Background and Objective: There is paucity of data regarding risk factors of stroke in young Pakistanis. The objective of this study was to identify the frequency of risk factors for ischemic stroke in the young Pakistani population Methods: This was a retrospective Cross sectional study conducted at Aziz Fatima Hospital Neurology outpatient’s department between January 2022 to April 2022.bAll patients presenting with an ischemic stroke within the past month and age between 20 and 49 years were included. Data was collected from patient notes using a table which listed the patient’s demographic information and risk factors. All the patients had appropriate investigations on site to look for cardiac and vessel abnormalities along with relevant blood tests. The results were then assessed using univariate analysis to divide patients according to age, gender and prevalence of risk factors. Results: A total of 53 patient’s data was collected. The mean age was 39 years. The commonest risk factor was hypertension (58%). The other risk factors were ischemic heart disease (36%), diabetes mellitus (34%), dyslipidemia (26%), smoking (21%), obesity (19%), atrial fibrillation (2%) and vasculitis (2%). Positive family history of stroke was found in 26%. Conclusion: Hypertension was the commonest risk factor for young age group under 50 years, followed by ischemic heart disease. Our younger population also had a higher frequency of causes like diabetes mellitus, dyslipidemia and smoking.
{"title":"Frequency of risk factors for stroke in young Pakistani population","authors":"Faizan Aslam, Atif Maqsood, Adeel Rauf, Kashif Nawaz, Azam Aslam","doi":"10.56310/pjns.v18i04.294","DOIUrl":"https://doi.org/10.56310/pjns.v18i04.294","url":null,"abstract":"Background and Objective: \u0000There is paucity of data regarding risk factors of stroke in young Pakistanis. The objective of this study was to identify the frequency of risk factors for ischemic stroke in the young Pakistani population \u0000 Methods: \u0000This was a retrospective Cross sectional study conducted at Aziz Fatima Hospital Neurology outpatient’s department between January 2022 to April 2022.bAll patients presenting with an ischemic stroke within the past month and age between 20 and 49 years were included. Data was collected from patient notes using a table which listed the patient’s demographic information and risk factors. All the patients had appropriate investigations on site to look for cardiac and vessel abnormalities along with relevant blood tests. The results were then assessed using univariate analysis to divide patients according to age, gender and prevalence of risk factors. \u0000 Results: \u0000A total of 53 patient’s data was collected. The mean age was 39 years. The commonest risk factor was hypertension (58%). The other risk factors were ischemic heart disease (36%), diabetes mellitus (34%), dyslipidemia (26%), smoking (21%), obesity (19%), atrial fibrillation (2%) and vasculitis (2%). Positive family history of stroke was found in 26%. \u0000 Conclusion: \u0000Hypertension was the commonest risk factor for young age group under 50 years, followed by ischemic heart disease. Our younger population also had a higher frequency of causes like diabetes mellitus, dyslipidemia and smoking.","PeriodicalId":19818,"journal":{"name":"Pakistan Journal of Neurological Sciences","volume":"67 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140455297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-16DOI: 10.56310/pjns.v18i04.283
Sohail Khan
Note: The editors of PJNS are aware that this article contains old data. However, we have decided to publish this article because a) the data is still important as this is a novel scale in assessment of parkinsonism, and b) the authors have written the article well and have mentioned this limitation of their manuscript. Background and Objective: A composite scale for parkinsonism and Parkinson’s disease (PD) that incorporates multiple motor system symptoms and systemic complaints and their severity may help the busy clinician in documenting the severity and progression of common and bothersome symptoms. The objective of this study was to study a new scale, Parkinson’s Symptoms Questionnaire (PSQ), to assess and track progression of parkinsonism. Methods: This was a cross-sectional study that was conducted from August 2004 to December 2009 in a private clinic in State of Iowa, United States. We developed a new scale, PSQ, to assess common symptoms of parkinsonism. It has 14 items and each is graded from 0 to 2, for a score range of 0 (normal) to 28 (most severe symptoms). We compared the scale to Parkinson's disease Questionnaire-8 (PDQ-8). Results: The analysis was performed on 42 patients. Of these 42 patients 24 were male (57%), 18 were female (43%). Ages ranged from 55 to 91. Since PDQ-8 measures disability and PSQ measures wellness, we hypothesized that a score of 100% in PDQ-8 should correspond to 0% in PSQ. PSQ showed a strong negative correlation with PDQ-8. Conclusion: The new scale showed promise to be used in clinical practice to quickly assess common symptoms in patients with parkinsonism and to document progression over time.
