Opportunities and challenges to non-communicable disease (NCD) research and training in Pakistan: a qualitative study from Pakistan.

Introduction: Most of the global non-communicable disease (NCD)-related death burden is borne by low and middle-income countries (LMICs). In LMICs like Pakistan, however, a major gap in responding to NCDs is a lack of high-quality research leading to policy development and implementation of NCDs. To assess institutional opportunities and constraints to NCD research and training we conducted a situational analysis for NCD research and training at Aga Khan University Pakistan.

Clinical efficacy of photodynamic therapy as an adjunct to scaling and root planing in the treatment of chronic periodontitis among cigarette smokers: A systematic review and meta-analysis.

Background: The aim of the study was to evaluate the clinical efficacy of adjunctive photodynamic therapy (PDT) as compared to scaling and root planing (SRP) alone in the treatment of chronic periodontitis among cigarette smokers.

Methods: Electronic databases including EMBASE, MEDLINE, Cochrane Oral Health Group Trials Register and Cochrane Central Register of Controlled Trials were searched up to January 2019. Randomized clinical trials (RCTs) with data on comparison between adjunctive PDT compared to SRP in each group were included.

Building Bridges through Science.

Science is ideally suited to connect people from different cultures and thereby foster mutual understanding. To promote international life science collaboration, we have launched "The Science Bridge" initiative. Our current project focuses on partnership between Western and Middle Eastern neuroscience communities.

Pattern of neurological diseases in adult outpatient neurology clinics in tertiary care hospital.

Objectives: The burden of neurological diseases in developing countries is rising although little is known about the epidemiology and clinical pattern of neurological disorders. The objective of this study was to understand the burden of disease faced by neurologists a in tertiary care setting.

Results: A prospective observational study was conducted of all presentations to neurology clinics at Aga Khan University Hospital Karachi over a period of 2 years.

A unique MRI presentation of fungal infection in the brain.

Fungal infections of CNS are common in certain geographic locations. MRI with or without contrast is a useful prediagnostic tool. However, the findings may sometimes be misleading.

Mortality and neurodevelopmental outcomes of acute bacterial meningitis in children aged <5 years in Pakistan.

Objective: Significant neurodevelopmental sequelae are known to occur after acute bacterial meningitis (ABM). This study determined the burden of such sequelae in Pakistani children aged <5 years to guide policies for Haemophilus influenzae type b (Hib) and pneumococcal vaccination.

Study Design: Cases of ABM were recruited from hospital-based surveillance and assigned to 1 of 3 etiologic groups (Hib, Streptococcus pneumoniae, or unknown etiology).

Clinical predictors of EMG-confirmed cervical and lumbosacral radiculopathy.

Background: Electromyography (EMG) for suspected cervical or lumbosacral root compression is often negative, producing expense and physical discomfort that could have been avoided. To improve patient selection for testing, we sought to identify clinical features that would accurately predict presence of radiculopathy on EMG.

Methods: Adult patients consecutively evaluated for suspected cervical or lumbosacral root compression at an academic clinical neurophysiology laboratory were prospectively enrolled.

Risk of multiple sclerosis after idiopathic optic neuritis in a Pakistani population.

Background And Objective: Optic neuritis (ON) is associated with a 38% ten-year risk of developing multiple sclerosis (MS) in Western populations, but the corresponding risk in non-Western populations is unclear. We conducted this study to estimate the risk of progression to MS after an episode of ON in a South Asian population.

Methods: Two hundred and fifty-three patients with idiopathic ON were identified by reviewing records of visual evoked potentials and chart notes from a single academic center spanning the years 1990-2007.

Hypotension at presentation is an indicator of poor prognosis in acute intracerebral haemorrhage.

Objective: To identify frequency of hypotension in a large cohort of patients with intracerebral haemorrhage and its prognostic significance.

Methods: We retrospectively reviewed medical records of 920 patients with spontaneous intracerebral haemorrhage (ICH). Patients were divided in three groups based on Diastolic blood pressure (DBP); hypotensive group (DBP < 70 mmHg), normotensive group (DBP; 71-90 mmHg) and hypertensive group (DBP > 90 mmHg).

Alzheimer disease therapeutics: perspectives from the developing world.

