for the APOS-Asia is getting its shape, but there are many
challenges to overcome. The legality and the process for documentation, copy rights, structure
and policy for the repository will be discussed in the coming days. Although the “walk through”
document has been developed even then the two main objectives of this year will be to give
some shape to the repository policy and the structure.
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IT session on 3rd day of meeting
Key Activities for 2010-2011

! Next APOS/ISPO Seminar - Board
! Co-ordinate staff exchanges Odom/Board
! Co-ordinate and arrange mentoring programs Sichoeun/Board
! Encourage the inclusion of CBR Program Sisary/Board
! APOS Annual Report Sisary/Board
! Create liaison with other service providers in the region Sisary/Board
! Encourage the use of follow-up and feedback systems from users Ki/Board
! Website activities Repository group
Challenges of the board

There were some gap in communication between the APOS board and other supportive groups.
The virtue board meeting agenda was not clear
The meetings could not be conducted smoothly
Improving:
To arrange communication protocol for task officers, repository officers, and board need to have
regular reports.
To develop proper agenda for board meetings
To monitor the work plan against action regularly
Conclusion:
APOS board meeting, 2010 ended successfully. Action Plan for year 2010-11 was developed and
the criteria for staff exchange program and mentoring was also formulated. APOS web pages
were introduced to participants. Next APOS meeting and ISPO seminar will be conducted in
Indonesia (Jakarta School of Prosthetics and Orthotics) as the school offers to host the ISPO
Seminar to raise awareness of P&O services in the country.
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SRI LANKA SCHOOL OF PROSTHETICS & ORTHOTICS (SLSPO)

HOSTS SRI LANKA'S FIRST REGIONAL SEMINAR ON DISABILITIES
CAUSED BY DIABETES, LEPROSY AND OTHER NEUROPATHIES
Helen Cochrane CPO(c), Cambodia Trust Clinical Mentor
On Sunday, February 14th 2010 at 09.00 am, the opening ceremony of a regional seminar hosted by
the SLSPO at the Cinnamon Grand Hotel, Colombo Sri Lanka began with a traditional oil lamp
ceremony to welcome faculty and participants from more than 12 countries.
The seminar, on Prosthetic and Orthotic Services including Rehabilitation related to Diabetes
and other Neuropathic Disabilities, was part of a range of SLSPO activities to support
rehabilitation professionals in continuing education and professional development in Sri Lanka and
the region. The seminar was co-ordinated by the International Society for Prosthetics and Orthotics
(ISPO) and funded by the Nippon Foundation of Japan and ISPO.
The seminar focused on the
needs of people affected by
diabetes and leprosy. The world
is facing an epidemic of
diabetes, with up to 70% of all
leg amputations as result of this
disease.
Although leprosy is consider to
be eliminated, new cases persist
in many countries and the
rehabilitation needs for people
who have had leprosy are
ongoing and present similar risks
for foot complications and Participants of the seminar
amputation as for individuals who have diabetes. In spite of its curable nature leprosy remains
highly stigmatized often resulting in discrimination and displacement for individuals who have been
affected. Timely, appropriate care of neuropathic condition has been shown to reduce disabilities
and may help to lessen the associated stigma and burden of disease.
The faculty comprised experts from Argentina, Netherlands, Sri Lanka, Sweden and USA.
Participants included doctors, physiotherapists, nurses and prosthetist/orthotists and included
guests from Pakistan, Bangladesh, Cambodia, India, Indonesia, Lao PDR, and Vietnam. The seminar
provided opportunities for building professional networks, learning from each other and sharing
knowledge and experience to improve services for patients in the future. Three days of lectures
were compliments by practical sessions on casting, assessment and diagnosis.
Prosthetics and orthotics as a part of the multi-disciplinary team are essential for mobility and
prevention of disabilities to reduce the burden of disease; the seminar in Colombo allowed for a
valuable collaboration across disciplines from around the region.
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NEWS AND EVENTS

Farewell to the Chairman
On 27th of January, 2010 a party was held in PIPOS to farewell the ex-chairman Dr. Khan Haider.
All PRSP members and PIPOS staff was invited in this event. Dr. Khan Haider served PIPOS for nine
years contributing a lot to PIPOS through his efforts. His leadership and kind attitude helped the
staff members of PIPOS to upgrade and standardize the teaching and rehabilitation services
being provided at PIPOS.
Dr. Khan Haider also delivered a speech in which he expressed his feelings and gratitude for the
opportunities that PIPOS provided him. He also recalled many of the activities that took place in
PIPOS during his chairmanship. PIPOS greatly appreciates his contribution and wishes him well
for future.
Dr. Khan Haider delivering his farewell speech Audience during the farewell speech
PIPOS Faculty Member Attends the International Seminar in Sri Lanka

