“Prevalence of Migraine in Females in District

Gujranwala and Gujrat”

CLINICAL CLERKSHIP FINAL YEAR PROJECT

PHARMACY PRACTICE-VIA (ADVANCED CLINICAL
PHARMACY-II) PHARM 716

MUHAMMAD ISMAIL
SAP ID: 70059314
Supervisor: Miss AQNA MALIK (PhD Scholar)

Department of Pharmacy

THE UNIVERSITY OF LAHORE

(2018-2023)

1
 UNDERTAKING BY STUDENT

I Muhammad Ismail Registration No. 70059314 declare that the contents

of my research project entitled

“Prevalence of Migraine in Females in District

Gujranwala and Gujrat”

is based on my own research findings and have not been taken from any
other work except the references and has not been published before.

Muhammad Ismail

2
 SUPERVISIOR LETTER

I Miss Aqna Malik certify that the contents and the form of research project
entitled

“Prevalence of Migraine in Females in District

Gujranwala and Gujrat”

Submitted by Muhammad Ismail Regd. No. 70059314 have been

found satisfactory and recommend it for the evaluation of the External
Examiner for the award of degree of PHARMACY PRACTICE-VIB
(ADVANCED CLINICAL PHARMACY-II)Pharm 716

SUPERVISOR: CHAIRPERSON:
Miss Aqna Malik(PhD Scholar) Dr. Talib Hussain PhD, (Pharmacy),
University of Huddersfield, UK

Department of Pharmacy Department of Pharmacy

3 Department of Pharmacy
 BIOSTATISTICIAN LETTER

I Mr. Asim Raza certify that the statistical analysis of research project
entitled

“Prevalence of Migraine in Females in District

Gujranwala and Gujrat”

Submitted by Muhammad Ismail Registration No. 70059314 have

been found satisfactory and recommend it for Final VIVA VOICE
Of PHARMACY PRACTICE-VIB (ADVANCED CLINICAL
PHARMACY-II)Pharm 716

Biostatistician Name Mr. Asim Raza(Phd Scholar)

Qualification Epidemiology (PhD scholar)
Designation Assistant Professor
Signature
Date

4
 PLAGIARISM EVALUATION REPORT

This is to certify that I have examined the Turnitin report of the research
project entitled

“Prevalence of Migraine in Females in District

Gujranwala and Gujrat”

The project contains no text that can be regarded as plagiarism. The overall
similarity index obtained from the Turnitin software is 12%.

_____________________ ____________________
Senior Officer QEC Miss Aqna Malik (PhD scholar)

Supervisor
Date: ________________ Date: _______________

5
 Dedicated
To,

I dedicated my dissertation work to my family, friends and respected teachers. A special

feeling of gratitude to my loving parents, whose words of encouragement pushed me
every time to focus on my work.

6
 Acknowledgments

The completion of this study could not have been possible without the expertise of my
supervisor
Miss Aqna Malik, respected dissertation advisor and understanding spirit during this
whole research.
A debt of gratitude is also owned to Mr Asim Raza (PhD Scholar) from Allied Health
Sciences.The composition of this undertaking could not have been possible without the
participation and assistance of so many people whose names may not all been umerated.
Their contribution are sincerely appreciated and gratefully acknowledged. However, I
would like to express my deep appreciation and indebtedness particularly to My
supervisor Miss. Aqna Malik, for her endless support, kind and understanding spirit
during this whole research. To Respective Chairperson of Department of pharmacy. To
all my relatives and friends and others who in one way or another shared their support,
either morally or physically. Above all, to the Almighty Allah, the most compassionate
and merciful, for giving the wisdom, strength, and knowledge.

Thank you.

Muhammad Ismail

7
 TABLE OF CONTENTS

Sr.no. CONTENTS PAGE NO

1 LETTERS I-IX
2 LIST OF FIGURES X
3 LIST OF ABBREVIATIONS AND ACRONYMS XI
4 ABSTRACT XII
5 CHAPTER 1: INTRODUCTION 1-5
Aims and Objectives
6 CHAPTER 2: REVIEW OF LITERATURE 6-10
7 CHAPTER 3: MATERIAL AND METHODS 9
3.1 : Study design 10
3.2 : Settings 10
3.3 : Study duration 10
3.4 : Sample size 10
3.5 : Sampling technique 11
3.6: DATA COLLECTION PROCEDURE 11
3.7 : DATA ANALYSIS 11
3.8: INCLUSION AND EXCLUSION CRITERIA 11
3.8.1 : Inclusion criteria
3.8.2 : Exclusion criteria
3.9 : ETHICAL CONSIDERATIONS 11

8 CHAPTET 4: RESULTS 12-47

9 CHAPTER 5: DISCUSSION 48-55

Conclusion
Recommendations

8
 Limitations
REFERENCES
10 ANNEXURE 56-66

Consent Forms
Questionnaire
Similarity index report form
Plagiarism report

9
 LIST OF FIGURES
S. No FIGURES Page No.
4.1. Marital Status 13
4.2. Age wise distribution of participants 14
4.3. Occupation 15
4.4. Frequency of Migraine Headache among Participants 16
4.5. Regular Headaches per Month among Participants 17
Frequency of Migraine Headache after Taking Medicine among
4.6. 18
Participants
4.7. Frequency of pain in migraine headaches among Participants 19
4.8. Frequency of pain in migraine headaches 20
4.9. Age of participants when migraine started 21
4.10. Description of migraine headache by participants 22
4.11. Patients awaken at night due to migraine headaches 23
4.12. GIT problems among participants 24
4.13. Optic problems among participants 25
4.14. CNS problems among participants 26

4.15. Problem faced by participants during travelling 27

4.16. Migraine Getting Worse among Participants with 28
4.17. Method makes migraine headache better among participants 29
4.18. Variation of Migraine in Female Participants 30
4.19. Migraine duration without taking medication 31
4.20. Family member with migraine headache among participants 32
4.21. Relation to the family member 33
4.22. Head or neck injury among participants 34
4.23. Other medical disorders among participants 35
4.24. Migraine headache diagnosed by neurologist 36
4.25. Differential Diagnosis among Participants 37
4.26. Participants treated with Botox 38
4.27. Working of Botox Injection 39
4.28. Diagnostic tests for migraine among participants 40
4.29. Prescription drugs Taken by Participants 41

10
4.30. OTC Drugs Taken by Participants 42
4.31. Frequency of OTC medication consumed by participants 43
Impact of migraine headache on quality of life among
4.32. 44
participants
4.33. OTC Drugs Used taken Participants 45
4.34. Home remedies utilized by participants 46
4.35. Medicine prescribed by physician after diagnosis of migraine 47

11
LIST OF ABBREVIATIONS AND ACRONYMS

Abbreviations Full form

NSAIDS Non-steroidal anti-inflammatory drugs

TGVS Trigeminal vascular system

12
 : Abstract:

Background:-
A frequent, long-lasting brain condition with cranial autonomic signs is migraine. It is
characterized by frequent, severe headache attacks that are frequently accompanied by
additional symptoms, a high degree of impairment, as well as personal, familial, and
societal effects. In Western nations, it affects about 12% of the general population and
three times more women than men. The severity and frequency of migraine attacks, as
well as the number and kind of coexisting conditions, all have an impact on migraine
disability. The most frequent co-occurring chronic diseases that considerably enhance the
effects of migraine on the individual are mood disorders, obesity, and medication usage.
Most migraineurs experience episodic migraine attacks, which typically occur 1-3 times
per month.

