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1
Priest, R. G. "Hospital Beds for Psychiatric Patients." Bulletin of the Royal College of Psychiatrists 10, no. 11 (November 1986): 322–23. http://dx.doi.org/10.1192/s0140078900023518.
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Members write to the College asking for guidance on planning services for psychiatric patients, and in particular on the desirable level of provision of hospital beds. At the request of the Executive and Finance Committee I am publishing the following information, based on a letter that I wrote to Regional Advisers.
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Sharma, Bhaskkar, and Rajesh Shrestha. "Psychiatric Morbidity in Elderly Patients attending OPD of Lumbini Medical College and Teaching Hospital." Journal of Universal College of Medical Sciences 9, no. 02 (December 31, 2021): 36–40. http://dx.doi.org/10.3126/jucms.v9i02.41996.
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INTRODUCTION: Geriatric psychiatry patients are increasing but enough work has not been done in this area of Nepal. We conducted this study to find out the prevalence of different psychiatric morbidities in elderly population and to find out if there are any age and gender specific differences. MATERIAL AND METHODS: Medical records of psychiatric patients above 65 years of age visiting outpatient department of Lumbini Medical College and Teaching Hospitalfrom April 1, 2018 to March 31, 2019 were reviewed. Risks of having different psychiatric disorders was estimated using odds ratio. RESULTS: A total of 300 cases were enrolled in the study. Mean age of the study group was 71.49(SD=6.99). There were more females. Depressive disorderwas the most common diagnosis followed by somatoform disorder, anxiety disorder, dementia and others. Depressive disorder was higher in females and in younger subgroup of the elderly patient.The risk of having dementia was higher in older group. CONCLUSION: Depressive disorder was the most common psychiatric disorderfollowed by somatoform disorder in elderly patients above 65 years of age. Male patients were more likely to suffer psychiatric disorder as compared to females in this age.
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Fuhrmann, Ross, and Clare Reeder. "Personal finances for long-stay psychiatric patients resettled into the community." Psychiatric Bulletin 20, no. 4 (April 1996): 215–17. http://dx.doi.org/10.1192/pb.20.4.215.
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It is important to ensure that the financial provision received by the long-stay psychiatric population is maintained as their care is relocated from hospitals to the community. A survey of the provision made by the 20 community homes to which Horton Hospital patients have been resettled was conducted. Comparison with the provision received by patients prior to resettlement revealed that the clothing allowance provided for patients without savings in Horton is often not maintained in the community and that resettled patients receive widely differing and frequently much smaller provision for clothing.
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Iqbal, Yousaf, Peter Haddad, Javed Latoo, Majid Alabdulla, Sultan Albrahim, Rajeev Kumar, and Ovais Wadoo. "Psychiatric presentations of patients with COVID-19: a retrospective review of 100 consecutive patients seen by liaison psychiatry services." BJPsych Open 7, S1 (June 2021): S257—S258. http://dx.doi.org/10.1192/bjo.2021.688.
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AimsCoronavirus disease 2019 (COVID-19) is associated with higher rates of psychiatric morbidity due to various factors, including quarantine, social isolation, stigma, financial difficulties and direct and indirect central nervous system impact of severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2).This study aimed to describe the psychiatric morbidity of patients with COVID-19 referred to liaison psychiatry services in Qatar.MethodThis study was a retrospective review of patient records of the first 100 consecutive SARS-Cov-2 positive patients referred to liaison psychiatry services. The study was approved by the Hamad Medical Corporation Institutional Review Board (IRB) (MRC-05–072). Data were analysed using descriptive statistics.ResultThe majority (n = 92) of 100 included patients were male and median age was 43 years. Patients were of diverse background with majority of South Asian (Indian, Pakistani, Bengali, Nepalese, and Afghan) (n = 60), followed by Qatari (n = 18) background. Mean length of hospital stay was 26.51 days.35 patients had severe or critical COVID-19 pneumonia, and 67 had at least one underlying physical comorbidity. Significant psychosocial stressors other than positive SARS-Cov-2 status, including lockdown, quarantine, finances and relationships issues were identified in 48 patients.A total of 35 patients had a positive past psychiatric history, out of which 17 were on maintenance psychotropic medications. Insomnia was the commonest psychiatric symptom (n = 65), followed by anxiety (n = 52), agitation (n = 42), depression (n = 39), changes in appetite (n = 32) and irritability (n = 30). The principal psychiatric diagnoses made were delirium (n = 29), acute stress reaction or adjustment disorder (n = 25), depression (n = 16), mania (n = 15), anxiety (n = 14), non-affective psychosis (n = 13), and dementia (n = 6). Approximately half of the patients with mania or non-affective psychosis had it as their first-onset disorder.ConclusionSARS-CoV-2, in both symptomatic and asymptomatic patients, is associated with a wide range of psychiatric morbidity which emphasizes clinicians’ vigilance for psychiatric symptoms. Insomnia was the commonest neuropsychiatric symptom which may have clinical practice and potential preventive strategies implications.Delirium, the commonest diagnosis in the study carries high morbidity and mortality and may reflect SARS-Cov-2 propensity to affect the brain directly and indirectly through a cytokine storm, organ failure, and prothrombotic state. Patients can also present with new-onset mania or non-affective psychosis. It is noteworthy that about two-thirds of the patients had no past psychiatric history.This study, along with expanding body of evidence may assist with resource allocation and liaison psychiatry services planning. It also underscores the importance of designing future studies to better understand longer-term psychiatric sequelae of COVID-19.
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Nocon, Andrew, and Dylan Tomlinson. "Inter-agency collaboration in the closure of psychiatric hospitals." Psychiatric Bulletin 14, no. 11 (November 1990): 646–50. http://dx.doi.org/10.1192/pb.14.11.646.
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The needs of people with mental health problems transcend agency boundaries. Service-planning, however, has often been carried out within the confines of individual agencies. Although inter-agency collaboration has been an integral part of official policy since 1974 (DHSS, 1974), joint planning has often been limited to the allocation of centrally-earmarked joint finance (DHSS, 1976). In the ten years following the introduction of joint planning, few authorities prepared, let alone attempted to implement, any broader joint strategies.
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Masterton, George, and Anthony J. Mander. "Psychiatric Emergencies, Scotland and the World Cup Finals." British Journal of Psychiatry 156, no. 4 (April 1990): 475–78. http://dx.doi.org/10.1192/bjp.156.4.475.
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Reductions in emergency psychiatric presentations to hospital occurred during and after the finals of the World Cup football competitions, an effect evident in women as well as men, and more marked among the mentally ill than those who were not. Increases in the numbers of schizophrenic and neurotic men presenting before, and alcoholic men during, the competitions can be attributed to the football. The generalised reductions during and after could reflect an indirect effect upon help-seeking, although actual relapse rates of mental illnesses might be affected. These changes could arise from enhancement of national identity and cohesion.
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Mujic, Fedza, Maite Von Heising, Robert J. Stewart, and Martin J. Prince. "Mental capacity assessments among general hospital inpatients referred to a specialist liaison psychiatry service for older people." International Psychogeriatrics 21, no. 4 (August 2009): 729–37. http://dx.doi.org/10.1017/s104161020900917x.
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ABSTRACTBackground: Mental capacity has been little studied among older general hospital inpatients.Methods: A retrospective analysis was undertaken of routinely collected data (age, gender, ethnicity, admission diagnosis, psychiatric diagnosis, Mini-mental State Examination score, whether capacity was assessed, the outcome of that assessment, and discharge destination) on referrals to a liaison psychiatry service for older people (2003–2006) from medical and surgical teams at a large London teaching hospital.Results: 1267 patients were referred to the service, of whom 379 (30%) were assessed for capacity. The most common mental capacity issues were placement (303 assessed of whom 54% lacked capacity), treatment (86 assessed, 59% lacking capacity) and finances (70 assessed, 79% lacking capacity). Cognitive impairment, dementia and delirium, rather than mental disorders were associated with incapacity. Those assessed and deemed to lack capacity for placement decisions were twice as likely to be placed in a care home, and four times as likely to be placed in an elderly mentally ill (EMI) facility, independent of dementia diagnosis and cognitive functioning.Conclusion: Referrals to a liaison psychiatry service for older people for assessment of mental capacity are common. The main mental capacity issues in older people were those linked to discharge planning. The relatively high proportion of those found to have capacity when capacity had been queried by referring clinicians attests to the important role of specialist liaison teams, particularly in complex cases, in protecting the autonomy of vulnerable older people, and avoiding institutionalization.
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Brooker, Charles, and Paul Beard. "Psychiatric Nursing — Quo Vadis?" Bulletin of the Royal College of Psychiatrists 9, no. 4 (April 1985): 70–72. http://dx.doi.org/10.1192/s0140078900001668.