{"title":"A new self-assessment questionnaire to assess parkinsonism: a cross-sectional study","authors":"Sohail Khan","doi":"10.56310/pjns.v18i04.283","DOIUrl":"https://doi.org/10.56310/pjns.v18i04.283","url":null,"abstract":"Note: The editors of PJNS are aware that this article contains old data. However, we have decided to publish this article because a) the data is still important as this is a novel scale in assessment of parkinsonism, and b) the authors have written the article well and have mentioned this limitation of their manuscript. \u0000Background and Objective: \u0000A composite scale for parkinsonism and Parkinson’s disease (PD) that incorporates multiple motor system symptoms and systemic complaints and their severity may help the busy clinician in documenting the severity and progression of common and bothersome symptoms. The objective of this study was to study a new scale, Parkinson’s Symptoms Questionnaire (PSQ), to assess and track progression of parkinsonism. \u0000Methods: \u0000This was a cross-sectional study that was conducted from August 2004 to December 2009 in a private clinic in State of Iowa, United States. We developed a new scale, PSQ, to assess common symptoms of parkinsonism. It has 14 items and each is graded from 0 to 2, for a score range of 0 (normal) to 28 (most severe symptoms). We compared the scale to Parkinson's disease Questionnaire-8 (PDQ-8). \u0000Results: \u0000 The analysis was performed on 42 patients. Of these 42 patients 24 were male (57%), 18 were female (43%). Ages ranged from 55 to 91. Since PDQ-8 measures disability and PSQ measures wellness, we hypothesized that a score of 100% in PDQ-8 should correspond to 0% in PSQ. PSQ showed a strong negative correlation with PDQ-8. \u0000Conclusion: \u0000 The new scale showed promise to be used in clinical practice to quickly assess common symptoms in patients with parkinsonism and to document progression over time.","PeriodicalId":19818,"journal":{"name":"Pakistan Journal of Neurological Sciences","volume":"554 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140454000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-17DOI: 10.56310/pjns.v18i02.266
Ijaz Ali, Zaid Waqar, Bushra Khalid, Maryam Naseem, Soban Khan, Sajid Ali, Muhammad Tariq, Muhammad Adil, Hira Badar Abbasi, Mazhar Badshah
Background: Stroke is the second most prevalent cause of dementia, the third biggest cause of mortality, and the top cause of disability globally. In addition to the conventionally recognized risk factors including smoking, diabetes, hypertension, ischemic heart disease, etc. Recent research on acute ischemic stroke has identified fresh risk variables, such as blood calcium, uric acid, homocysteine, and albumin levels. Hyperuricemia is frequently seen in patients with vascular risk factors and either directly or indirectly through the conventional risk factors.
Study: Case control study of 200 patients, 100 patients with stroke and 100 unmatched controls were accessed for vascular risk factor and hyperuricemia and odds ratio was calculated.
Results: Out of 100 patients in the case group, 25 (25%) and 75 (75%) had and did not have hyperuricemia. Whereas, out of 100 patients in the control group, 07 (7%) and 9 3 (93%) had and did not have hyperuricemia. The P-value was 0.001. Odds ratio was 4.42.
Conclusion: Hyperuricemia is linked positively to occurrence of ischemic stroke as evidenced by the positive odds ratio, further studies need to be done whether uric acid lowering therapy is useful in preventing stroke or reducing mortality.
