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Papers by jawed akbar

Research paper thumbnail of Correlates of Severity of Depression in Different Geographical Regions of

Pakistan Journal of Medical and Health Sciences, 2022

Objective: To access the Severity of Depression and cognitive impairment in different Geographica... more Objective: To access the Severity of Depression and cognitive impairment in different Geographical Regions of Pakistan Methodology: A prospective observational study was undertaken as a subsidiary of a multicentered study conducted between April to October 2018 at 2019 in psychiatric clinics all over Pakistan. Patients presented to the outpatients departments at study sites across PAKISTAN were assessed for depression severity using Patient Health Questionnaire-9 (PHQ-9). Each patient was assessed for cognitive impairment as well. The perceived deficits questionnaire (PDQ) was used to assess the degree of impairment. A total of 820 patients were a part of this study. Results: The highest frequency of mild depression was seen in Punjab (0.90%) whereas the highest frequency of moderate depression was seen in KPK(47.20%), Moderately Severe depression in Azad Kashmir (65.70%) and Severe depression in Punjab (40.90%) respectively. The mean perceived cognitive dysfunction scores in Punjab...

Research paper thumbnail of The Efficacy of Cognitive Behavioral Therapy in Addition to Pharmacotherapy Versus Pharmacotherapy Alone in the Treatment of Major Depressive Disorder in the Pakistani Population

Pakistan Journal of Medical and Health Sciences, 2022

Objective: To access the efficacy of cognitive behavioral therapy (CBT) in addition to pharmacoth... more Objective: To access the efficacy of cognitive behavioral therapy (CBT) in addition to pharmacotherapy versus pharmacotherapy alone in the treatment of major depressive disorder Methodology: A case-control study was conducted at different psychiatric clinics in Pakistan between April 2019 to October 2020. All participants with depression were divided into two groups; Group A patients were treated in compliance with the current treatment guidelines for antidepressant pharmacotherapy whereas patients in Group B were managed with CBT which included 15 individual 45 minutes sessions in addition to pharmacotherapy. The efficiency of the treatment was assessed on PHQ-9, with treatment being considered successful in patients with a significantly improved score. Results: 53.80% participants of Group A and 37.50% participants of Group B with moderate depression suffered a depressive episode within the last 12 months whereas 46.20% participants of Group A and 62.50% participants of Group B wi...

Research paper thumbnail of The Impact of Covid-19 on Medical Students: A Cross Sectional Survey

Pakistan Journal of Medical and Health Sciences, 2021

Aim: To understand the psychological impact of COVID – 19 on Medical Students of a private sector... more Aim: To understand the psychological impact of COVID – 19 on Medical Students of a private sector Medical University in Karachi, Pakistan. Method: This cross-sectional study was conducted among medical students studying at Hamdard College of Medicine and Dentistry, Karachi, Pakistan. The data collection was done through online survey from July 2020 to December 2020. The study aimed to gather data from many medical students. A total number of 420 students were participated from Hamdard College of Medicine and Dentistry in Karachi, Pakistan. The participants were selected from all years of MBBS and BDS programs . Results: Out of 420 participants, 236 (56.2%) were male and 184 (43.8%) female, with a male:female ration of 1.28:1. Majority of participants were single as 411 (97.9%), of 224 (53.3%) students living with their family, 150 (35.7%) in hostel and 46 (11%) living with friends. In our sample 369 (87.9%) students studying in MBBS program while only 51 (12.1%) BDS, among those 80 ...

Research paper thumbnail of Evaluation of Non-Pharmacological Remedies Adopted By The Patients with Diabetes Mellitus Type 2

Pakistan Armed Forces Medical Journal

Objectives: To determine the different types of non-pharmacological remedies adopted by the patie... more Objectives: To determine the different types of non-pharmacological remedies adopted by the patients with type 2 diabetes. Study Design: Cross-sectional study. Place and Duration of Study: Jinnah Postgraduate Medical Centre, Karachi from Oct 2018 to Nov 2019. Methodology: A total of 280 type 2 diabetes patients were enrolled in the study. All patients with multiple comorbidities and type 1 diabetes were excluded from the study. A pre-designed questionnaire was used to collect data using face to face interviews. The questionnaire was related to the biodata of the patients and the use of non-pharmacological measures to control the diabetes. Data was analyzed by using SPSS version 24. Results: The mean age of the patients was 54.7 ± 9.77 years. About 256 (91.4%) stated that they used non-pharmacological measures along with their medications to control diabetes. Most of the patients 248 (96.8%), were only on dietary modifications; regular exercise 82 (32%) and various types of medicinal...

