Prevalence of primary headache in association with age, sex, obesity and hypertension among patients received at OPD of Liaquat University Hospital, Hyderabad / Jamshoro

Aim and Objective: To determine the association of primary headache with age, sex, obesity and hypertension among patients received at medical Out-patient-department of Liaquat University Hospital, Hyderabad / Jamshoro

Study Design: It is a cross-sectional study conducted at Liaquat University Hospital Out-Patient Department, Hyderabad / Jamshoro, to determine the prevalence of primary headache in association with sex, age, obesity and hypertension

Place and Duration of Study: Out-Patient-Department of medicine in Liaquat University Hospital, Hyderabad / Jamshoro from 1[st] January 2015 to 1[st] June 2015

Methodology: This cross-sectional study was conducted with 200 patients [both male and female] from different age groups received in Out-Patient-Department of Liaquat University Hospital, Hyderabad. SPSS 20 version was used for analysis and results. Proforma questionnaires were used for patients including bio-data, history, blood pressure and BMI. Inclusion criteria: All adult patients, both males and females, over the age of 18 years, with presenting complaint of headache were included in the study after taking proper consent. Proper history taking, vital signs, neurological examination, eye examination, BMI, and random blood sugar level were performed. Exclusion criteria: Patients having stroke, hypoglycemia [blood sugar <60mg/dl], diabetic ketoacidosis, intracranial hypertension, eye problem, and Chronic Liver Disease were excluded from this study

Results: Out of a total number of 200 patients, 60% were female and 39% were male, while 1% was dropout during follow-up. Most of the patients were between the ages of 30-60 years. Our study determines 86% of patients have primary headache with normal blood pressure [normal BP 88%] and 13% have secondary headache mostly caused by hypertension [BP 10%], 1% patients was dropout during follow-up from study. Out of 200 patients, 48% were found to have a normal BMI [body mass index], whereas 39% were over weight and 11% had obesity and 2% came under category of morbid obesity

Conclusion: This study result determined that among the patients received at medical Out-Patient Department of Liaquat University Hospital, Hyderabad / Jamshoro, primary headache is more common in young females who have an increased body mass index and normal blood pressure. So it is prudent to spread awareness through media campaigns, seminars, and workshops etc, regarding prevention and proper treatment of primary headache in such patients

Frequency of early seizures in patients of acute ischemic stroke

Introduction: Stroke is the most common neurological disorder and leading cause of death and disability worldwide .Post stroke seizures are not uncommon complication of stroke, if remain untreated it may increase the rate of mortality in stroke patients

Objective: Aim of this study is to determine the frequency of early seizures [ES] among patients presenting with acute ischemic stroke at a tertiary care hospital

Materials and methods: Descriptive case series study, conducted at Department of neurology [SMBBMU] Shaheed Mohtarma Benazir Bhutto Medical University Hospital, Larkana for a Period of six months. A total number of 155 patients were enrolled according to inclusion and criteria

Results: Among 155 patients 103 patients [66.45%] were in 6th decade of life. Male patients were higher in frequency 89[57.42%] than female 66 [42.58%] patients. The mean age [+/-SD] of patients was 55.38 [+/-5.66] years with range of 39-65 years. At presentation, the mean duration [+/-SD] of stroke was 3.59 [+/-1.94 ] days. Mean time [+/-SD] lapsed between stroke and occurring of seizure was 3.09 [+/-2.98] days with range of 0-9 days. Mean duration [+/-SD] of seizures was 3.27 [+/-1.95] minutes. In this study 11[7.1%] patients of ischemic stroke have early seizures occurrence and frequency of male 9[10.1%] patients is higher as compared to female patients 2 [3%] Patients with male gender, elder age, longer stroke to fit duration and rural living patients were more prone to this complication of acute ischemic stroke

Conclusion: The early onset seizures in ischemic stroke patients is not common, however when occurs increases morbidity

Frequency and severity of depression in mothers of cerebral palsy children

Cerebral Palsy [CP] is a term used for non-progressive brain malformation during the development of brain, affects body movement and motor function. The global prevalence of CP is roughly ranging 1.4 to 4 per 1000 live births. It is observed that parents of CP child especially mothers has elevated levels of stress and depression than a mother of normal children

Objective: To determine the frequency and severity of depression in mothers of children with cerebral palsy attending tertiary care hospital

Material and methods: This is descriptive Cross Sectional study conducted at department of Neurology Civil Hospital Karachi / Dow University of Health Sciences from 01[st] March 2013 to 31[st] August 2013. Data was collected from Neurology OPD, Civil Hospital Karachi and Rehabilitation Centre DUHS Karachi. Urdu version of Siddiqui-Shah Depression Scale [SSDS] questionnaire used as a tool to identify depression among mothers' of CP child

Results: A total of 81 mothers, the primary caregiver of the CP children with history of cerebral palsy of at least 6 months duration, were evaluated. Out of those 40[49.38%] mothers of children with cerebral palsy had depression. Among them 30% [12/40] had mild depression, 60% [24/40] moderate and 10% [4/40] had severe depression

Conclusion: Depression is very much prevalent among mothers of CP children. This finding demands development of some effective guidelines, for the management of entire family particularly mother of a CP child