Mrs. Tabassum Rana (Assistant Professor and Head of Orthotic Dept.) attended the seminar on
disabilities caused by diabetes, leprosy and other neuropathies. The seminar was held from 14-
16th Feb, 2010 at Sri Lankan School of Prosthetics and Orthotics, Sri Lanka. This seminar was
sponsored by Nippon Foundation, Japan and coordinated by ISPO.
During the seminar many areas of neuropathic disorders were explained, such as identifying the
neuropathies, rehabilitation of neuropathies, the diabetic foot, neuropathy in leprosy,
conservative treatment of charcot foot, different levels of amputation, etc.
The seminar also aimed to increase the collaboration among the regional schools in developing
countries including PIPOS (Pakistan), SLSPO (Sri Lanka), CSPO (Cambodia), VEITCOT (Vietnam),
etc. Many expatriates from ISPO and other countries participated and delivered lectures during
the seminar.
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Mrs. Tabassum Rana (2nd from right) with other participants Practical session during seminar
Open Day for ICRC Delegation at PIPOS/PRSP

An open day for ICRC delegation was held recently in which a delegation consisting of 17 people
visited PIPOS/ PRSP. These delegates belonged to different departments of ICRC and they visited
to see the activities of ICRC in PIPOS/PRSP. Mr. Charles (ICRC representative) and Mr. Liaquat Ali
Malik (Managing Director, PIPOS) explained the collaborative activities of ICRC and PIPOS to the
delegation.
During their visit a complete tour to different areas of PIPOS/PRSP was arranged and the
participants were briefed about the prosthetic/orthotic treatment and fabrication procedures.
ICRC delegates during the open day at PIPOS/PRSP
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Welcome/Farewell Party, 2010

th
On the evening of 26 of March, 2010 a welcome party for the new intake students and farewell
rd th
party to the outgoing batch was held at PIPOS. The party was organized by 3 and 5 semester
students. It started at 7 pm and ended at 11 pm.
The party included different funny skits, musical programs and many other interesting
activities. Sundas Khalid Khan with Waqas Mehmood and Syed Abdul Haq with Maaz Khattak did
the comparing in party. Party was made astonishing and charming by the superb acting of
Sheryar and Manzoor Ahmad of 3rd semester. At the end awards were given by the chief guest
Prof. Dr. Bakht Sarwar to the organizers and Mr. Sheryar Khan for his best performance. The
wonderful party was concluded with a magnificent dinner.
Funny beat box Audience during the party
Training Workshop on Strategic Planning at PIPOS

A training workshop on strategic planning was held at PIPOS on April 16-17, 2010. Workshop was
attended by all the PRSP center managers and some selected staff members of PIPOS. Mr. Sami
Ullah (International Development Consultant) and Mr. Hussain Khattak(D.G Finance, PIPOS)
were the presenters of workshop. The objective of this workshop was to enable the participants
to demonstrate an advance level of understanding of the principal and practice of strategic
planning. The workshop included lectures, discussions and practical exercises related to each
topic. Main topics covered during this workshop were strategic governance, strategic analysis,
identifying strategic directions, action planning, writing and communicating the plan,
monitoring, evaluation and deviations from the plan.
Mr. Sami Ullah presenting his lecture Participants

17
REMINISCENCE
When I was a student in PIPOS
Ms. Uzma Jabeen

Assistant Professor, PIPOS
George Bernard Shaw says “Reminiscences makes one feel so deliciously aged and sad”. This is
very true, as we go ahead in life we find new dimensions and when we look back there is a
combination of pleasant and unpleasant memories.
It is always difficult to recall the past and write reminiscence because it is like holding the sand
in hand. We want to hold the memories tightly in our fist and still they slip out of hand, but the
important events always shine around us. Among them one memory is like North Star which
always guides us in Life. Such an event in my life is entrance in PIPOS. As I am moving forward in
my life my vision revolves around P&O.
It was September 1996, when I entered the lecture room where Dr. Altaf Ahmad (Principal of
PIPOS at that time) was delivering the introductory lecture. After the lecture we went to Lab
where a set of different tools were waiting for us. First question in my mind was “what am I
gonna be?”
Although in practical entry test I faced the drill machine, hack saw and rasp file (at that time I
didn't know the names of tools) and I never had an experience to hold them before. Anyway it
had gone well. I remember the first ever demonstration in PIPOS. It was about filing a metal
piece and was demonstrated by Miss Seema Ishaq (she was my inspiration as gorgeous and caring
personality), it was a long demo and ended only after I fainted. I was then taken to Gym in
Khyber Teaching Hospital's campus. After drinking a glass of water I felt better. The dream or
nightmare which I faced at night was” am I gonna be a Blacksmith?” But latter in First year when
we started the casting I felt relieved.
In the end of First year in March 1997, the International seminar on Dysmilia was organized by
PIPOS in the special education building. It was the first great event that I attended.
18
In second year, we started with SACH Foot and Ankle block, the question in my mind was” Am I
gonna be a carpenter?” But when we started Prosthetics my vision was changed but not cleared
because we never observed any patients until then. In third year when I fabricated a knee
disarticulation prosthesis; my vision was cleared and I felt proud. I made KDP for a 12 years old
girl (Uzma Rasheed) and the level of my joy and satisfaction knew no boundaries when I saw her
happy and smiling during gait training.
I still remember the Words of Mr. Liaquat Ali Malik who said at that time “there is no alternative
of satisfaction which you feel when a patient comes by crawling and goes upright because of
devices you provide to him”.
It was in January 2005, when I was going to passport office for my passport; because I was going
to Cambodia for my further studies and my mother was reluctant to send me abroad. But my
father's support and Dr. Sarwar's convincing power came in action and I went there for two years.
These two years were the most difficult time for me in a totally different culture. But thanks
God; this period ended up with success.
The greatest achievement was the moment when I was introducing APOS in front of people from
more than 15 countries. It is only PIPOS that provided me the platform from where I developed
myself.
I dedicate my success to my father, who died in March, 2009. It was his encouragement that gave
me strength to spend time in Cambodia and strive for the best. His death is a great loss to me, I
still feel as it was yesterday when he was with me but now no more. Dr. Abdul Zahir said about my
father “Physically he will not be in this world but his name would remain a live whenever you and
your sibling achieve success”. His words echo around me and give me courage.
I will always be thankful to my parents, teachers especially to Dr. Sarwar and friends who
contributed a lot in my life. But on top of everything, thanks to PIPOS because it is the axis
around which my professional achievements are revolving.
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PRSP SECTION
PRSP (PIPOS Rehabilitation Services Project)
PRSP (PIPOS Rehabilitation Services Project) is an extension of PIPOS (Pakistan Institute of

