10-year pattern of admissions in psychiatric unit at a tertiary care hospital in pakistan.

To identify the pattern of psychiatric morbidity in hospitalized patients of a tertiary care unit.Design; Details of patient’s admissions from the case register of psychiatric unit were recorded retrospectively.The study was conducted in Dept. of Psychiatry Jinnah Postgraduate Medical Centre JPMC Karachi and included data of ten years. RESULTS;- TA total of 5527 patients were hospitalized during period of ten years (1995 – 2004). Among them 62.612% (n = 3461) were males and 37.38 (n = 2066) were females. The majority of patients were in the age range of 15 – 44 years. On the basis of ICD classification, mood disorders (F 30 – F 39) (42.42%) were most frequent diagnosis made, followed by schizophrenia, schizotypal and delusional disorders (F20-F29) (26.50%), mental and behavioural disorders due to psychoactive substance use (9.5%).CONCLUSION; Pattern of inpatients psychiatric disorders is slightly different from outpatient population and comprised of mostly patients with un-manageable acute psychiatric disorder. This measure of assessment of needs will help in allocation of resources

Determination of the factors leading to noncompliance with antiepileptic drug

Background: Epilepsy is a chronic disorder or group of chronic disorder in which the indispensable feature is recurrence of seizures that are typically unprovoked and usually unpredictable. It is well established that non-adherence to antiepileptic drugs may lead to a loss of seizure control. Negative outcomes that may be associated with a loss of seizure control include: injury, increase hospitalizations, and decrease in productivity. All of these contribute to increased direct and indirect healthcare costs related to epilepsy. Objective: To determine factors leading to noncompliance with antiepileptic drugs in patients attending a tertiary care hospital. Methods & Results: In the crosssectional study design, total 203 patients, attending neurology outpatient clinic at Department of Neurology Civil Hospital Karachi, Pakistan, from August, 2010 to February, 2011, with epilepsy were included in the study. Non probability, purposive sampling technique was applied. Detailed history was taken from each patient. A structured proforma was filled for each patient at the time of visit and note was made of the factors that were responsible for non-compliance. Overall mean (±SD) age was 29.1 ±16.9 years (ranging from 6 to 60 years) with Male: Female = 1.9: 1. Most common reason for non compliance was high cost of antiepileptic drugs 126 (62.1%) followed by unemployment in 58 (28.6%) patients, more than one antiepileptic drug in 35 (17.2%) patients, side effects of antiepileptic drugs 19 (9.4%), freedom free periods from fits 18 (8.9%), deviation from prescription 13 (6.4%) and Non Availability of drugs 12 (5.9%). Conclusion: In this study, high cost of antiepileptic drugs was the most common reason for non compliance and non-availability of drugs was the least common reason. While unemployment was the second common reason for non-complianc

Frequency of peripheral neuropathy in newly diagnosed patients of diabetes mellitus iion clinical and electrophysiological basis

To determine the frequency of peripheral neuropathy in newly diagnosed patients of Diabetes Mellitus type II on clinical and electrophysiological basis. Methods: This is Hospital based descriptive cross sectional study conducted at department of Neurology Civil Hospital Karachi/ Dow University of Health Sciences from 20th December 2011 to 20th June 2012. Data was collected from Neurology OPD, Medicine OPD and Diabetic Clinic Civil Hospital Karachi. Results: Total no of patients were 107 who were already diagnosed as type 2 Diabetes Mellitus. Out of these, there were 57 (53.3%) male patients and 50 (46.7%) female patients, with ratio of males to female was . 1.14The age group distribution of study population ranged from 30-60 years and mean age was 45.19 with standard deviation of 7.38. It was observed that 35 (32.7%) patients had symptoms of peripheral neuropathy as compared to this 72 (67.3.2%) patients did not have symptoms of peripheral neuropathy while mean ± standard deviation of duration of symptoms was 2.42±1.95 months and 18 (16.8%) patients had peripheral neuropathy as compared to these 89 (83.2%) patients did not have peripheral neuropathy, clinical or electrophysiological. Conclusion: Diabetic Peripheral Neuropathy is a fairly common entity in our patients with type 2 Diabetes Mellitus and was seen as early as within four weeks of diagnosis in 16.8% of patients

Depression in stroke patients; a cross sectional study highlighting the association of stroke on age and gender basis.

Stroke is the second leading cause of death. Depressive disorder is characterized by period of sad mood and anhedonia occurring for two consecutive weeks. Among stroke survivors, the consequence of physical and psychological changes can be devastating. One of those psychological changes is post-stroke depression (PSD). Stroke itself has debilitating morbidity and superimposed PSD further decreases the quality of life of patients and impairs recovery. This study leads us to know the magnitude of post stroke depression

Multiple Sclerosis Care in Pakistan; Analysis Of Data Presented At First Paktrims Conference

Novel data on Multiple Sclerosis (MS) in Pakistan from leading institutes in the country was presented at the first Pakistan Treatment in Multiple Sclerosis (PAKTRIMS) Conference, organized by the section of Neurology, department of Medicine, Aga Khan University, Karachi on Saturday, December 18, 2021. Pakistan has been considered to have a low prevalence of MS; however, recent research reveals that it is not as uncommon as previously believed to be in the country. The true prevalence and incidence of MS in the country is unknown because of dearth of research. Data of MS patients enrolled in various private and public institutes in Pakistan highlights the current treatment offered in Pakistan for MS patients with steroids as the mainstay treatment and disease modifying therapy (DMT) mainly including azathioprine, ocrelizumab and rituximab. Available data featuring disease progression indicates a successful response to the treatment offered to patients with improved expanded disability status scale (EDSS) and radiological findings. The conference was a stepping stone towards future research in Pakistan as it has highlighted further requirements in the field of MS as far as our country is concerned. Available data majorly outlines demographic and disease characteristics, however, there is a need for research to fill in the gap for data in reporting MS diagnosis, treatment, and disease outcome to develop a better healthcare system geared towards MS patients in a low- and middle-income Country (LMIC)