{"title":"Association of hyperuricemia with ischemic stroke in adult population","authors":"Ijaz Ali, Zaid Waqar, Bushra Khalid, Maryam Naseem, Soban Khan, Sajid Ali, Muhammad Tariq, Muhammad Adil, Hira Badar Abbasi, Mazhar Badshah","doi":"10.56310/pjns.v18i02.266","DOIUrl":"https://doi.org/10.56310/pjns.v18i02.266","url":null,"abstract":"Background: Stroke is the second most prevalent cause of dementia, the third biggest cause of mortality, and the top cause of disability globally. In addition to the conventionally recognized risk factors including smoking, diabetes, hypertension, ischemic heart disease, etc. Recent research on acute ischemic stroke has identified fresh risk variables, such as blood calcium, uric acid, homocysteine, and albumin levels. Hyperuricemia is frequently seen in patients with vascular risk factors and either directly or indirectly through the conventional risk factors.
 Study: Case control study of 200 patients, 100 patients with stroke and 100 unmatched controls were accessed for vascular risk factor and hyperuricemia and odds ratio was calculated.
 Results: Out of 100 patients in the case group, 25 (25%) and 75 (75%) had and did not have hyperuricemia. Whereas, out of 100 patients in the control group, 07 (7%) and 9 3 (93%) had and did not have hyperuricemia. The P-value was 0.001. Odds ratio was 4.42.
 Conclusion: Hyperuricemia is linked positively to occurrence of ischemic stroke as evidenced by the positive odds ratio, further studies need to be done whether uric acid lowering therapy is useful in preventing stroke or reducing mortality.","PeriodicalId":19818,"journal":{"name":"Pakistan Journal of Neurological Sciences","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135304187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-13DOI: 10.56310/pjns.v18i02.252
Tipu Sultan
{"title":"Mandatory child neurology training for adult neurology residents in Pakistan","authors":"Tipu Sultan","doi":"10.56310/pjns.v18i02.252","DOIUrl":"https://doi.org/10.56310/pjns.v18i02.252","url":null,"abstract":"","PeriodicalId":19818,"journal":{"name":"Pakistan Journal of Neurological Sciences","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135786353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-13DOI: 10.56310/pjns.v18i02.237
None Mohammad Lateef, None Wasim Ikram Alvi, None Abdul Malik, None Neelum Jamal, None Muhammad Umair, Muhammad Athar Khan
Background and Objective:
Parkinson's disease is a degenerative neurological condition that affects a large number of individuals worldwide. One of the common non-motor symptoms associated with this disease is depression, which can pose challenges for both patients and their caregivers. The main objective of this research was to determine the frequency of depression among patients with Parkinson disease.
Methods:
This was a cross-sectional study that was conducted in Karachi, Pakistan, between March 26, 2022, and September 30, 2022. Male and female patients diagnosed with Parkinson's disease according to the UK Parkinson's Disease Society Brain Bank Clinical Diagnostic Criteria, who were receiving either outpatient or inpatient care at two medical facilities, ************ and ********, were evaluated for depression using the Hamilton Depression Rating Scale. The collected data were analyzed statistically, using the SPSS version.
Results:
According to the results of the study, 100 Parkinson's disease patients were included, out of which 81 individuals were identified as experiencing depression while the rest showed no signs of depression. Among those suffering from depression, 35 individuals were found to have mild depression, 52 had moderate depression, and 13 individuals had severe depression.
Conclusion:
The study concluded that depression is a common non-motor symptom among Parkinson's disease patients, with a substantial number of patients having mild to moderate depression.
