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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 psychiatric diagnosis, and 46(81.5%) of these were referred cases., Conclusions: Non-emergency visits constituted high percentage of emergency presentation.

Objective: To determine the frequency of co-morbid common primary headaches among depressed patients., Methods: This study was conducted at the Jinnah Postgraduate Medical Centre, Karachi, from July to December 2014, and comprised depressed patients. Diagnosis of depressive disorder was based on diagnostic criteria of International Classification of Diseases (10th version). For the diagnosis of common primary headaches, International Classification of Headache Disorders (2nd edition) criteria were applied. SPSS 17 was used for data analysis., Results: Of the 331 participants, 129(39%) were males and 202(61%) were females. The overall mean age was 31.40±8.6 years (range: 18-50 years). Besides, 208(62.83%) participants had no headache and 123(37.16%) had common primary headaches. Of the latter, 18(5.4%) had migraine with aura, 49(14.8%) had migraine without aura and 56(16.9%) had tension-type headache. Common primary headaches were more common in females and among those having severe depressive disorder., Conclusions: The primary headache was common among outpatients with depressive disorder, predominantly tension-type headache and migraine without aura.

Objective: To determine the frequency of different motivating factors to quit opioid use., Methods: The descriptive, cross-sectional study was conducted at the Department of Psychiatry and Behavioural Sciences, Jinnah Postgraduate Medical Centre, Karachi, from August 2012 to February 2013, and comprised opioid users. Demographic data was collected through a semi-structured questionnaire whereas motivational factor was assessed through a self-designed proforma. A motivational factor questionnaire was developed after a pilot study. In this questionnaire, different intrinsic and extrinsic factors were categorised into four types, i.e. biological, psychological, social and religious factors. SPSS 17 was used for data analysis., Results: Of the 157 participants, 148(94.3%) were males and 9(5.7%) were females. The overall mean age was 31.83±8.99 years (range: 14-57 years). The mean age of onset of using opioids was 25.79±7.17 years (range: 13-40 years). The mean duration of using opioids was 5.29±3.72 years (range: 1-20 years). Besides, 141(90%) patients were under the age of 45 years. Strong social factors included feeling of inability to care for family among 122(77.7%) participants, embarrassment in society 107(68.2%), and family pressure by parents/ spouse/ children 94(59.9%)., Conclusions: Family and social factors were found to be the main source of motivation for a person to quit substance abuse.

Background: Age-adjusted incidence of prostate cancer in Pakistan is 5.3 per 100,000 which is relatively low as compared to other Asian countries, but increasing numbers of cases are being reported. Data on risk factors associated with prostate cancer risk among Pakistani men are sparse. The objective of this study was to identify lifestyle factors associated with the risk of prostate cancer in Pakistani men., Methods: An unmatched case-control study was conducted in Lahore from February to October 2011. The study enrolled 195 histologically confirmed cases of adenocarcinoma of prostate from Shaukat Khanum Memorial Hospital and Institute of Nuclear Medicine and Oncology Lahore (INMOL) and Lady Reading Hospital. Peshawar, using purposive sampling technique. A total of 390 hospital controls were selected using convenient sampling technique from different teaching hospitals of Lahore after screening with prostate specific antigen levels. A semi-structured interview form was used to collect data through face-to-face interviews. Odds ratio was used as a measure of strength of association and was calculated using unconditional logistic regression., Results: Farmers were found to be at higher odds of prostate cancer (OR 19.76; 95% CI 5.51-70.80; p < 0.001). No significant association was found with marital status, ethnic background, religious affiliation and consanguineous marriages. Level of physical activity was inversely associated with prostate cancer risk (OR 0.05; 95% CI 0.01-0.26; p < 0.001). Positive association was found with increased red meat consumption (OR 11.82; 95% CI 2.88-48.54; p = 0.001) and dairy products intake (11.76; 95% CI 4.23-32.67; p < 0.001)., Conclusion: Red meat consumption, higher dairy products intake and working as farmers are strongly associated with increased odds of prostate cancer among Pakistani men.

Objective: To determine clinical manifestations of depressive disorder among cases below 18 years., Design: Cross-sectional study., Place and Duration of Study: Carried out at NMI (Neurospinal Medical Institute), Karachi, over a period of 3 years (October 2001 to 2004)., Patients and Methods: Four hundred consecutive cases, below the age of 18 years, were evaluated. One hundred cases were inducted in this study based on detailed history and interview by psychiatrists. The diagnostic criteria of ICD-10 (International classification of diseases in its tenth revision) of WHO was used. Results based on clinical features were tabulated and analysed with SPSS-10. Fisher s exact test/Chi-square test were used for comparison between male and female cases., Results: A total number of 400 consecutive cases, below the age of 18, who approached for psychiatric consultation, were evaluated. After applying the ICD-10 diagnostic criteria, a 100 (25%) of them were found to be suffering from depressive disorder. Among them, 54 were girls and 46 boys, giving a male to female ratio of 1:1.32 and statistically insignificant gender difference. Instead of mood disturbance, the most frequent presenting complaints included pain (55%), insomnia (33%), fear (16%), weakness (14%) and aggression (13%)., Conclusion: Depression is a common psychiatric disorder among the pediatrics and adolescents. The clinical presentation was usually found to be atypical.

'Insight', which is an indication of patient's understanding about his/her illness, needs particularly sensitive measures for its assessment. A questionnaire regarding insight, and brief psychosocial profile of the patients was applied to 103 cases. The cases were categorized according to the diagnosis and initial understanding of mental illness and 'insight' by the patients in our culture. The study did not support the popular belief that neurotics have and psychotics do not have insight.