BACKGROUND Despite its high prevalence,migraine remains underdiagnosed worldwide.A significant reason is the knowledge gap in physicians regarding diagnostic criteria,clinical features,and other clinical aspects of mi...BACKGROUND Despite its high prevalence,migraine remains underdiagnosed worldwide.A significant reason is the knowledge gap in physicians regarding diagnostic criteria,clinical features,and other clinical aspects of migraine.AIM To measure the knowledge deficit in physicians and medical students and to assess the prevalence of migraine in the same population.METHODS An online questionnaire was developed and distributed among physicians and final year medical students on duty in various medical and surgical specialties of Allied and DHQ Hospitals,Faisalabad,between October 2018 and October 2019.Inclusion criteria were public practicing physicians who experience headaches,while those who never experienced headaches were excluded.Different questions assessed respondents on their knowledge of triggers,diagnosis,management,and prophylaxis of the migraine headache.They were asked to diagnose themselves using embedded ICHD-3 diagnostic criteria for different types of migraine.Graphs,tables,and figures were made using Microsoft Office 2016 and Microsoft Visio,and data analysis was done in R Studio 1.4.RESULTS We had 213 respondents and 175 fulfilled inclusion criteria,with 99(52%),58(30%)and 12(6.3%)belonging to specialties of medicine,surgery,and others,respectively.Both genders were symmetrically represented(88 male and 87 female).Fifty-two(24.4%)of our 213 respondents were diagnosed with migraine,with 26(50%)being aware of it.Females had higher prevalence among study participants(n=28,32.2%)compared to males(n=20,22.7%,P=0.19).A majority(62%)of subjects never consulted any doctor for their headache.Similarly,a majority(62%)either never heard or did not remember the diagnostic criteria of migraine.Around 38%falsely believed that having any type of aura is essential for diagnosing migraine.The consultation rate was 37%(n=65),and migraineurs were significantly more likely to have consulted a doctor,and a neurologist in particular(P<0.001).Consulters and migraineurs fared better in the knowledge of diagnostic aspects of the disease than their counterparts.There was no significant difference in other knowledge aspects between consulters versus non-consulters and migraineurs versus nonmigraineurs.CONCLUSION Critical knowledge gaps exist between physicians and medical students,potentially contributing to misdiagnosis and mismanagement of migraine.展开更多
AIM To explore and to analyze the patterns in decisionmaking by pediatric gastroenterologists in managing a child with a suspected diagnosis of functional gallbladder disorder(FGBD).METHODS The questionnaire survey in...AIM To explore and to analyze the patterns in decisionmaking by pediatric gastroenterologists in managing a child with a suspected diagnosis of functional gallbladder disorder(FGBD).METHODS The questionnaire survey included a case history with right upper quadrant pain and was sent to pediatric gastroenterologists worldwide via an internet list server called the PEDGI Bulletin Board.RESULTS Differences in decision-making among respondents in managing this case were observed at each level of investigations and management.Cholecystokinin-scintigraphy scan(CCK-CS) was the most common investigation followed by an endoscopy.A proton pump inhibitor was most commonly prescribed treating the condition.The majority of respondents considered a referral for a surgical evaluation when CCK-CS showed a decreased gallbladder ejection fraction(GBEF) value with biliary-type pain during CCK injection.CONCLUSION CCK infusion rate in CCK-CS-CS and GBEF cut-off limits were inconsistent throughout practices.The criteria for a referral to a surgeon were not uniform from one practitioner to another.A multidisciplinary team approach with pediatric gastroenterologists and surgeons is required guide the decision-making managing a child with suspected FGBD.展开更多
文摘BACKGROUND Despite its high prevalence,migraine remains underdiagnosed worldwide.A significant reason is the knowledge gap in physicians regarding diagnostic criteria,clinical features,and other clinical aspects of migraine.AIM To measure the knowledge deficit in physicians and medical students and to assess the prevalence of migraine in the same population.METHODS An online questionnaire was developed and distributed among physicians and final year medical students on duty in various medical and surgical specialties of Allied and DHQ Hospitals,Faisalabad,between October 2018 and October 2019.Inclusion criteria were public practicing physicians who experience headaches,while those who never experienced headaches were excluded.Different questions assessed respondents on their knowledge of triggers,diagnosis,management,and prophylaxis of the migraine headache.They were asked to diagnose themselves using embedded ICHD-3 diagnostic criteria for different types of migraine.Graphs,tables,and figures were made using Microsoft Office 2016 and Microsoft Visio,and data analysis was done in R Studio 1.4.RESULTS We had 213 respondents and 175 fulfilled inclusion criteria,with 99(52%),58(30%)and 12(6.3%)belonging to specialties of medicine,surgery,and others,respectively.Both genders were symmetrically represented(88 male and 87 female).Fifty-two(24.4%)of our 213 respondents were diagnosed with migraine,with 26(50%)being aware of it.Females had higher prevalence among study participants(n=28,32.2%)compared to males(n=20,22.7%,P=0.19).A majority(62%)of subjects never consulted any doctor for their headache.Similarly,a majority(62%)either never heard or did not remember the diagnostic criteria of migraine.Around 38%falsely believed that having any type of aura is essential for diagnosing migraine.The consultation rate was 37%(n=65),and migraineurs were significantly more likely to have consulted a doctor,and a neurologist in particular(P<0.001).Consulters and migraineurs fared better in the knowledge of diagnostic aspects of the disease than their counterparts.There was no significant difference in other knowledge aspects between consulters versus non-consulters and migraineurs versus nonmigraineurs.CONCLUSION Critical knowledge gaps exist between physicians and medical students,potentially contributing to misdiagnosis and mismanagement of migraine.
文摘AIM To explore and to analyze the patterns in decisionmaking by pediatric gastroenterologists in managing a child with a suspected diagnosis of functional gallbladder disorder(FGBD).METHODS The questionnaire survey included a case history with right upper quadrant pain and was sent to pediatric gastroenterologists worldwide via an internet list server called the PEDGI Bulletin Board.RESULTS Differences in decision-making among respondents in managing this case were observed at each level of investigations and management.Cholecystokinin-scintigraphy scan(CCK-CS) was the most common investigation followed by an endoscopy.A proton pump inhibitor was most commonly prescribed treating the condition.The majority of respondents considered a referral for a surgical evaluation when CCK-CS showed a decreased gallbladder ejection fraction(GBEF) value with biliary-type pain during CCK injection.CONCLUSION CCK infusion rate in CCK-CS-CS and GBEF cut-off limits were inconsistent throughout practices.The criteria for a referral to a surgeon were not uniform from one practitioner to another.A multidisciplinary team approach with pediatric gastroenterologists and surgeons is required guide the decision-making managing a child with suspected FGBD.