Objective:-
To check the prevalence of migraine headache in community level.

Methodology:-
This observational cross-sectional study was conducted in rural and urban areas of Gujrat
and Gujranwala where a questionnaire was distributed to the people. The total number of
participants was 110 with 100% females who were the residents of Gujrat and
Gujranwala and its peripheries. The questionnaire includes two sections: Demographic
and Prevalence of Migraine which includes medical conditions, lifestyle habits, and
dietary information related to Migraine.

Results:-
In the present study out of 110 participants 100 %( 100) were female. The overall
prevalence of Migraine was 34% (37 out of 110) and 4% (4) was diagnosed with cluster
headache, 42% (46) was diagnosed with migraine headache, 34% (37) was diagnosed
with other disorder and 21% (23) was diagnosed with tension type headache.

Keywords:-
Migraine Headache, Headache, Abdominal Migraine and Menstrual Migraine.

13
 CHAPTER 01
INTRODUCTION

14
 1. INTRODUCTION:-
A frequent illness known as migraine causes a sharp ache in a specific location of the
head that lasts for 4 to 72 hours. Pain is frequently accompanied by symptoms including
sensitivities for illumination or noise, feeling sick, and vomiting. Some people may also
have auras, which are visual disturbances that can look like a series of or flashing lights,
prior to or during an attack of migraines. More people aged 20 to 50 than any other age
group are thought to get migraines, which affect over 10% of the world's population.
Nearly three times as many women as males suffer from migraines.[1] A substantial
survey carried out in the USA revealed that 5.6% of men and 17.1% of women reported
having migraine symptoms. An episodic migraine is one that happens fewer than 15 days
out of the month. When a person has headaches more than 15 days a month for a string of
three months or more, it is considered to be a chronic migraine. The transition from
episodic migraine to chronic migraine has been linked to the overuse of some
medications, including opiates, pharmaceuticals such as barb medications (NSAIDs), and
triptans, as well as excessive coffee intake. Additionally, it has been discovered that
chronic migraine is associated with disorders including obesity, obstructive breathing
while sleeping, depression, and anxiety.[2]

In both industrialized and developing nations, migraine is a serious health issue. It is a

chronic neurological condition that frequently causes headaches and nausea.[3] It is a
long-term neurological disorder that frequently results in nausea and headaches. Women
get migraines three times more frequently than men, according to past research.[4]
Asians, particularly the Chinese, were reported to have a very low migraine prevalence
(0.63% to 1.5%), according to various early surveys on migraine carried out in Asia.
These results are corroborated by a telephone survey of migraine prevalence in
Baltimore, Maryland, which found that whites (20.4% of women and 8.6% of males) had
the highest prevalence of migraine, followed by blacks (16.2% of women and 7.2% of
men), and Asian-Americans (9.2% of women and 4.8% of men).[5] There were a total of
302 community-based studies with 6,216,995 participants (6.216 years old on average,
0.91 male to female ratio). 11.6% (95% CI 10.7-12.6%; random effects) was the global
prevalence of migraines, with 10.4% in Africa, 10.1% in Asia, 11.4% in Europe, 9.7% in
North America, and 16.4% in Central and South America. The prevalence was 13.8% for
females, 6.9% for men, 11.2% for urban residents, 8.4% for rural inhabitants, and 12.4%
for school/college students when the pooled cohort was stratified. Our findings revealed
an upward trend in the prevalence of migraines worldwide.[6] Hormonal changes can
have an impact on migraine in women. Menstrual migraines are brought on by these
monthly changes. However, naturally contributing (internal) or extraneous (external)
changes in the amount of estrogen can impact a woman's migraines on a variety of other
occasions during her life.[7]

15
During established migraine attacks, one-third of the participants who originally felt pain
in particular areas such the eye, forehead, or temple afterwards acquired ipsilateral
hemicranias pain. [8] Additionally, a substantial percentage of migraine-affected women,
particularly 97%, stated that their headaches had at least 1 socioeconomic effect..[9] A
typical migraine headache is pulsing and unilateral, meaning it affects only one half of
the head. Aura, odd smells, and other sensory impressions are perceived by about one-
third of those who experience migraine attacks as warning signs that a severe headache is
about to strike. [10]Pain levels were higher in migraines without aura than in migraines
with aura.[11] Many patients believe that psychological variables, especially stress, are
important migraine and tension-related headache triggering. Stress is frequently cited as a
primary component in the onset of certain headache disorders.[12] According to research,
adult women who have a history of pediatric migraine are more likely to acquire weight
and migraines are linked to female obesity. According to studies, women who have a
track record of pediatric migraines may more inclined than those without a migraine
history to gain weight as adults. In addition, research indicates that women with
migraines are more likely to be obese than women without migraines. This link between
female obesity and migraines emphasizes the potential interaction between these two
diseases.[13] Depressive symptoms are more common among migraineurs, and they have
been shown to have an adverse effect on women's quality of life.[14] Depressive
symptoms are more common among migraineurs, and they have been shown to have an
adverse effect on women's quality of life. Research in the realm of migraine, particularly
regarding its pathophysiology, has demonstrated that sufferers of the ailment have a
distinctive phenotype of attacks that are linked to a particular biotype of the illness
known as the "sensitive brain." This expanding corpus of research emphasizes the
distinctive traits and underlying causes of migraines in those who show this phenotypic
character. [15]

The brain and its surrounding tissues are linked to migraine, a category of mysterious
neurological illnesses, and they are extremely important during migraine attacks. It is
understood that the cerebral cortex and the trigeminovascular system play important roles
in the migraine process. Once thought to be purely a vascular condition, migraine is now
understood to include complex interactions between significant inputs from both central
and peripheral nervous systems. This idea was previously challenged by persuasive data.
This insight emphasizes the complexity of migraine and the underlying mechanisms that
underlie it.[16] After examining existing migraine hypotheses, it will be determined that
the disorder is brought on by an interruption in the brain's subcortical aminergic sensory
modulatory circuits, in addition to various brainstem, hypothalamus, and thalamic
structures.[17]

