Diabetic autonomic neuropathy: frequent life disabling complication of diabetes-mellitus in low socioeconomic group

To determine the frequency and pattern of au-tonomic neuropathy in diabetic patients belonging to low socio-economic group of Korangi industrial area, Karachi. A selective group of 400 [168 male and 232 female] were investigated for the pattern of autonomic neuropathy. Thorough history, detailed physical examination, ECG monitoring and all baseline investigations were done. Complete evaluation of cardiovascular, gastrointestinal, urogenital, vasomotor and central nervous system was carried out. Data was analyzed in SPSS ver.14. There were 42% male and 58% females in the study. All of the patients had poor glycemic control. Orthostatic hypotension [43% abnormal], Hand-grip test [20% abnormal] and Valsalva maneuver [46% abnormal] were performed to assess cardiovascular autonomic neuropathy. While gastrointestinal, urogenital, vasomotor and central nervous system was assessed on clinical grounds. Prevalence of 40% is high at an average diabetic duration of 5-10 years and is of considerable concern. Physicians can evaluate autonomic as well as peripheral nerve dysfunction among diabetics through simple tests. Therefore stress on patient's education and awareness about the disease, its complication, treatment modalities and glycemic control is important

Tremors; myths and misconceptions; a 7-year clinical survey 2002-2009

To determine the myths and misconceptions about [Tremors] among those who developed this disorder and their health seeking behavior, and also among those who never had tremors, at the psycho-neurology and medical OPD of Sindh Govt. Hospital, Liaqatabad no. 10, Karachi. A single centre based cross-sectional survey, conducted from year 2002 to 2009 at Sindh Govt. Hospital [SGH] Liaqatabad no.10, Karachi. 403 adult patients of either sex with tremors were selected from medical and psycho-neurology OPD's. For comparison 100 healthy individuals from general population, who never had tremors, of the same area were also included. Questionnaires regarding different myths and misconceptions about tremors were filled by the patients/normal healthy people after obtaining the consent. Out of 403 selected patients [61.53% males and 38.47% females] majority belonged to the urban areas. Out of hundred normal healthy people 73 [73%] were males and 27 [27%] were females. Only 8% of the patients considered tremor was a neurological illness, while 33% of the patients and 41% of the general population related it to magic or witchcraft. Overall, females were more inclined to choose alternative medicine and spiritual therapy than males. Myths and Misconceptions about tremors are present in our society because of strong belief and observations. Provision of primary education, health education and using electronic media can play a key role in abolishing these misconceptions