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Background: Transcranial Direct Current Stimulation (tDCS) is a non-invasive brain stimulation technique. Constant electric current is passed through the patient's scalp with the aim of modulating cortical excitability. Stroke is a cerebrovascular disease characterized by hemorrhage or cerebral ischemia. This systematic review and meta-analysis are aimed at comparing the efficacy of motor cortex stimulation with that of cerebellar stimulation by using transcranial direct current stimulation. Method: Google Scholar, PubMed, EMBASE, Cochrane CENTRAL, and Physiotherapy Evidence Database (Pedro) databases were searched for studies. The extracted qualitative data was synthesized systematically. Cochrane RevMan software was used to conduct a meta-analysis of quantitative data. The fixed effects mean difference of the collected data was calculated at a 95% confidence interval (CI) for the changes in balance and side effects. Results: This research included 10 articles with seven studies assessing changes in balance (outcome measured in CoP and FMA scores) and side effects (tingling and itching were the most prevalent). There was no significant difference between the efficacy levels of m1-tDCS versus ctDCS (P = 0.18), m1-tDCS versus sham (P = 0.92), and ctDCS versus sham (P = 0.19). Itching and tingling sensation were the most common and were significantly prevalent in sham interventions (P < 0.00001). Conclusion: We found that motor cortex and cerebellar stimulations are both effective in improving motor function in stroke patients. There are no adverse effects to using the interventions besides mild itching and tingling experienced during the stimulation.
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INTRODUCTION: Across its historical trajectory, epilepsy has frequently been linked to evil forces, particularly in the sub-continent. This research was created to find out if educated Pakistanis still believe that epilepsy is caused by being possessed by spirits (Jinns). The objective of the study is to assess the knowledge, attitudes, and practices (KAP) regarding epilepsy within the educated populace of Pakistan. METHOD: After approval from the Ethical Review Committee, a population-based cross-sectional design was conducted in Chakwal District, Pakistan between February 1, 2018, and June 1, 2020, to evaluate the general knowledge and attitudes of the public toward epilepsy. A non-probability convenience sampling technique was utilized to recruit participants from different socioeconomic backgrounds across Chakwal District, and only individuals aged 18 years or older with at least 12 years of education were eligible to participate. A previously validated structured questionnaire was used to document findings. The study focused on several variables, such as knowledge about epilepsy and the percentage of people who have witnessed seizures, as well as sources of knowledge, subjective causes of epilepsy, beliefs in cure, transmission, and treatment options. RESULTS: The survey included 512 participants, and the age distribution was as follows: 18-29 years old accounted for 18% of the respondents, 30-44 years old accounted for 35%, and 45-60 years old accounted for 31%. There was a female predominance with a frequency of 312 (60.9%). When asked about their sources of knowledge about epilepsy, the majority of participants (59.57%) reported learning about epilepsy from friends and relatives. A smaller percentage (18.36%) reported learning about epilepsy from schools, while another 20.31% heard about epilepsy from media and relatives. CONCLUSION: The results of this research show that the general populace of Pakistan has a serious dearth of comprehension and information about epilepsy. Participants frequently held misconceptions about epilepsy being a hereditary disease and a mental condition, highlighting the need for focused education and information efforts to dispel these falsehoods. The fact that most participants got their knowledge about epilepsy from peers and family also emphasizes the value of peer education and social networks in spreading awareness of the disease.
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OBJECTIVE: To assess the functional ability and vitals of young children using six-minute walk test. METHODS: The analytical cross-sectional study was conducted from October 2019 to January 2020 at public and private schools of Rawalpindi and Islamabad after approval from the ethics review committee of Riphah College of Rehabilitation Sciences, Westridge Campus Rawalpindi, Pakistan, and comprised healthy children aged 7-12 years who were subjected to the six-minute walk test according to standardised guidelines. Data was collected using a semi-structured questionnaire. Anthropometric measurements, distance walked in six minutes, heart rate, respiratory rate, oxygen saturation, and rate of perceived exertion were the outcome variables. Data was analysed using SPSS 26. RESULTS: Of the 376 subjects, 225(59.8%) were boys and 151(40.2%) were girls. The mean age of the sample was 9.25±1.64 years. Mean distance covered by the children was 482.63±119.76 metres. Public school students performed better than those studying in private schools (p=0.001). The difference in gender terms was non-significant (p=0.926). Significant difference was observed in mean heart rate and respiratory rate post-walk (p<0.05). There was a weak positive correlation of the test with age and height (p<0.001), but not with weight, gender and body mass index (p>0.05). Conclusion: The level of functional ability of the young students improved with age and was better among those studying at public schools. Besides, anthropometric and physiological parameters influenced the text performance.