{"title":"Frequency of Depression among Patients with Parkinson Disease","authors":"None Mohammad Lateef, None Wasim Ikram Alvi, None Abdul Malik, None Neelum Jamal, None Muhammad Umair, Muhammad Athar Khan","doi":"10.56310/pjns.v18i02.237","DOIUrl":"https://doi.org/10.56310/pjns.v18i02.237","url":null,"abstract":"Background and Objective:
 Parkinson's disease is a degenerative neurological condition that affects a large number of individuals worldwide. One of the common non-motor symptoms associated with this disease is depression, which can pose challenges for both patients and their caregivers. The main objective of this research was to determine the frequency of depression among patients with Parkinson disease.
 Methods: 
 This was a cross-sectional study that was conducted in Karachi, Pakistan, between March 26, 2022, and September 30, 2022. Male and female patients diagnosed with Parkinson's disease according to the UK Parkinson's Disease Society Brain Bank Clinical Diagnostic Criteria, who were receiving either outpatient or inpatient care at two medical facilities, ************ and ********, were evaluated for depression using the Hamilton Depression Rating Scale. The collected data were analyzed statistically, using the SPSS version.
 Results:
 According to the results of the study, 100 Parkinson's disease patients were included, out of which 81 individuals were identified as experiencing depression while the rest showed no signs of depression. Among those suffering from depression, 35 individuals were found to have mild depression, 52 had moderate depression, and 13 individuals had severe depression.
 Conclusion:
 The study concluded that depression is a common non-motor symptom among Parkinson's disease patients, with a substantial number of patients having mild to moderate depression.","PeriodicalId":19818,"journal":{"name":"Pakistan Journal of Neurological Sciences","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135786183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-13DOI: 10.56310/pjns.v18i02.229
Amina Saddiqa, Zaid Waqar, Maryam Khalil, Muhammad Anas, Zeeshan Munawar, Ifrah Ayaz, Zakir Jan, Haris Majid
Tetralogy of Fallot is the most commonly seen cyanotic congenital heart disease. It includes four cardinal features: right ventricular outflow tract obstruction, misaligned ventricular septal defect, overriding aorta, and concentric right ventricular hypertrophy. Intracranial pathologies such as brain abscesses, cerebrovascular accidents, and intracranial haemorrhage all have been reported with Tetralogy of Fallot. Here we present a case who had subarachnoid haemorrhage with vitreous haemorrhage in Tetralogy of Fallot.
{"title":"Terson syndrome in a patient with unrepaired tetralogy of Fallot","authors":"Amina Saddiqa, Zaid Waqar, Maryam Khalil, Muhammad Anas, Zeeshan Munawar, Ifrah Ayaz, Zakir Jan, Haris Majid","doi":"10.56310/pjns.v18i02.229","DOIUrl":"https://doi.org/10.56310/pjns.v18i02.229","url":null,"abstract":"Tetralogy of Fallot is the most commonly seen cyanotic congenital heart disease. It includes four cardinal features: right ventricular outflow tract obstruction, misaligned ventricular septal defect, overriding aorta, and concentric right ventricular hypertrophy. Intracranial pathologies such as brain abscesses, cerebrovascular accidents, and intracranial haemorrhage all have been reported with Tetralogy of Fallot. Here we present a case who had subarachnoid haemorrhage with vitreous haemorrhage in Tetralogy of Fallot.","PeriodicalId":19818,"journal":{"name":"Pakistan Journal of Neurological Sciences","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135786356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-13DOI: 10.56310/pjns.v18i02.265
None Bushra Ammad Taimuri, None Abdul Malik, None Rabia Sana Muhammad, None Maryam Javed
Background and objective:
Stroke is the second leading cause of death and the third leading cause of disability. This study was designed to determine the frequency of hyperlipidemia in patients with ischemic stroke visiting at a tertiary care hospital in Karachi.