Although a majority of dementia patients live in middle-income and low-income countries, dementia represents an under-recognized public health burden in the developing world. Culturally and socially, it tends to be trivialized as an inevitable consequence of aging. Economic constraints are paramount, precluding the availability of institutionalized elder care and a state-sponsored health care system.

Factors associated with helmet use among motorcycle users in Karachi, Pakistan.

Objectives: Wearing a helmet is the single most effective measure for preventing head injuries in motorcycle users. The authors undertook this study to estimate compliance and determine reasons for noncompliance with helmet use among motorcyclists in their community.

Methods: This was a cross-sectional survey of motorcyclists in three large randomly selected public-access parking spaces across Karachi, Pakistan's largest city.

Cryptogenic middle cerebral artery infarction in pure red cell aplasia.

Pure red cell aplasia (PRCA) is a rare hematological disorder characterized by an isolated depletion of erythroid precursors with preservation of other cell lines. Neurological concomitants are not a recognized feature. We report a case of unexplained middle cerebral artery infarction in a 32-year-old woman with PRCA.

Drug compliance after stroke and myocardial infarction: a comparative study.

Background: Stroke and myocardial infarction (MI) are both life-threatening diseases of vascular origin with a tendency to recur. In both conditions, risk of recurrence is reduced through similar drug regimens.

Aim: To determine if compliance with prescribed medication after stroke or MI was similar in the two populations.

Heparin in the treatment of cerebral venous thrombosis.

Cerebral venous thrombosis (CVT) is a potentially life-threatening condition requiring rapid diagnosis and urgent treatment. Heparin anticoagulation is the time-honoured treatment, and is advocated in all cases of CVT, irrespective of etiology or presence of haemorrhage. The supportive evidence is largely observational; data from randomized placebo-controlled trials shows a nonsignificant trend favouring heparin.

Association of phosphodiesterase 4D gene with ischemic stroke in a Pakistani population.

Background And Objectives: Identification of STRK1 locus by the deCODE group followed by the discovery of phosphodiesterase 4D (PDE4D) gene in strong association with ischemic stroke patients has provided useful insights toward understanding the genetic etiology of the disease. In this study, we aimed at investigating the association between 3 polymorphisms of the PDE4D gene and ischemic stroke in the Pakistani population.

Methods: Three polymorphisms in PDE4D gene were analyzed in 200 patients of ischemic stroke and 250 controls of Pakistani origin using polymerase chain reaction-restriction fragment length polymorphism method.

Brainstem encephalitis with Kikuchi-Fujimoto disease.

A case of young woman is described who developed clinical and MRI features of brainstem encephalitis in the setting of fever and cervical lymphadenopathy. Lymph node biopsy revealed histiocytic necrotizing lymphadenitis (Kikuchi-Fujimoto disease), which may reflect host response to an unspecified immune insult.

Functional recovery following rehabilitation after hemorrhagic and ischemic stroke.

Objectives: To quantify recovery after rehabilitation therapy and to identify factors that predicted functional outcome in survivors of intracerebral hemorrhage (ICH) compared with cerebral infarction.

Design: Retrospective study of consecutive ICH and cerebral infarction admissions to a rehabilitation hospital over a 4-year period.

Setting: Free-standing urban rehabilitation hospital.

Patient knowledge and expectations for functional recovery after stroke.

Objective: Understanding the causes and outcomes of stroke is important for stroke survivors and may affect their success in rehabilitation and their risk of recurrent stroke; therefore, this study was performed to assess the knowledge and expectation of functional recovery in stroke patients undergoing acute inpatient rehabilitation.

Design: Survey study of 50 consecutive stroke patients undergoing inpatient rehabilitation at a single urban rehabilitation hospital.

Results: Forty-six percent of participants were able to correctly identify whether they had sustained a cerebral infarct or hemorrhage.

Family member knowledge and expectations for functional recovery after stroke.

Objective: To assess the stroke knowledge and expectations for recovery among the family members of stroke patients in an acute rehabilitation hospital.

Design: Survey study of 50 family members of stroke patients undergoing inpatient rehabilitation at a single urban rehabilitation hospital.

Results: Sixty percent of participants were able to identify whether their family member had sustained a cerebral hemorrhage or infarct; 48% were able to identify at least one treatment provided to their family member for his or her stroke.