Masood Munawar, Liu Yi Ming, Mohammad Umer Malik, Hammad Ali Asghar.
Parkinson Disease and Its Association between China and Pakistan.
Pak J Med Health Sci Jan ;6(4):1059-62.

Objective: To evaluate and compare the Parkinson disease patients between two races Chinese and Pakistanis, study the differences regarding clinical features, age of onset, treatment comparison and cost of management. Setting and design: The patient studies and reports were taken from two countries China and Pakistan. The PD patients observed were from Qilu Hospital Jinan, Shandong province China and Services Hospital Lahore. Demographical characteristics, clinical features, laboratory investigations and other investigations were recorded and were analyzed in the outdoor department. After the study 50 patients were choose from each country. After complete examination the prescription details were given and cost of management was recorded. Results: A total of 100 patients were observed. 50 patients from China and 50 patients from Pakistan out of which in Pakistan 42 patients were male and 8 female and in China 44 were male and 6 patients were female. The mean age of onset of the disease was 56 years in Pakistan and in China the mean age was 51.18 years. In our studies we found that (86%) of patients had onset of illness during the fifth or sixth decade of their life which is common in China. The mean duration of illness at the time of presentation was 6.9 years in China and that of Pakistan was 7.15 years. The mean cost of management for the patient in China is 53.51 dollars while that of Pakistan is 26.79 Dollars. Rigidity, Bradykinesia, tremors, hypomimia, primitive reflexes, difficulty in performing fine work and walking difficulty were the most common clinical signs in Pakistan and China. Patients had stage I or II (Hoehn-Yahr staging) disease at the time of presentation in China and in Pakistan patients had mean stage of 2.0-2.5 patients had predominantly unilateral symptoms in China which is common in Pakistan and China. (19%) patients had cognitive impairment. Conclusion: Tremor, rigidity, walking difficulty, Bradykinesia and difficulty in performing fine work are the most common clinical features. Disease severity increases with duration of the disease. Although the cost of management in Pakistan was less as compared to china but the quality of life was better in China. Cognitive impairment is not uncommon in these patients and is associated with disease duration and age of onset of the illness.

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