Prosthetic and Orthotic Sciences) whose mission is to provide high quality patient care by
providing assistive devices and related services to anyone no matter whatever their
affordability maybe. PRSP developed radically, particularly with the creation and establishment
of 09 centers in NWFP and one in AJK. This growth has its toll on quality of services, management
and education. It is further aggravated by the demand of national and International
organizations to extend PRSP services further in the NWFP, FATA, AJK and other provinces of
Pakistan.
Jan-March, 2010 Patient Record
Total Number of Cases 758 Jan-March, 2010

Orthotics 530
Prosthetics 228
Services provided Number of cases
New 499
Repair 117
Replacement 41
Review 101
20
CENTER PROFILE
PIPOS CHALL REHAB CENTER, BESHAM
Besham
Besham is one of the most beautiful area in district Shangla. It
has two sub divisions which are Puran and Alpuri. Shangla has
28 union councils having population of 10 lacs. Most of the
population is pashto speaking pashtoons.
According to the WHO the disability ratio in this area is 0.03%.
BESHAM & THE EARTHQUAKE Mr. Murad Ali
Center Manager/ Prosthetist & Orthotist
On Saturday October 08, 2005 at 8:52 am a devastating
earthquake 7.6 on Richter scale struck the Kashmir and five
northern districts of Pakistan. Among them Shangla was
one of the disaster prone areas of the earthquake wreckage
which affected almost whole of the population. The
earthquake disaster caused serious damages including
2000 deaths and leaving about 5000 people injured. Apart
from death and serious injuries the infrastructures like
health facilities, education institutions, link roads,
drinking water supply schemes, and many other
infrastructures of the district were completely destroyed.
PIPOS CHALL REHAB CENTER, BESHAM
PIPOS being the pioneer in rehabilitation, started its
services with DRI (DIRECT RELIEF INTERNATIONAL) and
Chall network for the PWDs.
A center was established in THQ Hospital Besham to
provide prosthetics/orthotics & physiotherapy services.
CENTER STATISTICS
Total registered patients : 653
Orthotic : 393
Prosthetic patients : 260
Physiotherapy patients : 7300
Prosthetic appliances delivered : 264
Orthotic devices delivered : 580
Total appliances delivered : 844
COORDINATION WITH OTHER ORGANIZATIONS
PIPOS rehab center has strong coordination with various national and international
organizations such as Chall network, ICRC, MRDEA (ERRA), HI (Handicap International), DRI
(Direct Relief International) etc.
21
ARTICLES SECTION
Comparing the effectiveness of different orthotic techniques for treatment of
Legg-Calve-Perthe's disease
By: Nizar Aktar

Assistant Professor, PIPOS
Introduction
Legg-Calve-Perthes' disease (LCPD), named after three orthopedic surgeons who first identified
it, is an avascular necrosis of the femoral head before skeletal maturity( see Fig. 1) (Orban &
Adam, 2007; Carpenter, 1975; Guille, Lipton, Szoke, Bowen, Harcke & Glutting, 1998).It is a
“self-limiting, non-inflammatory condition, affecting the capital femoral epiphysis with stages
of degeneration and regeneration leading to the restoration of the bone nucleus”(Perthes,
1954).The common signs and symptoms include mild pain at the antero-medial thigh ,
insufficiency of hip abductors, inguinal lymph nodes swelling, thigh muscles atrophy, 1-2 cm
limb shortening, restriction in hip abduction and medial rotation with femoral head flattening
(Frick, 2006; Joseph, Malpuri & Varghese, 2001; Ferguson, 1954; Carpenter,1975; Bowen,Foster
& hartzel, 1984; Raney & Brashear, 1971).
Fig.1 (a) shows Anterior Perthes disease of fourteen month child after the onset. The appearance is that
of a clean cut removal of the anterior half of the femoral head, leaving a normal posterior half.
Fig.1 (b) shows Petrthes diease of whole femoral head none month after the first symptom. The entire
epiphysis appears to be fragmented and flattened.
Treatment for LCPD includes observation (Goff, 1959), recumbency (Brothertorn, 1976;
Brothertorn & Mc Kibbin, 1977; Danforth, 1958), and containment of femoral head with in the
acetabulum through surgery, casts and Orthosis (Axer, 1965; Lioyd-Roberts, Catterall, &
Salamon, 1976; Pemberton, 1979).The choice of treatment is still a point of considerable
debate(Purvis, Dimon III, Meehan & Lovell, 1980)
The purpose of this assignment is to find out different orthotic techniques and compare them for
their advantages and disadvantages regarding patient's comfort and prognosis, which require a
deep knowledge of epidemiology, etiology and classification of this inexplicable disease.
22
Epidemiology of Legg-Calve-Perthes Disease (LCPD)