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In the last year or so the future of mental health services in this country has been intensively discussed. COHSE, MIND, and the Richmond Fellowship have produced their ‘blueprints', outlining details of the way they see services being organized. All variety of professional organizations have been busy presenting evidence to the House of Commons Social Services Committee which is specifically examining community care. The DHSS has committed more joint finance to ‘care in the community’ projects and Regional Health Authorities are examining the strategies to close large psychiatric hospitals. Consequently, District Health Authorities, in many cases, are planning the shape of a new mental health service which places increasingly less reliance on the large institution. The phrase ‘community care’ has now become so hackneyed in planning circles that for many it has lost whatever meaning it may have once had. However, despite all the rhetoric, and indeed all the planning activity, psychiatric nurses themselves have still to voice coherently their thoughts and fears about the shape of things to come.
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Sari, Seda Aybuke, Ozhan Pazarci, Seyran Kilinc, and Ayla Uzun Cicek. "Examining the Relationship Between Preventable Psychiatric Problems and Child Extremity Fractures." European Journal of Therapeutics 28, no. 4 (December 31, 2022): 279–84. http://dx.doi.org/10.58600/eurjther-28-4-0087.
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Objective: Extremity fractures (EF) are among the most common causes of admission to hospitals in children. We aimed to evaluate children treated for EFs by comparing them with the control group from a psychiatric perspective. Method: Thirty-six children aged between 3 and 17 years who administered to the Orthopedics and Traumatology clinic due to EF were included in the study. 36 children of similar age and gender with the study group were included as the control group. A child psychiatrist evaluated all children included in the study. A psychiatric diagnosis interview was conducted. The parents filled out the Conner’s Parent Rating Scale-Revised Short Form (CPRS-R:S). Results: Of the cases in the patient group, 66.7% were male. The ratio of rural residents in the patient group was higher compared to the control group. The most common fracture location was lower extremity (55.6%). The most common cause of the fracture was falling (52.8%). In the patient group, the ratio of the children who had previously experienced fracture was 36.1%. Psychopathology was detected to be at a higher level in the patient group. The most common was Attention Deficiency and Hyperactivity Disorder (ADHD). Children in the patient group scored higher on the CPRS-R:S than the control group. Conclusion: Children with EF exhibited more impulsive and hyperactive behaviours than controls and had more psychopathology. For this reason, it is essential to evaluate children who apply due to fracture in terms of psychopathology. Keywords: Extremity fracture, psychopathology, children
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Pang, A. H. T., L. C. W. Lam, and H. F. K. Chiu. "Developing psychogeriatric services in Hong Kong." Psychiatric Bulletin 19, no. 8 (August 1995): 506–8. http://dx.doi.org/10.1192/pb.19.8.506.
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Hong Kong is an international trade and finance centre situated on the southern coast of China, offering a unique blend of Western culture and Chinese tradition. With a largely private primary health care system, psychiatric services here have been predominately hospital centred. Following the 1992 Government Review of Rehabilitation Program Plan (Secretary of Health and Welfare, Hong Kong, 1992) development of community-based services has become the major local issue. Psychogeriatrics is the first sub-speciality to have achieved major progress in this area. Such a development illustrates how local psychiatrists faced the challenge of applying Western models to suit an Oriental population with a different socio-cultural value system.
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Simpson, C. J., C. P. Seager, and J. A. Robertson. "Home-Based Care and Standard Hospital Care for Patients with Severe Mental Illness: A Randomised Controlled Trial." British Journal of Psychiatry 162, no. 2 (February 1993): 239–43. http://dx.doi.org/10.1192/bjp.162.2.239.
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ObjectiveTo compare the efficacy of home based care with standard hospital care in treating serious mental illness.DesignRandomised controlled trial.SettingSouth Southwark, London.Patients189 patients aged 18–64 living in catchment area. 92 were randomised to home based care (daily living programme) and 97 to standard hospital care. At three months' follow up 68 home care and 60 hospital patients were evaluated.Main outcome measuresUse of hospital beds, psychiatric diagnosis, social functioning, patients' and relatives' satisfaction, and activity of daily living programme staff.ResultsHome care reduced hospital stay by 80% (median stay 6 days in home care group, 53 days in hospital group) and did not increase the number of admissions compared with hospital care. On clinical and social outcome there was a non–significant trend in favour of home care, but both groups showed big improvements. On the global adjustment scale home care patients improved by 26.8 points and the hospital group by 21.6 points (difference 5.2; 95% confidence interval -1.5 to 12). Other rating scales showed similar trends. Home care patients required a wide range of support in areas such as housing, finance, and work. Only three patients dropped out from the programme.ConclusionsHome based care may offer some slight advantages over hospital based care for patients with serious mental illness and their relatives. The care is intensive, but the low drop out rate suggests appreciation. Changes to traditional training for mental health workers are required.
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Ahmed, Riaz, Junaid Khan, Rahman Rasool Akhtar, and Talia Urooj. "Impact of COVID Pandemic on the Mental Well-Being of Orthopaedic Patients – A Single Centre Study." Journal of Rawalpindi Medical College 25, no. 1 (August 31, 2021): 122–25. http://dx.doi.org/10.37939/jrmc.v25i1.1683.
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Objectives:
To assess the frequency of psychiatric diseases in orthopaedic patients during the COVID-19 pandemic.
Material and methods:
This study was conducted from 20th April 2020 to 20th September 2020 at the Department of Orthopaedics, Benazir Bhutto Hospital, Rawalpindi, Pakistan. Patients aged 18 years and above and belonging to either gender with Orthopaedic injuries were included. Gender, age, injury mechanism, associated trauma, site of fracture, use of tobacco and mental health disorder was recorded.
Data was analyzed using SPSS version 23.
Results:
The study included 210 patients with Orthopaedic injuries. Mean age of patients in the study was 40.45±12.54 years. Falls were the most common mechanism of injury (50.4%) followed by motorcycle accidents (22.8%) and motor vehicle accidents (16.7%). 70.47% patients with Orthopaedic injuries were diagnosed with a mental health problem. There were notably higher rates of depression (33.1%) and anxiety (24.3%).
Conclusion:
There was a high frequency of psychiatric illnesses in Orthopaedic patients during the COVID-19 pandemic.
Keywords:
COVID-19, mental well-being, orthopaedic injuries, psychiatric illness.
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Alshammari, Shahd, and Abrar Alshammari. "Female Representation in the Golden Age of Kuwaiti Television." Middle East Journal of Culture and Communication 14, no. 1-2 (September 28, 2021): 68–80. http://dx.doi.org/10.1163/18739865-01401003.
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Abstract This paper addresses the representation of female rebellion and madness in the Kuwaiti musalsal ʿIla al-dunya al-salam which was produced in 1987. The show revolves around two sisters, Mahthootha and Mabrooka, adult women who are residents of a mental institution. The law dictates that their uncle is their guardian and has complete control of their finances. He devises a plan to strip them of their rights and their inheritance by committing them to the psychiatric institution. At the hospital, the audience meets many women with similar fates. The stereotypes of madness present it as dangerous and as affecting more women than men. Male domination features as a recurrent theme throughout, as all the male characters abuse their power, whether in the form of familial or medical authority. The dichotomy of sane/insane is reversed as the characters outside the hospital are cruel, corrupt and yet empowered due to social factors, gender and class. The series raises important questions and considers patriarchal oppression and Kuwaiti women’s experience in both the private and public spheres.
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Tong, K., C. Har, H. Kennedy, and M. Davoren. "Decision-making capacity regarding healthcare, welfare and finances in a secure forensic setting." European Psychiatry 65, S1 (June 2022): S349—S350. http://dx.doi.org/10.1192/j.eurpsy.2022.888.
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Introduction Impairment in decision-making capacity is a serious consequence of executive dysfunction secondary to serious mental disorders like schizophrenia. Functional mental capacity (FMC) refers to an individual’s ability to make and communicate legally competent decisions autonomously. Studies have shown that FMC is dependent on severity of psychosis and can improve with treatment. Objectives To ascertain the correlation between the scores on a structured judgement tool, namely the Dundrum Capacity Ladders (DCL) with level of acuity of treatment setting and length of stay in a secure forensic hospital. Methods Sixty-two patients were interviewed using the DCL across three domains – healthcare, welfare and finances. Correlation between DCL scores, length of hospital stay and level of acuity of treatment setting was assessed. Results As patients moved from higher to lower dependency wards, mean DCL score increased, indicating a higher level of capacity. Patients in high dependency wards were most impaired while those in the low dependency wards performed significantly better (rs=0.472, p<0.001). The longer the patients stayed in the hospital, up until five years, the higher the mean welfare domain score (rs=0.402, p=0.011) and mean DCL score (rs=0.376, p=0.018). Beyond five years of hospital stay, those who had lower DCL scores and did not improve had longer length of stay. Conclusions Patients’ FMC improve as they progress from high to low level of acuity of treatment setting. However, this is dependent on the length of hospital stay. FMC may be a measure of recovery in the forensic setting. Disclosure No significant relationships.
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Van Loon, H., H. Vandenbroele, S. De Bruyne, M. Glorieux, A. Wybo, B. Gillain, V. Dubois, and J. Peuskens. "Impact of the “puente project” on the public disease expenditure of a patient with schizophrenia in belgium." European Psychiatry 26, S2 (March 2011): 1521. http://dx.doi.org/10.1016/s0924-9338(11)73225-4.
