Medical Problems Armed Force Pakistan

An e-book by Virtual Learning Center Page 1 of 15
MEDICAL TESTS - ISSB

TABLE OF CONTENTS
This section of the book is meant to highlight some of the main medical problems for which candidates
are tested while joining armed forces of Pakistan. The information contained in the e-book are just a for
information being provided in good faith. Candidates are requested to consult official document for
exact details and related doctor for treatment as needed. An inaccuracy or error in the info in this this
document and suggested way forward in not our responsibility.
Table of Contents
Contents Page
1 Knee Knocking 2 Go
2 Flat Feet 4 →
3 BMI and Over Weight 6 →
4 Chest size and Expansion Requirement 10 →
5 Deviated Nasal Septum(DNS) 13 →
6 Carrying Angle of Elbows 14 →
7 Varicose Veins and its Treatment 15 →
The Points mentioned in this e-book are collected from open source in good faith for general information. You
are advised to consult a doctor for advice before starting any curative or other action.
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Knee Knocking
What is Knee Knocking. Genu valgum, commonly called "knock-knee", is a condition in which the knees angle
in and touch one another when the legs are straightened. Individuals with severe valgus deformities are typically
unable to touch their feet together while simultaneously straightening the legs. The term originates from the Latin
genu, "knee", and valgus which actually means bent outwards, but in this case, it is used to describe the lower
portion of the knee joint which bends outwards and thus the upper portion seems to be bent inwards. Mild knock-
knee is diagnosed when a person standing upright with the feet touching also shows the knees touching.
Why is it not acceptable in Defense Forces?
Adults with uncorrected genu valgum are typically prone to injury and chronic knee problems such as
chondromalacia (inflammation of the underside of the patella and softening of the cartilage) and osteoarthritis
(breakdown of joint cartilage and underlying bone). These in turn can cause severe pain and problems in walking.
Treatment of Knock Knees?
The best way to correct knock knees in adults is to strengthen the knee by doing a series of exercises like seated
quadriceps contraction, leg strengthening exercises and hamstring curls. Be sure to select exercises that work to
strengthen the muscles in your knee and not ones that put a lot of stress on the knee like running or mountain
climbing because these types of exercises can actually damage the knee instead. Being overweight can also cause
knock knees and because of this fact a good way to treat knock knees is to bring your weight down to a normal
level.
Excess weight can add a lot of stress to your knee only making the knock knee condition worse. Candidates with
little knock knees can start exercising and yoga to cure this problem, few of the exercise and treatments for knock
knees include taking vitamin D and calcium supplements, vitamin C supplements. Virasana, or hero pose, is
effective in treating flat feet and knock knees. Keep a block between thighs and try to move your legs as close as
you can, hold it for 3 mins, keep repeating. In a standing position, bring the legs 4 feet apart and stretch the arms
out to the side. Turn the right toes to the right and deeply bend the right knee. Activate the arches and keep the
right knee touching the wall. Hold for 30 seconds and repeat on the other side. If you have tried these various
methods and have had no results, then surgery may be the right answer for you. Usually for adults instead of
corrective surgery being done, most doctors will recommend an entire knee replacement as the best surgery to
correct knock knees.
Flat Feet
What is Flat Feet?
Flat feet (also called pes planus or fallen arches) is a postural deformity in which the arches of the foot collapse,
with the entire sole of the foot coming into complete or near-complete contact with the ground. Some individuals
(an estimated 20–30% of the general population) have an arch that simply never develops in one foot
(unilaterally) or both feet (bilaterally).
There is a functional relationship between the structure of the arch of the foot and the biomechanics of the lower
leg. The arch provides an elastic, springy connection between the forefoot and the hind foot. This association
safeguards so that a majority of the forces incurred during weight bearing of the foot can be dissipated before the
force reaches the long bones of the leg and thigh.
Flat feet can cause several problems like Feet tire easily, painful or achy feet, especially in the areas of the arches
and heels. The inside bottom of your feet become swollen. Foot movement, such as standing on your toes, is
difficult. It can also result in back, calf and knee pain. It can also cause swelling around the ankles, trouble
standing on tiptoes, difficulty jumping high or running fast.
What is the treatment of Flat Feet?
1. Wear More Supportive Shoes: Regardless of the type of flat feet you have, wearing shoes with good
arch support is going to provide at least some benefit, and it might possibly provide total relief of
your foot, leg or back symptoms.
2. Lose Weight If You Are Too Heavy: If you are overweight (especially obese), then losing weight has
a multitude of health benefits including taking the pressure off the bones, ligaments and tendons of
your feet, as well as providing better blood flow to the area.
3. Get Custom Made Orthotics: If you have flexible flat feet and spend lots of time standing or walking,
then consider a pair of custom made shoe orthotics. Orthotics are semi-rigid shoe inserts that support
the arch of your foot and promote better biomechanics while standing, walking and running. Health
professionals who make custom orthotics include podiatrists, osteopaths, physicians, chiropractors
and physiotherapists.
4. Consult a Podiatrist: A podiatrist is a foot specialist who is familiar with all conditions and diseases
of the feet, including flat feet. A podiatrist will examine your feet and try to determine if your flat feet
are by birth or acquired as an adult. They will take X-Rays of your feet. Depending on the severity of
your symptoms and the cause of your flat feet, the podiatrist may recommend orthotic therapy,
casting or bracing the foot, or some form of surgery.
Weight – BMI , Overweight and Underweight