Research paper thumbnail of Evaluation of self-esteem in adolescents of secondary school level

BJPsych Open, 2021

Aims To assess the frequency of low self-esteem among adolescents of secondary school level in pr... more Aims To assess the frequency of low self-esteem among adolescents of secondary school level in private schools of Karachi Method It was a cross-sectional descriptive study done in ten private schools of Karachi for a period of 6 months. The proposal of the study was accepted by ethical committee of Jinnah Postgraduate Medical Centre, Karachi (called Institutional Review Board or IRB).The subjects fulfilling inclusion criteria were enrolled after obtaining informed consent by their parents. A semi-structured Performa was used to assess students’ particulars and included Rosenberg Self-esteem Questionnaire as a part of Performa. The data were analysed using SPSS version 17.0. Frequencies & percentages were generated for the level of self-esteem.Stratified analysis was done with a p value <0.05 taken as significant. Result Out of the 246 students, 39.8% were of 14yrs of age, 36.2% were 15 years of age, while only 24% of adolescents were 16 years of age. Majority (64.2%) of the stude...

Research paper thumbnail of Spotlight on the Adolescent’s Mental Health: Distress and Coping amid the COVID-19 Pandemic

Pakistan Journal of Medical and Health Sciences

Background: COVID-19 pandemic globally challenged the healthcare sector as well as posed a seriou... more Background: COVID-19 pandemic globally challenged the healthcare sector as well as posed a serious threat to mental health among both young and adults rendering people with a sense of uncertainty and loss. Objective Aim: To assess the psychological burden among the adolescent population during the pandemic and lockdown. Methodology: A cross sectional study was moderated by the research team at the Department of Psychiatry and Behavioral Sciences, Jinnah Postgraduate Medical Center between April 2020 to October 2021. All individuals between the ages of 13 to 17 years were included. The proforma was circulated among residents of the province of Sindh that assessed the emotional symptoms, conduct problems, hyperactivity-inattention, peer relationship problems, and prosocial behaviors among participants. Results: The mean SDQ score was 24.97 with a standard deviation of 6.62. The mean scores for emotional symptoms, conduct problem, hyperactivity, peer problem, and prosocial Scale were 5...

Research paper thumbnail of Association of Sleep Disorders and Socio-demographic Characteristics in Patients with Depressive Disorder

Pakistan Journal of Medical and Health Sciences, 2021

Objectives: To assess the pattern of sleep and the correlation with socio demographic parameters ... more Objectives: To assess the pattern of sleep and the correlation with socio demographic parameters in patients with depressive disorder. Study Design: Descriptive cross sectional study. Study Setting and Duration: A psychiatric consultation clinic in Karachi from January 2015 till December 2019. Methodology: Patients between ages of 18 and 60 years, irrespective of gender were included in the study. Patients with florid psychotic symptoms, dementia and chronic debilitating medical illness such as chronic renal or liver failure were excluded. Pattern of sleep was categorized as patients with normal sleep (sound sleep of 7-9 hours), insomnia and hypersomnia. Diagnosis of Insomnia and hypersomnia was made according to ICD – criteria. Results: The mean age of patients was 30.89 (10.256) years. Age was significantly associated with the pattern of sleep among depressed patients. Younger patients between the ages of 18-35 years more frequently suffered from insomnia while the older patients ...

Research paper thumbnail of Assessment of Sleep Quality in Patients with Type 2 Diabetes Mellitus: A Prospective Observational Study from a Tertiary Care Centre

Research paper thumbnail of Factors leading to Non-Compliance to Antidepressants Among Patients with Major Depressive Disorder: A Cohort Study from Pakistan

Pakistan Journal of Medical and Health Sciences, 2022

Objectives: To determine and explore the factors that contribute towards non-compliance to antide... more Objectives: To determine and explore the factors that contribute towards non-compliance to antidepressants among patients with major depressive disorder. Methodology: A longitudinal multicenter study was conducted from April to October 2019 to October 2020 in several psychiatric clinics in Pakistan. All patients with diagnosed depression as per ICD 10 Criteria, who were above the age 18 years, gave consent to take part in the study were eligible for the study. Patients with a history of traumatic brain injury, aged < 18 years were excluded from the study. Compliance to treatment was measured through self-report and prescription refill data. Results: A total of 820 patients were included in this study. A median age of 33.0 (18-67) was observed with the majority of female patients. Out of the total study population of 820 patients, 284 (34.6%) reported non-compliance to the treatment. The cause of non-compliance was significantly associated with therapeutic management. The majority...