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IntroductionThe “Puente project”, rises up the adherence rate with 38% (1). The aim of the study was to analyse the economic impact of this disease management prgramme of patients with a schizophrenic disorder.Subjects and methods“Puente” stands for a programme of LAAP with active outreaching of patients with schizophrenia. The details of the data collection and the subjects have been described elsewhere (1).The hospitalisation rate and the length of stay of the 117 case control pairs have been compared. The cost of hospitalisation in Belgium, recently adjusted by De Ridder et al. (2), have been used in order to map the differences.ResultsThe number of hospital days totalised by 23 cases, was 2,152 days, in comparison to 6,371 realised by 42 controls,wich gives 18,6 hospital days per year for the cases and 38.9 days for the controls. Given an hospital cost per day in Belgium of 163.8 € per day, a crude saving of 3,328.5 € per case per year can be realised, correespondng with a net diminution of 2,428.5 € per patient year. Enrolling 1,675 cases per year, creates a saving of 4,066,533 € per year, an equivalent of 24,826 hospital days, or the cost of a psychiatric hospital of 85 beds occupied at 80%.ConclusionThe Puente programme realised a substantial drop in public patient expenditure of 3,328.5 € per patient year. This is a very strong argument to implement, to finance and to support “Puente” like disease programmes in Belgium.
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Toffoli, Nadia D., and Nathan Herrmann. "Determination of Financial Competence in Consultation-Liaison Psychiatry." Canadian Journal of Psychiatry 38, no. 9 (November 1993): 595–98. http://dx.doi.org/10.1177/070674379303800905.
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The aging of our population will require physicians to become more aware of the issues surrounding the determination of financial competence. This retrospective study involved the review of 46 medical or surgical patients in a university teaching hospital that were referred to the psychiatric consultation-liaison team for assessment of financial competency. Charts were reviewed for completeness of documentation using suggested criteria for determination of financial competence. The study found that while many criteria were frequently documented, documentation was incomplete for important criteria, such as calculating abilities, judgement, the patient's appreciation of the consequences of financial competence, presence of delusions with regard to finances and the patient's awareness of debt. Concerns are expressed regarding a physician's ability to recall details pertaining to cases before a tribunal without complete and careful documentation. The importance of establishing formal criteria for the determination of financial competence is also discussed.
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Alotaibi, Raied, Nynke Halbesma, Laura A. E. Bijman, Gareth Clegg, Daniel J. Smith, and Caroline A. Jackson. "Incidence, characteristics and outcomes of out-of-hospital cardiac arrests in patients with psychiatric illness: A systematic review." Resuscitation Plus 9 (March 2022): 100214. http://dx.doi.org/10.1016/j.resplu.2022.100214.
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Muijen, M., I. M. Marks, J. Connolly, B. Audini, and G. McNamee. "The Daily Living Programme." British Journal of Psychiatry 160, no. 3 (March 1992): 379–84. http://dx.doi.org/10.1192/bjp.160.3.379.
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Patients with a serious mental illness requiring admission were randomised to home care or standard hospital care. Over the initial 18 months, 60 patients entered each group and were studied for a mean of 10 months. Home care reduced hospital use by 80%, with patients being admitted for a mean of 14 days, compared with 72 days for the standard group, but this bed-saving made no difference in direct treatment costs. Home care offers individualised treatment, and many patients require continuing support with the emphasis on areas such as finances and housing.
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Funnell, Warwick, Valerio Antonelli, and Raffaele D'Alessio. "Accounting and psychiatric power in Italy: The royal insane hospital of Turin in the 19th century." Critical Perspectives on Accounting 61 (June 2019): 1–21. http://dx.doi.org/10.1016/j.cpa.2018.08.004.
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Curtis, Sarah, Wil Gesler, Kathy Fabian, Susan Francis, and Stefan Priebe. "Therapeutic Landscapes in Hospital Design: A Qualitative Assessment by Staff and Service Users of the Design of a New Mental Health Inpatient Unit." Environment and Planning C: Government and Policy 25, no. 4 (August 2007): 591–610. http://dx.doi.org/10.1068/c1312r.
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This pilot research project sought to provide a postoccupation assessment of a new mental health inpatient unit in East London, built under the Private Finance Initiative scheme. Qualitative discussion groups or unstructured interviews were used to explore the views of people who had been service users (but were currently well) and of nursing staff and consultants working in the new hospital. The participants gave their views on the aspects of the hospital which were beneficial or detrimental to well-being and the reasons for their views. Informants discussed hospital design in terms of: (1) respect and empowerment for people with mental illness; (2) security and surveillance versus freedom and openness; (3) territoriality, privacy, refuge, and social interactions; (4) homeliness and contact with nature; (5) places for expression and reaffirmation of identity, autonomy, and consumer choice; and (6) integration into sustainable communities. Themes emerging from this research were interpreted in light of ideas from geographical research on therapeutic landscapes constituted as physical, social, and symbolic spaces, as well as research from environmental psychology. The findings have practical implications for hospital design and underline the need to consider empowerment of patients in decisions over hospital design. We note the challenges involved in determining therapeutic hospital design given changing models of care in psychiatry, lack of consensus over models of care, and the varying and somewhat conflicting requirements these imply for the physical, social, and symbolic attributes of design of hospital spaces. We also note the implications of our findings for an interpretation of therapeutic landscapes as contested spaces.
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De Veyra, Jamila Marie J., and Clevelinda S. Calma. "Perceptions of Surgical and Other Medical Specialties about Medical Oncologists: A Survey among Physicians in a Filipino Tertiary Hospital." Asian Journal of Oncology 07, no. 03 (May 11, 2021): 134–41. http://dx.doi.org/10.1055/s-0041-1729345.
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Abstract Introduction There are unverified negative perceptions about medical oncologists. Identifying how they are perceived may provide guidance on how to strengthen the positive and correct the negative impressions. Methods Questionnaires were distributed to 528 physicians. They were asked to answer a Likert scale of opposing descriptors. Results Two hundred and fifty-nine of 528 physicians completed the questionnaire, yielding a 49% response rate. Medical oncologists were perceived to have a medical rather than social focus to their work, render holistic care, have a multifaceted role, communicate with many other professionals, work more effectively in a team, have deep relationships with patients, and care for their general well-being. They are considered to be the nonsporty, intellectual type, who do not consider themselves superior, but rather treat other physicians as colleagues. They are perceived to not only have the skills to deal with a psychiatric problem and a wide spectrum of patients, have a health education role, require a high level of intellectual skills, collaborate more with others, possess good interpersonal skills with an individual patient, but are also adept within a group. They are autonomous workers, but usually refer patients to other professionals as well. Lack of finances hinders referral to medical oncologists. Conclusion Perceptions were generally positive in terms of breadth of professional outlook, degree of patient interaction, projected professional image, perception of own professional status, possession of skills for a wide professional scope of responsibility, level of rapport with patient and colleagues, and degree of professional interdependence. Mainly financial factors are the barriers to referral to medical oncologists.
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S Abdelaziz,, Osama, and Zuraiha Waffa. "In-Hospital predictors of severity and mortality among neuro-covid patients: a covid-19 retrospectivecase control study." Journal of Neurology & Stroke 12, no. 5 (September 14, 2022): 148–60. http://dx.doi.org/10.15406/jnsk.2022.12.00517.
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Background: Global studies have exemplified that COVID-19 has neurological manifestations. This study gives an insight to the impact of COVID-19 on the nervous system in Alexandria, Egypt and identifies in-hospital predictors of severity and mortality among Neuro-COVID patients. Methods: This single centre, retrospective case-control study was conducted from August 1st, 2020 to January 31st, 2021, on patients admitted at the COVID-19 Isolation Hospital in Alexandria University, Egypt. A Neuro-COVID patient was defined as any patient with confirmed COVID-19 disease and evidence of one or more new onset nervous system clinical presentation. Results: Out of 1073 in-patients, 352 were Neuro-COVID patients (183 [52%] females and 169 [48%] males). The mean age was 36.64 ± 18.97 years and 161 (45.7%) had comorbidities. Most common involvement was neuromusculoskeletal system (240 [68.2%]), followed by central nervoussystem (164 [46.6%]) and peripheral nervous system (125 [35.5%]), whereas, psychiatric disorders (4 [1.1%]) were the least common. Myalgia (215 [61.1%]); anosmia (118 [33.5%]); headache (100 [28.4%]); ageusia (80 [22.7%]); altered level of consciousness (56 [15.9%]); arthralgia (43 [12.2%]) and dizziness (12 [3.4%]) were predominant presentations. Female Neuro-COVID patients were twice as more likely to be critical than moderate (P =0.030). Critical cases with nervous system presentations manifested 12 times higher risk of death when compared to severe cases (P <0.001). Conclusions: Nervous system involvement was predominant and clinically significant in COVID-19. Disease severity was identified as an independent predictor of mortality in hospitalised Neuro-COVID patients.
