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Neuromyelitis Optica Spectrum Disorder: A Case Report From Rehman Medical Institute, Peshawar., Dr. Muhammad Shahid Iqbal, Zainab Rustam, Omer Nasim Dec 2019

Neuromyelitis Optica Spectrum Disorder: A Case Report From Rehman Medical Institute, Peshawar., Dr. Muhammad Shahid Iqbal, Zainab Rustam, Omer Nasim

Pakistan Journal of Neurological Sciences (PJNS)

Devic's disease or Neuromyelitis Optica is a serious, rare idiopathic neurological disorder which affects the optic nerve and the spinal cord. A 15-year-old girl was admitted in the neurology was with a previous history of 4 episodes of weakness in both the lower limbs and urinary retention. The patient gradually lost her eyesight in both eyes at the age of 8. Initially, she was diagnosed as a case of Multiple Sclerosis at the age of 11 when she presented with first episode of lower limb weakness. Later, Seropositivity for Aquaporin 4 IgG and clear MRI scan of the brain confirmed …


Rare Presentation Of Cerebral Venous Sinus Thrombosis, Haris Majid Rajput, Anam Anis, Iqra Athar, Neelma Naz Khattak, Hanin Tanich, Mazhar Badshah Dec 2019

Rare Presentation Of Cerebral Venous Sinus Thrombosis, Haris Majid Rajput, Anam Anis, Iqra Athar, Neelma Naz Khattak, Hanin Tanich, Mazhar Badshah

Pakistan Journal of Neurological Sciences (PJNS)

We report case of a 16 year old girl with no known co-morbidities, presented with headache, quadriparesis and sudden vision loss. She had pallor and BMI was 33.09kg/m2. She had left 6th nerve palsy, bilateral papilledema and no perception of light. Motor examination showed power of 4/5 in all four limbs with bilateral extensor plantars. Neuroimaging was suggestive of superior saggital sinus thrombosis. CSF opening pressure was 72 cm of water.20 ml CSF was drained leading to improvement in headache and visual acuity. CVST presenting with quadriparesis and visual loss is a rare entity. Common presentations of CVST include headache, …


Cerebral Venous Sinus Thrombosis With Positive Dengue Serology, Sajid Hameed, Owais Hashmat, Mubashar Memon, Muhammad Wasay Dec 2019

Cerebral Venous Sinus Thrombosis With Positive Dengue Serology, Sajid Hameed, Owais Hashmat, Mubashar Memon, Muhammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

Dengue fever is a viral febrile illness caused by dengue virus and spread by Aedes mosquito worldwide. It usually manifests as an acute fever associated with body ache, skin rash, and thrombocytopenia. Neurological manifestations are relatively uncommon but well-known. We report a case of a 25-year-old male patient who presented to our hospital with acute febrile illness, headache, and vomiting. Extensive laboratory investigations were done and he was diagnosed with cerebral venous sinus thrombosis. Dengue serology was positive. He was treated with anticoagulation and hydration with complete recovery. The treatment with anticoagulation is challenging due to accompanying thrombocytopenia. Only two …


Culture Bound Syndromes In Pakistan: Implications And Strategic Vision For Health Management, Lamae Zulfiqar, Nazish Idrees, Muhammad Rafiq Dec 2019

Culture Bound Syndromes In Pakistan: Implications And Strategic Vision For Health Management, Lamae Zulfiqar, Nazish Idrees, Muhammad Rafiq

Pakistan Journal of Neurological Sciences (PJNS)

Understanding the culture a person belongs to is crucial as it forms the beliefs, values, perspectives, worries and hopes. It can then be used to assess the problems a person goes through and devise a treatment plan with a focus on belief system of a person. Culture bound syndromes are common in every society but are usually overlooked or given less consideration by professionals. These syndromes are belief systems associated with various diseases and disorders and can be very helpful in treatment, if understood in the perspective of a particular person as every syndrome is perceived differently by an individual …