Research paper thumbnail of Examine the Frequency of Postnatal Depression in Mothers having Malnourished Infants

Pakistan Journal of Medical and Health Sciences, 2021

Background: Healthy child development is dependent on a mentally and physically healthy mother. D... more Background: Healthy child development is dependent on a mentally and physically healthy mother. Depressions in mother can adversely affect their offspring healthy growth. Aim: To estimate the frequency of post-natal depression in mothers having malnourished infants. Place and duration of study: Department of Psychiatry, Balochistan Institute of Psychiatry & Behavioral Sciences, Qeutta from 1st January 2020 to 31st December 2020. Methodology: In this case control study 250 mothers (125 were malnourished infants or toddlers mothers and other 125 from healthy weight infants/toddlers mothers) were interviewed to assess their depressional state. Their stress inducing factors, age and other clinical comorbidities were also documented. Results: Mean mother age of malnourished infants/toddlers was 28.1±6.6 years in comparison to 27.8±5.2 years of healthy weight infants/toddlers mother’s respectively. Twenty four percent malnourished infant/toddlers’ mothers were single parent. Un-employed s...

Research paper thumbnail of Prevalence of Substance use Among Depressed Female Patients

Pakistan Journal of Medical and Health Sciences, 2021

Depressive disorder is a common mental disorder and one of the leading causes of disability aroun... more Depressive disorder is a common mental disorder and one of the leading causes of disability around the globe. It is characterized by depressed mood, lack of enjoyment, decreased activity, negative thoughts and reduced concentration for at least two weeks. Globally 350 million people are suffering from depression and 18.34 million people from Southeast Asia alone. Major depressive disorder is growing in overall disease burden around the world. It is predicted to be the leading cause of disease burden by 2030, and it is already the leading cause in women worldwide. Depression affects the prefrontal cortex, cingulate gyrus, amygdala, hippocampus, thalamus and hypothalamus. These brain regions are involved in the regulation of motivation, eating, sleeping, energy level, circadian rhythm, and responses to rewarding and aversive stimuli, which are all abnormal in depressed people.

Research paper thumbnail of Anxiety and Depression in Parents of Children With Cerebral Palsy: A Case-Control Study

Pakistan Journal Of Neurological Surgery, 2022

Objectives: To assess the occurrence of anxiety and depression in parents caring for a child wit... more Objectives: To assess the occurrence of anxiety and depression in parents caring for a child with Cerebral Palsy. Material and Methods: A case-control study took place at the Gambat Medical Center and Jinnah Postgraduate Medical Centre from January 2019 to April 2021. There were two group categories; Group A served as the control group while Group B consisted of parents of children with cerebral palsy. Either the mother or father of the children was included and those parents who had more than one child were excluded from this study. They were screened for anxiety and depression using the Hospital and Anxiety and Depression Scale (HADS). Results: 112 participants were included with 56 in each group. A parent with a cerebral palsy child had significantly higher levels of depression score on HADS compared to the control group (depression; 16.67 ± 5.24 vs. 8.39 ± 4.01; p < 0.001). Similarly, anxiety was higher in parents who had a child with cerebral palsy (p<0.001). Most of t...

Research paper thumbnail of Pattern of presentations at psychiatric emergency services of a public sector tertiary care hospital, Pakistan

Journal of the Pakistan Medical Association, 2020

Objective: To determine the pattern of presentations and characteristics of patients at a psychia... more Objective: To determine the pattern of presentations and characteristics of patients at a psychiatric emergency services facility. Methods: The cross-sectional study was conducted in November 2016 at the Department of Psychiatry and Behavioural Sciences, Jinnah Postgraduate Medical Centre, Karachi, and comprised all patients presenting to the departmental emergency services. Data was documented on a pre-designed semi-structured proforma, and analysed using SPSS 22. Results: Of the 316 cases, 162(51.3%) were males and 154(48.7%) were females. The overall mean age was 30.78+/-13.09 years (range: 8-80 years). Psychiatric emergencies comprised suicidal attempt, excitement, violence, altered sensorium, altered/ inappropriate behaviour and extrapyramidal symptoms / acute dystonia together constituting for 123(38.9%) of the total presentations, while there were 20(6.33%) cases of hysterical fits and 6(1.89%) with acute anxiety symptoms. Overall, 56(17.7%) subjects were found to have no ps...