Methods:
This was a descriptive cross-sectional study and was done in Department of Medicine, LCMD/ Dar-ul-Sehat Hospital Karachi, Pakistan. A total of 184 patients were studied during the study period of six months and all the consecutive patients were recruited who presented with acute stroke in the department of medicine from the duration April 1st 2022 to September 30th, 2022.Those fulfilling the inclusion criteria for this study were included for data analysis, while the patients who did not meet the said criteria were excluded. Their serum lipid levels were collected within 24 hours of admission. Hyperlipidemia was measured through fasting lipid profile and was labeled as present if any one or more of the following profile like total cholesterol >200 mg/dl, LDL cholesterol > 100 mg/dl, TGL > 150 mg/dl, HDL cholesterol < 40 mg/dl, as appropriate.
Results:
The mean age of the patients was 65.17±12.73. Average systolic and diastolic blood pressure was 152.34±21.31 & 83.35±13.71 mm Hg respectively. Mean duration of smoking and diabetes mellitus in first ever ischemic stroke patients was 9.33±4.03 & 13.65±5.8 years respectively, whereas average fasting blood sugar was found 151.98±69.73mg/dl; 118 (64%) were males and 66 (36%) were females. A total of 124 (67.4%) of patients had a history of hypertension, while 94 (51.1%) were diabetic. Fifty-three (28.8%) of patients had a history of coronary artery disease while 22 (11.95%) patients had history of smoking. Increased triglycerides level was seen in 47 (25. 5%). The frequency of hyperlipidemia was 145 (79%) patients respectively.
Conclusion: Frequency of hyperlipidemia was 145 (79%) in patients with ischemic stroke which is moderately high in our setup. A high prevalence of hyperlipidemia is alarming in our setup and requires attention of the physicians on modifiable risk factors.
{"title":"Frequency of hyperlipidemia in patients with ischemic stroke visiting at a tertiary care hospital in Karachi","authors":"None Bushra Ammad Taimuri, None Abdul Malik, None Rabia Sana Muhammad, None Maryam Javed","doi":"10.56310/pjns.v18i02.265","DOIUrl":"https://doi.org/10.56310/pjns.v18i02.265","url":null,"abstract":"Background and objective:
 Stroke is the second leading cause of death and the third leading cause of disability. This study was designed to determine the frequency of hyperlipidemia in patients with ischemic stroke visiting at a tertiary care hospital in Karachi.
 Methods:
 This was a descriptive cross-sectional study and was done in Department of Medicine, LCMD/ Dar-ul-Sehat Hospital Karachi, Pakistan. A total of 184 patients were studied during the study period of six months and all the consecutive patients were recruited who presented with acute stroke in the department of medicine from the duration April 1st 2022 to September 30th, 2022.Those fulfilling the inclusion criteria for this study were included for data analysis, while the patients who did not meet the said criteria were excluded. Their serum lipid levels were collected within 24 hours of admission. Hyperlipidemia was measured through fasting lipid profile and was labeled as present if any one or more of the following profile like total cholesterol >200 mg/dl, LDL cholesterol > 100 mg/dl, TGL > 150 mg/dl, HDL cholesterol < 40 mg/dl, as appropriate.
 Results:
 The mean age of the patients was 65.17±12.73. Average systolic and diastolic blood pressure was 152.34±21.31 & 83.35±13.71 mm Hg respectively. Mean duration of smoking and diabetes mellitus in first ever ischemic stroke patients was 9.33±4.03 & 13.65±5.8 years respectively, whereas average fasting blood sugar was found 151.98±69.73mg/dl; 118 (64%) were males and 66 (36%) were females. A total of 124 (67.4%) of patients had a history of hypertension, while 94 (51.1%) were diabetic. Fifty-three (28.8%) of patients had a history of coronary artery disease while 22 (11.95%) patients had history of smoking. Increased triglycerides level was seen in 47 (25. 5%). The frequency of hyperlipidemia was 145 (79%) patients respectively.