Can Early Orthotic Support And Physical Therapy Improve The Functional Level And Decrease Rate Of Surgical Interventions In Spastic Cerebral Palsy?, Sarfraz Ahmad, Syeda Rahat, Syeda Bushra Dec 2019

Can Early Orthotic Support And Physical Therapy Improve The Functional Level And Decrease Rate Of Surgical Interventions In Spastic Cerebral Palsy?, Sarfraz Ahmad, Syeda Rahat, Syeda Bushra

Pakistan Journal of Neurological Sciences (PJNS)

cerebral palsy is a disorder of movement and posture that results from a non progressive lesion of brain within 3 years of age. To determine the role of early orthotics and physical therapy in improving the functional status and in decreasing the rate of surgical interventions in management of spastic diplegic cerebral palsy child.


Mental Health Of University Male Students Viewing Internet Pornography: A Qualitative Study, Komal Razzaq, Muhammad Rafiq Dec 2019

Mental Health Of University Male Students Viewing Internet Pornography: A Qualitative Study, Komal Razzaq, Muhammad Rafiq

Pakistan Journal of Neurological Sciences (PJNS)

This research was carried out to explore psychosocial and mental health issues of adults viewing pornography on the internet. Study Design: For this purpose, a qualitative research design was used. Method: In- depth interviews were conducted with twenty five university male students to explore the psychosocial issues in cases of internet pornography. After gathering the data from participants, a software, NVivo11 Plus was used for data management and analysis. This was also used for labelling and themes and categories generation. Results: After data analysis, main three categories generated on psychosocial issues associated with viewing internet pornography which were psychological issues, …


Outcome In Patients With Myasthenia Gravis Managed With Or Without Thymectomy, Safia Bano, Muhammad Athar Javed, Waqas Arshad Dec 2019

Outcome In Patients With Myasthenia Gravis Managed With Or Without Thymectomy, Safia Bano, Muhammad Athar Javed, Waqas Arshad

Pakistan Journal of Neurological Sciences (PJNS)

Myasthenia gravis is a chronic acquired autoimmune disorder in which autoantibodies are produced against acetylcholine receptors present on neuromuscular junction. It results in neuromuscular transmission blockage hence muscle weakness occurs. Thymus gland is considered as having crucial role in development of these antibodies. Screening patients for thymoma and removal of the thymus gland with surgery has an important aspect in management of disease.


Empowerment Of Primary Health Care In An Outreach Resource-Limited District In Punjab: A Strategy For Improving Adherence To Antiepileptic Drug Treatment In Children With Epilepsy., Muhammad Akbar Malik, Arshad Rafique, Ahmad Omar Virk Dec 2019

Empowerment Of Primary Health Care In An Outreach Resource-Limited District In Punjab: A Strategy For Improving Adherence To Antiepileptic Drug Treatment In Children With Epilepsy., Muhammad Akbar Malik, Arshad Rafique, Ahmad Omar Virk

Pakistan Journal of Neurological Sciences (PJNS)

There is wide acknowledgement of the need for community involvement in the optimal management of children with epilepsy (CWE) in outreach financially constrained districts of the developing countries, but there is scarce data on comprehensive community-based childhood epilepsy treatment programs assessment.


Rhabdomyolysis Due To Status Epilepticus Causing Acute Renal Failure, Iqra Athar, Neelma Naz Khattak, Haris Majid Rajput, Anam Anis, Hanin Tanich, Mazhar Badshah Dec 2019

Rhabdomyolysis Due To Status Epilepticus Causing Acute Renal Failure, Iqra Athar, Neelma Naz Khattak, Haris Majid Rajput, Anam Anis, Hanin Tanich, Mazhar Badshah

Pakistan Journal of Neurological Sciences (PJNS)

Acute renal failure is one of the most common complications of rhabdomyolysis. Rhabdomyolysis is a serious syndrome and should be suspected in patients presenting after direct or indirect muscle injury, seizures, strenuous exercise, crush injuries and ingestion of drug or toxins. Rhabdomyolysis secondary to status epilepticus is a serious complication, leading to life threatening acute renal failure. Therefore, early recognition of risk of rhamdomylosis in status epilepticus and initiation of treatment is important.


