Migraine in physicians and final year medical students:A crosssectional insight into prevalence,self-awareness,and knowledge from Pakistan

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.

Clinical Observation on Tuina Therapy for Cervicogenic Headache

Objective： To observe the clinical effects of tuina therapy for cervicogenic headache. Methods： Fifty-four cases were randomized allocated into tuina group and medicine group, 27 cases in each group. The patients in the tuina group treated with tuina therapy, and the patients in the medicine group take ibuprofen orally. The headache degree （Visual Analogue Scale, VAS）, frequency of headache occurrence and the neck disability index （NDI） were compared 2 weeks pre-treatment and 2 weeks post-treatment. Results： Before treatment, there were no significant differences in the headache VAS, frequency and NDI between the two groups. After treatment, headache VAS, frequency and NDI were significantly decreased, and there were statistical differences between the tuina group and the medicine group （P 〈 0.01）. Conclusion： Tuina therapy is more effective for treating cervicogenic headache than routine dose of ibuprofen.

Observation on Clinical Effects of Electroacupuncture for Migraine Without Aura

Objective: To observe the clinical effects of electroacupuncture(EA) for migraine without aura. Methods: The migraine patients in conformity with the conditions were randomly divided into two groups, 34 cases in each group. The treatment group was given EA and the control group was given the routine acupuncture treatment, to observe various pain indexes respectively before and one month after the treatment. Results: The general effect was remarkably better in the treatment group than that in the control group(P<0.05). Conclusion: EA is an effective therapy for migraine without aura.