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Klug, Mikayla J., April N. Smith, and Paul L. Price. "A retrospective analysis of inpatient utilization of paliperidone palmitate and readmission rates." Mental Health Clinician 4, no. 5 (September 1, 2014): 260–63. http://dx.doi.org/10.9740/mhc.n222763.
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Introduction: This study evaluated pharmacoeconomic considerations, specifically drug cost and patient readmission rates, of the non-formulary agent paliperidone palmitate, within the Alegent Creighton Health system. Pharmacy reimbursement rates for paliperidone palmitate are better on an outpatient versus inpatient basis. Given the low reimbursement rates for inpatient psychiatric care and the high cost of paliperidone palmitate, the drug cost could be justified if patients who received the injection demonstrated a subsequent reduction in readmission. Methods: The electronic medical record was used to identify patients who received at least one inpatient injection of paliperidone palmitate within the Alegent Creighton Health system from January 2010 – April 2012. Indication, dose, administration date, concurrent antipsychotics, length of stay (LOS), discharge date, and time to readmission were also recorded. Finance reports determined hospital cost and reimbursement for each inpatient stay and pharmacy cost of each paliperidone palmitate injection. Results: Thirty-two patients received paliperidone palmitate during the period specified. The average LOS was 18 days. The readmission rates for the paliperidone palmitate patients versus all patients at our institution with a diagnosis related group (DRG) of psychosis were as follows: within 30 days, 22% vs 12.5%; 60 days, 15% vs 15%; and 90 days, 25% vs 18%, respectively. The hospital experienced a net loss of roughly $5,610 per stay for the patients studied and paliperidone palmitate alone constituted approximately 16% of the total hospital cost per each patient stay. Discussion: In this limited patient population, it appears inpatient administration of paliperidone palmitate increased hospital cost without significantly reducing readmission rates at 30, 60, or 90 days post-injection. If patients are due for their monthly maintenance dose while hospitalized, the injection should be deferred to outpatient care if discharge is anticipated within one week since product labeling states maintenance injections can be given seven days after the monthly due date and outpatient reimbursement for the drug is superior.
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Mubarak, A. R., Ismail Baba, Low Heng Chin, and Quah Soon Hoe. "Quality of Life of Community-Based Chronic Schizophrenia Patients in Penang, Malaysia." Australian & New Zealand Journal of Psychiatry 37, no. 5 (October 2003): 577–85. http://dx.doi.org/10.1046/j.1440-1614.2003.01228.x.
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Objective: This is a study of the quality of life (QOL) of 174 community-based chronic schizophrenia patients in Penang, Malaysia. Method: The study samples were selected from the Out Patient Department, Department of Psychiatry, Penang General Hospital, Malaysia. The data was collected through personal interviews with the respondents. A questionnaire prepared by the research team was used to collect data on background characteristics. Lehman's (1988) Quality of Life Interview was used to collect data on patients’ QOL. Result: Equal number of males and females participated in the study. The interviews on QOL indicated problems in the areas of life in general, place of living, daily activities, social relations, finance, work and general health. The results also revealed that community-based schizophrenia patients had acute poverty and experienced social isolation, discrimination and exploitation in the workplace. Conclusion: Implications of these results on the implementation process of National Mental Health Policy in Malaysia are discussed. The research paper also discusses the negative impacts of limited rehabilitation facilities available in the community and its implications on the QOL of severely mentally ill patients. The need for immediate research attention on QOL of such patients in the South-east Asian region has been highlighted.
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Cardoso, G., C. Pacheco, and J. Caldas-de-Almeida. "Quality of care in longer term mental health institutions in Portugal." European Psychiatry 26, S2 (March 2011): 2148. http://dx.doi.org/10.1016/s0924-9338(11)73851-2.
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IntroductionDeinstitutionalisation of the mentally ill is an ongoing process in European countries. Quality of care in residential facilities, however, was seldom assessed in part due to the lack of adequate instruments.ObjectivesTo assess the quality of care in Portuguese residential facilities for long term mental patients.MethodsQuality of care in residential facilities was assessed with the toolkit developed by the DEMoBinc study using interviews with the units’ managers, and the users.ResultsThe 20 units assessed across Portugal were mainly located in the city; 13 were in a hospital setting and 7 in the community. Most of the units (90%) had no maximum length of stay, and 60% were mixed-gender; 85% of the users were not compulsory. Most of the units (60%) had no one-bedrooms, and their aim was rehabilitative in 40%, and rehabilitative plus providing support in 40%. The rate of patients with a bank account was 49.4%, 32.4% were in charge of their finances, while only 14.1% had voted.In hospital vs. community units patients were more frequently men (80.5 vs. 53.8%) and older (51.1 ± 13.7 vs. 43.3 ± 9.6, p < .001). In community units the treatment was more frequently explained (50 vs. 26.3%), patients’ involvement was higher (40.4 vs. 19.5%), while mean GAF scores (64.9 vs. 60.2) did not differ.ConclusionsPortuguese results show that in spite of the effort to create new facilities for the longer term mentally ill, a lot still has to be done to improve the quality of care they provide.
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Paul, Diyammi Mark. "Psychosocial Supports Offered to People with Psychotic Disorders by Community Members in Temeke District, Tanzania." International Journal of Social Science Studies 10, no. 6 (November 18, 2022): 80. http://dx.doi.org/10.11114/ijsss.v10i6.5711.
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This study was about psychosocial support offered to people with psychotic disorders by community members in Temeke district, Tanzania. The findings answered two questions which are: what is the quality of psychological support offered by community members to people suffering from psychotic disorders? To what extent do the people with the psychotic disorder have been socially supported and included in the social network within their communities? Both qualitative and quantitative methods of data collection were used and a descriptive design was adopted. Participants were People with Psychotic Disorders (PPDs) who had received treatment at the psychiatric unit of Temeke district hospital in 2020. A total of 80 PPDs were randomly sampled, of which 57answered study questions by themselves, and 23 were presented by their caregivers. The study noted that both psychological and social supports were rarely given to people with psychotic disorders by community members. It was further revealed that there was a strong and significant association between psychosocial supports and hospitalisation or prognosis of PPDs (p-value < 0.0001). In which one unit increase in psychological supports could significantly reduce hospitalisation of PPDs by 0.365 units (p-value 0.025). Meanwhile, one unit increase in social supports could significantly reduce hospitalisation by 0.22 units (p-value 0.038). Hence, psychosocial supports from community members were significantly important in reducing hospitalisation and improving the prognosis of PPDs. It was recommended that the community should be educated on the causes, treatment, and importance of ‘psychosocial support’ in the comprehensive treatment of psychotic disease.
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PASSIK, STEVEN D., CAROL RUGGLES, GRETCHEN BROWN, JANET SNAPP, SUSAN SWINFORD, TERRENCE GUTGSELL, and KENNETH L. KIRSH. "Commentary: Is there a model for demonstrating a beneficial financial impact of initiating a palliative care program by an existing hospice program?" Palliative and Supportive Care 2, no. 4 (December 2004): 419–23. http://dx.doi.org/10.1017/s1478951504040568.
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The value of integrating palliative with curative modes of care earlier in the course of disease for people with life threatening illnesses is well recognized. Whereas the now outdated model of waiting for people to be actively dying before initiating palliative care has been clearly discredited on clinical grounds, how a better integration of modes of care can be achieved, financed and sustained is an ongoing challenge for the health care system in general as well as for specific institutions. When the initiative comes from a hospital or academic medical center, which may, for example, begin a palliative care consultation service, financial benefits have been well documented. These palliative care services survive mainly by tracking cost savings that can be realized in a number of ways around a medical center. We tried to pilot 3 simple models of potential cost savings afforded to hospice by initiating a palliative care program. We found that simple models cannot capture this benefit (if it in fact exists). By adding palliative care, hospice, while no doubt improving and streamlining care, is also taking on more complex patients (higher drug costs, shorter length of stay, more outpatient, emergency room and physician visits). Indeed, the hospice was absorbing the losses associated with having the palliative care program. We suggest that an avenue for future exploration is whether partnering between hospitals and hospice programs can defray some of the costs incurred by the palliative care program (that might otherwise be passed on to hospice) in anticipation of cost savings. We end with a series of questions: Are there financial benefits? Can they be modeled and quantified? Is this a dilemma for hospice programs wanting to improve the quality of care but who are not able on their own to finance it?
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Picardi, Angelo, Marco Miniotti, Paolo Leombruni, and Antonella Gigantesco. "A Qualitative Study Regarding COVID-19 Inpatient Family Caregivers’ Need for Supportive Care." Clinical Practice & Epidemiology in Mental Health 17, no. 1 (November 19, 2021): 161–69. http://dx.doi.org/10.2174/1745017902117010161.