16
In order to properly treat this headache syndrome with a holistic approach, it is necessary
to frequently analyses the sensitivity and intensity of these symptoms within the target
group.[18] The use of other migraine drugs, as well as trips to doctors' offices and ERs,
were reduced when a preventive medication was included to migraine care. Additionally,
there was a decreased utilization of computed tomography and magnetic resonance
imaging scans when both acute and preventative medicines were used.[19] Attacks of
migraine regulate vascular tone and the flow of pain signals by affecting the trigeminal
vascular system (TGVS), which includes the network of intracranial and extra cranial
meningeal blood vessels and ocular structures.[20] Additionally, it has been claimed that
cheese and chocolate contributed to their headache. [21] The confounding effect of sleep
on the interval determination means that migraine sufferers may have headaches brought
on by alcoholic beverages such as wine within a few hours or the morning following the
consumption of alcohol.[22] Exercise is frequently near the top of healthcare
professionals' lists of suggested lifestyle changes to lessen migraine burden. Exercise
reduces stress hormones like growth hormone and cortisol as well as inflammatory
modulators like various cytokines. Additionally, it has been demonstrated that exercise
has an impact on microvascular health, which may be related to cortical spreading
depression.[23] A small percentage of women experience their first migraine attack while
pregnant or soon after giving birth. In the first trimester, migraine attacks frequently
become more frequent, but later in pregnancy, they should become less frequent.[24]
Chlorpromazine, dimenhydrinate, and diphenhydramine can be used to treat severe
migraine attacks; metoclopramide should only be used during the third trimester of
pregnancy. Meperidine and morphine have no risk in humans, however they shouldn't be
taken after the third trimester, according to the risk categories set by the US FDA.[25]
The clinical characteristics of trauma-induced migraine as well as the results of
electroencephalography, angiography, computerized tomography, and cerebrospinal fluid
analysis are discussed and contrasted with those of spontaneous migraine. Current
theories on the neurological phenomenon of migraine in general are tied to theories about
the pathophysiology of this disorder.[26] By 2 hours after treatment, studies have
indicated that acetaminophen, aspirin, ibuprofen, and a product combining aspirin,
acetaminophen, and caffeine are more effective than placebo at lowering moderate or
severe migraine pain to mild or no discomfort. However, individuals experiencing
morbidity with 50% or more episodes and/or vomiting with 20% or more attacks were
routinely omitted from published trials of OTC medications.[27] The use of age-old,
straightforward home remedies for headaches, such as head binding. Using head binding
as a home treatment is so common.[28]

17
 CHAPTER 02
LITERARTURE REVIEW

18
 2. LITERATURE REVIEW:-
Around 15% appear to experience migraines, 4% experience persistent headaches, and
perhaps 1-2% experience headache from taking too many medications. 0.2-0.3% of
people have experienced cluster headaches in their lifetime. The women between the ages
of 20 and 50 have the largest prevalence in UK. The following paragraphs examines the
incidence and economical impact of migraines, taking into account how it affects the
standard of living, level of efficiency, and use of medical care. It highlights the
significance of productive supervision techniques. [29] The particulars underlying
migraine headaches, aura, and related symptoms, as well as their diagnostic criteria. It
talks about the difficulties in correctly identifying migraine and separating it compared to
other headache diseases. Migraine is a widespread and frequently disabling disorder that
affects 28 million Americans, or around 18% of women and 6% of men.1,2 Migraine
clearly lowers health-related quality of life and is a significant contributor to workplace
absenteeism and poor productivity.3-6 The issue costs American firms over $13 billion
annually.[30]

Punjab and Sindh have more migraine than Khyber Pakhtunkhwa and, probably,
Baluchistan, whereas Punjab has more TTH than all other provinces.[31] In both the
general public and those who visit specialized clinics, more than 50% of women with
migraine claim that their symptoms are related to their period.[32] Self-medication is
common among educated adolescents, despite the fact that most are aware of its negative
effects. To ensure safe practices, the kids must be educated. To stop this issue from
getting worse, strict regulations on drug marketing and sales need to be put in place.[33]
The analysis talks on ideas including sensitization and brain broadening melancholy.
Stress, fasting, climatic changes, sleep-related factors, and hormonal changes in women
have been identified as the top five migraine triggers. The anamnesis should cover 12
triggers, and all patients should receive advice on changing their lifestyles.[34]
Comprehensive migraine treatment plans place a strong emphasis on being aware of and
avoiding triggers as part of the therapeutic plan. Removing correctable environmental
triggers may increase employee attendance and productivity among migraineurs because
migraine has a significant economic impact.[35]

The particulars underlying migraine headaches, aura, and related manifestations, as well
as their criteria for diagnosis. It talks about the difficulties in correctly identifying
migraine and separating it compared to other headache diseases. Another study
discovered that a 0.1 mg per day estrogen patch, worn for a total of seven days right
before the start of menstruation, significantly decreased menstrual migraines, although
lesser levels had no impact. Because of their consistent absorption as opposed to the
oscillations brought on by oral supplementation, patches and gels are thought to be more
advantageous. Based on the results of recent studies, melatonin medication for migraine

19
prophylaxis has proven to be very effective. When compared to other migraine therapies,
melatonin is incredibly cost-efficient in addition to being effective and tolerable.
Melatonin and other complementary therapies for migraine prevention are topics of
expanding literature. Although studies are still scarce and of poor quality, growing data
suggests that melatonin may be a suitable replacement for the prophylactic that is now
used.[36] In order to help doctors monitor and treat migraine patients appropriately,
guidelines have been published. There are many clinical practice recommendations for
treating migraines that have been published in various nations. Since they are intended
for all clinicians who treat headaches, they must be simple to understand and should be
taught to medical students and residents.[37]

For many women, the menopausal phase, which occurs in the years before menopause,
can frequently result in migraines getting worse. Whereas perimenopause can start in the
ten years before menstruation, as far back as the midway to late 30s, it symbolizes the
finish of the years of reproduction. In the USA, menopause normally occurs at the age of
51. Hot flashes, irregular periods, sleep deprivation trouble paying attention, and a
decline in libido are among symptoms of this transition, which is characterized by
changing the functioning of ovaries and hormonal levels. One in ten persons worldwide
suffer from migraines, which are twice as prevalent in women. Students in schools and
colleges as well as people who live in cities showed higher incidence. There were
regional differences, with Central and South America having a higher prevalence than
other regions with comparable prevalence.[38]

Patients who suffer from recurrent migraines, who respond poorly to acute therapies, or
who depend significantly on abortive drugs might consider migraine prevention.
Adopting preventive measures can improve how well acute treatment plans and short-
term prophylactic work. It is significant to remember that a preventive medication's full
effects could not become apparent for no fewer than a two-month period of regular use.
Just before the start of menstruation women who currently take every day preventative
medicine may find it helpful to temporarily raise the dosage. Numerous preventive
treatments are available, including calcium-channel -blockers, antidepressants,
antiepileptic drugs, and, in the case of persistent migraines, botulinum toxin. Millions of
people in the United States and across the world suffer from migraines, a chronic,
recurrent, and incapacitating ailment. A complete recovery to function and productivity
for migraine sufferers requires appropriate acute care treatment. Triptans are usually
effective, well tolerated, and safe serotonin (5-HT)1B/1D receptor agonists. There are
seven triptans available globally, however not all are available in every nation. There are
also numerous administration routes, allowing doctors and patients a variety of options.
The available triptans are comparable, although pharmacological heterogeneity allows a
little bit of variation in their efficacy profiles. In clinical trials, all triptans outperformed
placebo, and several, such rizatriptan 10 mg, eletriptan 40 mg, almotriptan 12.5 mg, and
20
zolmitriptan 2.5 and 5 mg, are quite similar to one another and the original triptan.[39]
Over the past five years, there have been significant advancements in the treatment of
migraine, including new mechanism-based therapies that complement standard care and
lessen the illness burden associated with migraine. Although there are many therapeutic
alternatives available to effectively treat migraines, there are still a number of challenges,
including the present information gap about individualized treatment for patients. To find
possible mechanism-based therapeutic targets, greater study on the molecular causes of
migraine is first necessary. Second, strategies for precision medicine that adapt novel
treatments to each patient's particular migraine profile must be created.[40]