Research paper thumbnail of Right Unilateral Versus Bilateral Electroconvulsive Therapy in Patients With Clinical Depression

Cureus, 2021

Introduction Electroconvulsive therapy (ECT) is a functional treatment for a significant mental i... more Introduction Electroconvulsive therapy (ECT) is a functional treatment for a significant mental illness that involves a momentary application of electrical stimulation to induce generalized seizures. The use of right unilateral (RUL) and bilateral (BL) ECT has been controversial. Thus, the study aimed at comparing the effectiveness of RUL ECT and BL ECT in treating depression. Methodology A longitudinal study was conducted between September 2016 and January 2021 at a tertiary care hospital in Sindh, Pakistan. All patients over the age of 18 with clinically diagnosed depression in the last month were included in the study. Baseline depression scores and post-treatment scores were determined using Hamilton Depression Rating Scale (HDRS). All patients were assigned to each treatment group. Group A was administered right unilateral electroconvulsive therapy, while group B was administered bilateral electroconvulsive therapy. Adverse effects were documented right after treatment, at four hours, and then one day after therapy. Depression severity was determined after each ECT session using the HDRS scale. Electroconvulsive therapy was discontinued when an HDRS score of 10 was achieved. Results The mean HDRS score at baseline in the bilateral ECT group was 24.99 ± 3.938, which lowered to 17.56 ± 2.65 by the 3rd session, 12.45 ± 3.76 by the 6th session, and to 11.86 ± 2.3 by the end of treatment (p<0.0001). Similarly, the right unilateral ECT was equally effective in improving the depressive symptoms (p<0.0001). There was no significant difference between the efficacy of bilateral and unilateral placements of electrodes in electroconvulsive therapy (p=0.116).

Research paper thumbnail of Physical Co-Morbidity according to ICD-10 Criteria among Patients with Depressive Disorder

Journal of the Liaquat University of Medical and Health Sciences, 2016

Research paper thumbnail of Association of Somatic Symptoms with Depressive Disorder

Pakistan Journal of Medical and Health Sciences

Objectives: To determine the association of somatic symptoms with Depressive disorder. Study Desi... more Objectives: To determine the association of somatic symptoms with Depressive disorder. Study Design: Descriptive cross sectional study. Study Setting and Duration: At department of medicine and allied OPD at Pir Syed Abdul Qadir Shah Jeelani Institute of Medical sciences, GAMBAT, Sindh, Pakistan, from 10th August 2019 to 31st January 2020. Methodology: The sample size of the study was 140. All the patients of both gender between ages of 18 to 60 years, having depressive disorder as per ICD-10 (International classification of diseases version-10) criteria as mild, moderate and severe were enrolled. Somatic symptoms were assessed through somatic symptoms scale-8. The collected data was analyzed by Statistical Packages for Social Sciences (SPSS) version 22.0. Results: Among 140 clients 131 (93.60%) were females with age range of 22 to 44 years. Among all majority were married, illiterate and were household by occupation. Amongst all mostly were having severe depressive disorder 62.9% f...

Research paper thumbnail of The Perspective of General Practitioners about Mental Illness: A Cross-sectional Observational Study from a Tertiary Care Centre, Pakistan

Journal of Pharmaceutical Research International

Objectives: To assess the general practitioner's perspective on mental illness in a tertiary ... more Objectives: To assess the general practitioner's perspective on mental illness in a tertiary health care setting. Study Setting and Duration: Online seminar in March 2020, Jinnah Postgraduate Medical Centre, Karachi. Study Design: Cross-sectional, Observational study Methodology: A total of 152 general practitioners were enrolled in the study. All house officers, psychiatric specialists, staff members, and patients were excluded from the study. An online survey instrument was used to collect data from general practitioners through social media. The questionnaire was related to the biodata of the physicians and their perspective on mental health disorders. Data was analyzed by using SPSS Version 26. Results: A total of 152 general practitioners participated in the study. The mean age of participants was 39.76 (11.540) years. The majority of them were male and married with an average experience of 12.80 (10.90) years. According to the participants, the most common symptoms experie...