Neurology Training In Pakistan: 2020-2025, Safia Bano, Sarwar Jamil Siddique, Ahsan Numan Numan Dec 2019

Neurology Training In Pakistan: 2020-2025, Safia Bano, Sarwar Jamil Siddique, Ahsan Numan Numan

Pakistan Journal of Neurological Sciences (PJNS)

As the year 2019 comes to end, many advances in neurology has been occurred over worldwide and is still going on. The emergence of new devices and drugs will help neurologists with additional therapeutic options to optimize the patient care especially in more complex cases. Antibody therapies especially monoclonal antibodies are flooding the landscape in nearly every discipline of neurology is no exception. We watched newer clinical trials, gain FDA approval for use, and many more therapeutic evidence-based interventions enter the pipeline. Neurology in the 20th century has undergone extraordinary changes, particularly in the past few decades. We trace the …


Development And Validation Of Juvenile Criminal Thinking Styles’ Inventory, Fatima Sana, Muhammad Rafiq Dec 2019

Development And Validation Of Juvenile Criminal Thinking Styles’ Inventory, Fatima Sana, Muhammad Rafiq

Pakistan Journal of Neurological Sciences (PJNS)

The current research explored the styles of criminal thinking among juvenile delinquents in Pakistani cultural context. Initially, 40 juvenile delinquents were interviewed individually to generate an item pool of 34 distinct thought statements. After excluding repetitive items a list of 19 items was piloted on 30 juvenile delinquents as a self-report measure of 5-point rating scale (Juvenile Criminal Thinking Styles’ Inventory). Finally, a sample of 211 juvenile delinquents were given the final list of 19 items, Measure of Criminal Social Identity (Boduszek, Adamson, Shevlin, & Hyland, 2012; Shagufta, 2015), and a demographic form. Principal Component factor analysis determined a three …


Science Of Lifestyle; Strategies For Change, Raza Ur Rahman Sep 2019

Science Of Lifestyle; Strategies For Change, Raza Ur Rahman

Pakistan Journal of Neurological Sciences (PJNS)

Since the start of 21st century the focus of medical treatment is changing from curative to the preventive medicine and now functional recovery and quality of life are the outcome of curative medicine. These new outcomes of modern medicine can be achieved through adopting the strategies that enhance wellness of patient. The methods of enhancing wellness are in practice since centuries and their effectiveness has been handed down through word of mouth and tradition. They continue to evolve and were first documented in 1970s, by Canyon Ranch1, as a strategy to improve health through the principles of a healthy lifestyle. …


What, When And For Whom Model Of Nutrition: A Health Management Approach, Muhammad Rafiq Sep 2019

What, When And For Whom Model Of Nutrition: A Health Management Approach, Muhammad Rafiq

Pakistan Journal of Neurological Sciences (PJNS)

Studies have shown that nutrition plays an important role in the pathophysiology of different health issues either physiological, or psychological. Nutrition is implicated in the development of health issues in different ways. The purpose of this mini review was to suggest a comprehensive model of nutrition, “What, When and for Whom Model of Nutrition”, in the light of existing literature. For this purpose, existing literature was explored to study the role of nutrition on mental health in perspective to, what type of nutrition, when it is consumed and/or who consumes it. Researchers concluded that it is not only what we …


Diagnostic Dilemmas Of Progressive Supranuclear Palsy, Humera Saeed, Qurat Ul Ain Khan, Syeda Masharab Jilani, Syeda Maheen Batool Sep 2019

Diagnostic Dilemmas Of Progressive Supranuclear Palsy, Humera Saeed, Qurat Ul Ain Khan, Syeda Masharab Jilani, Syeda Maheen Batool

Pakistan Journal of Neurological Sciences (PJNS)