Though the association between ovarian steroid hormones and migraine can be unclear,
estrogen in particular has a major impact on migraine. However, the reactions to varying
estrogen levels reveal useful information about the underlying reasons for hormone-wise
driven migraines and suggest prospective treatment options. Recognizing that migraines
are a chronic biological illness that vary in intensity and frequency as women experience
menstrual transitions is crucial for migraine sufferers and their medical professionals.
Either severe episode therapy and preventative medicines for migraine should take into
account hormones phases and circumstances that occasionally may call for hormones
modification. Propranolol, timolol, amitriptyline, divalproex, sodium valproate, and
topiramate are suggested as first-line migraine preventive medications due to the
availability of sufficient data and general agreement. The effectiveness of gabapentin
with naproxen sodium is at least somewhat established. Botulinum toxin has also shown
to be moderately beneficial, although more research is required to determine its function
in migraine prevention. Candesartan, Lisinopril, atenolol, metoprolol, nadolol, fluoxetine,
magnesium, vitamin B2 (riboflavin), coenzyme Q10, and hormone therapy are supported
by a small body of research in migraine prophylaxis.[41]

21
 CHAPTER 03
MATRERAIL AND METHDOLOGY

22
 3. MATERIAL AND METHODOLOGY:
3.1 STUDY DESIGN:

An observational, descriptive, and cross-sectional investigation was conducted by

distributing questionnaires to students at the University of Lahore Gujrat Campus and to
the resident of Gujranwala and Gujrat. The learning about their degree of knowledge and
awareness regarding migraine, the awareness of migraine was projected using
prospective approach, in the specified time frame.

3.2 SAMPLE SOURCE AND TIME FRAME:

Students of University of Lahore Gujrat Campus and patient from Gujranwala and Gujrat
were sample source. Date were collected from 1 Sep 2022 to 2 Jan 2023. Sample size
includes 32 questionnaires. Data of 110 participants was obtained.

3.3 INCLUSION AND EXCLUSION CRITERIA:

All the participants within the age limit of 10 to above 50 years of age were included in
study. Participants below and above this age limit were excluded. Old and newborns were
also excluded from study.

3.4 DATA COLLECTION:

Awareness of migraine was predicted among the students and female participants of
Gujranwala and Gujrat during the time frame of study. Socio-demographic information,
knowledge, attitude and practice of participants were recorded. All the participants that
falls in the inclusive criteria were included in the study. Practice includes experience of
migraine, frequency of migraine, pain sensation, cause, preferred treatment and
recommendation.

3.5 DATA COLLECTION INSTRUMENTS:

Data collection instruments used for collecting date were closed-ended questionnaires.
The questionnaires contain four sections. The first section contains the socio-
demographic information. These were Gender, Age, Education and Weight. Second
section was about the general knowledge about migraine. Third section was about the
attitude and causes of migraine. Fourth section was about practice and experience.
Overall questionnaires consist of 32 questions. 9 out of 32 questions were having option
of YES/NO while other contains multiple options respectively.. The time of interview
was approximately 5 to 15 minutes.

23
3.6 DATA COLLECTION METHODS:

 Questionnaires were circulated among university students and patients from

Gujranwala and Gujrat.
 Patients suffering from migraine were interviewed to check there knowledge
regarding migraine.
3.7 DATA COLLECTION SCALES:

 Certain numerical values were used to express age, weight, gender and marital status.
 Response to questionnaires was also monitored.
 Percentage and frequencies was used to describe the awareness among individuals.
3.8 STATISTICAL DESIGN:

3.8.1 DATA ANALYSIS:

Date collected in study was analyzed using excel. Descriptive analysis was used for
statistical evaluation i.e. frequency and percentage of migraine in female, frequency and
percentage of people in age of 10-50 who experienced migraine.

3.8.2 ETHICAL APPROVAL:

Research Ethics Committee (REC), Department of Pharmacy, and University of Lahore

Gujrat Campus ethically approved this study.

24
CHAPTER 04
RESULTS

25
4.1. DEMOGRAPHICS

4.1.1. Marital Status

Data collection showed that among 110 participants, 4% (4) are divorced, 20% (22) are
married, 75% (83) are single 1% (1) are widowed.

80 75

70
Marital Status Of Participants(%)

60

50 Divorced
Married
40
Single

30 Widowed

20
20

10
4
1
0

Figure 4.1.1: Marital status among participants

26
4.1.2. Age

Among 110 participants 15% (16), are the age of 10-20, 61% (67) are the age of 20-29,
9% (10) are the age of 30-39, 11% (12) are the age of 40-49 and 5% (5) are the age of
above 50.

70

61
60
Age wise dristribution in participants(%)

50

10 – 20
40
20 – 29
30 – 39
30
40 – 49
Above 50
20

10
15
9 11
5
0

Figure: 4.1.2. Age-wise distribution among participants

27
4.1.3. Occupation

Among 110 participants, business women were 5% (5), housewives were 12% (13),
illiterate was 8% (9), others were 3% (3), students were 65% (72) and teachers were 6%
(7).

70

65
60
Occupation Wise Distribution(%)

50
Business woman
Housewife
40
Illiterate
Others
30
Student
Teacher
20

10
12
8
5 3 6
0

Figure 4.1.3. Occupation among participants

28
4.2. PREVALENCE

4.2.1. Frequency of Migraine Headache among Participants (%)

Among 110 participants, all-time migraine headaches were 0% (0), daily 31% (34),
monthly 51% (56), none 5% (5), and yearly 14% (15).

60
Frequency of Migraine Headache amoung

50
51

40
All time
Participants(%)

Daily
30 Monthly
31
None
Yearly
20

10 14

0 5
0

Figure 4.2.1: Frequency of Migraine Headache among Participants (%)

29
4.2.2. Regular Headaches per Month among Participants (%)

Among 110 participants, regular headaches from 12-24 hours were 5% (6), regular
headaches from 3-4 hours were 27% (30), regular headaches from 5-12 hours were 22%
(24) and regular headaches not more than 2 hours were 45% (50).

50
45
45
Reguler Headacher Per Month among Participants (%)

40

35

30 12-24 hours
27
3-4 hours
25
22 5-12 hours
20 Not more than 2 Hours

15

10
5
5

Figure 4.2.2: Regular Headaches per Month among Participants

30
4.2.3. Frequency of Migraine Headache after Taking Medicine among
Participants (%)

Among 110 participants, migraine headaches lasted from 12-24 hours 8% (9), migraine
headaches lasted from 3-4 hours 26% (29), migraine headaches lasted from 5-12 hours
10% (11), migraine headaches lasted not more than 2 hours were 37% (41), migraine
headache lasts from several days or longer were 5% (5) and with no migraine headache
were 14% (15) .

40
37

35
Frequency of Migraine Headache after Taking

30
Medicine among Participants(%)

26 12-24 Hours
25 3-4 Hours

5-12 Hours
20
No more than 2 hours

15 14 None

10 Several days 1 week or longer

10 8

5
5

Figure 4.2.3: Frequency of Migraine Headache after Taking Medicine among

Participants

31
4.2.4. Frequency of pain in migraine headaches among Participants (%)

Among 110 participants, that have mild pain were 35% (39), moderate pain were 15%
(17) and severe pain were 49% (54).

