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The diagnostic criteria for fibromyalgia (FM) have relied heavily on subjective reports of experienced symptoms coupled with examination-based evidence of diffuse tenderness due to the lack of reliable biomarkers. Rheumatic disorders that are common causes of chronic pain such as rheumatoid arthritis, systemic lupus erythematosus, osteoarthritis, and chronic low back pain are frequently found to be comorbid with FM. As a result, this can make the diagnosis of FM more challenging. We aim to develop a reliable classification algorithm using unique spectral profiles of portable FT-MIR that can be used as a real-time point-of-care device for the screening of FM. A novel volumetric absorptive microsampling (VAMS) technique ensured sample volume accuracies and minimized the variation introduced due to hematocrit-based bias. Blood samples from 337 subjects with different disorders (179 FM, 158 non-FM) collected with VAMS were analyzed. A semi-permeable membrane filtration approach was used to extract the blood samples, and spectral data were collected using a portable FT-MIR spectrometer. The OPLS-DA algorithm enabled the classification of the spectra into their corresponding classes with 84% accuracy, 83% sensitivity, and 85% specificity. The OPLS-DA regression plot indicated that spectral regions associated with amide bands and amino acids were responsible for discrimination patterns and can be potentially used as spectral biomarkers to differentiate FM and other rheumatic diseases. [ABSTRACT FROM AUTHOR]

Spirituality is an important part of social sciences as well as of human evolution, activity and transcendence. Spirituality also plays an important part in coping with trauma in the aftermath of natural and/or manmade disasters. The role of spirituality in medicine has also received some attention. Although research has shed light on the role of spirituality in management of patients suffering from a variety of illnesses, there is a need for greater understanding on the role of spirituality to solve some of medicine's greatest mysteries. Various researches have been done to evaluate health professionals' account as well as patients' perspective on significance of spiritual issues in psychiatric management. There have been studies from Pakistan that have looked at the role of religion in patients' illness, which showed that desire of patients from their physicians to express a prayer for them aloud and others accepted that being in care of 'God-fearing physicians' would have a positive impact on their health. In order to determine the importance of spiritual need in the treatment plan and to propose bio-psycho-social and spiritual model for evaluation of medical and psychiatric illnesses, the Research question is designed to evaluate patients and health professionals' opinions regarding the significance of spirituality in patients' illnesses and management. As far as we can determine no previous study in Pakistan has been conducted in which both patients' and health professionals' were evaluated. We will conduct interviews of both 40 patients and 40 health professionals from following specialties to gain their opinion on spiritual discussion. For health professionals we would use 17-item proforma questionnaire. Informed and Written consent will be taken from all respondents. However, Patient will be interviewed separately in an outpatient department of Neurology, Psychiatry, Oncology, Medicine, Family Medicine and Rheumatology. 5-Item self-devised tool will be applied on patients. Patients' privacy and confidentiality will be maintained. Interview will be conducted from Follow-up patients. The focus would be to highlight areas which may need attention in improving therapeutic alliance as well as patients' satisfaction also to improve quality of care and outcome of illnesses in long term. In the context of Pakistan, the findings of the study have special significance of spiritual discussion in mental and medical illnesses. The need of psychiatry chaplain ship, inculcation of spirituality in academics and integration of spiritual services in social support can be assessed. [ABSTRACT FROM AUTHOR]