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Background: Family caregivers of COVID-19 inpatients are exposed to multiple sources of distress. These include not only losing friends, colleagues and members of the family, but also the fear of possible losses in sociality, finances and, impoverished communication with sick family members and health care providers. Objective: This study describes the psychological experience of COVID-19 inpatient family caregivers to highlight the main sources of distress, issues, concerns and unmet needs. Methods: Two focus groups were independently organized with COVID-19 inpatient family caregivers and health care personnel of COVID-19 wards in order to highlight family caregivers’ practical and psychological burden and related needs. A thematic analysis was conducted to analyze the data. Results: Family caregivers mentioned they needed more information about the patient’s condition with more attention being paid to their own emotional state. Feelings of impotence, concerns about how to deal with patient’s discharge, significant psychological distress, and anxiety were frequently reported by study participants. Conclusion: Study findings suggest the need to strengthen the assistance of COVID-19 patient family caregivers. In the pandemic scenario, family caregivers might represent a crucial resource, which can guarantee rapid discharges, support home health care and thus relieve pressure on hospital systems.
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Rog, David, Jeremy Hobart, and Joela Mathews. "150 The 70 UK centre multiple sclerosis service and DMT prescribing audit: practical project solutions." Journal of Neurology, Neurosurgery & Psychiatry 93, no. 9 (August 12, 2022): e2.106. http://dx.doi.org/10.1136/jnnp-2022-abn2.194.
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IntroductionThis audit (presented ABN2021), identified multiple problems highlighting that the UK MS community should maximise influence, efficiency and data usage. Here, we addresshow.AimTo present practical steps taken to improve UK MS care.MethodsAudit results were discussed with key stakeholders. Potential projects were proposed, discussed and refined. A set of deliverable projects actionable by the UK MS community was identified.Funding models that maximise investments were considered.ResultsThe projects, for which funding has been sought, are:• Clarifying roles and responsibilities of MS team members• Website, to facilitate communication and good practice repository• Where’s the care? – UK MS care map development• Recording care – MS team documentation• Measuring outcomes – MS expectation frameworks (for Patients and teams)• Maximising core activities – making blueteq (and prescribing databases) indispensable• Advancing data value – improving Hospital Episode Statitics• (HES data) For delivery, quality and routine use• Ensuring the future – making MS an attractive career optionFor delivery, a ring-fenced entity (Transforming MS 4 All) was established within an existing not-for-profit community interest company (CiC).ConclusionsThese deliverable, impactful projects should improve UK MS care. Managing finances under a CiC enables transparency, accountability and reinvestment of funding, to sustain services. Neverthe- less, much more is needed.
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Yusuf, Hadiza, Mohammed G. Magaji, Bilkisu B. Maiha, Sani I. Yakubu, Wazis C. Haruna, and Shafiu Mohammed. "Impact of pharmacist intervention on antidepressant medication adherence and disease severity in patients with major depressive disorder in fragile north-east Nigeria." Journal of Pharmaceutical Health Services Research 12, no. 3 (July 2, 2021): 410–16. http://dx.doi.org/10.1093/jphsr/rmab030.
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Abstract Objectives Medication adherence is emerging as a major public health challenge particularly in patients with depression. The aim of this study was to explore the usefulness of a pharmacist intervention to improve antidepressant medication adherence and disease severity in patients with major depressive disorder. Methods This prospective interventional study was conducted between April 2019 and March 2020 among 101 patients at the Federal Neuro-Psychiatric Hospital, Maiduguri, Nigeria. Consenting patients were randomised into usual care or intervention groups using a computer-generated list. Data were collected at baseline, 3 months and 6 months. Medication adherence and depression severity were assessed using the Medication Adherence Rating Scale and Beck Depression Inventory respectively. Key findings At baseline, both the usual care and intervention groups had low mean scores for medication adherence [5.22 (SD = 1.51) versus 5.46 (SD = 1.46)] and high mean scores for depression severity [24.16 (SD = 13.50) versus 27.07 (SD = 16.12)]. At 6 months, there was a significant difference (P < 0.001) between the mean medication adherence scores of 5.22 (SD = 1.90) and 9.15 (SD = 1.62), in the usual care and intervention groups respectively. A significant difference (P = 0.033) was also observed at 6 months between the mean depression severity scores of the usual care and intervention groups [21.40 (SD = 11.52) and 17.34 (SD = 6.96)]. Medication adherence (P < 0.001, Partial eta squared = 0.279) and depression severity (P < 0.001, Partial eta squared = 0.170) positively changed with time in the presence of the intervention. Conclusions The intervention significantly improved antidepressant medication adherence and disease severity in patients with major depressive disorder.
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Morgan, Graeme W., Kirsty Foster, Brendan Healy, Craig Opie, and Vu Huynh. "Improving Health and Cancer Services in Low-Resource Countries to Attain the Sustainable Development Goals Target 3.4 for Noncommunicable Diseases." Journal of Global Oncology, no. 4 (December 2018): 1–11. http://dx.doi.org/10.1200/jgo.18.00185.
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The United Nations Sustainable Development Goals 2015 to 2030 includes a specific goal for health (Sustainable Development Goal [SDG] 3) with 13 targets, including SDG3.4 for the control and treatment of noncommunicable diseases (NCDs), namely, cardiovascular diseases, cancer, diabetes, and chronic lung disease. There is considerable concern that SDG3.4 may not be achieved. The WHO Best Buys for NCDs has emphasized prevention, and although crucial, it alone will not achieve the 30% reduction in NCDs by 2030. Likewise, a strengthened health system is required as all NCDs are likely to require hospital facilities and community services for optimal management. This is a major problem for low-resource countries (LRCs) —that is, low-income countries and lower-middle-income countries—as most currently have a poorly developed health system, including cancer services, in need of upgrading. This is a result of the extreme poverty of LRCs, where 40% to 80% of the population live on less than USD $1.25 per day, with the average health spending by governments in low-income countries at $110 per person per year. In this article, we outline a comprehensive national cancer services plan for LRCs. Surgery, radiotherapy, and chemotherapy for cancer treatment also require input from other specialties, such as anesthesia, pathology, laboratory medicine, a blood bank, and diagnostic radiology. This will provide a focus for adding additional specialties, including cardiology, respiratory medicine, and psychiatry, to support the management of all NCDs and to contribute to the overall strengthening of the health system. The national cancer services plan for LRCs will require significant funding and input from both in-country and overseas experts in health, cancer, and finance working collaboratively. Success will depend on thoughtful strategic planning and providing the right balance of overseas support and guidance, but ensuring that there is in-country ownership and control of the program is essential.
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Uçar, Ayşenur, and Aynur Doğrusöz. "The Prognostic Role of In-Hospital Mortality Predictors and De Ritis Ratio in Patients with Upper Gastrointestinal System Bleeding." Pakistan Journal of Medical and Health Sciences 16, no. 5 (May 30, 2022): 1324–26. http://dx.doi.org/10.53350/pjmhs221651324.
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Material-Method: In our tertiary hospital's intensive care unit, we studied the clinical and laboratory records of 243 patients who had been admitted with upper GIS bleeding between January 2018 and April 2022. Results: Patients with upper gastrointestinal haemorrhage who were hospitalised were 65.8% male (M/F: 56/22). Mean age was 68.611.56 years old. One cutoff value was determined for the De Ritis ratio: 1.54. The mortality rate within the hospital was 13.1%.. Conclusion: Our results showed for the first time that the De Ritis ratio was not associated with in-hospital mortality in GI bleeding but further large clinical studies are needed to examine this issue.
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Gaban, Ana Carolina, and Kátia Stancato. "Quality of life of patients at the referral Emergency Unit of the Clinics Hospital/Unicamp." Revista de Enfermagem UFPE on line 6, no. 2 (January 6, 2012): 386. http://dx.doi.org/10.5205/reuol.2052-14823-1-le.0602201218.