LCPD primarily affects boys more than girls by a ratio of 4 to 1(Joseph, et al. 2001; Sanctis &
Rondinella, 2000; Orban & Adam, 2007; Ferguson, 1954). The common age of onset ranges from 4
to 8 years (some cases have been diagnosed in children from age 3 to 11) and usually affect one
hip, however 10 % of patients have bilaterality (Ferguson, 1954; Caterall, 1971; Guille et al.
1998).The frequency of right and left hip involvement is almost same (Guille et al. 1998;
Wenger, Ward & Herring, 1991)
Etiology
A number of causative factors in LCPD have been explained in different research papers. These
ideas include vascular factors especially obstruction of posterior circumflex artery (Joseph, et
al. 2001; Sanctis & Rondinella, 2000; Hayek, Kenet, & Lubetsky, 1999), traumatic factors for
example repetitive micro traumatism in hyperactive children (Goff, 1954; Carpenter,1975) ,
congenital malformations like delay in skeletal maturation (Bogaert, Rosa & Moens, 1999; Boss &
Misselevish, 2003), hormonal growth abnormalities (Matsumoto, Enomoto, & Takahashi, 1998;
Kim, Randall & Bian, 2005), malnutrition like increased incidence in low income families(Orban
& Adam, 2007) and racial factors for example Japanese, Asians and Central Europeans have high
frequency of this syndrome while native Australians and Americans have decreased occurrence
(Orban & Adam, 2007).This disease remains somewhat of a mystery and the exact cause of the
ischemic necrosis of femoral head cannot be identified (Carpenter,1975).
Classification
Several classification methods have been developed, however
Catteral classification is most important one which is based on the
amount of femoral epiphysis involvement and has four groups of
LCPD (see Fig.2) (Nochimson, 2008; Canale, et al. 1972).Group 1
has limited involvement of anterior femoral epiphysis (least
severe) and Group IV has the involvement of entire epiphysis (most
severe) while Groups II and III are in-between to the other two and
held in reserve prognosis (Orban & Adam, 2007; Carpenter, 1975).
Fig. 2 shows Catterall classified Legg-Calve-Perthes disease in to
four stages. In stages 1; necrosis is present at the anterior aspect of
the femoral head as noted by the dotted areas. Lysis is present,
but there is no bony sequestration. In stage 2, bony sequestration is
present as noted by the central areas of radiopacity. A medial and
lateral column of normal bone protects the central area from
collapse. In stage 3, extensive bony sequestration dimishes support
and increases the chance of residual deformity. Metaphyseal cyst
formation is noted by the lines lashed areas. In stage 4, total
involvement produces significant residual deformity shown by the
jagged areas that indicate sclerosis and decreased size of the
femoral head. Retrieved from Gerberg & Michael, 1996.
23
Prognosis
The prognosis of LCPD is generally influenced by factors like age and sex of the patient along
with stages of the disease at the time of diagnosis (Catterall, 1971). It is directly proportional to
the degree of femoral head necrosis; the more extensive the involvement, the poorer the
prognosis (Canale, et al, 1972; Carpenter, 1975). Prognosis of LCPD is good with Catteral I and II
,while it is poor with III and IV (Orban & Adam, 2007; Herring, Kim & Browne, 2004).The central
position and distribution of forces over the femoral head can be achieved by conservative
approaches and surgical methods (Roposch, Mayr & Linhart, 2003). Surgical treatment consists
of innominate osteotomy and varisation osteotomy of proximal part of femur (Salter, 1973;
Harrison & Menon, 1966) while for conservative treatment abduction orthoses are considered
effective (Roposch, et al. 2003).
Different Orthotic Techniques and their Effectiveness

A number of ambulatory abduction orthoses have been developed including containment splint,
Scottish Rite Abduction Orthosis(SRO), Newington Brace, Tachjidian brace, Craig abduction
walking splint, Synder sling, Weight bearing orthosis and Toronto Legg-Perthes Brace (Purvis, et
al. 1980; Orban & Adam, 2007; Futami & Suzuki, 1997; Herring, J.A. 1994).The effectiveness of
all these designs are compared by placement of the femoral head with in the acetabulum to
equalize pressure on the articular cartilage, maintaining good range of motion and to promote a
round head in a normal acetabulum (Petrie & Bitenc, 1971; Orban & Adam, 2007;Cocchiarella,
Chalenor & Katz, 1972). Furthermore, these braces are also compared on prognostic factors like
age of onset and stage of the disease.
Comparison in femoral head containment

