Knowledge, attitude and practice about [Sudden unexpected death in epilepsy patients] among neurologists and paediatricians

Neurologists and pediatricians in Pakistan are generally not aware of sudden unexpected death in epilepsy patients and do they discuss this issue with the patients. To assess the Knowledge Attitude and Practices about [Sudden Unexpected Death in Epilepsy Patients] among neurologists and pediatricians. Department of Neurology, Jinnah Postgraduate Medical Centre, June 2005. Neurologists and pediatricians of Jinnah Postgraduate Medical Centre, Karachi were given a consent form to participate in the study. It was an interview-based study where a questionnaire was applied to the participants. There were 6 questions pertaining to the awareness about sudden unexpected death in epilepsy patients; about discussing the death with the patients and raising issue of sudden death in the discussion of epilepsy management. A total of 41 doctors [26 neurologists and 15 pediatricians] participated in the study. Amongst the neurologists, 13 [50%] were aware of and 6 [23.1%] had seen a case of unexpected death in epilepsy patients. Amongst the pediatricians, only 2 [13.3%] knew about it and had seen a case of sudden death. Overall 15/41[36.6%] doctors were aware of and 8/41 [19.5%] had seen a case of unexpected death in epilepsy patients. The patients of the above doctors never asked about it, except for one relative of a patient, who had lived abroad. Most of the doctors had never discussed this issue with the patients and none of them raised this issue in discussion about epilepsy management. The terminology of unexpected death in epilepsy patients was not known to many doctors and there is a need to increase awareness about this in doctors and general public

Migraine: Comorbidity with depression

To identify and see impact of coexisting depression in diagnosed cases of migraine. Hospital-based case-control study. Department of Neurology, Jinnah Postgraduate Medical Centre Karachi. Patients of all ages and both sexes attending neurology OPD at JPMC between October 1998 to October 1999 were included. International Headache Society criteria for diagnosis of migraine and Urdu version of Hospital Anxiety and Depression Scale for diagnosis of depression was used. Migraine with Depression cases [MWD] were compared with Migraine without depression as controls [MC]. Duration and frequency of migraine, co-morbidity with depression. Out of 100 migraineurs, 40 were MWD and 40 MC were taken from the remaining 60 migraineurs. Among MWD and MC females were common: 72%[29] and 78%[31] respectively. Of the females MWD, most of the patients belonged to the age group 31-40years; 52%[15] patients, compared to MC where age group 21-30 years; 58%[18] was common. Among the males, maximum number of migraineurs belonged to the age groups of 22-30 years for both MWD and MC i.e. 46%[05] and 56%[05] respectively. Fifty percent of MWD reported having migraine attacks for 10 or more years, whereas only 18% of MC had the similar duration. [P-value =<0.01]. Ninety percent [n=36] of MWD reported maximal disability during the headache as compared to the 62.5%[25] of MC. 62.5%[25] of MWD had an average frequency of 4 or more attacks per month compare to 55%[22] of MC having once per month or less. [P-value =0.001]. Migraineurs with long history and high frequency might benefit from psychiatric evaluation and addition of antidepressant drugs to their therapeutic regimen