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ABSTRACTObjective: to understand the quality of life (QOL) of patients treated at the referenced Emergency Unit of the Clinics Hospital of the State University of Campinas. Method: quantitative, cross-sectional and descriptive study, using the abbreviated version of the World Health Organization Quality of Life assessment, the WHOQOL-bref in 100 patients admitted to the service. The characteristics of QOL studies cover four areas - physical, psychological, environmental and social relationships. Results: the population’s average age was 40.0 years, ranging from age 18.0 to 83.0 years. There was a female predominance, 71.0% women and 29.0% men. We observed the highest score in the psychological domain (66.0) (SD: 17.0), and the environmental domain showed the lowest (55.0) (SD: 15.0), which includes availability and quality of health services. The social relationships domain had a higher maximum score, scoring 100, followed by the physical domain (96), psychological (92) and environmental (91). Conclusion: the identification of problems and needs presented by patients on site, by the QOL assessment at the moment of their admission to the service in their physical, social, psychological aspects and their relationship with the environment, allows nurses to focus their assistance and direct patients to other services (psychiatry, nutritionist, social worker, physiotherapy, others). This way, without mischaracterizing the treatment provided by the service, treatment can be offered according to the average of the parameters of QOL presented by the patients, these being the ultimate consumers of the health service. Key words: quality of life; patients; epidemiology. RESUMOObjetivo: conhecer a qualidade de vida (QV) dos pacientes atendidos na Unidade de Emergência Referenciada do Hospital de Clínicas da Universidade Estadual de Campinas. Método: estudo quantitativo, transversal e descritivo, utilizando a escala abreviada de qualidade de vida da Organização Mundial de Saúde, o WHOQOL-bref, em 100 pacientes. O projeto foi aprovado pelo Comitê de Ética em Pesquisa da Faculdade de Ciências Médicas da Universidade Estadual de Campinas, parecer nº 1036/2009. Resultados: a população apresentou idade média de 40,0 anos, com variação da faixa etária de 18,0 a 83,0 anos. Houve predomínio do sexo feminino, 71,0% mulheres e 29,0% homens. Observou-se o maior escore no domínio psicológico (66,0) (DP:17,0), e o domínio ambiental apresentou o menor (55,0) (DP: 15,0), que inclui disponibilidade e qualidade dos serviços de saúde. O domínio relações sociais apresentou maior pontuação máxima, com escore 100, seguidos pelo domínio físico (96), psicológico (92) e ambiental (91). Conclusão: a identificação dos problemas e necessidades apresentados pelos pacientes no local, pela QV apresentada no momento da admissão ao serviço, em seus aspectos físicos, sociais, psicológicos e relações com o meio ambiente, possibilita ao enfermeiro o enfoque assistencial e direcionamento a outros serviços (psiquiatria, nutricionista, assistência social, fisioterapia, outros). Assim, sem descaracterizar o atendimento do serviço, há o acréscimo do olhar terapêutico de acordo com a média dos parâmetros de qualidade de vida apresentados pelos pacientes, sendo estes, os consumidores finais do serviço de saúde. Descritores: qualidade de vida; pacientes; epidemiologia.RESUMENObjetivo: conocer la calidad de vida (QOL) de los pacientes atendidos en la Unidad de Emergencia de Referencia en Hospital de Clínicas en la Universidad Estatal de Campinas. Método: cuantitativo, transversal, descriptivo, utilizando la escala abreviada de la calidad de vida de la Organización Mundial de la Salud, el WHOQOL-bref en 100 pacientes ingresados en el sitio. Las características de los estudios de la calidad de vida cubren cuatro áreas - física, la relación psicológica, social y medio ambiente. Resultados: la edad media de la población fue de 40,0 años, que van desde los 18,0 a 83,0 años. Hubo predominio del sexo femenino, las mujeres 71,0% y 29,0% hombres. Hemos observado el mayor puntaje en el dominio psicológico (66,0) (DE: 17,0), y del medio ambiente mostraron la más baja (55,0) (DE: 15,0), que incluye la disponibilidad y la calidad de los servicios de salud . El dominio de las relaciones sociales tenían una puntuación máxima más alta, anotando 100, seguido por el dominio físico (96), psicológicos (92) y ambientales (91). Conclusión: la identificación de problemas y necesidades que presentan los pacientes en el sitio, presentado por la QOL al ingresar en el servicio en términos de relación física, social, psicológica y con el medio ambiente, permite a las enfermeras para enfocar la asistencia y orientación a otros servicios (psiquiatría, especialista en dietética, trabajo social, fisioterapia, otro). Por lo tanto, sin estropear la atención del servicio, busque la adición de tratamiento de acuerdo con el promedio de los parámetros de QOL presentadas por los pacientes, siendo estos últimos los usuarios finales de los servicios de salud. Descriptores: calidad de vida; pacientes; epidemiologia.
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Shafique, Ahmad, Ehsan Ul Haq, Umer Hussain, Wajiha Abbas, Sundus Iftikhar, and Mujtaba Nadeem. "To Determine Frequency of Anxiety and Depression in Temporo-mandibular Joint Disorders." Pakistan Journal of Medical and Health Sciences 16, no. 9 (September 30, 2022): 10–12. http://dx.doi.org/10.53350/pjmhs2216910.
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Background: Temporomandibular disorder (TMD) is a general term that refers to disorders associated with the temporomandibular joint (TMJ) and the masticatory muscles. Due to the complexity of the masticatory system, TMD symptoms may be caused by different physiological and/or psychosocial factors, such as malocclusion and occlusal interferences, alterations in the masticatory muscles, direct trauma to the jaw or TMJ, micro trauma caused by continuous parafunctional habits Aim: To determine frequency of anxiety and depression in temporomandibular joint disorders. Methods: Cross sectional study design was conducted in the Department of Oral and Maxillofacial surgery, Mayo Hospital Lahore for a period 6 months. a total 365 cases fulfilling inclusion criteria was enrolled in study from Oral and Maxillofacial surgery Mayo Hospital Lahore. Informed written consent was taken from patients and then their data according to variables in proforma was recorded. Anxiety and depression was measured by researcher himself according to operational definition. Results: The mean age of cases was 28.95 ± 6.71 years with minimum and maximum age of 18 and 40 years. In this study there were 185(50.68%) male and 180(49.32%) female cases. The mean Hospital Anxiety and Depression (HAD) score was 12.15±11.75 with minimum and maximum score as 0 and 42. Anxiety and depression was seen in 180(49.32%) of the cases while 185(50.68%) of the cases did not has anxiety and depression. Conclusion Through the findings of this study it is found that the frequency of Anxiety and depression is very much high. So we should formulate proper treatment strategy with the help of psychiatry department to cope this issue. No doubt it will help to improve their prognosis and better quality of life. Keywords: Physical therapy specialty, Electromyography, Facial pain, Temporomandibular joint, Anxiety, Depression
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Murata, Lisa, Jaime Jones, Alexandra Baines, Carrie Robertson, and Karen Daley. "M243. EFFECTIVENESS AND SATISFACTION WITH A SCHIZOPHRENIA RECOVERY DAY PROGRAM." Schizophrenia Bulletin 46, Supplement_1 (April 2020): S228. http://dx.doi.org/10.1093/schbul/sbaa030.555.
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Abstract Background Schizophrenia is a complex disorder typically defined by the presence of positive symptoms that include hallucinations, delusions, and disorganisation in speech and behaviour, negative symptoms of avolition and social withdrawal, and a decline in functioning. Despite an ability to treat clinical symptoms, functional recovery in schizophrenia remains poor. The Recovery Day Program at the Royal Ottawa Mental Health Centre is a multi-disciplinary intervention tailored to help people living with schizophrenia attain recovery goals, lead more satisfying lives, engage in activities, develop a social network and assist in community reintegration. Eligibility criteria are: 18 years of age or older, meet DSM V criteria for Schizophrenia Spectrum illness, have clinical needs that cannot be met in the community, have housing, require intensive recovery support/integration into community, be able to engage in day hospital programming and develop recovery goals. Maximum number of day clients in Day Program is 20. Client admissions began in June 2016. As of November 2019, there have been 50 admissions with 29 discharges. Age range of clients was 20–60 years (mean 36.5). Clients were invited to provide feedback on their experience with the Day Program for program evaluation and improvement of service. Methods A qualitative and quantitative evaluation of functional outcomes and patient satisfaction was conducted. Measures were administered at admission and discharge: The Illness Management and Recovery Scale (IMRS), a custom-generated activity and goal attainment scale, Quality of Life Scale, The World Health Organization Disability Assessment Schedule 2.0, the Modified Global Assessment of Functioning Scale and the Clinical Global Impression Scale. The Ontario Perception of Care Survey for Mental Health and Addictions (OPOC) was administered during a two month period from January 2019. Results Discharge results were available for 29 individuals out of 50 admissions. Clients identified goals in areas including vocational, social, educational, symptom management, optimizing independence, minimizing substance use, managing finances and stable housing; group and individual interventions targeted these areas. Interventions occur at the hospital and in the community. Results of the activity summary identify significant change in community integration in the following areas: employment (admission 5% and discharge 47%), unpaid/volunteer work (admission 11% and discharge 42%), course or study (admission 0% and discharge 32%), social/recreation/group activities (admission 63% and discharge 100%). Results show a significant increase in IMRS scores over time. Goal achievement was statistically significant according to the goal attainment scale (mean at intake 3.4 and at discharge 8.6). Results show that goal importance did not change over time. Open ended questions about day programming were added to the OPOC. Of 15 respondents, the average length of time in the Program was 16 months. Majority of respondents attended as much as they liked, while those unable to attend as much as they wanted, identified that increased attendance may have been helpful to achieving their goals. Discussion Overall, clients were very satisfied with services provided. There were significant achievements in goal attainment over time with targeted interventions provided in functional domains including employment, unpaid/volunteer work, course of study and social/recreation activities. Our data suggest that a medium term, intensive day program increases functional outcomes and personal satisfaction for individuals with a Schizophrenia Spectrum disorder. Further study would be important to assess how these changes are sustained over time.
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Misterka, Justin, Katherine E. Russell, Rosemarie Basile, Rosemarie Kurtz, Carina JohnKlein, Gillian Glasser, and Thomas Gut. "A-277 Neurocognitive and Psychological Profile of a 57-Year-Old Long-COVID Patient After 42 Days an a Ventilator." Archives of Clinical Neuropsychology 37, no. 6 (August 17, 2022): 1428. http://dx.doi.org/10.1093/arclin/acac060.277.