60
Frequency of pain in migraine headaches among

49
50

40
35
Participants (%)

Mild
30 Moderate
Severe

20
15

10

Figure 4.2.4: Frequency of pain in migraine headaches among Participants

32
4.2.5. Frequency of pain in migraine headaches (%)

Among 110 participants, migraine headache on behind both eyes were 30% (33),
migraine headache on behind the left eye were 14% (15), migraine headache on behind
the right eye were 12% (13), migraine headache on bilateral side were 20% (22),
migraine headache on unilateral side were 17% (19) migraine headache with not specific
side were 7% (8).

35

30
Frequency of pain in migraine headaches (%)

30

25
Behind both eyes
20 Behind the left eye
20
17 Behind the right eye
Bilateral
15 14
Unilateral
12
None
10
7

Figure 4.2.5: Frequency of pain in migraine headaches

33
4.2.6: Age of participants when migraine started (%)

Among 110 participants, migraine headaches started from 10-20 age was 46% (51),
migraine headaches started from the age of 20-29 were 35% (38), migraine headaches
started from the age of 30-39 were 12% (13), migraine headache started from the age of
40-49 were 2% (2), and migraine headache started from the age of above 50 were 5% (6).

50
46
Age of participants when migraine started (%)

45

40
35
35
10 – 20
30
20 – 29
25 30 – 39
40 – 49
20
Above 50
15
12
10
5
5
2
0

Figure 4.2.6: Age of participants when migraine started

34
4.2.7: Description of migraine headache by participants (%)

Among 110 participants, 41%(45) describe as Ache/pressure, 5%(6) describe as Dull,

21%(23) describe as a tight band and 33%(36) describe as Throbbing/pounding.

45
41
40
Description of migraine headache by

35 33

30
participants (%)

Ache/pressure
25
Dull
21
Like a tight band
20
Throbbing/pounding
15

10
5
5

Figure 4.2.7: Description of migraine headache by participants

35
4.2.8. Patients awaken at night due to migraine headaches (%)

Among 110 participants, people awaken all-time was 4 %( 4), people never awaken was
18 %( 20), people awaken occasionally was 44 %( 48), and the people who awaken often
was 35 %( 38).

50

45 44
Patients awaken at night due to migraine

40
35
35
headaches (%)

30 All time
Never
25
Occasionally
20 18 Often

15

10

5 4

Figure: 4.2.8: Patients awaken at night due to migraine headaches

36
4.2.9. GIT problems among participants (%)

Among 110 participants, 10%(9) experience diarrhea, 5%(5) experience flatulence,

44%(48) experience Nausea and 43%(47) experience vomiting.

50

45 44 43
GIT problems among participants (%)

40

35
Diarrhea
30
Flatulence
25
Nausea
20
Vomiting
15
9
10
5
5

Figure.4.2.9: GIT problems among participants

37
4.2.10. Optic problems among participants (%)

Among 110 participants, 10%(11) experience colored lights, 20%(22) experience eyelid
droops, 19%(21) experience loss of vison and 30%(33) experience sparkling/flashing.

35

30
30
Optic problems among participants (%)

25

20 Colored lights
20 19
Eyelid droops
Loss of Vision
15
Sparkling/flashing
10
10

Figure 4.2.10: Optic problems among participants

38
4.2.11. CNS problems among participants (%)

Among 110 participants, 37%(41) experience difficulty concentrating, 18%(20)

experience loss of consciousness, 14%(15) experience numbness, 19%(17) experience
speech difficulty and 14%(15) experience weakness of arm or leg.

40
37

35
CNS problems among participants (%)

30

Difficulty concentrating
25
Loss of consciousness
20 18 Numbness/tingling
17
Speech difficulty
15 14 14
Weakness of arm or leg

10

Figure 4.2.11: CNS problems among participants

39
4.2.12. Problem faced by participants during travelling (%)

Among 110 participants, 08%(09) experience difficulty in bright sunshine, 22%(24)

experience problem from certain smells or perfumes 21%(23) experience fatigue and
41%(45) experience from loud noise.

45
41
40
Problem faced by participants during

35

30
Bright Sunshine
travelling(%)

25 22 Certain smells or perfume

21
20 Fatigue
Loud noise
15

10 8

Figure 4.2.12: Problem faced by participants during travelling

40
4.2.13. Migraine Getting Worse among Participants with (%)

Among 110 participants, 3%(09) experience while drinking beer, 29%(32) experience
from cheese 54%(59) experience no specific idea and 4%(4) experience from other
things.

60
54

50
Migraine Getting Worse among
Participent with(%)

40 Beer
Cheese
29
30 Chocolate
None
20 Others

11
10
3 4

Figure 4.2.13: Migraine Getting Worse among Participants

41
4.2.14. Method makes migraine headache better among participants
(%)

Among 110 participants, 26%(29) feel better in darkness, 7%(8) feel better from exercise
57%(52) feel better with 12%(12) feel better from quite the things and 3%(3) have no
specific idea.

60

52
Method makes migraine headache better

50
among participants (%)

40 Darkness
Exercise
30 26 None
Quiet
20 Rest

12
10 7
3

Figure 4.2.14: Method makes migraine headache better among participants

42
4.2.15. Variation of Migraine in Female Participants (%)

Among 110 participants, 67 %( 74) experience change while their menstrual periods, 12
%( 13) experience change while their pregnancy, and 21 %( 23) experience change with
hormonal drugs.

80

70 67
Variation Of Migraine in Female

60
Participent(%)

50
o Menstrual periods
40 o Pregnancy
Other hormonal drugs
30
21
20
12
10

Figure 4.2.15: Variation of Migraine in Female Participants

43
4.2.16. Migraine duration without taking medication (%)

Among 110 participants, migraine headaches lasted from 12-24 hours 34% (37), migraine
headaches lasted from 3-4 hours 17% (19), migraine headaches lasted from 5-12 hours
15% (16), migraine headaches lasted not more than 2 hours were 28% (31), and migraine
headache lasts from several days or longer were 5% (6).

40

35 34
Migraine duration without taking

30 28
12-24 Hours
medication (%)

25
3-4 Hours
20 17 5-12 Hours
15 No more than 2 hours
15
Several days 1 week or longer
10
6
5

Figure 4.2.16: Migraine duration without taking medication

44
4.2.17. Family member with migraine headache among participants (%)

Among 110 participants, 68% have migraine headaches in their family members and 32%
do not have migraine headaches in their family members.

Family member with migraine headache

among participants (%)

32

No
Yes

68

Figure 4.2.17: Family member with migraine headache among participants

45
4.2.18. Relation to the family member (%)

Among 110 participants, 15% (16) were brothers, 16% (18) were fathers, 26% (29) were
mothers and 22% (24) were sisters.

30
26
Relationship to participants among

25
22

20
Participants(%)

Brother
16
15 Father
15
Mother
Sister
10

Figure 4.2.18. Relationship to participants among Participants

46
4.2.19. Head or neck injury among participants (%)

Among 110 participants, 19% (21) have head or neck injuries and 81% (89) do not have
head or neck injuries.

