Summary: Purpose: To determine comparative prevalence rates, demographics, phenomenology, seizure classification, presumptive etiology, treatment status, and selected socioanthropological aspects of epilepsy in Pakistan and Turkey.

Summary: Purpose: To assess the stigmatization and psychosocial problems of persons with epilepsy in Pakistan.Methods: A population-based, cross-sectional epidemiologic study of 241 persons with epilepsy identified from an at-risk population of 24,130 individuals (64.7% from urban and 35.3% from rural areas). Of these patients, 77% suffered from recurrent non-febrile generalized convulsions. We evaluated degree of stigmatizations (i.e., avoidance by friends, neighbors, and others), and the effect of epilepsy on other psychosocial aspects (e.g., marriage), and also the relationships between gender and level of education of the patients, and stigmatization.Results: Patients with epilepsy in Pakistan do not appear to be highly stigmatized, but their education and grades are affected by the disorder. They have difficulty performing activities of daily living and find it hard to make decisions about whether to marry or to have children. Women believed that they were more dangerous to others, received less help from their families, and, more frequently than men, encouraged others to avoid them. Women were also more likely than men to express the belief that people with epilepsy should not marry, but in fact, women more frequently married as compared men-a fact influenced by social and cultural pressures, including pressure from family, because it is nearly always the responsibility of the parents to arrange the marriage of a daughter. Influence of education indicates that people with epilepsy who have higher education, as compared with those with less education, had fewer children, were less often avoided by their classmates and neighbors, had fewer problems with plans for education, less frequently encouraged others to avoid them, were more frequently married, and believed that they were more dangerous to others. Most people believed that their conditions had a physical basis; only 3.1% attributed their epilepsy to supernatural causes. Conclusions: Stigmatization regarding epilepsy has not been proven to be an important feature in the culture of Pakistan because none of the observations are statistically significant as per P-value.

Validation study of the Mini-Mental State Examination in Urdu language for Pakistani populationObjective: This study was conducted primarily to validate and determine the optimal cutoff score in the diagnosis of dementia among Pakistani’s and study the effects of gender and education on the MMSE performance in our population.Methods: Four hundred participants took part in the study. Patient with dementia recruited from five major hospitals from Pakistan. The MMSE was translated into Urdu. Results: There were 61 men and 39 women in dementia group and 225 men and 75 women in the control group. The mean score of Urdu MMSE were lower in patients with dementia 18.5 ± 5.6 (range 0-30) as compared to the controls 26.8 ± 2.6 (range 7-30). This difference between groups was statistically significant (p<0.001). Educational based MMSE score below 15 yielded perfect sensitivity and specificity for the diagnosis of dementia.Conclusions: These finding confirm the influence of level of education on MMSE score and education stratified cutoff scores should be used while screening for cognitive impairment in this population.

Validation study of the Mini-Mental State Examination in Urdu language for Pakistani populationObjective: This study was conducted primarily to validate and determine the optimal cutoff score in the diagnosis of dementia among Pakistani's and study the effects of gender and education on the MMSE performance in our population.Methods: Four hundred participants took part in the study. Patient with dementia recruited from five major hospitals from Pakistan. The MMSE was translated into Urdu.Results: There were 61 men and 39 women in dementia group and 225 men and 75 women in the control group. The mean score of Urdu MMSE were lower in patients with dementia 18.5 ± 5.6 (range 0-30) as compared to the controls 26.8 ± 2.6 (range 7-30). This difference between groups was statistically significant (p<0.001). Educational based MMSE score below 15 yielded perfect sensitivity and specificity for the diagnosis of dementia.Conclusions: These finding confirm the influence of level of education on MMSE score and education stratified cutoff scores should be used while screening for cognitive impairment in this population.