 Conclusion: Frequency of hyperlipidemia was 145 (79%) in patients with ischemic stroke which is moderately high in our setup. A high prevalence of hyperlipidemia is alarming in our setup and requires attention of the physicians on modifiable risk factors.","PeriodicalId":19818,"journal":{"name":"Pakistan Journal of Neurological Sciences","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135786186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-13DOI: 10.56310/pjns.v18i02.264
None Hamza Imran, None Adnan Yousuf, None Mohammad Wasay
Background and Objectives:
Hepatitis infection may raise the incidence of stroke and other cerebrovascular abnormalities, according to several studies. However, its association is controversial. This review looked to compile the most recent research on the relationship between HBV and HCV, atherosclerosis, and stroke.
Methods:
This article reviews the literature on the connection between hepatitis B and C viruses with stroke and atherosclerosis. The search included articles from PubMed, PakMediNet, and Google Scholar, as well as a Medline search using specific keywords and MeSH terms. A total of 2655 articles were identified. Out of these 2655 articles we identified 134 articles in English for review. These 134 articles comprised of original studies, individual case studies, and retrospective cohorts. The review included original research, individual case reports, and retrospective cohorts published after 1990. Studies addressing co-infection with HIV were excluded.
Results:
After the screening, many articles were selected which included several topics of discussion under the said heading. The studies were closely examined to gather pertinent information relevant to the review's objectives. Most of the literature emphasized the link between chronic hepatitis and the risk of stroke.
Conclusion:
Although current evidence does tilt the scale in favor of hepatitis-causing cerebrovascular disease, this review study has some limitations, such as the lack of prospective cohorts and limited evidence for the natural history of hepatitis patients in relation to cardiovascular and cerebrovascular diseases.
{"title":"Chronic Hepatitis B, C, and stroke; association and pathophysiology","authors":"None Hamza Imran, None Adnan Yousuf, None Mohammad Wasay","doi":"10.56310/pjns.v18i02.264","DOIUrl":"https://doi.org/10.56310/pjns.v18i02.264","url":null,"abstract":"Background and Objectives:
 Hepatitis infection may raise the incidence of stroke and other cerebrovascular abnormalities, according to several studies. However, its association is controversial. This review looked to compile the most recent research on the relationship between HBV and HCV, atherosclerosis, and stroke.
 Methods:
 This article reviews the literature on the connection between hepatitis B and C viruses with stroke and atherosclerosis. The search included articles from PubMed, PakMediNet, and Google Scholar, as well as a Medline search using specific keywords and MeSH terms. A total of 2655 articles were identified. Out of these 2655 articles we identified 134 articles in English for review. These 134 articles comprised of original studies, individual case studies, and retrospective cohorts. The review included original research, individual case reports, and retrospective cohorts published after 1990. Studies addressing co-infection with HIV were excluded.
 Results:
 After the screening, many articles were selected which included several topics of discussion under the said heading. The studies were closely examined to gather pertinent information relevant to the review's objectives. Most of the literature emphasized the link between chronic hepatitis and the risk of stroke.
 Conclusion:
 Although current evidence does tilt the scale in favor of hepatitis-causing cerebrovascular disease, this review study has some limitations, such as the lack of prospective cohorts and limited evidence for the natural history of hepatitis patients in relation to cardiovascular and cerebrovascular diseases.
","PeriodicalId":19818,"journal":{"name":"Pakistan Journal of Neurological Sciences","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135786352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Note: The editors of PJNS are aware that this article contains old data. However, we have decided to publish this article because a) the data is still important as there is paucity of data in this regard from Pakistan, and b) the authors have written the article well and have mentioned this limitation of their manuscript.
Background and objectives:
Little is known about the clinical profile and outcome of myasthenia gravis in Pakistan. The objective of this study is to review the clinical characteristics of patients with myasthenia gravis in Pakistan, and the outcome of investigations and treatment.
Methods:
The study comprised a retrospective review of charts of patients diagnosed with myasthenia gravis at Aga Khan University Hospital in Karachi, Pakistan, over a period of 16 years from 1987 to 2003. The following features were reviewed: (i) clinical presentation, (ii) investigations especially nerve conduction studies, acetylcholine receptor antibodies, and imaging studies of the thorax, (iii) treatments administered (including thymectomy). Data analysis was done using Excel sheets.
