ObjectiveTo determine the frequency of non-motor symptoms (NMS) in patients of Parkinson’s disease (PD) presenting to a movement disorder clinic at a tertiary care centre in Pakistan, and how frequency of NMS is different in male and female patients.Study designObservational, cross-sectional study.SettingTertiary care centre.ParticipantsOut of 102 patients, 85 were included. Inclusion criteria were patients with PD diagnosed according to the UK Parkinson’s Disease Society Brain Bank Clinical Diagnostic Criteria, age ≥18 years, able to give consent and have no difficulty in answering questions. Exclusion criteria were diseases that resemble PD, stroke, dementia, patients unable to provide information and history of antipsychotic use.ResultsThe NMSQuest revealed a mean of nearly seven different NMS per patient. Autonomic problems such as constipation (56%) and nocturia (49%) were the most common NMS, while urinary urgency was reported by 35% of patients. Low mood and feeling sad were reported by 47%, whereas feeling anxious/panicky was reported by 36%. Problem with memory was reported by 45% of patients. Feeling of light-headedness and dizziness was reported by 40% of patients. Problems with sexual relationship were reported by 30% of patients. The most common sleep problem was difficulty falling sleep (29%). Pain not related to the musculoskeletal system was reported by 30% of patients. Loss or change in the ability to taste or smell was reported by 29% of patients. The rest of NMS were less than 25% in frequency. Feeling sad or blue, feeling light-headed/dizzy, unexplained pain, unpleasant sensations in the legs, difficulty in swallowing and faecal incontinence were more common in female participants, while problems with sex were more common in male participants.ConclusionNMS are quite prevalent in PD in our population. Certain NMS are more common in women as compared with men. There is a need for a large-scale study to look for the association of different NMS with sex.
The narrative 'Threading my Prayer Rug' highlights the condition of the character named Biya in her journey to becoming an American Muslim from a Pakistani Muslim. This research has presented the complexity of home for the Pakistani diaspora by using the diasporic paradigm of the post-colonial perspective. It has aimed to identify the concept of plurality of home and the problems of unhomeliness. By utilizing Uehara (2007) model of narrative analysis, this research claims that the diaspora's attempt of making their multiple homes have shattered altogether after the incident of 9/11 and diaspora have faced the problem of unhomeliness. The narrative rejects the fixity of the concept of home as the characters in the narrative have attempted to create a blended identity by considering both Pakistan and America as their homes. This unhomeliness makes the diaspora reunite with their first home for their recognition and reconciliation; henceforth, the home of the Pakistani diaspora in Pakistan only.
Objective: To assess olfactory dysfunction in Parkinson's disease (PD) patients in Pakistan utilizing an autochthonous smell test. Setting: Tertiary care center, single-center study. Materials and Methods: Eighty-seven non-demented patients with PD, who fulfilled Queen Square Brain Bank Criteria were enrolled at the Movement Disorder Clinic, Lahore General Hospital (LGH), Lahore. Fifty-eight controls matched by gender, age, and place of residence were enrolled among patients and visitors attending other hospital clinics. Both groups underwent olfactory testing using the Pakistani Smell Identification test (PKSIT). The participants were required to identify the smell from a set of choices and were scored out of 10. Results: Among patients in the study group, the mean duration of disease was 4.7 years (range 6 months to 19 years). The PD onset mean age was 52.15 ± 13.02 years among patients. The mean number of smell test items accurately recognized by the PD patients was 4.55 ± 2.4. A multiple linear regression demonstrated that age (P < 0.05) but not disease duration (P = 0.899) was a significant determinant of the smell test result in PD and control groups. The mean number of smell test items appropriately recognized by the controls was 7.33 ± 1.69. Logistic regression showed that the PKSIT had 73.2% sensitivity and 84.3% specificity to distinguish PD from control. Conclusion: PKSIT being easily available, cheap, and more convenient to use in the Pakistani population, can be used in the evaluation of olfactory dysfunction in PD subjects.
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