Pakistan Army checks weight at per Body Mass Index (17-23). Many of the candidates applying for
defense forces encounter a problem with their weight. Either their weight is above the limit
(overweight) or not up to the requirement (underweight). In this file, you’ll find some ways to
increase and decrease your weight in order to achieve fitness for defense forces level.
Weight Gain Tips:

Being underweight is defined as having a body mass index (BMI) below 17. Here are some tips to
get your BMI above 17.5.
1. Eat More Calories Than Your Body Burns: You need to eat more calories than your body
burns in order to gain weight. Aim for 300-500 calories per day above your maintenance
level, or 700-1000 calories if you want to gain weight fast.
2. Eat Lots of Protein: Protein forms the building blocks of your muscles. Eating sufficient
protein is required to gain muscle weight instead of just fat. Here are some energy-dense foods
that are perfect for gaining weight:
a) Nuts: Almonds, walnuts, macadamia nuts, peanuts, etc.
b) Dried fruit: Raisins, dates, prunes and others.
c) High-fat dairy: Whole milk, full-fat yogurt, cheese, cream.
d) Fats and Oils: Extra virgin olive oil and avocado oil.
e) Grains: Whole grains like oats and brown rice.
f) Meat: Chicken, beef, pork, lamb, etc. Choose fattier cuts.
g) Tubers: Potatoes, sweet potatoes and yams.
h) Dark chocolate, avocados, peanut butter, coconut milk, granola, trail mixes.
3. Lift Heavy Weights and Improve Your Strength: In order to make sure that the excess
calories go to your muscles instead of just your fat cells, then it is absolutely crucial to lift
weights. Go to a gym and lift, 2-4 times per week. Try to increase the weights and volume
over time.
4. Don’t drink water before meals: This can fill your stomach and make it harder to get in
enough calories.
5. Eat more often: Squeeze in an additional meal or snack whenever you can, such as before bed.
6. Drink milk: Drinking whole milk to quench thirst is a simple way to get in more high-
quality protein and calories.
7. Try weight gainer shakes: If you are really struggling, then you can try weight gainer
shakes. These are very high in protein, carbs and calories.
8. Use bigger plates: Definitely use large plates if you are trying to get in more calories, as
smaller plates cause people to automatically eat less.
9. Add cream to your coffee: This is a simple way to add in more calories.
10. Take creatine: The muscle building supplement creatine monohydrate can help you gain a
few pounds in muscle weight.
11. Get quality sleep: Sleeping properly is very important for muscle growth.
12. Eat your protein first and vegetables last: If you have a mix of foods on your plate, eat the
calorie-dense and protein-rich foods first. Eat the vegetables last.
13. Don’t s moke: Smokers tend to weigh less than non-smokers, and quitting smoking
often leads to weight gain.
14. Use Figs: Take 2-3 figs (Injeer) and soak them in cold water overnight. Eat the water-
soaked figs in the morning on empty stomach along with the water.
15. Milkshakes: Have banana & dates milk shake twice a day, daily.
16. Walk: Walk daily for 30 minutes
Weight Loss Tips:

In order to lose weight more efficiently, you must first take a diet plan. Here is diet plan to lose weight.
Start following this weight loss diet plan, along with diet tea and cardio exercise and watch yourself
come back in shape.
• For Breakfast: Brown bread with poached egg and tea or coffee without sugar.
• For Lunch: Steamed or poached fish or chicken piece with steamed vegetables or raw salad.
• For Dinner: Again, steamed or poached fish or chicken piece with steamed vegetables or raw
salad.
• For Oily Food: If you still crave for oily food then allow yourself to have it only once a eek.
Overall completely avoid oil, fats and sugar.
• For Snacks: If you feel hungry in between the meal times, just have a handful of fruits or nuts
and not a piece more.
• For Hot Beverage: Instead of drinking tea or coffee during the day as a hot beverage, drink
diet tea. Prepare
a day’s diet tea and keep it in a flask.
• For Diet Tea: Boil 6 cups of water with 1.5" cinnamon stick, 1 teaspoon ginger-garlic paste,
1/4 teaspoon nigella seeds, 1/4 teaspoon fenugreek seeds and 1/4 teaspoon carom seeds. Turn
off the heat and shift to a teapot. Add 3 teaspoon of green tea to it, cover and let it rest for 4-5
minutes.
• For Losing Bulge: It is important to do a cardio exercise along with following the weight loss
diet plan to lose that bulge. Perform a cardio exercise every morning and evening.
• For Cardio Exercise: You don’t have to buy expensive machines or put yourself in pain to
lose that bulge. Make good use of the nearby park and run a kilometer a day, then ride a
bicycle in the evening or the next day. This works specially on your belly and thighs and keeps
your heart healthy. If you cannot run, then walk as fast as you can. Running, bicycling and
waking fast are the best weight loss cardio exercises.
• Drink Water, Especially Before Meals: Drinking water can boost metabolism by 24-30% over
a period of 1-1.5 hours, helping you burn off a few more calories.
• Coffee (Preferably Black): Studies show that the caffeine in coffee can boost metabolism by 3-
11%, and increase fat burning by up to 10-29%.
• Green Tea: Green tea contains small amounts of caffeine, it is also loaded with powerful
antioxidants called catechins, which are also believed to work synergistically with the caffeine
to enhance fat burning.
• Cook with Coconut Oil: These fats have been shown to boost metabolism by 120 calories per
day, and also reduce your appetite so that you eat up to 256 fewer calories per day.
• Spicy Foods: Spicy foods like Cayenne pepper contain Capsaicin, a compound that can boost
metabolism and reduce your appetite slightly.
• Exercise: Do exercises like Jogging, Cycling and treadmill (in gym).
• Lift Weights: One of the worst side effects of dieting, is that it tends to cause muscle loss and
metabolic slowdown, often referred to as starvation mode. The best way to prevent this from
happening is to do some sort of resistance exercise, like lifting weights.
• Eat More Vegetables and Fruits: Vegetables and fruits have several properties that make them
effective for weight loss. They contain few calories, but a lot of fiber. They are also rich in
water.
Chest Size and Expansion
Some candidates are declared “Under- Chest” during their Initial Medical Examination and hence
they have to wait for 6 months for the next course to start. In this article I will try to cover the chest
requirements of defense forces, the reasons of being under-chest and the tips through which you can
increase your chest.
Chest Requirement in Defense Forces
Chest measurement is taken in two dimensions during the medical and requirements of both dimensions
must be met in order to get fitness.
 Chest Size: The medical officer/assistant will measure your chest with your shirt off with a
measuring tape (inches-tape). He will put the measuring tape around your back and will meet
the ends in front of your chest. The minimum chest size must be 79 cm i.e. 31.1 inches.
 Chest Expansion: After measuring the chest size, he will ask you to take a deep breath so
that he can check your chest expansion. The minimum chest expansion must be 5 cm. So
after expansion, your chest must be at least 84 cm in size i.e. 33 inches.
Tips to Increase Chest Size
Increasing your chest size is not an easy job and it can’t be increased within 2 days or a week so
throw these things out of your mind. If you want to increase your chest you need at least a month or
three weeks for the changes to appear. You will need two essential things on daily basis i.e. Diet and
Exercise. Here are some tips.
1. Eat healthy food: This is essential when you're going for a muscular chest. Eating too many
processed carbohydrates and fats will make you feel too fatigued to work out well. You may
also end up gaining fat instead of muscle. Eat a balanced diet of whole grains, protein (meat,
fish, eggs, tofu, etc.), fruits and veggies and fiber.
2. Eat more than three meals a day: When you're focusing on muscle growth, your body
needs a lot of fuel. Eating three regular-sized meals a day isn't going to cut it. Add two more
meals and make sure all of your portion sizes are bigger than normal. You may have to eat
more than you actually feel hungry for, but you'll be happy with the results when you see
your chest getting bulkier.
3. Meal Timings: Eat a healthy meal an hour or so before working out. Go for healthy
carbohydrates like quinoa, beans, or brown rice, paired with a light protein. Eat another
meal after you work out to help your muscles repair and build up stronger. Avoid sugary
drinks and desserts, fast food, meat that is laden with nitrates and hormones, and salty snack
foods.
4. Drink plenty of water: You should be drinking 8-10 glasses a day, both to keep you
hydrated and to help your muscles process the protein you're taking in. Drink water before
and after each workout.
5. Do push-ups: For maximum benefits, do a variety of push-ups. There's nothing more

