PurposeThe primary objective of this study was to assess the overall frequency of primary headaches in subjects with a moderate to severe major depressive disorder. A further objective was to determine the frequency of primary headache sub-types in this population.Materials and methodsThis descriptive, cross-sectional study was conducted at the outpatients’ clinic of the department of psychiatry, Pakistan Railways Teaching Hospital, an affiliate of Islamic International Medical College, Rawalpindi. The duration of the study was from December 2016 to May 2017. One hundred and ten consecutive patients with a major depressive disorder (MDD) were assessed for a primary headache, according to the diagnostic criteria of International Classification of Headache Disorders second edition (ICHD-2). MDD patients with moderate to severe depression according to the diagnostic and statistical manual of mental disorders (DSM-5) were enrolled in the study. A semi-structured proforma was designed to gather information on sociodemographic variables. The data was analyzed by utilizing Statistical Package for Social Sciences, version 22 (IBM Corp., Armonk, NY, US).ResultsOf the 110 MDD patients enrolled, a primary headache was present in 45 (40.90%) cases. Additionally, five of these patients had a migraine with aura (11.11%), 12 had a migraine without aura (26.66%), and 28 had a tension-type headache (62.22%). In the females, migraines with or without aura was frequent (35.29%), while a tension-type headache was more common in males (72.72%).ConclusionMore than one-third of the sample had a primary headache syndrome, which shows a high comorbidity between a migraine and its variants and MDD. There is a need to undertake further studies with larger samples to elucidate this relationship.
Objectives: To determine the effects of high-intensity multimodal exercise training on bone mineral density and muscle performance in postmenopausal women. Method: The two-armed, parallel, pilot randomised controlled trial was conducted from November 2020 to July 2021 at Riphah Rehabilitation Centre, Rawalpindi, Pakistan, and comprised women aged 45-70 having been in the post-menopause phase for at least 3 years, with body mass index <30, community ambulant and willing to have exercise therapy. The subjects were randomised into two equal groups. The experimental group A received supervised high-intensity resistance, weight-bearing, balance and mobility training twice weekly for 8 months. The control group B received low-to–moderate intensity exercises. Femoral neck and lumbar spine bone mineral density (g/cm2) were taken through a dual-energy X-ray absorptiometry scan. Muscle performance was measured using 1 repetition maximum for leg and trunk extensors, and 30 sec sit to stand test. Data was analysed using SPSS 21. Results: Of the 101 women screened, 28(27.7%) were enrolled; 14(50%) in group A having mean age 53.36±6.28 years, and 14(50%) in group B having mean age 51.71±4.82 years (p>0.05). Group A showed significantly more improvement than group B both with respect to lumbar spine bone mineral density and muscle performance (p<0.05). Conclusion: Supervised high-intensity multimodal exercise training protocol had a positive effect on lumbar spine bone mineral density and muscle performance in postmenopausal women. Clinical Trial Number: NCT04653350 Link https://clinicaltrials.gov/ct2/show/NCT04653350 Key Words: Osteoporosis, Post-menopausal, Bone density, Strength, Muscle.
Aim: The noninvasive B-mode transocular ultrasound (TOU) measurement of the optic nerve sheath diameter (ONSD) is becoming popular to monitor intracranial pressure (ICP). Different studies report varied values for normal ONSD. Our primary aim was to find the TOUmeasured normal ONSD in healthy adult Pakistanis living in Islamabad Capital Territory (ICT).
Background: Knee osteoarthritis is a common musculoskeletal disorder, enhancing performance of Vastus Medialis Oblique (VMO) can reduce the symptoms. Objective: The study objective was to determine the effects of Electromyographic Biofeedback (EMG BF) on the performance of VMO in patients with knee osteoarthritis (OA). Methods: A Randomized Controlled Trial (RCT) was conducted at Pakistan Railway General Hospital, Rawalpindi from July to December 2019. In this study, n=30 patients with a diagnosis of knee OA were recruited with the age ranging from 50 to 65 years. The participants were randomly allocated to two groups. Group A has received isometric exercises with Electromyographic Biofeedback (EMG BF) training and Group B has received only isometric exercises for 6 weeks. The Assessments were taken at the baseline and after 6th week of intervention. The outcome measure of vastus medialis oblique (VMO) performance was maximum voluntary isometric contraction (MVIC), measured by an EMG BF device, and one-repetition maximum (1RM)). The VMO muscle thickness was measured by musculoskeletal ultrasound. SPSS version 21 was used for data analysis. Results: The mean age of the group A was 58.94±3.1 years and of group B was 59.44±2.9 years. There was found significant between-group improvement (p<0.001) in VMO thickness and 1RM. But for MVIC between-group difference was not significant (p>0.05). Within-group analysis for all variables was statistically significant (p 0<.001) in both experimental and control groups. Conclusion: It is concluded that VMO training with an EMG BF device is more effective to enhance VMO thickness and strength in terms of 1RM in patients with knee osteoarthritis. Keywords: Osteoarthritis, Electromyography Biofeedback, One repetition maximum
Carbonic anhydrase-II deficiency is an autosomal recessive disorder grounded on a triad of cerebral calcification, osteopetrosis and renal tubular acidosis away in which proximal tubules, distal collecting ducts or combined. 1 Other features include growth and mental retardation along with the complications of osteopetrosis. 2 The only treatment to cure the calcification is allogeneic bone marrow stem cell replacement; however it does not have any considerable effect on the renal lesions 3 We report a case of a 3 week old male child of Afghan origin with all these features who was clinically diagnosed as having carbonic anhydrase type II deficiency however unfortunately the baby passed during cranioplasty and genetic testing for enzyme deficiency could not be done. Our aim to present this case of a male child of Afghan origin is to enhance the awareness about this rare syndrome in our medical community and inviting further research for a possible Afghan mutation of CA-II gene.
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