Present and future of neurology in pakistan

Neurology started as a department in early nineteen sixties in Dow Medical College and King Edward Medical College and initially having a separate department of neurology was not mandated in medical colleges by Pakistan Medical and Dental Council¹. Some neurology training programs do not give exposure to subspecialties and training is focused on adult neurology². From 2015 to 2016, several conferences were held on neurology including an Annual Meeting in Quetta, movement disorder conference in Lahore

Gutka Associated Optic Neuropathy

Optic neuropathy may be multi factorial in origin. It’s association with gutka use in South East Asia is most likely under diagnosed and often overlooked, considering it is a diagnosis of exclusion. The Optic nerve toxicity is well known occurring due to medications, metals, organic solvents, methanol, and carbon dioxide.1 Over recent years the effect of smokeless tobacco has been highlighted as one of the common causes of toxic optic neuropathy (TON), as visual impairment is already a colossal global health issue. Nonetheless,as high as 80 percent of the total burden of cases of blindness globally are due to causes that are actually preventable as per the World Health Organization (WHO). Various forms of tobacco have been used traditionally across cultures. A distinct form of chewable tobacco is gutka commonly used in South East Asia ,it is as an amalgam with additional areca or betel nuts, slaked lime, and spices.2 Out of 303 million smokeless tobacco users, 248 million (81%) live in south east Asia. In this region 24% men and 11% women use smokeless tobacco.3 However, in the age of global connectivity and escalating immigrant settlements gutka use is now a reason for public health concern in western countries as well

Neurology in the 21st century: contemporary state of diagnostics and therapeutics

Although neurological disease has been recognized since antiquity, neurology as a systematic clinical discipline is less than 130 years old. Neurological practice has traditionally been constrained by the complexity of the human nervous system, which has been slow to yield its secrets. Over the last three decades, however, clinical neurology has been transformed in terms of both diagnostics and therapeutics and now marches in lockstep with the cutting edge of medicine. Efficacious treatments are now available for the majority of neurological diseases, including epilepsy, migraine, Guillain-Barre syndrome, Parkinson\u27s disease, multiple sclerosis, and ischemic stroke. This neurological revolution has been enabled by advances in neuroimaging and through the integrated application of basic research, drug development, biotechnology and clinical trial methodology. Neurology in the 21st century is a dynamic specialty offering relief and benefit to many patients, and holding the promise for one day conquering neurological disease in all its manifestations