Head or neck injury among participants

(%)

19

No
Yes

81

Figure 4.2.19: Head or neck injury among participants

47
4.2.20. Other medical disorders among participants (%)

Among 110 participants, 5%(6) diagnosed with asthma, 5%(6) diagnosed with gastric
ulcers, 9%(10) diagnosed with heart disease, 18%(20) diagnosed with HPT, and 62%(68)
have no other health disorder.

70
62
Other medical disorders among participants

60

50
Asthma
40 Gastric ulcers
(%)

Heart disease
30 High blood pressure
None
20 18

9
10
5 5

Figure 4.2.20. Other medical disorders among participants

48
4.2.21. Migraine headache diagnosed by neurologist (%)

Among 110 participants, 55% did not evaluate their migraine headaches by neurologist
and 45% evaluate their migraine headaches by a neurologist.

Migraine headache diagnosed by

neurologist (%)

45 No
55 Yes

Figure 4.2.21: Migraine headache diagnosed by a neurologist

49
4.2.22. Differential Diagnosis among Participants (%)

Among 110 participants, 4%(4) was diagnosed with cluster headache, 42%(46) was
diagnosed with migraine headache, 34%(37) was diagnosed with other disorder ,and
21%(23) was diagnosed with tension type headache.

45
42
40
Differential Diagnosis among

35 34
Participants (%)

30
Cluster
25 Migraine
21
20 Other
Tension-type
15

10

5 4

Figure 4.2.22: Differential diagnosis among Participants

50
4.2.23. Participants treated with Botox (%)

Among 110 participants, 12%(13) were treated with botox injections, and 88%(97) were
not treated with botox injections.

Participants treated with Botox (%)

12

No
Yes

88

Figure 4.2.23: Participants treated with Botox

51
4.2.24. Working of Botox Injection (%)

Among 110 participants, it works in 25%(28) ,but in 75%(82) it does not work.

Working of Botox Injection (%)

25

No
Yes

75

Figure 4.2.24. Working of Botox Injection

52
4.2.25. Diagnostic tests for migraine among participants (%)

Among 110 participants, 3% (3) people experienced all test, 10% (11) people
experienced CT scan test, 15% (17) people experienced MRI test, 67% (74) people
experienced X-ray test, and 5% (5) people does not experienced any test.

80

70 67
Diagnostic tests for migraine
among participants (%)

60

All
50
CT scan
40 MRI
None
30
X-ray

20 15
10
10 5
3
0

Figure 4.2.25: Diagnostic tests for migraine among participants

53
4.2.26. Prescription drugs Taken by Participants (%)

Among 110 participants, 51% (56) take prescription drugs and 48% (53) do not take
prescription drugs.

Prescription drugs Taken by Participants (%)

No
48
51 Yes

Figure 4.2.26: Prescription Drugs Taken by Participants

54
4.2.27. OTC Drugs Taken by Participants (%)

Among 110 participants, 51% (56) take OTC drugs and 48% (53) do not take OTC drugs.

OTC Drugs Taken by Participants (%)

No
48
51 Yes

Figure 4.2.27. OTC Drugs Taken by Participants

55
4.2.28. Frequency of OTC medication consumed by participants (%)

Among 110 participants, 40% (44) participants consumed OTC 10 times, 11% (12)
participants consumed OTC 20 times, 3% (3) participants consumed OTC 30 times, 45%
(50) participants does not consume OTC, and 1% (01) participants consumed OTC 40
times.

50
45
45
40
consumed by participants (%)
Frequency of OTC medication

40

35
10 time
30 20 time
25 30 time

20 None
o 40 time
15
11
10

5 3
1
0

Figure 4.2.28: Frequency of OTC medication consumed by participants

56
4.2.29. Impact of migraine headache on quality of life among
participants (%)

Among 110 participants, 41% (45) were extremely affected, 26% (29) were moderately
affected, 8% (9) were not at all and 25% (27) were very little affected.

45
41
40
Impact of migraine headache on

35
quality of life among

30
participants(%)

26 Extremely
25
25 Moderately

20 Not at all
Very little
15

10 8

Figure 4.2.29: Impact of migraine headache on the quality of life among participants

57
4.2.30. OTC Drugs Used taken Participants (%)

Among 110 participants, 8% (9) used Aspirin, 23% (25) used Ibuprofen, 34% (37) used
Naproxen, 33% (36) used Paracetamol, and 1% (1) used Ponston.

40

35 34 33
Aspirin(Disprin)
OTC Drugs Used taken

30
Participants(%)

Ibuprofen(Brufen)
25 23
Naproxen (Synflex)
20

15 Paracetamol(Panadol)

10 8 Ponston (Mefenamic
Acid)
5
1
0

Figure 4.2.30.OTC Drugs taken by Participants

58
4.2.31. Home remedies utilized by participants (%)

Among 110 participants, 7% (8) used Coffee/Tea to treat migraine 3% (3) take rest to
treat migraine and 90% (99) did not use any remedy.

100
90
90

80
Home Remedies utilized by

70
participants (%)

60
Coffee/Tea
50 Rest
None
40

30

20

10 7
3
0

Figure 4.2.31: Home Remedies utilized by participants

59
4.2.32. Medicine prescribed by physician after diagnosis of migraine (%)

Among 110 participants, 12% (13) prescribed Almotriptan, 14% (15) prescribed
Sumatriptan, 22% (24) prescribed Zolmitriptan, and 53% (58) does not prescribe any of
them.

60
53
Medicine prescribed by physician after

50
diagnosis of migraine

40
Almotriptan(Axert)
NONE
(%)

30
Sumatriptan(Sumatec)
22
Zolmitriptan(Zomip)
20
14
12
10

0
Figure 4.2.32: Medicine prescribed by physician after diagnosis of migraine

60
CHAPTER 05
DISCUSSION

61
5. Discussion:
According to our research, 34% of people in the Gujrat and Gujranwala divisions suffer
from migraines. 37 of the 110 participants had either recently acquired a diagnosis of
migraine or had a migraine diagnosis. According to the study, patients' most common
symptoms after a migraine attack were nausea and vomiting. Additionally, a sizable
portion of individuals mentioned having visual difficulties that were accompanied by
dazzling or flashing sensations, which suggests that optic issues are very common in
connection with migraines. According to the study's findings, migraine sufferers
frequently struggle to concentrate, which suggests that the central nervous system (CNS)
is involved during migraine attacks. In addition, the study found that a prevalence rate of
41% of participants (45 out of 110 people) said that loud noise was a significant migraine
trigger. This shows that in those who are susceptible, contact with loud noises frequently
triggers migraine attacks. According to the data gathered for this study, migraine
sufferers who eat cheeses or chocolates are more probable to have more frequent attacks
than non-consumers. The results also showed that sleep is important in preventing
migraine headaches since exposure to sunlight and loud noises might make them worse.
With a prevalence rate of almost 67% (74 out of 110 participants) reporting migraines as
they relate to their cycles of menstruation the menstrual cycle was found to be a
significant trigger for migraine headaches in female participants.