Research paper thumbnail of Correlates of Severity of Depression in Different Geographical Regions of

Pakistan Journal of Medical and Health Sciences, 2022

Objective: To access the Severity of Depression and cognitive impairment in different Geographica... more Objective: To access the Severity of Depression and cognitive impairment in different Geographical Regions of Pakistan Methodology: A prospective observational study was undertaken as a subsidiary of a multicentered study conducted between April to October 2018 at 2019 in psychiatric clinics all over Pakistan. Patients presented to the outpatients departments at study sites across PAKISTAN were assessed for depression severity using Patient Health Questionnaire-9 (PHQ-9). Each patient was assessed for cognitive impairment as well. The perceived deficits questionnaire (PDQ) was used to assess the degree of impairment. A total of 820 patients were a part of this study. Results: The highest frequency of mild depression was seen in Punjab (0.90%) whereas the highest frequency of moderate depression was seen in KPK(47.20%), Moderately Severe depression in Azad Kashmir (65.70%) and Severe depression in Punjab (40.90%) respectively. The mean perceived cognitive dysfunction scores in Punjab...

Research paper thumbnail of The Efficacy of Cognitive Behavioral Therapy in Addition to Pharmacotherapy Versus Pharmacotherapy Alone in the Treatment of Major Depressive Disorder in the Pakistani Population

Pakistan Journal of Medical and Health Sciences, 2022

Objective: To access the efficacy of cognitive behavioral therapy (CBT) in addition to pharmacoth... more Objective: To access the efficacy of cognitive behavioral therapy (CBT) in addition to pharmacotherapy versus pharmacotherapy alone in the treatment of major depressive disorder Methodology: A case-control study was conducted at different psychiatric clinics in Pakistan between April 2019 to October 2020. All participants with depression were divided into two groups; Group A patients were treated in compliance with the current treatment guidelines for antidepressant pharmacotherapy whereas patients in Group B were managed with CBT which included 15 individual 45 minutes sessions in addition to pharmacotherapy. The efficiency of the treatment was assessed on PHQ-9, with treatment being considered successful in patients with a significantly improved score. Results: 53.80% participants of Group A and 37.50% participants of Group B with moderate depression suffered a depressive episode within the last 12 months whereas 46.20% participants of Group A and 62.50% participants of Group B wi...

Research paper thumbnail of The Impact of Covid-19 on Medical Students: A Cross Sectional Survey

Pakistan Journal of Medical and Health Sciences, 2021

Aim: To understand the psychological impact of COVID – 19 on Medical Students of a private sector... more Aim: To understand the psychological impact of COVID – 19 on Medical Students of a private sector Medical University in Karachi, Pakistan. Method: This cross-sectional study was conducted among medical students studying at Hamdard College of Medicine and Dentistry, Karachi, Pakistan. The data collection was done through online survey from July 2020 to December 2020. The study aimed to gather data from many medical students. A total number of 420 students were participated from Hamdard College of Medicine and Dentistry in Karachi, Pakistan. The participants were selected from all years of MBBS and BDS programs . Results: Out of 420 participants, 236 (56.2%) were male and 184 (43.8%) female, with a male:female ration of 1.28:1. Majority of participants were single as 411 (97.9%), of 224 (53.3%) students living with their family, 150 (35.7%) in hostel and 46 (11%) living with friends. In our sample 369 (87.9%) students studying in MBBS program while only 51 (12.1%) BDS, among those 80 ...

Research paper thumbnail of Evaluation of Non-Pharmacological Remedies Adopted By The Patients with Diabetes Mellitus Type 2

Pakistan Armed Forces Medical Journal

Objectives: To determine the different types of non-pharmacological remedies adopted by the patie... more Objectives: To determine the different types of non-pharmacological remedies adopted by the patients with type 2 diabetes. Study Design: Cross-sectional study. Place and Duration of Study: Jinnah Postgraduate Medical Centre, Karachi from Oct 2018 to Nov 2019. Methodology: A total of 280 type 2 diabetes patients were enrolled in the study. All patients with multiple comorbidities and type 1 diabetes were excluded from the study. A pre-designed questionnaire was used to collect data using face to face interviews. The questionnaire was related to the biodata of the patients and the use of non-pharmacological measures to control the diabetes. Data was analyzed by using SPSS version 24. Results: The mean age of the patients was 54.7 ± 9.77 years. About 256 (91.4%) stated that they used non-pharmacological measures along with their medications to control diabetes. Most of the patients 248 (96.8%), were only on dietary modifications; regular exercise 82 (32%) and various types of medicinal...