effective than this. Space your hands farther than shoulder-width apart, shoulder-width apart
or close together. Place your feet on a bench and do decline push-ups, or place feet on the
floor and hands on a bench for incline push-ups. Push yourself to failure for each set.
6. Do dips: These can be performed on a dip bar or even between two high-backed chairs.
Hold yourself upright between the bars or chairs, then bend your elbows and lower your
body until you feel a stretch in your chest. Return to the starting position and repeat. For
added benefit, tie a weight plate around your waist or grasp a dumbbell between your
ankles or knees while performing this exercise.
7. Do pull-ups: It will help you to have large amount of weight in your hands and also will
strengthen the stomach muscles, especially the upper and lower abs. It will also make
your back stronger.
8. Do bench presses: The bench press is considered the single most effective exercise for
those seeking to build a big chest. Lifting heavy weights with few repetitions is the best
way to build muscle. You can use a bench press machine, barbell or even dumbbells to
perform this exercise. Select a weight that you can lift at 7 to 10 times. Lie on a weight
bench on your back. Grip the bar with hands slightly wider than shoulder-width apart.
Lower the bar slowly until it touches your chest. Then return to the starting position.
Repeat until you have completed this movement 5 to 7 times, or reached failure. Rest for
a bit, then do 2 more sets. If you can perform 10 repetitions easily, add more weight.
9. Use dumbbells or a cable station to do flies: Lighter weights are recommended for this
exercise; as heavier weights are harder to handle during this movement. Lie on your back
and grasp a dumbbell or cable handle in each hand. Extend your arms straight up in front
of you. Keep your arms extended and slowly lower your hands to either side of your
body. Return to the starting position. Repeat for a total of 3 sets of 10 to 12 repetitions.
Increase weight after you can perform 12 repetitions easily.
Deviated Nasal Septum

Nasal septum deviation or deviated nasal septum (DNS) is a physical disorder of the nose, involving a
displacement of the nasal septum. The nasal septum separates the left and right airways in the nose,
dividing the two nostrils. Some displacement in the nasal septum is common, affecting 80% of people,
most unknowingly.
Only more severe cases of a deviated septum will cause symptoms of difficulty breathing and require
treatment. Symptoms of a deviated septum include infections of the sinus and sleep apnea (pauses in
breathing or periods of shallow breathing during sleep), snoring, repetitive sneezing, facial pain,
nosebleeds, difficulty with breathing, and mild to severe loss of the ability to smell.
What is the treatment of DNS?

If you have a deviated septum, you will need a type of surgery called septoplasty. In this procedure,
the surgeon will move your septum to a normal position. In some cases, the surgeon also will reshape
the external appearance of your nose in a procedure called rhinoplasty. When the two procedures are
done at the same time, the surgery is called a septorhinoplasty. The surgery is performed quickly (lasts
roughly 1 hour) and does not result in any cosmetic alteration or external scars. Recovery from the
procedure may take anywhere from 2 days to 4 weeks to heal fully.
Carrying Angle of Elbows