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Abstract Objective: The neuropsychological impact of COVID-19 is a budding area of research. Studies suggest greater neurological abnormalities in patients presenting with a severe illness course, particularly those with acute respiratory distress syndrome. The purpose of this case study was to characterize the neurocognitive and psychological profile of a 57-year-old male following prolonged hospitalization for COVID-19 in March 2020, including 42 days on mechanical ventilation. Method: Relevant data were collected via clinical interview, neuropsychological testing, and medical record review. Hospital course was notable for hypertension, acute kidney failure, and pressure ulcers. Computerized tomography and electroencephalogram revealed mild cortical atrophy and mild to moderate generalized slowing, respectively. Approximately 15 months post-discharge, subjective complaints during the evaluation included cognitive “fogginess,” increased impulsivity, decreased frustration tolerance, forgetfulness, fatigue, mobility difficulties, and dyspnea upon exertion. Results: Neuropsychological testing, within the context of likely average premorbid functioning, revealed declines in motor functioning, confrontation naming, phonemic fluency, planning/organization, visual memory, and aspects of verbal memory. Poor performance on select memory tasks was likely driven by executive dysfunction. Behaviorally, the patient presented as disinhibited, impulsive and labile. Emotionally, he endorsed symptoms of posttraumatic stress, anxiety, and depression. These post-COVID-19 sequelae have impacted functioning across multiple domains including ability to work, medication and finance management, and complex decision-making. Conclusions: Results suggest bilateral frontal and temporal dysfunction rather than subcortical deficits from hypoxia. Similar to post-intensive care syndrome, the etiology of functional impairment in severely ill, hospitalized COVID-19 patients appears multifactorial. Likely mediating factors include COVID-19 itself, associated complications, intervention methods, and psychological distress.
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Iqbal, Faheem, Ujala Nazir, Fida Muhammad, Bilal Mustafa, and Omer Saqib Gill. "In Hospital Outcomes of Cardiogenic Shock among Patients with Acute Myocardial Infarction." Pakistan Journal of Medical and Health Sciences 16, no. 5 (May 30, 2022): 1447–49. http://dx.doi.org/10.53350/pjmhs221651447.
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Aim: To evaluate in-hospital cardiogenic shock (CS) outcomes after acute myocardial infarction. Study Design: A descriptive study. Place and Duration:InPunjab Institute of Cardiology, Lahorefor six-months duration from 18th June 2021 to 17th December 2021. Materials and Methods: After meeting the inclusion criteria, 200 consecutive patients with cardiogenic shock afterwardsthe acute myocardial infarction were studied. The major group was Group I consisting of 105 (52.5%) subjects; these were CS patients with STEMI. The patients of group-IIcomprised of 80 (40%) subjects, these were cases with CS with Non-STEMI and patients of the group III were 15 (7.5%); with acute left bundle branch block (LBBB) in the CS setting. Results: The mean age of the study people was 57.2 ± 29.40. The males in the studied people were 130 (65%), and women 70 (35%). In group I; 50 (47.6%) was the in-hospital mortality, group II has in-hospital mortality of 57 (71.3%) and in group III it was 7 (46.7%) cases. Conclusions: Patients who developed cardiogenic shock afterwardsacute myocardial infarction have high ratio of mortality during their stay in hospital. This is because there are more risk factors in this subset of patients. Keywords: acute myocardial infarction, cardiogenic shock, hospital mortality, left bundle branch block.
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Shah, Riaz Ahmed, Suhail Ahmed Soomro, Abdul Sattar Abro, Muhammad Faheem Ahsan, Shahnawaz Khatti, and Aneeta Kumari. "Frequency and Causative Factors of Splenic Trauma at Liaquat University Hospital/Jamshoro." Pakistan Journal of Medical and Health Sciences 16, no. 5 (May 30, 2022): 1378–80. http://dx.doi.org/10.53350/pjmhs221651378.
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Objective: To evaluate the frequency and causative factors of splenic trauma in patients presented with abdominal blunt trauma at the surgical emergency of the Liaquat University Hospital Jamshoro (Hyderabad). Material and methods: This was a cross-sectional and retrospective study, carried out at the surgical units of Liaquat University Hospital Jamshoro from December 2013 to November 2014. All the patients admitted with abdominal trauma, aged >12 years of either gender, were included. After taking informed consent, a complete medical history, especially regarding the cause of the injury, and a physical examination were done. All the patients were evaluated for splenic trauma after imaging diagnosis and operative findings. A self-made proforma was used for the data collection of age, gender, residence, causes of the injury, and presence of the splenic trauma. Data was analyzed by using SPSS version 26. Results: A total of 250 cases of abdominal trauma were studied, and splenic trauma cases were found in 60 (22.7%). Out of 60 participants, most of the cases were aged 18 to 30 years (46.7%) and 31 to 40 years (38.3%). Males were seen in the majority of 44 (73.3%), while females were 16 (26.7%). According to the causative factors of the splenic trauma, road traffic accidents were the most common (51.1%), followed by falls (19.1%), stab wounds (17.0%), and fire arm injuries (12.8%). Conclusion: As per the study conclusion, the young males mostly suffered from splenic trauma, which was observed to be 22.7% among patients with abdominal trauma. Road traffic accidents (RTA) and falls from height were observed to be the most common causative factors. Keywords: abdominal trauma, splenic trauma, causes
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Dayo, Abdul Rashid, Shahzad Memon, Yar Muhammad Tunio, Kashif Ali, Maria Basheer, and Ruqayya Farhad. "Screening of HIV Infection in Patients with Pulmonary Tuberculosis at a Tertiary Care Hospital." Pakistan Journal of Medical and Health Sciences 16, no. 5 (May 30, 2022): 1368–70. http://dx.doi.org/10.53350/pjmhs221651368.
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Objective: To determine the frequency of HIV infections in patients with pulmonary tuberculosis. Patients and methods: This cross-sectional study, was conducted at the Department of Medicine, Ghulam Muhammad Mehar Medical College, Sukkur, from October 2019 to 2020. All the patients had pulmonary TB of any duration; their ages ranged from 15 years to 45 years, and both genders were included. Sputum analysis for the patients with known pulmonary tuberculosis was done for AFB (Positive/Negative). Sputum was also sent for a GeneXpert test for the diagnosis of MDR TB. The patient's sputum culture and sensitivity were checked from the record and the XDR TB, if present in that record, was noted. In all patients with PTB, blood was taken and sent for serology. HIV was assessed by serology. All of the data was taken and recorded into the proforma at its completion, and was then analyzed by SPSS version 26 for the research purpose. RESULTS: The average age of the patients was 34.2±10.3 years, and the average duration of TB was 8.1±3.9 months. Out of all, 90 (64.3%) were males and 50 (35.7%) were females. In distribution for types of pulmonary tuberculosis, 1st line drug response was found in 41 (29.4%) patients, MDR TB in 60 (42.8%), while XDR TB was found in 39 (27.8%) patients. HIV infection serology was found to be positive in 53 (37.9%) patients. As per stratification, the HIV serological infection was significantly higher among males (p-0.004), while it was statistically insignificant according to the patients' age and disease status (p->0.05). CONCLUSION: It was to be concluded that the prevalence of HIV infection was documented as considerably high in patients with pulmonary tuberculosis. Therefore, all individuals having tuberculosis should be evaluated for HIV risk factors and advised to get tested. Keywords: HIV, Pulmonary Tuberculosis, Co-Infection
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Ullah, Saleem, Sami ullah, Muhammad Abbas Khan, Javed Khurshed Shaikh, Gulzar Ali Buriro, and Syed Nadeem Hassan Rizvi. "Outcomes of Left Main Percutaneous Coronary Intervention." Pakistan Journal of Medical and Health Sciences 16, no. 5 (May 30, 2022): 1400–1402. http://dx.doi.org/10.53350/pjmhs221651400.
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Objective: The objective of this research is to assess the efficacy of left main coronary artery (LMCA) revascularization and to document the outcomes for patients who underwent this procedure. Methodology: The National Institute of Cardiovascular Diseases (NICVD) in Karachi conducted a cross-sectional study from January 2018 to December 2019 and discovered that participants had a decreased risk of developing heart disease. All patients aged 18 and above who received percutaneous LMCA revascularization at the study location were considered for inclusion. We evaluated patient outcomes in the hospital by charting and doing telephonic follow-ups for one year. Regarding quantitative variables, the results were expressed as means and standard deviations, and concerning qualitative variables, as percentages. Results: The study center treated 95 patients with LM PCI during the study period. 68 (71.5%) of the people who had LM PCI had unprotected LM. LM PCI was most commonly performed on 44 patients (46.3%) presenting with unstable angina. Ninety-one (95.7%) patients required PCI due to native LM illness, while four patients (4.2%) underwent LM PCI as a rescue treatment. There were 41.7 ± 26.9 months of follow-up on average. Participants were followed up on average for 41.7 ±26.9 months, and they were admitted to the hospital on average for 4.45 ±3.2 days. The death rate in the hospital was 12.6%, and this was followed by the mortality rate at 1 year and a mean follow-up of 7.5% and 6.7%, respectively. Conclusion: Hemodynamically unstable patients, or those who cannot have bypass surgery for various reasons, have a successful therapy option in Pakistan: LM percutaneous coronary intervention. It may be necessary for the future to conduct prospective studies to evaluate whether PCI can be used to treat LM lesions when compared with existing treatments. Keywords: Percutaneous coronary, Intervention Coronary artery disease, Intravascular ultrasound, Left main coronary artery.