Research paper thumbnail of Evaluation of self-esteem in adolescents of secondary school level

BJPsych Open, 2021

Aims To assess the frequency of low self-esteem among adolescents of secondary school level in pr... more Aims To assess the frequency of low self-esteem among adolescents of secondary school level in private schools of Karachi Method It was a cross-sectional descriptive study done in ten private schools of Karachi for a period of 6 months. The proposal of the study was accepted by ethical committee of Jinnah Postgraduate Medical Centre, Karachi (called Institutional Review Board or IRB).The subjects fulfilling inclusion criteria were enrolled after obtaining informed consent by their parents. A semi-structured Performa was used to assess students’ particulars and included Rosenberg Self-esteem Questionnaire as a part of Performa. The data were analysed using SPSS version 17.0. Frequencies & percentages were generated for the level of self-esteem.Stratified analysis was done with a p value <0.05 taken as significant. Result Out of the 246 students, 39.8% were of 14yrs of age, 36.2% were 15 years of age, while only 24% of adolescents were 16 years of age. Majority (64.2%) of the stude...

Research paper thumbnail of Spotlight on the Adolescent’s Mental Health: Distress and Coping amid the COVID-19 Pandemic

Pakistan Journal of Medical and Health Sciences

Background: COVID-19 pandemic globally challenged the healthcare sector as well as posed a seriou... more Background: COVID-19 pandemic globally challenged the healthcare sector as well as posed a serious threat to mental health among both young and adults rendering people with a sense of uncertainty and loss. Objective Aim: To assess the psychological burden among the adolescent population during the pandemic and lockdown. Methodology: A cross sectional study was moderated by the research team at the Department of Psychiatry and Behavioral Sciences, Jinnah Postgraduate Medical Center between April 2020 to October 2021. All individuals between the ages of 13 to 17 years were included. The proforma was circulated among residents of the province of Sindh that assessed the emotional symptoms, conduct problems, hyperactivity-inattention, peer relationship problems, and prosocial behaviors among participants. Results: The mean SDQ score was 24.97 with a standard deviation of 6.62. The mean scores for emotional symptoms, conduct problem, hyperactivity, peer problem, and prosocial Scale were 5...

Research paper thumbnail of Association of Sleep Disorders and Socio-demographic Characteristics in Patients with Depressive Disorder

Pakistan Journal of Medical and Health Sciences, 2021

Objectives: To assess the pattern of sleep and the correlation with socio demographic parameters ... more Objectives: To assess the pattern of sleep and the correlation with socio demographic parameters in patients with depressive disorder. Study Design: Descriptive cross sectional study. Study Setting and Duration: A psychiatric consultation clinic in Karachi from January 2015 till December 2019. Methodology: Patients between ages of 18 and 60 years, irrespective of gender were included in the study. Patients with florid psychotic symptoms, dementia and chronic debilitating medical illness such as chronic renal or liver failure were excluded. Pattern of sleep was categorized as patients with normal sleep (sound sleep of 7-9 hours), insomnia and hypersomnia. Diagnosis of Insomnia and hypersomnia was made according to ICD – criteria. Results: The mean age of patients was 30.89 (10.256) years. Age was significantly associated with the pattern of sleep among depressed patients. Younger patients between the ages of 18-35 years more frequently suffered from insomnia while the older patients ...

Research paper thumbnail of Assessment of Sleep Quality in Patients with Type 2 Diabetes Mellitus: A Prospective Observational Study from a Tertiary Care Centre

Research paper thumbnail of Factors leading to Non-Compliance to Antidepressants Among Patients with Major Depressive Disorder: A Cohort Study from Pakistan

Pakistan Journal of Medical and Health Sciences, 2022

Objectives: To determine and explore the factors that contribute towards non-compliance to antide... more Objectives: To determine and explore the factors that contribute towards non-compliance to antidepressants among patients with major depressive disorder. Methodology: A longitudinal multicenter study was conducted from April to October 2019 to October 2020 in several psychiatric clinics in Pakistan. All patients with diagnosed depression as per ICD 10 Criteria, who were above the age 18 years, gave consent to take part in the study were eligible for the study. Patients with a history of traumatic brain injury, aged < 18 years were excluded from the study. Compliance to treatment was measured through self-report and prescription refill data. Results: A total of 820 patients were included in this study. A median age of 33.0 (18-67) was observed with the majority of female patients. Out of the total study population of 820 patients, 284 (34.6%) reported non-compliance to the treatment. The cause of non-compliance was significantly associated with therapeutic management. The majority...