Frequency of various clinical and electrocardiac manifestation in patients with acute organophosphorous compound [OPC] poisoning

Background: worldwide, OPC are the most widely used insecticides in developing countries like Pakistan, where agriculture is the main occupation and easily available everywhere, therefore, the OPC poisoning is very common. WHO recently reports that pesticides poisoning occurs about 3 million/year with mortality > 3 lac/year and 99% belong to developing countries

Objective: to determine the frequency of various clinical and electro cardiac manifestation in OPC poisoning

Methodology: prospective observational study, conducted from Dec 2008 to April 2010 in Department of Medicine and Intensive Care Unit [ICU] at Liaquat University of Medical and Health Sciences, Jamshoro / Hyderabad

Results: out of 70 adult patients, 28[40%] were males and 42[60%] were females. The nature of OPC poisoning was suicidal in 58 [82.86%] and accidental/incidental in 12 [17.14%]. There were 43 [61.43%] farmers, 21 [30%] house-workers and 6 [8.57%] college students. There was a high ratio of insecticides [Melathion, Parathion, and Mite/rat House fly killer Carbamates] by ingestion/ inhalation route. The cardiac manifestations were Sinus Tachycardia in 20[28.6%], Non Cardiac Pulmonary Edema and Sinus Bradycardia 15[21.4%] each, Hypertension in 13[18.6%] and Hypotension in 07[10%]. Common ECG changes noted in our study were prolonged QTc - interval among 28[40%], prolonged P-R interval in 11[15.7%], atrial fibrillation, ventricular Tachycardia and extra systole were found as; 06 [8.6%], 05 [7.1%] and 05 [7.1%] respectively. Common neurological findings were flaccid paralysis in 28[40%] patients with respiratory muscle involvement in 10 cases, delirium in 11[17.5%], impairment of consciousness in 8[11.4%], and extrapyramidal features, fasciculation's, convulsions, and cranial nerve involvement were in 6 [8.6%], 5[7.1. %], 7[10%] and 5[7.1%] respectively

Conclusion: in routine hospital practice, the suicidal cases are very common due to acute OPC poisoning. Many cases are hospitalized with critical condition with predominant involvement of cardiac and neurological features. Early diagnosis with appropriate treatment with specific antidotes and ICU management can minimize the fatal consequences of OPC poisoning. It is further recommended that more studies are required to provide awareness regarding this important public health problem

C-reactive protein [CRP] and other risk factors in acute ischemic stroke patients

Introduction: Stroke is a common cause of mortality and morbidity in developing countries; stroke is second leading cause of death after cardiac disease worldwide. Apart from established major risk factors for Ischemic Stroke [IS] i.e.; Hypertension, Diabetes Mellitus, Smoking and Hyperlipidemia, a burning but still debatable issue is raised serum C - reactive protein [CRP], that is also thought to be the major risk factor for acute IS due to participation in formation of Atherosclerosis in the cerebral vessels in genetically prone patients

Objective of study: To find out significance of serum levels of CRP among CT scan proved acute ischemic stroke patients

Study Design and Place: This is a prospective observational study was conducted at Department of Medicine, Liaquat University of Medical and Health Sciences, Jamshoro/Hyderabad from July 2009 to June 2010

Data Collection: Patients meeting the inclusion criteria were enrolled in this study after obtaining informed consent, and were evaluated thoroughly for c reactive protein and other risk factors. All the selected cases were investigated for; Complete blood count, Urine detail report, CT scan brain plain, Serum C-Reactive Protein [CRP] Level, Fasting and Random Blood Sugar, Fasting Lipid Profile ECG and X-Ray chest PA View. The data was collected on a predesigned proforma designed for this study

Results: Out of 150 selected adult cases of CT scan proved Ischemic Stroke, male were 120 [80 %] and female were 30 [20 %]. Male to female ratio was 4:1. Their ages were between 20-80 years. Among these patients high level of CRP [> 10mg / L] was found in 132 [88 %]. Out of these Male were 110 [73.3 %] and that of Female were 22 [14.7%] respectively. Frequency of other major risk factors in male and female IS patients was also observed

Conclusion: A close relationship between high level of CRP and acute IS was found, because in acute IS patients high levels of CRP was observed but again it needs further studies high sample size to establish the c reactive protein as a independent risk factor for acute ischemic stroke

Frequency of helicobacter pylori in ischemic stroke

Objective: To find out the frequency of helicobacter pylori antibodies [IgG] among cases of ischemic stroke

Study Design: Cross-sectional study

Place and Duration: Medical Unit-II, Liaquat University Hospital Jamshoro/Hyderabad, from July 2009 to June 2010

Methodology:Helicobacter pylori [H.pylori] antibodies [IgG] on ELISA and color doppler ultrasound of carotid arteries were performed in CT Scan confirmed cases of ischemic stroke along with other routine investigations. A pre-designed proforma was used to record the data

Results: Among 150 CT scan confirmed ischemic stroke cases, 110 [73.3%] were males and 40 [26.7%] were females [2.7:1]. The H.pylori antibodies [IgG] were present in 121 [80.7%] cases among which males were 99 [66%] and females were [14.7%]

Conclusion: H.pylori antibodies [IgG] were present in very high proportion [80.7%] among cases of ischemic stroke