Containment is based on the principle of directing the femoral head in to acetabulum and can be
achieved by different types of braces (Wang et al. 1995).
Containment splint enforces the femoral head with in the acetabulum by abduction, flexion and
internal rotation of hip and is better in containment than Synder sling (see Figs.3-A, 3-B)
(Bowen, et al. 1984; Harrison, Turner, & Nicholson, 1969) while in SRO which is the most widely
used orthosis(Martinez et al. 1992), hips are held abducted, flexed and externally rotated (see
Figs. 4-A & 4-B) (Meeham, Angel & Nelson, 1992; Orban & Adam, 2007).
Newington brace allow the containment to be achieved through 45 degrees abduction, 20

degrees internal rotation and knees and hips are held at 10 degrees of flexion(see Fig.5-A, 5-B)
(Curtis, Gunther, Gossling, & Paul, 1992).On the other hand, Tachjidian brace achieves
maintenance only through abduction and internal rotation (see Figs.6) (Tachdjian, 1972).
Craig abduction walking splint is a bit different from the above in which containment of hip is
achieved through abduction, internal rotation and extension instead of flexion at the same time
as using regular axillary crutches (Craig, Kramer, & Watanab, 1963).While Toronto Legg-Perthes
brace allows walking maintaining hips at 45 degrees abduction and the remaining hip and knee
motions are permitted (Fig.7) (Bobechko, McLaurin & Moyloch, 1968).
24
Weight bearing orthosis which is not much popular in use provides maintenance by abduction
and flexion of the hip (Wang et al, 1995) but it also allows medial and lateral movements that
leads to deterioration of femoral head (Bobechko et al, 1968).
Fig. 3- A (Anterior view) and Fig.3- B (Side view): The containment splint. The Right hip is held in
abduction, flexion, and full internal rotation. Adapted from Harrison et al. 1969.
Fig. 4-A: The Scottish Rite abduction orthosis. Frontal view of orthosis, showing the pelvis band. Single
axis hinge joints and pistoning the abduction bar. Retrieved from Meehan, et al. 1992
Fig. 4- B: Anteroposterior radiograph of the pelvis, made with the patient standing while wearing the
orthosis, showing coverage of the affected right hip with 30 degrees of abduction. Retrieved from
Meehan, et al. 1992
Figs. 5-A (Anterior view) and 5-B (Posterior view) :The Newington brace; Note careful molding and
setting of stabilizing shells, as well as foot-ankle components to maintain slight internal rotation.
25
Fig. 6 shows Tachdjian trilateral socket hip abduction orthosis, Retrieved from Tachdjian, 1972
Fig.7 Shows the Toronto brace for Legg-Perthes disease in use. Retrieved from Bobechko, et al. 1968
Comparison involving restrictions/allowance in activities/ ROM and patient/parent

acceptance
Containment splints need high degree of parental co-operation, cause temporary atrophy,
shortening of foot and reduction in limb length (Harrison, Turner, & Nicholson, 1969) while SRO
has minimum psychological effects of long term use(Purvis, et al. 1980), allowing knee and ankle
for full range of motion (Meeham, et al. 1992; Orban & Adam, 2007) , better for hyperactive
patients in sports activities like swimming and skiing, jumping and bike riding (Purvis, et al.
1980) and widely accepted by parents and patients because of easy donning and doffing as well
as require minimum management (King, Fisher, Gage, & Glossing, 1980; Purvis, et al. 1980).
Furthermore, SRO is used without any crouches while the use of cranes with Newington, Craig
and Containment braces are necessary(Craig, et al. 1963; Curtis, et al.1974; Evans & Lioyd-
Roberts, 1958; Kelly, Canale, &Jones, 1980) and are heavier than SRO (Purvis, et al. 1980;
Reister & Eilert, 1997).Craig abduction splint allows the patient to perform activities of daily
livings like going up and down the stairs and manuering through narrow spaces but also can cause
blisters on lateral border of feet, skin irritation and tightness of iliotibial band and tensor fascia
lata (Carpenter, 1975).
26
Comparison in Sphericity of the femoral head

