Assessment of Dementia Caregiver Burden in Karachi, Pakistan using 10/66 Protocol

ABSTRACT INTRODUCTION: Care arrangements and caregiver burden of people with dementia (PWD) are different in low and middle income countries (LMICs) than in developed countries. This is the first study in Pakistan assessing caregiver burden using the 10/66 protocol. METHOD: PWD were recruited from outpatient clinics and from the community in Karachi and were diagnosed according to DSM-IV TR. Three scales were used: 1. Zarit Burden Interview (ZBI) to assess caregiver burden. 2. Caregiver Activity Survey (CAS) to assess activities that the caregiver engaged in the last 24 hours to care for PWD and 3. General Health Questionnaire- 12 (GHQ 12) to assess caregiver emotional distress. The scales were translated, back translated, and tested for conceptual validity in Urdu. The data was entered using EPIDATA and was assessed using SPSS version 22.0. Ethical approval was obtained from institutional review board of Aga Khan University, Karachi

Dementia- is it high time to replace the term in Neurological nosology?

Dementia is a term used universally by clinicians and researchers for cognitive impairment that affects a person’s ability to function ((1). This is the term used by the American Academy of Neurology (AAN) in their nosology. Diagnostic and Statistical Manual of Mental Disorders V (DSM V) has replaced the term with Major Neurocognitive Disorder (2). The term HIV- associated dementia (HAD) was also replaced by HIV- associated neurocognitive disorder (HAND) by the AAN AIDS Task forc

Assessment of Care-Arrangement of People with Dementia in Karachi by 10/66 Protocol

Background and objective: Pakistan is a low middle-income country (LMIC) in South Asia with a rising aging population. This study aimed to understand care-arrangement and resources of people with dementia (PWD) in Karachi, Pakistan. Methods: This cross-sectional mixed-method (qualitative and quantitative) study was carried out using 10/66 protocol for dementia patients. Data collection for the study was done from September 2016 till August 2017.This assessed characteristics of patients and caregivers, the economic impact of caregiving, and resources available to care for people with dementia (PWD). Results: One-hundred-nineteen PWD and their caregivers were included in the study. The average gross national product (GNP) per PWD per capita was $140. Majority of the caregivers were married women, family members, and full-time housewives. Three quarters of the caregivers were patients’ children or spouse residing with the patient, in a 2-to-3-bedroom house. Majority of the time of the caregivers’ day was spent with the PWD. Conclusion: In Pakistan majority of PWD are dependent on female family members for care. Caregiver roles are full-time responsibilities with little to no burden shared by others. There is low monthly GNP per PWD with a high cost of medical needs of PWD

Barriers and Challenges to Mental Health Care in Pakistan

World Health Organization (WHO) defines health as a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity (1). Despite being a global health-related burden, and a major cause of morbidity worldwide including Pakistan, mental health diseases are an overlooked entity in our country. In Pakistan, we have seen a rapid improvement in the treatment of conditions related to physical health over the course of years, but mental health issues are still being given limited priority. Pakistan is the 6th most populated country in the world with a current estimated population of 210 million and a growth rate of 2% per year (2). It is a developing country that faces several health challenges when dealing with communicable as well as non-communicable diseases including mental health problems

Stress, Anxiety and Depression in students of a private medical school in Karachi, Pakistan

Objective: To determine frequency of stress, anxiety and depression and their coping mechanisms in undergraduate students of a private sector university. Methods: A cross sectional study was conducted at Aga Khan University recruiting students from Medical School, School of Nursing & Midwifery, and Dental Hygiene program who had attended at least six months on campus from October 2016 until August 2017. The “Aga Khan University Anxiety and Depression Scale” and “Student-Life Stress Inventory” scales were used to assess depression and anxiety, and stressors. Results: A total of 283 students participated in this study and all of them scored higher than the cutoff on both scales labeling them as highly stressed. Students from dental hygiene program reported more stressors as compared to MBBS (p\u3c0.001) and SONAM (p=0.002). Factors identified as stressors included pressure to pass exam, meeting family’s expectations of good academic performance, and missing home. Conclusion: Stress, anxiety and depression are found to be highly prevalent among undergraduate students in medical setting in Karachi. Awareness, recognition, and timely management may reduce stress among the students and improve their performance and quality of life

Association of bipolar I disorder with conversion disorder and syncope- a retrospective clinical study from Pakistan

Bipolar I disorder (BD I) is a chronic mood disorder that begins in early adulthood. Its association with conversion disorder and syncope has not been widely studied, especially in Pakistani population

Dementia survey among Attendees of a Dementia Awareness Event in Karachi, Pakistan

There is little information available about peoples\u27knowledgeregarding symptoms of dementia, dementia diagnosis, and care arrangementsfor dementia patients in Pakistan. Aims: We aimed to find out if patients with dementia and their caregivers were aware of diagnosis, the most common and most distressing symptoms, and care arrangement for these patients

Nanopharmaceuticals: A Boon to the Brain-Targeted Drug Delivery

Brain is well known for its multifarious nature and complicated diseases. Brain consists of natural barriers that pose difficulty for the therapeutic agents to reach the brain tissues. Blood-brain barrier is the major barrier while blood-brain tumor barrier, blood-cerebrospinal (CSF) barrier and efflux pump impart additional hindrance. Therapeutic goal is to achieve a considerable drug concentration in the brain tissues in order to obtain desired therapeutic outcomes. To overcome the barriers, nanotechnology was employed in the field of drug delivery and brain targeting. Nanopharmaceuticals are rapidly emerging sub-branch that deals with the drug-loaded nanocarriers or nanomaterials that have unique physicochemical properties and minute size range for penetrating the CNS. Additionally, nanopharmaceuticals can be tailored with functional modalities to achieve active targeting to the brain tissues. The magic behind their therapeutic success is the reduced amount of dose and lesser toxicity, whereby localizing the therapeutic agent to the specific site. Different types of nanopharmaceuticals like polymeric, lipidic and amphiphilic nanocarriers were administered into the living organisms by exploiting different routes for improved targeted therapy. Therefore, it is essential to throw light on the properties, mechanism and delivery route of the major nanopharmaceuticals that are employed for the brain-specific drug delivery

Impact of Parental Involvement on Achievement Score of Students at Elementary Level

The aim of this research was to investigate the impact of parental involvement on the achievement score of elementary-level students. Parental involvement was the independent variable and the achievement scores of students were the dependent variable. Whereas, demographic variables like school status, SES, and parents’ qualifications were also important. This study was comparative in nature and all elementary-level schools were taken as population. Elementary campuses of boys and girls were conveniently selected from the public sector in Faisalabad and taken as accessible population. From this accessible population, a sample of 376 students (307 male and 69 female) were drawn who have passed the elementary exams. Demographic sheets, copies of elementary result cards, and questionnaires were collected in order to find out the impact of parental involvement on the achievement scores of students at the elementary level. Descriptive statistics (mean, standard deviation, frequency) was employed along with ANOVA, and t-test for data analysis. Keeping in view the results taken from Punjab Examination Commission, significant differences between the academic performance of the children belonging to the businessmen class and the job holders’ class were noticed. Further, it was also determined from the dished-out results that the difference in academic achievement level is significant when more involvement of parents was there