Research paper thumbnail of Examine the Frequency of Postnatal Depression in Mothers having Malnourished Infants

Pakistan Journal of Medical and Health Sciences, 2021

Background: Healthy child development is dependent on a mentally and physically healthy mother. D... more Background: Healthy child development is dependent on a mentally and physically healthy mother. Depressions in mother can adversely affect their offspring healthy growth. Aim: To estimate the frequency of post-natal depression in mothers having malnourished infants. Place and duration of study: Department of Psychiatry, Balochistan Institute of Psychiatry & Behavioral Sciences, Qeutta from 1st January 2020 to 31st December 2020. Methodology: In this case control study 250 mothers (125 were malnourished infants or toddlers mothers and other 125 from healthy weight infants/toddlers mothers) were interviewed to assess their depressional state. Their stress inducing factors, age and other clinical comorbidities were also documented. Results: Mean mother age of malnourished infants/toddlers was 28.1±6.6 years in comparison to 27.8±5.2 years of healthy weight infants/toddlers mother’s respectively. Twenty four percent malnourished infant/toddlers’ mothers were single parent. Un-employed s...

Research paper thumbnail of Prevalence of Substance use Among Depressed Female Patients

Pakistan Journal of Medical and Health Sciences, 2021

Depressive disorder is a common mental disorder and one of the leading causes of disability aroun... more Depressive disorder is a common mental disorder and one of the leading causes of disability around the globe. It is characterized by depressed mood, lack of enjoyment, decreased activity, negative thoughts and reduced concentration for at least two weeks. Globally 350 million people are suffering from depression and 18.34 million people from Southeast Asia alone. Major depressive disorder is growing in overall disease burden around the world. It is predicted to be the leading cause of disease burden by 2030, and it is already the leading cause in women worldwide. Depression affects the prefrontal cortex, cingulate gyrus, amygdala, hippocampus, thalamus and hypothalamus. These brain regions are involved in the regulation of motivation, eating, sleeping, energy level, circadian rhythm, and responses to rewarding and aversive stimuli, which are all abnormal in depressed people.

Research paper thumbnail of Anxiety and Depression in Parents of Children With Cerebral Palsy: A Case-Control Study

Pakistan Journal Of Neurological Surgery, 2022

Objectives: To assess the occurrence of anxiety and depression in parents caring for a child wit... more Objectives: To assess the occurrence of anxiety and depression in parents caring for a child with Cerebral Palsy. Material and Methods: A case-control study took place at the Gambat Medical Center and Jinnah Postgraduate Medical Centre from January 2019 to April 2021. There were two group categories; Group A served as the control group while Group B consisted of parents of children with cerebral palsy. Either the mother or father of the children was included and those parents who had more than one child were excluded from this study. They were screened for anxiety and depression using the Hospital and Anxiety and Depression Scale (HADS). Results: 112 participants were included with 56 in each group. A parent with a cerebral palsy child had significantly higher levels of depression score on HADS compared to the control group (depression; 16.67 ± 5.24 vs. 8.39 ± 4.01; p < 0.001). Similarly, anxiety was higher in parents who had a child with cerebral palsy (p<0.001). Most of t...

Research paper thumbnail of Pattern of presentations at psychiatric emergency services of a public sector tertiary care hospital, Pakistan

Journal of the Pakistan Medical Association, 2020

Objective: To determine the pattern of presentations and characteristics of patients at a psychia... more Objective: To determine the pattern of presentations and characteristics of patients at a psychiatric emergency services facility. Methods: The cross-sectional study was conducted in November 2016 at the Department of Psychiatry and Behavioural Sciences, Jinnah Postgraduate Medical Centre, Karachi, and comprised all patients presenting to the departmental emergency services. Data was documented on a pre-designed semi-structured proforma, and analysed using SPSS 22. Results: Of the 316 cases, 162(51.3%) were males and 154(48.7%) were females. The overall mean age was 30.78+/-13.09 years (range: 8-80 years). Psychiatric emergencies comprised suicidal attempt, excitement, violence, altered sensorium, altered/ inappropriate behaviour and extrapyramidal symptoms / acute dystonia together constituting for 123(38.9%) of the total presentations, while there were 20(6.33%) cases of hysterical fits and 6(1.89%) with acute anxiety symptoms. Overall, 56(17.7%) subjects were found to have no ps...