The shape of femoral head is examined by the Mose method (1964) in which a transparent plate
with a series of concentric circles is placed on the antero-posterior and lateral radiographs (see
Fig. 8) (Katz, 1967). If the outline of the head and the two circles are coinciding i-e have the
same radius, the head is spherical and the result is considered as good. If the head is elliptical
(difference of 2mm between the two circles and outline of head) the result is fair and if the
difference is greater than 2 mm both in frontal and lateral views the result is considered as poor
(Petrie & Bitenc, 1971).
Fig.8 (A & B) show a good result assessed by method of Mose, in frontal and lateral views respectively.
Retrieved from Petrie & Bitenc, 1971.
Although SRO is a popular method of treatment ( Meechan et al. 1992,; Martinez, et al. 1992)
even though the results reported by Wang et al. (1995) treating patients with SRO, were
significantly worse for Mose measurements than those for hips treated with Petrie cast,
exercises and non-weight bearing orthoses. But in Cooperman and Stulberg (1986) study, 71%
patients have achieved spherical heads through the use of SRO; while 64% through Newington
brace. Martinez, et al. (1992) and Meehan, et al. (1992) concluded in their reports that SRO did
not offer any advantage as compared with other methods, or with no treatment. Authors of early
reports found SRO to be successful in spherecity of femoral head compared to other braces but
recent studies did not show a positive response to its outcome (Martines, Weinstein & Dietz,
1992; Kamegaya, 1987). Kelly, et al. (1980) reported 80% good results (100% spherical heads) in
their study relative to the use of Synder sling. Herring, (1994) has shown deep concern that
despite having good results why Synder sling method has been abandoned.
Comparison on prognostic factors
Majority of the studies stated that the prognosis of LCPD depends on the age of onset and stage
of the disease i-e Caterall classification (Sticker & Barone, 2001).It is also mentioned in these
articles that the proportion of poor results increases with the age of onset, especially after the
age of six ( Catterall, 1971; Gossling, 1973; Katz, 1967; Mose, 1964)
Fulford, Lunn & Macnicol (1993) compared the outcome of Ischial Weight Bearing Brace with
osteotomy in patients with average age of 6 years and 4 months and hips in catterall groups III
and IV. It is found with 26% good and 30% poor result compared with 20% and 23% that had
27
osteotomy. The results obtained by Kelly et al. (1980) through using Synder Sling Orthosis for
patients with same age and catterall groups as in Fulford et al. (1993) study, were 50% good and
26% poor. It means that the results of Synder sling orthosis are better than ischial weight bearing
brace and osteotomy.
Meehan et al. (1992) reported the use of SRO in patients who were more than 6 years of age and
their hips had catterall grades III and IV involvement, only 35% patients had good result. On the
other hand Martinez et al (1992) treated 31 patients of same age and catterall grades by using
Weight Bearing Orthosis. No hip had good result; only 35% hips had a fair result. It is clear from
these results that Weight bearing orthosis is contraindicated for treating severely involved hips
(Martinez et al. 1992).
Conclusion
Legg-Calve-Perthes' disease is a disorder that involves growth of the immature proximal femoral
epiphysis. Containment of the femoral head with in the acetabulum is currently the preferred
method which can be achieved by either surgical or non operative methods. The degree of
necrosis, age at the onset, and deformity of femoral head are important factors in predicting the
outcome of treatment. Most of the authors suggest that Catterral I and II stages should be
treated through non surgical treatment, while surgical intervention is best for Catterral III and
IV. Among the non surgical techniques, Scottish Rite abduction orthosis was preferred by authors
of early reports but recent studies have rejected it because of having several disadvantages. The
management of patients with LCPD is problematic because the best method is unknown.
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31
HOPE ! There is nothing loftier than

human hope and nothing deeper
than human heart. If a question is
asked that what does a man live
by?? The inevitable answer would
be hope. Hope is the only
stimulus for living as life is so full
of setback, doubts, fears, worries
& tragic accidents. At every step
we need kinds of assurance in
order to cling to life. All religions
of world consider hope as one of
the fundamental virtue. If hope
was not there; humanity would
have perished long before
national and individual life
flourishes. Hope is thus a great
stimulus to efforts and progress.
It is a great source of happiness
and it is always associated with better things to come. All human beings are engaged in a quest
for happiness, they would have stopped the quest in the most difficult conditions but hope gives
man the capacity to endure and fight against the odds of life.
Disillusionment meets us on all path of life but every where it is hope that always succeeds in the
divine scheme of things. Hope keep on rising in human chest all the time, if one hope fails
another takes its place. Human heart usually contains several hopes simultaneously so that the
non realization of one hope doesn't cause much distress. Hope like all heavenly blessings reigns
everywhere: the sky, high palaces and the smallest ones. Dark hamlets all are lit up by hope, its
light may become dim but it never extinguishes even in the darkest hour of life. There is no limit
to hope. A dying man keeps on hoping for his recovery, he is hoping against hope. Hope is given up
only when death actually comes. Indeed hope is natural as breathing and as breathing ends with
death so hope also dies with it. Man's life is woven with dreams, ambitions and hopes. If he had
not experienced hope, ambitions and dreams, society and civilization would not have made any
progress. Hope & dreams are the main springs for advancement in life.
By: Hina Arooj

nd
Semester 2
32
Biggest Brain Damaging Habits

No breakfast: People who don't take breakfast are going to have a lower sugar level. This leads
to an insufficient supply of nutrients and cause brain degenerations.
No eating: It cause harding of brain arteries
leading to decrease in mental power.
Smoking: It causes multiple brain shrinkage
and may lead to Alzheimer.
High sugar concentration: Too much sugar
will interrupt the absorption of proteins &
nutrients causing malnutrition.
Air pollution: The brain is largest oxygen
consumer in our body. Inhaling polluted air
decreases the supply of oxygen to brain,
bringing about decrease in brain efficiency.
Sleep deprivation: Sleep allows our brain to rest as long term deprivation from sleep will
accelerate the death of brain cells.
Face covered while sleeping: It increases the concentration of carbon dioxide & decreases the
concentration of oxygen that may lead to brain damaging effects.
Working your brain during illness: Working, studying with sickness may lead to decrease in the
effectiveness of the brain as well as damage of the brain.
By: Aimal Alam
Semester 2nd
What the Teachers of PIPOS Mostly Use To Say

