Objectives: To determine the prevalence of Anxiety & Depression among thestudents of Peoples University of Medical and Health Sciences for Women Nawabshah and toascertain the relative impact of rural environment. Study Design: Cross-sectional, questionnairebasedsurvey. Setting: Peoples University of Medical & Health Sciences for Women (PUMHSW),Nawabshah. Methods: This is the only medical university for female students located in theinterior of Sindh. The students belong to various rural districts of the Sindh Province. Aftertaking verbal consent the questionnaire of the Aga Khan University Anxiety & Depression Scale(AKUADS) Urdu version was administered to the students from first year to the final year. A scoreof ≥20 on AKUADS was used as a cut-off for the presence of anxiety and depressive symptoms.The data collected was tabulated and analyzed using SPSS 19. Results: Out of a total of 1035students in a five year MBBS program at PUMHSW, 851 students responded &agreed toparticipate. The response rate was 82.2%. According to the AKUADS 66.7% of female studentswere found to have anxiety and depression. Majority of the students were originally from variousrural districts of Sindh. The Prevalence of anxiety and depression among students of 1st year,2nd year, 3rd year, 4th year and 5th year was 71.1%, 76.9%, 53.7%, 70.7% and 63.6% respectively.It was significantly higher in 1st year and 2nd year as compared to 3rd, 4th and 5thyear (p<0. 05)students. Those aged <21 years were most vulnerable (p<0.025).Marital status and eitherliving at home or in hostel was statistically not significant (p<0.922 and p<0.596 respectively).None of the students were using antidepressants nor they ever visited a psychiatrist before.All students were attending lectures and hospital postings regularly. Conclusion: Our studyindicates that a high proportion of female medical students particularly those belonging tothe rural areas of Sindh suffer from anxiety and depression during the course of their medicaleducation. Female gender, younger age and the rural environment appears to have a profoundnegative impact. The overall prevailing situation warrants a proper psychiatric evaluation ofthese students so that remedial measures can be undertaken whenever necessary.

Objectives: To determine the Neurological profile of patients residing in therural areas of Sindh during their visit to a tertiary care hospital in Nawabshah. Study Design:Retrospective observational study. Setting: Outpatient Department of Neurology at the PeoplesUniversity of Medical & Health Sciences for Women (PUMHSW), Nawabshah. Period: From14.4.2014 to 31.3.2015. Methods: A questionnaire regarding different Neurological disorderswas developed and data about patients presenting in OPD were registered. The data collectedwas tabulated and analyzed using SPSS 19. Results: A total of 861 patients were registered.Out of these 409 (47.5%) were male and 452 (52.5%) were females with male to female ratio of0.9. The age ranged from 06 months to 90 years and the mean age was 31.57± SD 16.7 7. Out of861 patients 477 (55.4%) visited neurology OPD on their own, 314 (36.47%) on the advice of theirfamily and friends and only 70(8.13%) were referrals by the general practitioners. Majority of thepatients 475 (55.17%) were the residents of villages and small towns while 386 (44.83%) wereresiding in the city of Nawabshah. The frequency of major category of neurological disordersincluding Headache, Epilepsies, Stroke, Neuromuscular disorders, Movement disorders,Spinal cord disorders, Dementias, Psychiatric disorders and Miscellaneous group was 33.%,19.%, 7%, 9%, 4%, 1%, 2%, 16% and 9% respectively. Conclusion: Neurological diseases arecommon among patients residing in the rural areas of Sindh. Headaches, epilepsies, stroke,psychiatric, neuromuscular and miscellaneous disorders were frequent presentations. Lack ofadequate referrals by the general physicians needs to be addressed emphatically. This studyprojects the burden of neurological problems in the under served areas.