Research paper thumbnail of Right Unilateral Versus Bilateral Electroconvulsive Therapy in Patients With Clinical Depression

Cureus, 2021

Introduction Electroconvulsive therapy (ECT) is a functional treatment for a significant mental i... more Introduction Electroconvulsive therapy (ECT) is a functional treatment for a significant mental illness that involves a momentary application of electrical stimulation to induce generalized seizures. The use of right unilateral (RUL) and bilateral (BL) ECT has been controversial. Thus, the study aimed at comparing the effectiveness of RUL ECT and BL ECT in treating depression. Methodology A longitudinal study was conducted between September 2016 and January 2021 at a tertiary care hospital in Sindh, Pakistan. All patients over the age of 18 with clinically diagnosed depression in the last month were included in the study. Baseline depression scores and post-treatment scores were determined using Hamilton Depression Rating Scale (HDRS). All patients were assigned to each treatment group. Group A was administered right unilateral electroconvulsive therapy, while group B was administered bilateral electroconvulsive therapy. Adverse effects were documented right after treatment, at four hours, and then one day after therapy. Depression severity was determined after each ECT session using the HDRS scale. Electroconvulsive therapy was discontinued when an HDRS score of 10 was achieved. Results The mean HDRS score at baseline in the bilateral ECT group was 24.99 ± 3.938, which lowered to 17.56 ± 2.65 by the 3rd session, 12.45 ± 3.76 by the 6th session, and to 11.86 ± 2.3 by the end of treatment (p<0.0001). Similarly, the right unilateral ECT was equally effective in improving the depressive symptoms (p<0.0001). There was no significant difference between the efficacy of bilateral and unilateral placements of electrodes in electroconvulsive therapy (p=0.116).

Research paper thumbnail of Physical Co-Morbidity according to ICD-10 Criteria among Patients with Depressive Disorder

Journal of the Liaquat University of Medical and Health Sciences, 2016

Research paper thumbnail of Association of Somatic Symptoms with Depressive Disorder

Pakistan Journal of Medical and Health Sciences

Objectives: To determine the association of somatic symptoms with Depressive disorder. Study Desi... more Objectives: To determine the association of somatic symptoms with Depressive disorder. Study Design: Descriptive cross sectional study. Study Setting and Duration: At department of medicine and allied OPD at Pir Syed Abdul Qadir Shah Jeelani Institute of Medical sciences, GAMBAT, Sindh, Pakistan, from 10th August 2019 to 31st January 2020. Methodology: The sample size of the study was 140. All the patients of both gender between ages of 18 to 60 years, having depressive disorder as per ICD-10 (International classification of diseases version-10) criteria as mild, moderate and severe were enrolled. Somatic symptoms were assessed through somatic symptoms scale-8. The collected data was analyzed by Statistical Packages for Social Sciences (SPSS) version 22.0. Results: Among 140 clients 131 (93.60%) were females with age range of 22 to 44 years. Among all majority were married, illiterate and were household by occupation. Amongst all mostly were having severe depressive disorder 62.9% f...

Research paper thumbnail of The Perspective of General Practitioners about Mental Illness: A Cross-sectional Observational Study from a Tertiary Care Centre, Pakistan

Journal of Pharmaceutical Research International

Objectives: To assess the general practitioner's perspective on mental illness in a tertiary ... more Objectives: To assess the general practitioner's perspective on mental illness in a tertiary health care setting. Study Setting and Duration: Online seminar in March 2020, Jinnah Postgraduate Medical Centre, Karachi. Study Design: Cross-sectional, Observational study Methodology: A total of 152 general practitioners were enrolled in the study. All house officers, psychiatric specialists, staff members, and patients were excluded from the study. An online survey instrument was used to collect data from general practitioners through social media. The questionnaire was related to the biodata of the physicians and their perspective on mental health disorders. Data was analyzed by using SPSS Version 26. Results: A total of 152 general practitioners participated in the study. The mean age of participants was 39.76 (11.540) years. The majority of them were male and married with an average experience of 12.80 (10.90) years. According to the participants, the most common symptoms experie...