Dr. Bakht Sarwar: “Use “Objective” of this news
these bloody thick meninges” letter.
Sir Liaquat: “Basically we all Sir Aziz: “For me it's Ok for
are technician” you I don't know”
Madam Tabbasum: “Aisi kia Madam Uzma: “…… … …….
khas baat hai” Exactly”
Sir Sajjad: “When you come Sir Mian Ihsan: “Blood aati
to PIPOS plan yourself” hai blood jati hai”
Sir Nizar: “Machine itself Sir Jehan Zeb: “Nasira!
says I am OK” & “Thank you” Danda khabara na da.”
Madam Momi: Go to
“Objective”. What is the By: Zohaib Hassan Mirza
Semester 7th
33
A VERY LITTLE PRAYER

OH God
For me a BMW will be the best
five Corrals will do for the rest.
.
Job like M.D of PIPOS will suit me

here is no other duty which can Fruit me.
For a change, green card is necessary
it's the day's need, not an accessory.
I assure You, I will give my Zakat
never will I miss a single “Rakat”,
Give me a very happy life with
eleven kids and a Stylish wife. My content does not allow to ask for more
because You are also God of Millions more.
I need only a ten-canal bungalow By: Ijaz Ali Khan
with a little garden where Sprinkles flow. Semester 5th
OH! These Teachers

When a student is late for class
He /she is not punctual.
When a teacher is late
He /she has much work to do.
When a student hasn't completed his work
He /she is irresponsible.
When a teacher hasn't completed her work
He /she is not a machine.
When a student can't understand the lesson
He /she is dumb.
When a teacher can't explain anything
It needs no explanation.
.
When a student talk to someone in class
It is bad behavior.
When a teacher does the same
He/she has something important to discuss.
By: Nadia Shah
Semester 2nd
34
Steps to Gain Satisfaction

1. In time of danger, you must remain cool and calm even if other people are blaming you.
2. You must be able to work long and hard and wait patiently for the results. You must not
give up your efforts if the results are late in coming.
3. You should not be over proud or excited when you succeed, not ever discouraged when
fail. Both success & failures are imposters who pretend to be more important than they
really are. Don't pay much attention to them but go on working as usual.
4. Be single, don't be double. If you are double, you will soon be in trouble.
5. You may dream and build castles in the air, but you must be able to work hard to make
your dreams come true.
By: Nasir Ahmed
Semester 2nd
Words of Wisdom
The selfish one letter word is 'I' avoid it.
! The most essential ten letter word is
!
“confidence” develop it.
The most satisfying two lettered word is
!
“WE” use it.
By: Anum Ishtiaq
The most poisonous three lettered word is
! Semester 5th
“EGO” kill it.
The most used four lettered word is “love”
!
value it.
The most pleasing five lettered word is
!
“smile” keep it.
The fastest spreading six letter word is
!
“rumor” ignore it.
The hardest working seven letter word is
!
“success” achieve it.
The most unenviable eight letter word is
!
“jealousy” distance it.
The most powerful nine letter word is
!
“knowledge” acquire it.
35
Conversation of a
Computer Engineer with His Wife
Husband (returning late from work): Good
evening dear. I am not logged in.
Wife: Have you brought the grocery?

Husband: Bad command or file name.
Wife: But I told you in the morning.

Husband: Erroneous syntax.
Wife: What about my new TV.

Husband: Variable not found.
Wife: At least give me your credit card, I want

to do some shopping.
Husband: Sharing violation, access denied.....
Wife: Do you love me or do you only love computer or are you just being funny?
Husband: Too many parameters.
Wife: It was a great mistake that I married an idiot like you.

Husband: Data type mismatch.
Wife: You are a useless nut.

Husband: By default.
Wife: What about your salary?

Husband: File in use….Try after sometime.
Wife: Who was in the car with you this morning?

Husband: System is unstable press Alt+Ctrl+Del to reboot.
Wife: What is the relation between you and receptionist?

Husband: Only user in my right group.
Wife: What is my value in the family?

Husband: Unknown virus.
By: Waqas Mehmood

rd
Semester 3
36
The Story of the Pencil

A boy was watching his grandmother write a graphite inside. So always pay attention to
letter , at one point he asked: 'Are you writing what is happening inside you.
a story about what we've done or is it a story
about me?'. His grandmother stopped writing Finally, the pencils fifth quality: It always
her letter and said to her grandson: 'I am leave a mark. In just the same way, you should
writing about you actually, but more know that everything you do in life will leave
important than the words is the pencil I am a mark, so try to be conscious of that in your
using. I hope you'll be like this pencil when every action.
you grow up'.
By: Syed Abdul Haq
th
Intrigued, the boy looked at the pencil. It did Semester 5
not seem very special. 'But its just like any
other pencil that I've ever seen!'
That depends on how you look at things. It has

five qualities which , if you manage to hang on
to them , will make you a person who is always
at peace with the world.
First quality: You are capable of great things,

but you must never forget that there's a hand
guiding your steps. We call that hand 'ALLAH'
and he always guides us according to his will.
Second Quality: Now and then, I've to stop

writing and use a sharpener. That makes the
pencil suffer a little but afterwards, he's
much sharper. So you too, must learn to bear
certain pains and sorrows, because they'll
make you a better person.
Third Quality: The pencil always allows us to

use an eraser to rub out any mistakes. This
means that correcting something we did, is
not necessarily a bad thing; it helps to keep us
on the road to justice.
Fourth quality: What really matters for the

pencil is not its wooden exterior but its
37
HUMAN FIGURE DRAWING TEST (HFDT)