In this report authors discuss similarities between psychiatric phenomenon i.e. catatonia and neuropsychiatric syndromes such as progressive supranuclear palsy (PSP) in a 51 years old male, known case of hypertension and diabetes, who presented to the psychiatric services with mutism, stereotypical movements of upper limbs, echolalia, anteriorly flexed neck, swallowing difficulty, decreased oral intake, urinary and fecal incontinence for a period of 1 year worsened for 6 months. Patient was initially treated for catatonia with benzodiazepines and electroconvulsive therapy but did not improve. A neuropsychiatric consultation was sought and a diagnosis of possible PSP was made according to the National …


Gbs With Non-Hodgkin Lymphoma, A Rarity, Javaria Munir, Umer Aziz Qazi Sep 2019

Gbs With Non-Hodgkin Lymphoma, A Rarity, Javaria Munir, Umer Aziz Qazi

Pakistan Journal of Neurological Sciences (PJNS)

Patients of Non-Hodgkin’s lymphomas may develop neurological signs and symptoms. This case is of a 76 year old male recently diagnosed with Non-Hodgkin’s lymphoma and on chemotherapy who presented with sudden bilateral leg weakness and inability to walk. The signs and symptoms, neurological examinations and Nerve conduction studies revealed a polyneuropathy which was consistent with Guillain-Barré syndrome (GBS). This has been seen in patients with Hodgkin's lymphoma but is rare in NHL.


Neurotoxicity In A Young Patient With Diffuse Large B-Cell Lymphoma After First Dose Of Intrathecal Triple Therapy., Ali Sajjad, Sajid Hameed, Sara Khan Sep 2019

Neurotoxicity In A Young Patient With Diffuse Large B-Cell Lymphoma After First Dose Of Intrathecal Triple Therapy., Ali Sajjad, Sajid Hameed, Sara Khan

Pakistan Journal of Neurological Sciences (PJNS)

Intrathecal triple chemotherapy (ITT) including cytarabine arabinoside, methotrexate and glucocorticoids is a standard regimen for prophylaxis and treatment of hematological malignancies, owing to their high proclivity for invasion of the neuraxis. Unfortunately, intrathecal chemotherapy is associated with various neurological adverse effects including seizures, encephalopathy, myelopathy, arachnoiditis and cauda/conus syndrome. We present a case of 33-year-old lady with primary bone diffuse large B-cell lymphoma. She had received 4 cycles of R-CHOP* and later 2 cycles of R-DHAP**. The first dose of ITT was administered along with the last cycle of R-DHAP. On the third day post-ITT, she developed acute bilateral lower …


Post-Stroke Seizures: A Clinically Oriented Analysis, Sajid Hameed, Haris Hakeem, Mohammad Wasay Sep 2019

Post-Stroke Seizures: A Clinically Oriented Analysis, Sajid Hameed, Haris Hakeem, Mohammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

Stroke is an important cause of secondary epilepsy, especially in the elderly. Not only does this impact morbidity and mortality in an adverse way, it also prolongs the hospitalization. Various risk factors have been described in literature that increase the risk of seizures in a patient with stroke. Post stroke seizures fall on a spectrum of acute symptomatic and unprovoked seizures with varying pathophysiology and risk of subsequent development of epilepsy. Hence, the treatment approaches are also different. However, randomized controlled trials are lacking to guide monitoring and management strategies in post stroke seizures and the approaches remain individualized to …


The Natural Predominant Sleeping Positions In Cerebral Palsy; Does It Correlate With The Type Of Cerebral Palsy?, Sarah Razaq, Muhammad Aleem Arshad, Tahira Amjad Sep 2019

The Natural Predominant Sleeping Positions In Cerebral Palsy; Does It Correlate With The Type Of Cerebral Palsy?, Sarah Razaq, Muhammad Aleem Arshad, Tahira Amjad

Pakistan Journal of Neurological Sciences (PJNS)

To see the natural positions of cerebral palsy subjects during sleep and their correlation with the particular type of cerebral palsy.