When your arms are held out at your sides and your palms are facing forward, your forearm and hands
should normally be about 5 to 15 degrees away from your body. This is the normal "carrying angle" of
the elbow. This angle allows your forearms to clear your hips when you swing your arms, such as
during walking and especially during parade. It is also important when carrying objects as well.
Why normal carrying angle of the elbow is important?
As said above, normal carrying angle of the elbow helps us to carry objects easily. In defense forces, we
do physical activities a lot, so having normal carrying elbow is must for defense services. Certain
fractures of the elbow can increase the carrying angle of elbow, causing the arms to stick out too much
from the body. This is called an excessive carrying angle. If the angle is decreased so that the arm
points toward the body, it is called a “gunstock deformity.”
Treatment of excessive carrying angle of the elbow?
A doctor can advise whether any of these treatments are appropriate for your specific medical situation.
Always discuss all treatment options with your doctor before making a decision, including whether to
start or discontinue any treatment plan. If you think you carrying angle is not normal, then it is better to
consult a doctor for proper measurement and cure.
Varicose veins
Varicose veins are veins that have become enlarged and twisted. The term commonly refers to the
veins on the leg, although varicose veins can occur elsewhere as well. Veins have pairs of leaflet
valves to prevent blood from flowing backwards. Leg muscles pump the veins to return blood to the
heart (the skeletal-muscle pump), against the effects of gravity. When veins become varicose, the
leaflets of the valves no longer meet properly, and the valves do not work (valvar incompetence).
This allows blood to flow backwards and they enlarge even more. Varicose veins are most common
in the superficial veins of the legs, which are subject to high pressure when standing.

Varicose veins can cause aching, heavy legs. Appearance of spider veins in the affected leg and ankle
swelling. A brownish-yellow shiny skin discoloration near the affected veins. Redness, dryness, and itchiness
of areas of skin, termed stasis dermatitis or venous eczema, because of waste products building up in the leg.
Cramps may develop especially when making a sudden move as standing up. Minor injuries to the area may
bleed more than normal or take a long time to heal. In some people the skin above the ankle may shrink
because the fat underneath the skin becomes hard. Restless legs syndrome appears to be a common
overlapping clinical syndrome in patients with varicose veins and other chronic venous insufficiency.
Whitened, irregular scar-like patches can appear at the ankles.
What is the treatment of Varicose Veins?

1. Self-Care: Self-care such as exercising, losing weight, not wearing tight clothes, elevating
your legs, and avoiding long periods of standing or sitting can ease pain and prevent
varicose veins from getting worse.
2. Compression Stockings: Wearing compression stockings all day is often the first approach
to try before moving on to other treatments. They steadily squeeze your legs, helping veins
and leg muscles move blood more efficiently. The amount of compression varies by type
and brand.
3. Sclerotherapy: In this procedure, your doctor injects small- and medium-sized varicose veins
with a solution that scars and closes those veins. In a few weeks, treated varicose veins
should fade.
4. Laser Surgeries: Laser surgery works by sending strong bursts of light onto the vein,
which makes the vein slowly fade and disappear. No incisions or needles are used.
5. High Ligation and Vein Stripping: This involves tying off a vein before it joins a deep
vein and removing the vein through small incisions. This is an outpatient procedure.
Removing the vein won't adversely affect circulation in your leg because veins deeper in
the leg take care of the larger volumes of blood.

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An e-book by Virtual Learning Center Page 1 of 15

MEDICAL TESTS - ISSB

Why is it not acceptable in Defense Forces?

Treatment of Knock Knees?

Why is it not acceptable in Defense Forces?

What is the treatment of Flat Feet?

Weight – BMI , Overweight and Underweight

Weight Gain Tips:

a) Nuts: Almonds, walnuts, macadamia nuts, peanuts, etc.

b) Dried fruit: Raisins, dates, prunes and others.

c) High-fat dairy: Whole milk, full-fat yogurt, cheese, cream.

e) Grains: Whole grains like oats and brown rice.

f) Meat: Chicken, beef, pork, lamb, etc. Choose fattier cuts.

g) Tubers: Potatoes, sweet potatoes and yams.

quality protein and calories.

16. Walk: Walk daily for 30 minutes

Weight Loss Tips:

a day’s diet tea and keep it in a flask.

• Exercise: Do exercises like Jogging, Cycling and treadmill (in gym).

Chest Size and Expansion

Chest Requirement in Defense Forces

Tips to Increase Chest Size

5. Do push-ups: For maximum benefits, do a variety of push-ups. There's nothing more

Deviated Nasal Septum

Why is it not acceptable in Defense Forces?

What is the treatment of DNS?

Carrying Angle of Elbows

Why normal carrying angle of the elbow is important?

Treatment of excessive carrying angle of the elbow?

Why is it not acceptable in Defense Forces?

Whitened, irregular scar-like patches can appear at the ankles.

What is the treatment of Varicose Veins?

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