Validation Study of the Mini-Mental State Examination in Urdu Language for Pakistani Population

Validation study of the Mini-Mental State Examination in Urdu language for Pakistani population. Objective: This study was conducted primarily to validate and determine the optimal cutoff score in the diagnosis of dementia among Pakistani’s and study the effects of gender and education on the MMSE performance in our population. Methods: Four hundred participants took part in the study. Patient with dementia recruited from five major hospitals from Pakistan. The MMSE was translated into Urdu. Results: There were 61 men and 39 women in dementia group and 225 men and 75 women in the control group. The mean score of Urdu MMSE were lower in patients with dementia 18.5 ± 5.6 (range 0-30) as compared to the controls 26.8 ± 2.6 (range 7-30). This difference between groups was statistically significant (p\u3c0.001). Educational based MMSE score below 15 yielded perfect sensitivity and specificity for the diagnosis of dementia. Conclusions: These finding confirm the influence of level of education on MMSE score and education stratified cutoff scores should be used while screening for cognitive impairment in this population

Validation Study of the Mini-Mental State Examination in Urdu Language for Pakistani Population

Validation study of the Mini-Mental State Examination in Urdu language for Pakistani population. Objective: This study was conducted primarily to validate and determine the optimal cutoff score in the diagnosis of dementia among Pakistani’s and study the effects of gender and education on the MMSE performance in our population. Methods: Four hundred participants took part in the study. Patient with dementia recruited from five major hospitals from Pakistan. The MMSE was translated into Urdu. Results: There were 61 men and 39 women in dementia group and 225 men and 75 women in the control group. The mean score of Urdu MMSE were lower in patients with dementia 18.5 ± 5.6 (range 0-30) as compared to the controls 26.8 ± 2.6 (range 7-30). This difference between groups was statistically significant (p\u3c0.001). Educational based MMSE score below 15 yielded perfect sensitivity and specificity for the diagnosis of dementia. Conclusions: These finding confirm the influence of level of education on MMSE score and education stratified cutoff scores should be used while screening for cognitive impairment in this population

Simple and sensitive chromatographic method development for in-vitro and in-vivo analysis of doxorubicin-loaded poly lactic-co-glycolic acid nanoparticles

Purpose: To develop a bioanalytical high performance liquid chromatography (HPLC) method for the quantification of doxorubicin in biological fluids and polymeric nano-formulations. Methods: Analysis of doxorubicin in polymeric nanoparticles and biological samples was carried out at 252 nm using Purospher® RP-18 end-capped column (250mm×4.6mm,5µm) secured with a guard column cartridge RP18 (30mm×4.6mm,10µm). The mobile phase used was 0.025M phosphate buffer and acetonitrile (ACN) (65:35, v:v) in isocratic mode at a flow rate of 0.9 ml/min, run time of 10 min, column oven temperature of 30 °C, and injection volume of 40 μL. Results: The standard curve for doxorubicin was linear (0.999) in the concentration range of 0.022 - 1.00 μg/mL in human and albino mice plasma. Nominal retention times of doxorubicin and IS were 3.5 and 5.5 min, respectively. Mean recovery was within acceptable limits (100 ± 2 %). The limit of detection (LOD) and limit of quantification (LOQ) were 0.012 and 0.022 μg/mL, respectively. Conclusion: A reliable HPLC method has been successfully developed, validated and applied for the in vitro analysis of doxorubicin released from polymeric nanoparticles and in vivo pharmacokinetic studies in albino mice. The method may also be applicable to the analysis of doxorubicin in human fluids

Prevalence of obesity in patients suffering from migraine

Background: Migraine is one of the most common primary headaches, accounting for significant morbidity in patients suffering from it. An association between obesity and migraine has been documented in the past, despite some studies pointing to the contrary. Author’s purpose is to calculate the prevalence of obesity in migraine patients in order to contribute to the existing concepts. A positive correlation could lead to the employment of weight loss interventions in the management of obese patients with migraine.Methods: In this cross-sectional study, 400 patients, recently diagnosed with migraine, attending the Neurology Outpatient Department at the Dr. Ruth KM Pfau Civil Hospital Karachi were enrolled after taking informed consent.  Migraine was diagnosed using International Classification of Headache Disorders III (ICHD III) criteria. Height (meters) and weight (kilograms) were measured and body mass index calculated. This data was kept confidential. The results were tabulated and analyzed using SPSS version 19.  Continuous quantitative data were analyzed using chi square test. A p Value of less than or equal to 0.05 was considered significant.Results: The mean age of enrolled participants was 30.69±6.96 years, 204(51%) were >30 years of age, 159(39.8%) were male and 241(60.3%) were female, mean height was 1.55±0.1 meters, mean weight was 56.26±12.98 kg, and mean duration of migraine was 5.04±2.02 weeks. The prevalence of obesity in patients with migraine was 108 (27%).Conclusions: It was concluded that the prevalence of obesity in patients with migraine was 27%