According to the research's results, those who used their migraine medicine had a
considerable decrease in the time that migraine episodes lasted, with most attacks ending
in 2 to 3 hours. Nevertheless, those who skipped their medicine experienced worsening
migraines that might persist approximately a week. The study also showed a significant
frequency of migraines in participants' families, with almost 68% of those surveyed
reporting a migraine history. Additionally, it was discovered that people with
hypertension were more likely to suffer from migraines. In addition, the study showed
that participants were unaware of migraine headaches because so few of them had sought
medical attention. In this study, zolmitriptan and sumatriptan were the drugs that doctors
recommended for migraine sufferers. However, a significant portion of individuals
utilized the OTC medication naproxen to alleviate their migraines. According to the
study's results, cerebral and meningeal artery spasms may contribute to migraine attacks.
It is hypothesized that the various elements that have been designated as suspected
migraine triggers do so by operating on a mechanism that is prevalent. So, the issue is
brought up. Even so. There is no proof that certain migraine symptoms are brought on by
a vasomotor mechanism that regulates the artery system in other parts of the body, such
the cerebral arteries. The following can be used to summarize these suggestions.
Migraines almost often occur in those who are more susceptible by a neuropathic gene.

62
In order to achieve the best therapeutic results for treating migraines, a thorough history
examination is necessary. Few illnesses, in my opinion, warrant as much time spent
understanding them from a therapeutic standpoint as migraines. The patient's everyday
activities is carefully examined as part of the first phase in treatment, and any evident
stimuli that may be causing the migraines are found and addressed. The doctor may
uncover intriguing details throughout the history investigation that the individual in need
may have missed or suppressed, and the sufferer themselves may disclose specific
situations that they found out from experience can cause a migraine attack. It is crucial to
evaluate the patient's mental health and try to reduce any worry as much as you can.
Recently, peptone therapy has produced encouraging outcomes. With special emphasis
on the first one, medications like Luminal, bromides, and nitrites are frequently
beneficial. It is typically advised to take 1J grains before bed, but for these treatments to
be fully effective, it is important to take them consistently over time.

Ophthalmologic migraines must be mentioned when considering migraines from an

ophthalmological standpoint. Giibler and Saundby both documented cases of recurrent
ocular palsy after migrainous headache attacks in 1860 and 1882, respectively. Möbius
carried out a thorough examination of the situation in 1884, offering important insights.
Ophthalmologic migraine is the word Charcot coined to characterize this condition. It is
important to recognize these scholars' historical contributions to our understanding and
characterization of ophthalmologic migraines. Ophthalmologic migraine headaches in
these circumstances are often more intense than regular migraine headaches and might
linger for many days. An ocular palsy begins to appear when the headache goes away and
usually goes away in a few hours. Although rarely the fourth and sixth cranial nerves may
also be damaged, the third cranial nerve is most frequently impacted. Although the
precise underlying etiology of migraines is still unknown, there is frequently evidence
that inherited factors play a role. Farquhar Buzzard agreed with the hypothesis that
epilepsy might be a symptom of instability in a significant brain process that is either
linked to or overlaps with the vasomotor system at a recent Lettsomian Lecture.
According to Farquhar Buzzard's idea, a particular proportion of individuals has a
permanent neurological disease that causes epileptic fits as one of its external symptoms.
A similar notion that suggests migraine sufferers have a persistent underpinning
condition of neural instability in the system is applicable to migraines. The pathology of
migraines is still little understood, therefore treatment methods are still empirical and
mostly symptom-focused. Medications including luminal, bromides, and nitrites have
proven help in some circumstances, but it is frequently necessary to conduct experiments
in order to find the best course of action for each patient. It is crucial to identify and get
rid of triggers including eye strain, certain foods, prescription drugs, and psychological
problems. Although some patients may find comfort from correcting their refractive and
balance disorders, Buzzard thinks that the advantages of these treatments have been
overstated, even when they are carried out with the utmost care.
63
CONCLUSION:-
Migraine is one of the most common neurological conditions and is the third most
common disabling disorder globally; yet, up to 50% of sufferers do not receive medical
care. Women are disproportionately affected by a ratio of 3:1, in part due to hormonal
differences with changes in estrogen appearing to be the main driver. Many other factors,
including serotonin, prostaglandins, and central processing, appear to play an important
role in the pathophysiology of migraine and discussing risks and benefits with patients
are essential parts of pharmacological treatment. Stroke is associated with migraine,
particularly in women with migraine with aura, and hormone use is currently not
recommended in this subtype. To improve our care of patients, more studies need to be
done to expand our knowledge of migraine in women, including hormonal effects on the
pathogenesis of migraine and stroke.

64
RECOMMENDATIONS:-
 Data were obtained from one District, and the next studies needed data collected from
all over the province or country for a more precise study.
 Further studies are needed with proper time duration for the collection of data.
 Proper awareness should be provided about the use of Migraine.
 Don’t take any medication without doctor’s recommendation.

65
LIMITATIONS:-
 Our research has some limitations, as it was conducted through a survey of limited
hospitals so for proper evaluation all hospitals should be surveyed
 Our sample population excluded those people residing in different cities of except
Gujranwala and Gujrat.
 Our sample have only female participants.

66
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68
ANNEXURE

69
 CONSENT FORM
You are invited to participate in a research study conducted by Muhammad Ismail.
The purpose of this research is to evaluate the “Prevalence of Migraine in Females
in District Gujranwala and Gujrat”

Risks and Discomforts

Mention if there will be any known risks associated with this research.

Potential Benefits
Mention if there will be benefits to the participant that would result from their
participation in this research.

Protection of Confidentiality
We will do everything we can to protect your privacy. Your identity will not be revealed
in any publication resulting from this study.

Voluntary Participation
Your participation in this research study is voluntary. You may choose not to participate
and you may withdraw your consent to participate any time. You will not be penalized in
any way should you decide not you participate or to withdraw from this study.

CONSENT
I have read this consent form and have been given the opportunity to ask
questions. I give my consent to participate in this study.

Participant’s Signature __________________ Date: ____________________

70
 ‫تحقیق میں شرکت کا دعوت نامہ‬

‫عنوان‪:‬‬

‫نقصانات اور تکلیف‪ :‬اس تحقیق سے کسی قسم کے نقصان یا تکلیف کا اندیشہ نہیں ہے ۔‬

‫ممکنہ فوائد‪ :‬آپکو ایک اہم تحقیق میں حصہ لینے کا موقعہ دیا جاۓ گا۔‬

‫رازداری کا تحفظ‪ :‬ہم آپ کی معلومات کے تحفظ کے لیے وہ سب کچہ کریں گے جو ہم کر سکتے ہیں۔ تحقیق‬
‫کے متعلق اکٹہی کیی گیی تمام معلومات کو انتہا ئی خفیہ رکھا جاے گا۔ ڈیٹا انٹری اور تجزیے کے دوران آپ‬
‫کے متعلق وہ تمام معلومات جن سے آپ کی شناخت ہو سکتی ہو کو ختم کر دیا جاے گا۔ اس تحقیق کے نتیجے‬
‫میں شائع ہونے والی کسی بھی اشاعت میں آپ کی شناخت کو ظاہر نہیں کیا جاے گا۔‬