This test was conducted by Ms. Nida Khan (Psychologist) during her lectures in PIPOS
38
39
FUNNY MOMENTS
This section has been included in the magazine on the demand of students and faculty members
Last Night Study Big Show on the Scene
PIPOS ka PIR aur MUREED Honey Bee kai kaatnai kay baad..
PIPOS ka Mirza Ghalib Sari cleaning mai karoon ga.
40
Broken Heart Mujh Sai Jo Takrai Ga Pash Pash Ho Jaye Ga
World War III 3-idiots
Lagtha Hai Cake Kuch Ziyada Hi Meetha Tha Un-indentified object between two men
41
At last…exhaust band ho gaya Learning on finger tips
Akhir mai bhi final year mai poohanch gaya Pakhtoonkhwa……. zinda bad
PIPOS anathashram Baichara.. kab sai line mar raha hai
42
Jab basit hang ho jatha hai….tho waqas issay restart kartha hai Ala toto marchakai khuree
Sheryara! Os kho khandai..bya ba jarai Muchai ho tho…natho lal jaisi ho
baraf kai sa gorai…margari da PIPOS kai nast di… Khul ja sim sim..Khana AA raha hai
43
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Volume I (Jan-June, 2008) Volume II (July-Dec, 2008) Volume III (Jan-June, 2009) Volume IV (July-December, 2009)
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PIPOS EXPLORER

Volume V (January - June, 2010)

Mr. Liaquat Ali Malik

Ms. Sundas Khalid Khan

Mr. Waqas Mehmood

Ms. Hina Arooj

Mr. Aimal Alam

Collaboration of PIPOS with ICRC ................................................................................... 06

Report on APOS meeting (2010).......................................................................................... 10

Report on seminar at SLSPO................................................................................................. 14

News and Events................................................................................. .................................. 15

Sitting Row (L to R) Prof. Dr. Bakht Sarwar (Patron in Chief)

Standing Row (L to R) Mr. Waqas Mehmood (Co-Editor)

ORTHOTICS: It is the branch of orthopaedic science that deals with the

COLLABORATION OF PIPOS WITH NATIONAL AND INTERNATIONAL ORGANIZATIONS

COLLABORATION OF PIPOS WITH ICRC

The International Committee of the Red Cross (ICRC)

intention to assist PIPOS to grow to a centre of excellence contributing quality services to

The Physical Rehabilitation Program

Home Care Project (HCP)

The orthotic devices for these patients are manufactured in PIPOS.

Renovation of PIPOS Rehabilitation Area

The PMS was developed as a tool to manage the

The PMS include the following (most important

Scholarships for Students

Clinical Placement of Final Year Students

APOS MEETING 2010, SRI LANKA

APOS Meeting Proceedings:

Oil Lamp lighting ceremony

IT session on 3rd day of meeting

Key Activities for 2010-2011

Challenges of the board

SRI LANKA SCHOOL OF PROSTHETICS & ORTHOTICS (SLSPO)

NEWS AND EVENTS

PIPOS Faculty Member Attends the International Seminar in Sri Lanka

Open Day for ICRC Delegation at PIPOS/PRSP

ICRC delegates during the open day at PIPOS/PRSP

Welcome/Farewell Party, 2010

Funny beat box Audience during the party

Training Workshop on Strategic Planning at PIPOS

Mr. Sami Ullah presenting his lecture Participants

Ms. Uzma Jabeen

PRSP (PIPOS Rehabilitation Services Project) is an extension of PIPOS (Pakistan Institute of

Jan-March, 2010 Patient Record

Total Number of Cases 758 Jan-March, 2010

Services provided Number of cases

By: Nizar Aktar

Epidemiology of Legg-Calve-Perthes Disease (LCPD)

Different Orthotic Techniques and their Effectiveness

Comparison in femoral head containment

Newington brace allow the containment to be achieved through 45 degrees abduction, 20

Comparison involving restrictions/allowance in activities/ ROM and patient/parent

Comparison in Sphericity of the femoral head

Axer, A. (1965). Subtrochanteric Osteotomy in comparative study of osteonecrosis in man

(1972). Innominate osteotomy in Legg-Calve- differential. The Physician and Spots

Legg-Calve-Perthes Disease. J Bone Joint Surg osteotomy in treatment of Legg-Calve-

HOPE ! There is nothing loftier than

By: Hina Arooj

Biggest Brain Damaging Habits

What the Teachers of PIPOS Mostly Use To Say

A VERY LITTLE PRAYER

Job like M.D of PIPOS will suit me

OH! These Teachers