Tacrolimus-Associated Posterior Reversible Encephalopathy Syndrome In Allogenic Hematopoietic Stem Cell Transplant, Hina Imtiaz, Maryam Jamil Syed, Dureshahwar Kanwar, Bushra Taimuri, Sajid Hameed Sep 2019

Tacrolimus-Associated Posterior Reversible Encephalopathy Syndrome In Allogenic Hematopoietic Stem Cell Transplant, Hina Imtiaz, Maryam Jamil Syed, Dureshahwar Kanwar, Bushra Taimuri, Sajid Hameed

Pakistan Journal of Neurological Sciences (PJNS)

Tacrolimus is an immunosuppressive drug used to lower the risk of transplant rejection in individuals after solid organ or hematopoietic transplantation. Cases of posterior reversible encephalopathy syndrome (PRES) as a complication of tacrolimus therapy are infrequently documented. The pathogenesis of this phenomenon is not well understood. Here, we report a case of an 18-year-old female with a history of acute myeloid leukemia that developed PRES after undergoing an allogeneic stem cell transplant and subsequent immunosuppressive therapy with tacrolimus.


Cross-Sectional Study Of Knowledge Of Stroke Management Amongst Doctors Of A Tertiary Care Hospital; Peshawar, Pakistan, Muhammad Fozan Khan, Farzana Behttani, Omer Nasim, Muhammad Shahid Iqbal, Sohail Khan, Muhammad Khizar Hayat Sep 2019

Cross-Sectional Study Of Knowledge Of Stroke Management Amongst Doctors Of A Tertiary Care Hospital; Peshawar, Pakistan, Muhammad Fozan Khan, Farzana Behttani, Omer Nasim, Muhammad Shahid Iqbal, Sohail Khan, Muhammad Khizar Hayat

Pakistan Journal of Neurological Sciences (PJNS)

Stroke is one of the leading causes of mortality and neurological disability worldwide. ‘Time is brain’ and prompt management of stroke is vital to improve the outcomes. Knowledge of stroke management is important for clinicians working in various specialties and this study focused on evaluation of this vital aspect.


An Overview Of Autism: Is It Treatable In Pakistan?, Tania Nadeem, Rabeeka Aftab, Nargis Asad Sep 2019

An Overview Of Autism: Is It Treatable In Pakistan?, Tania Nadeem, Rabeeka Aftab, Nargis Asad

Pakistan Journal of Neurological Sciences (PJNS)

Autism Spectrum Disorder (ASD) is a clinically complex, pervasive neurodevelopmental disorder with early appearing social communication deficits and repetitive sensory–motor behaviors.1 Although affected individuals differ significantly from one another, typically the disorder is characterized by impairment in social reciprocity and communication. Children usually have speech delays or lack of social interaction including: lack of eye contact, limited response to name, decreased interest in peers, and restricted shared attention with parents.1 Autistic individuals also exhibit repetitive behaviors like flapping, lining, or stacking objects and narrowly focused rigid interests such as paying particular attention to spinning objects.1 It usually manifests before 3 …


Extended Window Intravenous Thrombolysis: Is Conventional Window Of 4.5 Hours Coming To An End?, Malik Muhammad Adil, Narmeen Masood Sep 2019

Extended Window Intravenous Thrombolysis: Is Conventional Window Of 4.5 Hours Coming To An End?, Malik Muhammad Adil, Narmeen Masood

Pakistan Journal of Neurological Sciences (PJNS)

The current standard of care to treat acute stroke patients presenting within 4.5 hours of stroke symptom onset is intravenous (IV) Alteplase.1 Over the past decade, tremendous efforts have been made to challenge the conventional window of 4.5 hours for the administration of Alteplase to expand the patient population which can benefit from thrombolysis. Based on the recent meta-analysis, 2 we have strong evidence supporting the use of IV thrombolysis in patients presenting between 4.5 to 9 hours of symptom onset with favorable perfusion imaging and it appears that the era of the conventional 4.5 hours window may be coming …


Polyneuropathy Associated With Iga Paraproteinemia: A Case Report And Literature Review., Waleed Shahzad, Sumaira Nabi, Hafiza Faiza Mushtaq, Tehmina Inayat, Muhammad Hassan, Haris Majid Rajput, Zakir Jan, Mazhar Badshah Jun 2019

