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