Multiple sclerosis in Pakistan: Current status and future perspective

Shah, Zara; Wasay, Mohammad; Chaudhry, Burhan; Fredrikson, Sten

doi:10.1016/j.jns.2020.117066

Cited by 10 publications

(11 citation statements)

References 24 publications

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“…In female patients, the frequency of vitamin D deficiency suffering from MS was significantly high as compared to males. The findings are 13,14 similar to many other studies. Pakistan is having the highest prevalence rate of 15 vitamin-D deficiency in South East Asia.…”

Section: Discussionsupporting

confidence: 92%

Frequency of 25-Hydroxy Vitamin D Deficiency in Patients With Multiple Sclerosis

Butt

Arman²,

Ansari³

2022

KMUJ

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OBJECTIVE: To determine the frequency of 25-hydroxy vitamin-D deficiency in Patients with multiple sclerosis (MS). METHODS: This cross-sectional study was conducted at Civil Hospital Karachi, Pakistan from January to December 2019. One hundred and sixty five diagnosed cases of MS of either gender, aging 20-55 years, not taking vitamin-D supplements, steroids and could go outside in the sun were selected through non-probability consecutive sampling technique. Patients having history of rickets, parathyroid disease, chronic liver or renal diseases were excluded. Blood sample was taken to measure 25-hydroxyl vitamin D3 levels. A level of <20 ng/ml was considered as vitamin-D deficient. Logistic regression analysis was used to identify determinants. RESULTS: Out of 165 MS patients, 106 (64.24%) were females, 66 (40%) had income between PKR 10000-25000, 51 (30.9%) were illiterate and 12 (7.3%) had graduate level education. Majority (n=101; 61.21%) had relapsing-remitting MS. Mean age of enrolled participants was 32.92±8.19 years and mean duration of MS was 2.17±0.84 years. Ninety-nine (60%) patients had history of adequate sun exposure. Vitamin-D deficiency in MS patients was 55 (33.3%). Female patients with MS had 2.9 times more likely to be vitamin-D deficient compared to male patients (95% CI: 1.3-6.5). Vitamin-D deficiency In MS patients having no or primary level education patients was recorded in 38 (69.1%) patients as compared to 17 (31.9%) case having secondary or higher education (p-value=0.046). CONCLUSION: Vitamin-D deficiency is common in MS patients. Female and less educated MS patients are at a higher risk of being vitamin-D deficient.

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Section: Discussionsupporting

confidence: 92%

Frequency of 25-Hydroxy Vitamin D Deficiency in Patients With Multiple Sclerosis

Butt

Arman²,

Ansari³

2022

KMUJ

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“…Multiple sclerosis is the most debilitating neurological disorder affecting young patients in full physical activity between 20 and 40 years [1], with a predominance of women [2] and whose main risk factors are smoking, obesity, low exposure to ultraviolet rays, vitamin D deficiency as well as infections including the Epstein Bar Virus [3].…”

Section: Discussionmentioning

confidence: 99%

Multiple Sclerosis Revealed by Anterior Uveitis

Dahi

Khamaily

Salem

et al. 2020

EJMED

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Multiple sclerosis is an autoimmune inflammatory disease of the central nervous system, leading to the formation of foci of demyelination. Ocular involvement is quite frequent and multiple, dominated by inflammatory optic neuropathies, oculomotor nerve damage, nystagmus and uveitis. We report an atypical case of multiple sclerosis revealed by an anterior unilateral synechiatic hypertensive uveitis in a young patient of 27 years.

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“…1 It is the most common disabling neurological disease in young adults, between 20 and 40 years of age. 2 The prevalence of MS in Pakistan is estimated to be 10 per 100 000 population. 3 Intrathecal immunoglobulin synthesis is commonly found in MS. 4 The diagnosis of MS is largely clinical and is supported by diagnostic tests including brain MRI, spinal fluid analysis and neurophysiological testing, with oligoclonal banding (OCB) via isoelectric focusing electrophoresis (IFE) being the gold standard.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of CSF kappa free light chains for the diagnosis of multiple sclerosis (MS): a comparison with oligoclonal bands (OCB) detection via isoelectric focusing (IEF) coupled with immunoblotting

et al. 2022

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This study was done to evaluate the diagnostic accuracy of cerebrospinal fluid kappa free light chain (KFLC) for diagnosis of multiple sclerosis, against isoelectrofocusing (IEF) to detect oligoclonal bands (OCB) as gold standard. 64 cases were divided into positive and negative based on the OCB results. Diagnostic accuracy was calculated for the 1 mg/L cut-off. The 1 mg/L cut-off yielded a percent agreement of 86.1% and Cohen’s kappa value of 0.8. Youden’s index, yielded a cut-off of 0.92 mg/L as optimal (90.3% specificity and 90.9% sensitivity). The analytical time was 3 hours and 55 min for IEF and 25 min for KFLC. The cost of a single OCB test was PKR12 000 (US$68.17) compared with PKR4150 (US$23.58) for KFLC. KFLC proved to be an accurate, cheaper and time-saving alternative and can be performed prior to the contemporary testing.

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Multiple sclerosis in Pakistan: Current status and future perspective

Cited by 10 publications

References 24 publications

Frequency of 25-Hydroxy Vitamin D Deficiency in Patients With Multiple Sclerosis

Frequency of 25-Hydroxy Vitamin D Deficiency in Patients With Multiple Sclerosis

Multiple Sclerosis Revealed by Anterior Uveitis

Evaluation of CSF kappa free light chains for the diagnosis of multiple sclerosis (MS): a comparison with oligoclonal bands (OCB) detection via isoelectric focusing (IEF) coupled with immunoblotting

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