Polyneuropathy Associated With Iga Paraproteinemia: A Case Report And Literature Review., Waleed Shahzad, Sumaira Nabi, Hafiza Faiza Mushtaq, Tehmina Inayat, Muhammad Hassan, Haris Majid Rajput, Zakir Jan, Mazhar Badshah

Pakistan Journal of Neurological Sciences (PJNS)

Paraproteinemia is precipitated by an accumulation of monoclonal plasma cells or B lymphocytes. Idiopathic neuropathies that are associated with paraproteinemia account for only 10% of the neuropathies. Paraprotein acts like an antibody and is targeted against myelin and axons present in the peripheral nerves. Despite being of interest for quite a long time, the caudal relationship between paraproteinemias and peripheral neuropathies still remains a sorcery. We report a case of a middle aged male who presented with pain and parasthesias in both arms and legs. His workup revealed him to be having a paraproteinemic neuropathy consistent with IgA Lambda chains …


Humanism And Mental Health Of Married Female Patients With Systemic Lupus Erythematosus., Hafiza Muzammal Shafiq, Dr. Muhammad Rafiq, Dr. Zahid Mahmood Jun 2019

Humanism And Mental Health Of Married Female Patients With Systemic Lupus Erythematosus., Hafiza Muzammal Shafiq, Dr. Muhammad Rafiq, Dr. Zahid Mahmood

Pakistan Journal of Neurological Sciences (PJNS)

Autoimmune diseases exert adverse impact on the psychological, social and physical well-being of the individuals who suffer from such diseases. Systemic lupus erythematosus is one of chronic illnesses that disturb the all areas of life especially psychosocial perspective of life. In such conditions, belief and view of patients about their own self is necessary to prognosis of their health. Studies suggest that humanism is one of those protective factors that can lead risky health towards better life.


Vgkc Antibody (Anti Lg1) Associated Limbic Encephalitis In A Young Adult With Full Recovery., Farheen Niazi, Madeeha Iftikhar, Rizwan Ali, Tahir Aziz Jun 2019

Vgkc Antibody (Anti Lg1) Associated Limbic Encephalitis In A Young Adult With Full Recovery., Farheen Niazi, Madeeha Iftikhar, Rizwan Ali, Tahir Aziz

Pakistan Journal of Neurological Sciences (PJNS)

A young boy with no premorbids was admitted with fever, fits and psychosis. His initial investigations including cerebrospinal fluid (CSF) routine examination, electroencephalogram(EEG) and MRI brain with contrast were normal. His autoimmune encephalitis panel revealed positive voltage gated potassium channel(VGKC) antibodies, anti -leucine rich glioma inactivated 1 antibody (LG1) group and was give five doses of methylprednisolone and five sessions of plasmapheresis. Psychiatric symptoms took one month to respond. He had a complete recovery. Autoimmune limbic encephalitis should be diagnosed promptly in young patient with fit, psychosis and a high index of suspicion should be kept as initial work up …


Is It Really Transverse Myelitis? Acute Flaccid Myelitis A Rare Entity., Hina Yusuf, Arsalan Ahmad, Ejaz Ahmed Khan Jun 2019

Is It Really Transverse Myelitis? Acute Flaccid Myelitis A Rare Entity., Hina Yusuf, Arsalan Ahmad, Ejaz Ahmed Khan

Pakistan Journal of Neurological Sciences (PJNS)

Acute Flaccid Myelitis is a relatively new and rare disease entity which was recognized for the first time in United States in 20121. Usually children below 18 years of age present with sudden onset rapidly progressive flaccid paralysis sometimes following upper respiratory tract infection. To date no cases have been reported from Afghanistan and Pakistan. We are reporting case of a young girl who presented with sudden onset flaccid paralysis and respiratory distress. Her MRI Cervical spine showed longitudinally extensive transverse myelitis. One year after the onset of disease flaccid paraparesis continued despite various treatments. It is important to report …