Objectives: To determine the various patterns of headache presenting to Neurology OPD Liaquat University Hospital Jamshoro/Hyderabad. Study Design: Descriptive, cross-sectional study. Setting: Department of Neurology, Liaquat University of Medical & Health Sciences (LUMHS). Period: July to December 2016. Methods: Data was collected on developed profoma, the same was analyzed on SPSS 22nd version. Results: Out of 238 patients, 61 (25.6%) were male 177 (74.4%) were female patients. Age group distribution of study population ranged from 04 - 65 years with mean age was 31.66 with standard deviation of12.72. Out of 238 patients 170 (71.4%) were diagnosed as primary headache disorders, 56 (17%) were secondary headache while 12 (%) were labeled as cranial neuropathies and facial pains. Migraine without aura 113(65.3%) followed by tension type headache 35(20.2%) were most common primary headache disorder. Among secondary headaches Cervicogenic headache 16(30.2%) was most common cause followed by headache secondary to sinusitis, hypertension and trauma 8(15.1%), 7 (13.2%) and 6(11.3%) respectively. Trigeminal Neuralgia 9 (75.0%) was most common painful cranial neuropathies. Conclusion: Primary as well as secondary headache disorders are most prevalent in female at an age range of 21-40 years with majority of them suffering from migraine followed by tension and Cervical origin respectively.

ABSTRACT… Objectives:To determine the prevalence of Anxiety & Depression among the students of Peoples University of Medical and Health Sciences for Women Nawabshah and to ascertain the relative impact of rural environment. Study Design: Cross-sectional, questionnairebased survey. Setting: Peoples University of Medical & Health Sciences for Women (PUMHSW), Nawabshah. Methods: This is the only medical university for female students located in the interior of Sindh. The students belong to various rural districts of the Sindh Province. After taking verbal consent the questionnaire of the Aga Khan University Anxiety & Depression Scale (AKUADS) Urdu version was administered to the students from first year to the final year. A score of ≥20 on AKUADS was used as a cut-off for the presence of anxiety and depressive symptoms. The data collected was tabulated and analyzed using SPSS 19. Results: Out of a total of 1035 students in a five year MBBS program at PUMHSW, 851 students responded &agreed to participate. The response rate was 82.2%. According to the AKUADS 66.7% of female students were found to have anxiety and depression. Majority of the students were originally from various rural districts of Sindh. respectively).None of the students were using antidepressants nor they ever visited a psychiatrist before. All students were attending lectures and hospital postings regularly. Conclusion: Our study indicates that a high proportion of female medical students particularly those belonging to the rural areas of Sindh suffer from anxiety and depression during the course of their medical education. Female gender, younger age and the rural environment appears to have a profound negative impact. The overall prevailing situation warrants a proper psychiatric evaluation of these students so that remedial measures can be undertaken whenever necessary. Key words:Anxiety, Depression, Rural, Female Gender.

Objective: The purpose of this study was to assess the ability of postgraduate medical students whether they can diagnose migraine and tension-type headache according to the International Headache Society criteria and whether they had an adequate clinical knowledge for the management of these headaches. Study Design: Cross Sectional Study. Setting: Departments of Neurology, PUMHS, Nawabshah and LUMHS, Jamshoro. Period: March and April 2018. Material & Methods: A questioner was designed outlining three options for the diagnosis of Migraine and Tension Type Headache (TTH) and the students were asked to pick the correct option which is based on the International Headache Society (IHS) criteria. In addition, a few more questions were incorporated relating to the management of these headaches, confidence in making the diagnosis, knowledge of most common type of headache, need for neuroimaging, presence of childhood migraine and the role of genes in causing migraine. Data was analyzed by using SPSS version 18. Results: A total of 73 postgraduate students responded to the questionnaire. Among them 21 were enrolled in MD and 52 were enrolled in FCPS training program. For migraine and TTH diagnostic criteria only 34% and 19% were able to pick the correct answers respectively. Although there answers were incorrect 65.8% students were confident about their diagnosis. Majority (58.9%) thought TTH as the most common headache and 11% thought migraine is the commonest. Most of the students 90.4% would go for neuroimaging in selected cases and the remaining 9.6%. Thought neuroimaging is indicated in every case of headache. In response to have you ever seen a child with migraine in 71% the response was NO. As far the question is there a role of genes in causing migraine 63% said YES while 37% thought there is NO role of genes in Migraine. Choice of drugs for acute and prophylactic treatment was also noted. Conclusion: The ability of postgraduate medical students to diagnose and treat migraine and tension-type headache was found to be less than satisfactory. There is a need for designing headache-specific CME programs for the postgraduate students so that their diagnostic and treatment abilities can be improved.