Efficacy of memantine in treating patients with migraine and tension-type headache

Objective: To assess the efficacy of Memantine as a preventive and therapeutic intervention for migraine and tension-type headache. Methods: This clinical trial was conducted over a period of 3 months. A total of 44 subjects, with diagnosed migraine and/or tension-type headache, presenting to a private neurology clinic in Karachi, Pakistan were selected through purposive sampling technique. Patients were treated with incremental doses of Memantine. Adult patients belonging to both genders were included in the study. Data was analyzed using SPSS version 16.0 and associations were made using Chi square test with p-value of less than 0.05 taken as significant. Results: Out of 44 patients, 35 (79.5%) were females and 9 (20.5%) were males which shows a very high occurrence of migraine and tension-type headache in females. Average age was found to be 32.6 ≈ 33 years. Efficacy of the drug was observed to be 81.8% which is significantly high. The baseline MIDAS score when compared with the score at 3-month follow-up by applying Wilcoxon signed rank test showed mean ± S.D (39.52±21.27 vs. 6.72±6.41) where p=0.000 (\u3c0.05) which shows a highly significant result. All 44 patients were known cases of migraine while 25% (11) of them also suffered from tension-type headache. Patients were treated with incremental doses of Memantine and were observed for the efficacy of the drug. Patients maintained their diaries of intensity of pain, distressing influence of the pain and how it hindered their daily routine. Results showed that intensity of pain decreased significantly by the end of the 3rd month of treatment and majority of the patients felt less distressed on their final follow-up visit. By the end of the 3rd month, the level of hindrance in the daily routines of the patients caused by the headache also fell significantly. Conclusion: Memantine has significant beneficial effects in reducing intensity of pain and disability in patients with migraine and tension type headache

Seasonal variation and Seroprevalence of Dengue fever in Karachi, Pakistan

Introduction: Dengue fever is a rapidly emerging arthropod born viral disease becoming an international public health problem. Approximately 500,000 people suffer from dengue hemorrhagic fever and dengue shock syndrome with 20,000 deaths annually. Objective: To identify seasonal variation and seroprevalence of dengue fever for primary and secondary dengue infections. Methodology: The study was conducted on 4900 plus subjects with mean age of 30 years, admitted to Dow University Hospital, Karachi. Reported cases were diagnosed by immuno-chromatography kit, used to measure the presence of IgG and IgM antibodies against dengue virus. Results:  Seasonal variation of seropositive dengue patient from 2010 to 2013 showed most prominent dengue fever disease onset found in the month of October whereas least seen in the months from Jan to April. Age wise younger subjects were more prone to the infection with mean age of 21 to 30 years. 64% of the total febrile seropositive cases were male as compare to female patients noted 36%. Conclusion: Dengue disease is a threat to Pakistani population, being a developing country there should be more focus in eradicating this debilitating disease, to reduce the economic burden. Through adapting vaccination strategies, proper sanitation and awareness programs. Special campaign for sprays and dengue control measures prior to month of October and fall season should be adopted essentially on regular basis. Keywords:  Dengue fever, haemorrhagic fever, dengue virus, dengue Prevalence, Ig

SEASONAL VARIATION AND RECENT STATUS OF TYPHOID FEVER IN A TERTIARY CARE HOSPITAL

ABSTRACT In many developing countries, typhoid fever is endemic. Early diagnosis is important for appropriate treatment on time

Investigation of Antibiotics Susceptibility and Resistance Pattern of ESBL and CRE Producing Escherichia coli and Klebsiella pneumonia Isolates from Northern Region of Saudi Arabia

The presence of ESBLs and CRE in E. coli and Klebsiella pneumoniae poses a significant challenge in healthcare and community settings. These enzymes can confer resistance to multiple antibiotics, limiting treatment options for infections caused by these strains. This resistance complicates infection management, leading to prolonged illness, increased healthcare costs, and higher mortality. This cross-sectional study, conducted from 2021 to 2022 at three hospitals in the northern border region of Saudi Arabia, involved collecting 541 samples from various wards and units. Samples were inoculated on blood-agar and MacConkey’s media, incubated overnight at 37°C, and analyzed for growth. Antibiotic susceptibility was tested using the “MicroScan WalkAway-96 SI-automated system. A total of 541 positive cases were collected from three major cities in the northern border territory of Saudi Arabia. Observations show that E. coli (18.66%, n = 101) was the most prominent pathogen, compared to Klebsiella pneumoniae (9.9%, n = 54). Females were more prone to ESBL-producing E. coli infections, with 67% having a urinary tract infection, whereas male patients were more predisposed to respiratory K. pneumoniae infections (54% compared to females at 46%). Out of 155 samples, 49.01% were ESBL-producing E. coli, and 20.38% were ESBL+CRE. Furthermore, 15.68% of K. pneumoniae were ESBL producers. E. coli showed resistance to 92% of ampicillin, 90% of oxacillin, 79% of ceftazidime, 76% of cefepime, 57% of aztreonam, and 53% of cephalothin, while amikacin (85%), imipenem, and meropenem were effective. Klebsiella pneumoniae showed 74% resistance to ampicillin, 67% to ceftazidime, 63% to co-trimoxazole, 57% to amoxicillin-clavulanate, and 42% to aztreonam. The sensitive antibiotics were imipenem (46%), aztreonam (42%), and amikacin (44%). The results are both intriguing and alarming. It is crucial to address the spread of ESBL and CRE-producing organisms

The Psychological Impacts of Acne

Objective: To determine the frequency of different category of Dermatology Life Quality Index (DLQI) in patients with Acne Vulgaris visiting to tertiary care hospital. Study Design: Descriptive Cross-Sectional Study. Place and Duration: This study was conducted at the Department of Dermatology, Shaheed Mohtarma Benazir Bhutto Medical University, Larkana, Pakistan during the period from August 23, 2019 to February 22, 2020. Materials and Methods: All patients who fulfilled the inclusion criteria and visited to SMBBMU, Larkana were included in the study. Informed consent was taken after explaining the procedure, risks and benefits of the study. In our study, patients with acne vulgaris were diagnosed on the basis of relevant clinical history and examination. Patients were asked to fill the DLQI questionnaire themselves to assess the DLQI. All the collected data were entered into the proforma attached at the end and used electronically for research purpose. Results: Mean ± SD of age was 25.4±5.2 years. Out of 343 patients, 157 (45.8%) were male and 186 (54.2%) were female. In frequency of different category of dermatology life quality index (DLQI) 44 (12.8%) patients had no effect, 105 (30.6%) had mild, 74 (21.6%) moderate effect, 86 (25.1%) had very large while 34 (9.9%) patients had extreme larger effect. Conclusion: It is to be concluded that his study showed significant impairment of QoL in acne patients. Assurance and counseling along with early treatment of acne vulgaris are important to reduce disease-related psychosocial sequelae. Keywords: Dermatology Life Quality Index, Acne Vulgaris, Influencing Factors, Quality of Life, Psychosocial, Cosmetological Treatments</jats:p