Spectrum Of Electroencephalogram Finding In Children With Newly Diagnosed Epilepsy –An Experience At A Tertiary Care Hospital., Sanam B. Rajper, Khairunnisa Mukhtiar, Fozia Baloch, Shahnaz H. Ibrahim, Abdul Rashid Memon Jun 2019

Spectrum Of Electroencephalogram Finding In Children With Newly Diagnosed Epilepsy –An Experience At A Tertiary Care Hospital., Sanam B. Rajper, Khairunnisa Mukhtiar, Fozia Baloch, Shahnaz H. Ibrahim, Abdul Rashid Memon

Pakistan Journal of Neurological Sciences (PJNS)

Epilepsy is the most common neurological disorders that affect all age groups. It is characterized by at least two unprovoked seizures more than 24 hours apart. The most common investigation used for both diagnosis and management is an Electroencephalogram (EEG), which is relatively cheap and easy to perform. However, EEG requires technical expertise and is prone to misinterpretation. Objective: To determine the frequency of abnormal EEG findings in children with newly diagnosed epilepsy at tertiary care hospital.


Patent Foramen Ovale Closure In Young Patients With Cryptogenic Stroke: A Case Series And Follow Up From Saudi Population., Aishah Albakr, Noman Ishaque, Rizwana Shahid, Alaa Jamal Al Obaidli, Noora Waleed Alayyaf, Mohammed Almansoori, Sarah Ali Saleh Al Amri Jun 2019

Patent Foramen Ovale Closure In Young Patients With Cryptogenic Stroke: A Case Series And Follow Up From Saudi Population., Aishah Albakr, Noman Ishaque, Rizwana Shahid, Alaa Jamal Al Obaidli, Noora Waleed Alayyaf, Mohammed Almansoori, Sarah Ali Saleh Al Amri

Pakistan Journal of Neurological Sciences (PJNS)

One quarter of cerebral infarctions are cryptogenic and most of these patients are young. Patent Foramen Ovale (PFO) is found to be more prevalent in young persons with cryptogenic stroke and risk of stroke recurrence in such patients ranges from as low as 2% per annum to as high as 12% per annum. Since patients with PFO and cryptogenic stroke are young they need more effective ways to reduce risk of stroke recurrence hence percutaneous closure of PFO seems reasonable approach to deal with this etiology of stroke in such population. We report four cases of cryptogenic stroke in young …


The Mhgap; Will It Bridge The Mental Health Treatment Gap In Pakistan?, Shireen Najam, Aisha Sanober Chachar, Ayesha Mian Jun 2019

The Mhgap; Will It Bridge The Mental Health Treatment Gap In Pakistan?, Shireen Najam, Aisha Sanober Chachar, Ayesha Mian

Pakistan Journal of Neurological Sciences (PJNS)

In Pakistan, the treatment gap for mental disorders is significantly high. Pakistan faces a unique problem of sustainable delivery. In 2009, WHO launched a mental health gap action program (mhGap) to provide evidence-based services at the primary and secondary level for the prevention and management of psychiatric and neurological disorders. This article highlights the discrepancies of the systems and issues related to mental health services provision in Pakistan. By discussing two initiatives of mhGap implementation for the Pakistani health system, authors have surveyed core areas where the sustainability of such a model can be compromised. The structural challenges marked by …


Alterations In Human Reaction Time Upon Consumption Of Taurine-Caffeine Based Energy Drink. A Gender Based Study., Asif Abbasi, Amaila Fazal, Faizan Mirza, Sadaf Ahmed Jun 2019

Alterations In Human Reaction Time Upon Consumption Of Taurine-Caffeine Based Energy Drink. A Gender Based Study., Asif Abbasi, Amaila Fazal, Faizan Mirza, Sadaf Ahmed

Pakistan Journal of Neurological Sciences (PJNS)

Energy drinks contains several potentially psychoactive ingredients including taurine, glucoronolactone, and caffeine that increases the human performances, reaction time and mood with relative differences to visual and auditory stimuli between both the genders.