‫رضاکارانہ شمولیت‪ :‬اس تحقیقی مطالعہ میں آپ کی شرکت رضاکارانہ ہے۔ آپ کو شرکت نہ‬
‫کرنے اور کسی بھی وقت پغیر وجہ بتانے اس تحقیق میں شمولیت کو چھوڑنے کا اختی ار ہے۔‬
‫شرکت نہ کرنے یا اس میں شمولیت کو چھوڑنے کی صورت میں آپ کے خ الف کوئی کاروایی‬
‫نہیں کی جاے گی‬
‫درجذیل معلومات تحقیق میں شامل ہونے والوں کے لیے پڑھیں اور ان کا جواب دیے گیے خانوں میں درج‬
‫کریں۔‬
‫‪‬‬ ‫میں نے معلوماتی شیٹ جو کہ تحقیق کی وضاحت کر رہی ہے کو سمجھ لیا ہےاورمجھے تحققیق کے‬
‫سواالت کرنے کا موقع دیا گیا تھا۔‬
‫‪‬‬ ‫میں سمجھ گیا‪/‬گیی ہوں کہ میری شرکت رضاکارانہ ہے اور یہ کہ میں کسی بھی وقت اپنا ارادہ بدل سکتا‪/‬سکتی‬
‫ہوں اور تحقیق سے دستبردار ہو سکتا‪/‬سکتی‬
‫‪‬‬ ‫میں سمجھ گیا‪/‬گیی ہوں کہ میرے جوابات خفیہ رکھے جاءیں کے۔ میں محقیقیین کو اس بات کی اجازت دیتا‪/‬دیتی‬
‫ہوں کے وہ جوابات کو جانچ سکیں۔‬
‫میں سممجھ گیا‪/‬گی ہوں کے معلومات میرے نام کے بجاے نمبر کی صورت میں محفوط کی جائیں گی۔ تا کہ ‪‬‬
‫میں نتائج کی اشاعت کے دوران کسی بھی طرح سے شناخت نہ کیا جا سکوں۔ میں اس بات سے رضامند ہوں‬
‫کے جو معلومات مجھ سے لی جائہیں گی وہ تحقیق میں استعمال ہوں گی۔‬
‫میں اوپر بتایی گی تحقیق میں شامل ہونے کے لیے رضامند ہوں اور محقیقین کو اپنا پتہ تبدیل ہونے کی صورت ‪‬‬
‫میں مطلع کروں گا‪/‬گی۔‬

‫رضا مندی‪:‬میں نے یہ اجازت نامہ پڑھا ہے اور مجھے سوال پوچھنے کا موقع دیا گیا ہے۔‬
‫میں اس سٹڈی میں شرکت کے راضی ہوں۔‬

‫تاریخ _______‬ ‫دستخط____________________‬ ‫شرکت کنندہ کا نام _____________‬

‫اجازت لینے والے کا نام ________________ دستخط ____________تاریخ ____________۔‬

‫‪71‬‬
 : Health Status Survey Questionnaire:
The purpose of this form is to obtain a report of your state of health. This form is
designed to be completed by yourself and does not require a doctor’s signature. The
answer you give us will be hidden from anyone. Therefore, it is very important that you
give an accurate answer to these questions. Do you have a minute to answer these
questions?

Age:

o 20 – 29

o 30 – 39

o 40 – 49

o 50 – 59

o 60 – 69

o Above 70

Gender:

o Female

o Male

Marital Status:

o Married

o Single

o Divorced

o Widowed

Occupation:

o Housewife

o Student

o Teacher

o Illiterate

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o Business man/woman

: Check all the questions carefully and mark the correct one:
1. What frequency of migraine headaches do you experience?

o Daily

o Monthly

o Yearly

o None

o All time

2. How many regular headaches do you have per month?

o No more than 2 hours

o 3-4 hours

o 5-12 hours

o 12-24 hours

3. How long do your migraine headaches usually last after you take your
migraine medicine?

o No more than 2 hours

o 3-4 hours

o 5-12 hours

o 12-24 hours

o Several days 1 week or longer

4. How painful are your migraine headaches?

o Mild

o Severe

o Moderate

73
5. Where are your migraine headaches usually located?

o Behind the right eye

o Behind the left eye

o Behind both eyes

o Bilateral

o Unilateral

o Other

6. How old were you when your migraine headaches started?

o 20 – 29

o 30 – 39

o 40 – 49

o 50 – 59

o 60 – 69

o Above 70

7. How would you describe your migraine headaches?

o Throbbing/pounding

o Ache/pressure

o Like a tight band

o Dull

o Other

8. Do your migraine headaches awaken you at night?

o Never

o Occasionally

o Often

o All time

74
9. Did you ever experienced GIT problems?

o Nausea

o Vomiting

o Diarrhea

o Flatulence

10. Did you ever-experienced optic problems?

o Eyelid droops

o Loss of vision

o Sparkling/flashing

o Colored lights

o None

11. Did you ever-experienced CNS problems?

o Numbness/tingling

o Weakness of arm or leg

o Difficulty concentrating

o Speech difficulty

o Loss of consciousness

12. Did you ever experience one of these problems during traveling?

o Fatigue

o Certain smells or perfume

o Loud noise

o Bright Sunshine

o None

13. Did you experience your migraine getting worse?

o Chocolate

75
o Cheese

o Beer

o Other

o None

14. Which method makes migraine headaches better?

o Rest

o Exercise

o Quiet

o Darkness

o None

15. How long do your migraine headaches usually last if you do not take your
migraine medicine?

o No more than 2 hours

o 3-4 hours

o 5-12 hours

o 12-24 hours

o Several days 1 week or longer

16. Do your migraine headaches change with the following?

o Menstrual periods

o Birth control pills

o Pregnancy

o Other hormonal drugs

17. Do any of your family members have migraine headaches?

o No

o Yes

76
18. Relation to the family member:

o Brother

o Sister

o Father

o Mother

19. Have you ever had a head or a neck injury?

o No

o Yes

20. Have you ever been diagnosed to have any health disorder?

o High blood pressure

o Asthma

o Heart disease

o Gastric ulcers

21. Have you had your migraine headaches evaluated by a neurologist?

o No

o Yes

22. What was the diagnosis?

o Migraine

o Tension-type

o Cluster

o Other

23. Have your migraines been treated with Botox?

o No

o Yes

77
24. Did the Botox treatment work?

o No

o Yes

25. Which test you have experienced for your migraine headaches:

o CT Scan

o MRI

o X-ray

o None

o All

26. Are you taking any prescription drugs to treat your migraine headaches?

o No

o Yes

27. Are you taking any OTC drugs to treat your migraine headaches?

o No

o Yes

28. How many times in the last month have you used the over-the-counter
medications?

o 10 time

o 20 time

o 30 time

o 40 time

o None

29. To what extent do your migraine headaches affect your quality of life?

o Extremely

o Moderately

78
o Very little

o Not at all

30. Which OTC drug you used to treat your migraine headaches?

Ibuprofen(Brufen) Naproxen (Synflex) Aspirin(Disprin) Paracetamol(Panadol)

31. Are you taking any home remedy to treat your migraine headaches?

Yes

No

32. After the diagnosis which Medicine is prescribed by your physician?

Sumatriptan(Sumatec)

Zolmitriptan(Zomip)

Almotriptan(Axert)

NONE

Other

79
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