Results:
Of the 83 patients, 51(61.4%) were males, whereas 32 (38.6%) were females. The age range was from 12 to 81 years, mean age of 43.7 years (SD± 18.2). In the 60 years plus group, there were three times as many males as compared to females. Limb weakness was noted in 58 (69.9%), ocular symptoms in 57(68.7%), and oropharyngeal symptoms in 54(65.1%) patients. Three (3.6%) presented in a state of myasthenic crisis. Tensilon test was performed in 34 patients and was positive in 31(91.2%), repetitive nerve conduction studies (RNS) were performed in 37 patients and was positive in 26(70.3%), acetylcholine receptor antibodies were done in 60 patients, and were positive in 55(91.7%). Thymic enlargement was seen in 28 out of 43 patients who underwent CT-Scan/MRI studies of the thorax. Besides pyridostigmine, most patients received immunosuppressive therapy with either steroids or azathioprine or both. The thymectomy was performed in 44 patients.
Conclusion:
The general disease pattern of MG, as noted in our series, appears to follow a similar pattern as noted worldwide. However, this retrospective and hospital-based study has its limitations, and more prospective and epidemiological studies are needed.
{"title":"Clinical presentation, evaluation, and management of patients with myasthenia gravis at a tertiary care center in Pakistan","authors":"Aziz Sonawalla, None Shafaq Saleem, Salim Allana, None Rabia Qaiser, None Rohma Shamsi","doi":"10.56310/pjns.v18i02.255","DOIUrl":"https://doi.org/10.56310/pjns.v18i02.255","url":null,"abstract":"Note: The editors of PJNS are aware that this article contains old data. However, we have decided to publish this article because a) the data is still important as there is paucity of data in this regard from Pakistan, and b) the authors have written the article well and have mentioned this limitation of their manuscript.
 Background and objectives:
 Little is known about the clinical profile and outcome of myasthenia gravis in Pakistan. The objective of this study is to review the clinical characteristics of patients with myasthenia gravis in Pakistan, and the outcome of investigations and treatment.
 Methods: 
 The study comprised a retrospective review of charts of patients diagnosed with myasthenia gravis at Aga Khan University Hospital in Karachi, Pakistan, over a period of 16 years from 1987 to 2003. The following features were reviewed: (i) clinical presentation, (ii) investigations especially nerve conduction studies, acetylcholine receptor antibodies, and imaging studies of the thorax, (iii) treatments administered (including thymectomy). Data analysis was done using Excel sheets.
 Results: 
 Of the 83 patients, 51(61.4%) were males, whereas 32 (38.6%) were females. The age range was from 12 to 81 years, mean age of 43.7 years (SD± 18.2). In the 60 years plus group, there were three times as many males as compared to females. Limb weakness was noted in 58 (69.9%), ocular symptoms in 57(68.7%), and oropharyngeal symptoms in 54(65.1%) patients. Three (3.6%) presented in a state of myasthenic crisis. Tensilon test was performed in 34 patients and was positive in 31(91.2%), repetitive nerve conduction studies (RNS) were performed in 37 patients and was positive in 26(70.3%), acetylcholine receptor antibodies were done in 60 patients, and were positive in 55(91.7%). Thymic enlargement was seen in 28 out of 43 patients who underwent CT-Scan/MRI studies of the thorax. Besides pyridostigmine, most patients received immunosuppressive therapy with either steroids or azathioprine or both. The thymectomy was performed in 44 patients. 
 Conclusion: 
 The general disease pattern of MG, as noted in our series, appears to follow a similar pattern as noted worldwide. However, this retrospective and hospital-based study has its limitations, and more prospective and epidemiological studies are needed.","PeriodicalId":19818,"journal":{"name":"Pakistan Journal of Neurological Sciences","volume":"106 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135786354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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