Neurological burden in Baluchistan province, Pakistan

Total population of Balochistan is about13.16 million, while there are only nine qualified Neurologists in the whole province who look after not only neurological disorders of the province, but also patients from nearby countries like Afghanistan and Iran. The common neurological disorders are Stroke, Neuropathies, Myopathies, Epilepsy, Migraine, SSPE, Multiple Sclerosis, Meningitis, Myasthenia Gravis, Parkinson\u27s disease and infectious diseases especially Tuberculosis, which is very common

A review of brain death protocols across the globe and need for brain death guideline for Pakistan.

The concept of brain death was first formally presented in United States of America in 1968 (Ad Hoc Committee of the Harvard Medical School to examine the definition of Brain Death, 1968) in part to facilitate organ donation. It is a widely accepted term in most countries but some like Japan do not consider it as death. According toAAN, brain death is defined as death due to irreversible loss of function of the entire brain — comparable to circulatory death, which is defined as irreversible loss of function of the circulatory system. The purpose of our study is to review brain death protocols from various parts of the world to ultimately formulate a concise brain death protocol for Pakistan

Risk Factors for Stroke In, Bolan Medical Complex Hospital Quetta

Stroke is one of the leading causes of physical impairment and mortality worldwide. Optimizing preventive strategies will help decrease the burden of stroke. The objectives of this study were to determine common stroke risk factors, by analyzing a comprehensive panel of variables in our local population. 200 patients were consecutively enrolled in this prospective observational study at stroke unit (SU) of Bolan Medical Complex Hospital over 6 months from March 2019 to August 2019. Structured questionnaires were prepared History and clinical examination were performed to gather relevant information. CT scan of brain was done to confirm the diagnosis of stroke. Other necessary tests were run. A total of 200 patients were included in the study, of which 98 (49%) were males and 102 (51%) were females. Vascular risk factors were present in 182 patients (91%), of which the most common was hypertension in 121 patients (60.5%) followed by smoking in 89 patients (44.5%), diabetes in 62 patients (31%) and obesity in 58 patients (29%). Dyslipidaemia was present in 17 patients (8.5%), cardiac disease 14 patients (7.0%), ischemic heart diseases in 7 (3-5%), arterial fibrillation in 5 (2.5) and 5 (2.5) had a family history of stroke. Hypertension was the most common stroke identified in this study, likely because of the great pervasiveness of this disease in our region. This study also highlights the prevalence of other vascular risk factors including smoking, diabetes mellitis, obesity, dyslipidaemia, and ischemic heart diseases in our community, which are associated with poor physical activity, low income, and poor health awareness. We suggest numerous community-based awareness programs in Baluchistan to improve local area perception about stroke and its risk factors

Misperception About Epilepsy Among Common Public in Balochistan

ABSTRACT Background and Objective: Epilepsy is a treatable chronic neurological illness that is frequently associated with supernatural activity. The objectives of this study were to determine common myths and misperception about epilepsy by analysing a comprehensive panel of variables in our local population. Methods: We conducted a face-to-face questionnaire interview survey in three different shopping malls. One thousand people were randomly enrolled in this cross-sectional study at Quetta, Baluchistan, during the period of 21 august 2021 to 30 august 2021. Results: A total of 1000 people were interviewed; among them 220(22%) were male and 780(78%) were female. Individuals between the age of 20 years and above were included in the study. Nine-hundred-eighty (98%) respondents had heard about epilepsy. Out of thousand people 419 (41.9%) thought that epilepsy was a brain disease, 488 (48.8%) responded that it was a ghost attack. Twenty-three (2.3%) believed it to be psychosis. The aspects of knowledge tested were on causes, types, and management of epilepsy. Forty-nine (4.9%) people believed that epilepsy was due to head trauma, 488 (48.8%) said it’s ghost attack, 67 (6.7%) said it’s because of evil eye, and 293 (29.3%) peoples believed that epilepsy was caused by black magic. Nine-hundred-twenty-eight (92.8%) people believed that home remedies such as sniffing shoes were effective in epilepsy. Conclusion: This study revealed a lack of awareness about epilepsy in Balochistan, as well as the prevalence of both negative and favourable attitudes about epilepsy. This result was much surprising because in this era of modern medicine and technology, still superstitious beliefs prevail among large population. The study also emphasized to increase public awareness and epilepsy education initiatives to change public opinions and promote the use of standard epileptic treatment

Epilepsy in pakistan: national guidelines for clinicians

Epilepsy is one of the most common chronic neurological disorders requiring prolonged treatments and drugs. According to The World Health Organization (WHO), epilepsy is one of those serious brain disorders that affect not only the individual but has a deep impact on the family and society in general. Approximately 50 million people are affected with epilepsy around the world36, though proper epidemiological studies do not exist for Pakistan it is estimated that the prevalence of epilepsy is 9.99/1000. Highest prevalence is seen in people younger than 30 years of age, i.e. about 2 million people and 1/10th of the world burden of epilepsy is in Pakistan! The guidelines available in developed countries are gauged in a setting where epilepsy care is provided by epileptologists/neurologists. In Pakistan the scenario is different, there is only one neurologist for 1.4 million (14lac) population contrast to US where one neurologist for 26 thousand people 29. So there is a desperate need to adapt to alternate guidelines with strategies to provide epilepsy management at a primary care level and to standardize epilepsy care on a National level

Epilepsy in Pakistan: national guidelines for clinicians (part 2)

In 2013 an international taskforce of the ILAE shaped out a communal definition of Epilepsy.(2) This definition is useful for all or most practical purposes, thus more helpful in management. Epilepsy was defined as recurrent unprovoked seizures i.e 2 or more at least 24 hours apart. The revised practical definition implies that Epilepsy can be considered even after a single seizure in individuals who have other factors predictive of a second unprovoked seizure, a risk set at 60%. The factors include the diagnosis of an epilepsy syndrome, structural lesions like stroke, CNS infections, intraparenchymal contusions after trauma, as well as reflex seizures such as photosensitive seizures

Neurological disorders and disability in Pakistan: A cross-sectional multicenter study

Background/objective: The aim of this study is to identify frequencies of various neurological disorders (NDs) and associated disability in patients attending neurologic clinics in rural and urban centers in Pakistan. Methods: This is an observational study conducted in 39 neurological centers in both rural and urban areas, public and private health sectors all over Pakistan. This study was conducted between august 2017 to December 2019. Results: A total of 28,845 adults were enrolled. Mean age of the study participants was 46.2 ± 17.2 years, 15,252 (52.9%) were men and 13,593 (47.1%) were women. Most common comorbid medical condition was hypertension 7622(26.4%) followed by Diabetes 3409(11.8%). Among neurological diagnoses, vascular diseases (20%) were the most common followed by Headache disorders (18.6%), Epilepsy (12.5%), nerve and root diseases (12.4%), Psychiatric diseases (10%), Dementias (8%) and movement disorders (7.9%). Half of the patients 15,503(53.7%) had no neurological disability, while minor disability was present in 10,442(36.2%) of cases. Moderate to severe disability was present in 2876(10%) cases. Headache disorders, psychiatric diseases, muscle pain/muscle related disorders and demyelinating diseases were more common in women. Vascular diseases, movement disorders and Dementias were more common in 46 years and above age group whereas headache disorders, Epilepsy and Psychiatric disorders were more prevalent in \u3c46 years age groups. Conclusion: Vascular diseases are the most common presentation of patients in neurology clinics followed by headache disorders and epilepsies. Minor disability was present in 36% while moderate to severe disability was present in 10% case