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Khan, Bakht Umar, Fayaz Ahmed Memon, Muhammad Shehram, Muhammad Shahid, Fahad Khalid, and Nayyar Arif. "Pericardial Effusionin Patients Admitted in Emergency Department: Frequency and Causes." Pakistan Journal of Medical and Health Sciences 16, no. 5 (May 30, 2022): 1450–52. http://dx.doi.org/10.53350/pjmhs221651450.
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Objective:A study of pericardial effusions in individuals with dyspnea was conducted to evaluate the prevalence and aetiology. Study Design:Prospective/Observational Study Place and Duration: Multicenteric study conducted at DHQ Hospital Bagh AJK/ Federal Govt. Polyclinic Hospital Islamabad and DHQ Teaching Hospital Gujranwala Medical College, Gujranwala. Duration was six months from 1st Oct 2021 to 31st March 2022. Methods:There were 135 patients of both genders had ages 18-75 years were presented in this study. Patients with dyspnea were admitted to emergency department. After obtaining informed written consent, we compiled detailed demographic information on all enrolled patients.Pericardial effusion was detected in all cases using echocardiography.The causes of pericardial effusion have been studied." SPSS 22.0 was used to analyze the data. Results: There were 75 (55.6%) males and 60 (44.4%) females in this study. Mean age of the patients was 58.16±10.79 years and had mean BMI 23.9±10.45 kg/m2. Majority of the patients were illiterate 90 (66.7%) and 45 (33.3%) were literate. We found frequency of pericardial effusions among 26 (19.3%) cases. Majority were males 17 (65.4%) and 9 (34.6%) were females. Most common cause of pericardial effusions were neoplastic diseases 10 (38.5%), idiopathic found in 8 (30.8%) cases, 3 (11.4%) had uremia, bacterial infections in 2 (7.7%) cases, frequency of HIV cases was 2 (7.7%) and 1 (3.8%) had other causes. Among 26 patients of pericardial effusions, small size effusion found in 14 (53.8%) cases, moderate size in 8 (30.8%) cases and large size in 4 (15.4%) cases. Conclusion: According to this study,patients with unexplained dyspnea had an increased risk of developing pericardial effusion,. The most prevalent cause of pericardial effusion was a neoplastic disease. Keywords:Electrocardiogram, Causes, Pericardial Effusion, Frequency, Dyspnea
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Rehman, Javaid Ur, Sami ullah, Naveed ullah, Javed Khurshed Shaikh, Iftikhar Ahmed, and Tariq Ashraf. "Prevalence of Angiographically Significant Left Main Disease at a Tertiary Care Hospital in Karachi; A Large Cardiac Interventional Study." Pakistan Journal of Medical and Health Sciences 16, no. 5 (May 30, 2022): 1424–26. http://dx.doi.org/10.53350/pjmhs221651424.
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Objective: To determine the prevalence of significant left main coronary artery disease (Stenosis more than 50%) at NICVD Karachi. Method: We conducted this observational cross-sectional study retrospectively at NICVD Karachi. Our institution analyzed both emergency and elective coronary angiography data from 5th July 2018 to 5th July 2020 for the existence of significant left main coronary artery disease. A study of coronary artery disease only included patients with significant left main coronary artery disease. Approximately 50% stenosis was considered significant left main coronary artery disease. Results: A total of 10,828 patients were selected for the study population, out of the total of 8975 males and 1853 female patients who underwent coronary angiography during our mentioned period at NICVD Karachi, 327 patients (3%) showed significant left main coronary artery disease. 277 patients (83%) were male and 50(17%) were female. About 50% of patients were between the ages of 60 -80 years old Minimum age was 32 years and the maximum age was 95 years. Hypertensive were 5197 (48%) and diabetes was 2480 (22.9%). The maximum number of patients in CCS grade II angina is about 239 (73.0%). Conclusion: High prevalence of disease in the Left major coronary artery is associated with greater mortality and morbidity in our CAD patients. Keywords: Coronary artery diseases, left main coronary artery, coronary intervention, coronary angiography
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Eshiet, Unyime Israel, Blessing Ante, and Abasiodiong Uwak. "Evaluating quality of life and satisfaction with pharmaceutical care services among patients with type II diabetes mellitus receiving care in a resource-limited setting." American Journal of Pharmacotherapy and Pharmaceutical Sciences 1 (November 30, 2022): 8. http://dx.doi.org/10.25259/ajpps_11_2022.
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Objectives: Quality of life assessment is considered an important measure of outcome in long-term illness and management. Patient satisfaction surveys are essential in obtaining a comprehensive understanding of the patient’s needs and their opinion of the service received. The purpose of this study was to determine the health-related quality of life (HRQOL) and satisfaction with pharmaceutical care services among patients with type II diabetes mellitus (DM) receiving care in Nigeria. Materials and Methods: A cross-sectional prospective study was conducted among 120 patients with type II DM receiving treatment at General Hospital Ikot Ekpene in Akwa Ibom state, Nigeria. Patients who met the eligibility criteria and attended clinic appointments at the medical outpatient clinic as well as those admitted into the medical wards of the hospital during the period of the study were recruited. Data on the extent of patients’ satisfaction with pharmaceutical care as well as their quality of life in diabetes were obtained using the patient satisfaction with pharmaceutical care questionnaire, and the patient quality of life based on diabetes related complaints questionnaire. The duration of the study was 7 months. Data obtained were analyzed using the Statistical Program and Service Solutions version 25.0 computer package with statistical significance set at P < 0.05. Results: The quality of life of the patients based on diabetes-related complaints was poor. Fatigue was the most frequently reported complaint (n = 116; 96.6%), followed by polyuria (n = 106; 88.33%). The overall mean scores of patient satisfaction with pharmacists’ friendly explanation and management of therapy were 4.03 (±0.52) and 3.53 (±0.44), respectively. There was a statistically significant relationship between patients’ satisfaction with pharmacists’ friendly explanations and patient complaints of weight changes (r = 0.219; P < 0.05), decreased energy levels (r = 0.205; P < 0.05), and numbness (r = 0.270; P < 0.01). Furthermore, there was a statistically significant relationship between patients’ satisfaction with pharmacists’ therapy management and patients’ complaint of fatigue (r = 0.187; P < 0.05), numbness (r = 0.189; P = 0.05), and blurred vision (r = 0.204; P < 0.05). Conclusion: The HRQOL of the patients was poor as the majority of the patients had diabetes-related complaints. Patients’ satisfaction with the pharmaceutical care services offered was good. Periodic evaluation of the quality of life and satisfaction with health-care services among patients with DM is recommended.
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Yuniastutiningsih, Hesti, Diadjeng Setya Wardani, and Novida Ariani. "Relationship of Family Support and Referral Procedures for Delays in Maternal Emergency Referral at Tamiang Layang Hospital, East Barito Regency." Pakistan Journal of Medical and Health Sciences 16, no. 5 (May 30, 2022): 1342–46. http://dx.doi.org/10.53350/pjmhs221651342.
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The case of late referral is one of the main problems with maternal and infant mortality in Indonesia. The maternal mortality rate in Indonesia is at the highest position in Southeast Asia, at 305 per 100,000 live births. The concept of three models of procrastination is a determinant that has a considerable role in the occurrence of maternal death in society. These delays include being late in recognizing red flags and making decisions, being late in reaching health facilities, and being late in getting help. When a maternal emergency occurs, the rapid decision- making by the mother or family to decide on referral approval is a contributing factor to the success of medical interventions to prevent mortality. In addition, survival depends on the fast and appropriate initial management and implementation of referral procedures by the midwife or referring health center. This study aims to determine how the relationship between family support and referral procedures for delays in maternal emergency referrals with delays in decision making as intervening variables. This type of research is analytical with a cross- sectional design. A sample of 92 respondents was taken using accidental sampling techniques using inclusion and exclusion criteria. Data were obtained by distributing family support questionnaires to referral patients and structured interviews for referring midwives to explore referral procedures. The data were analyzed using chi-squere tests and path analysis. Of the 92 referral cases, 57 respondents (61.9%) experienced delays in making decisions and 8 cases (8.7%) experienced delays in referrals. The results of statistical tests on predisposing factors were found to have no meaningful relationship with delays in maternal emergency referrals with a p value of > α 0.05. The results of the path analysis on 2 independent variables, namely family support and referral procedures for delays in decision making and their impact on referral delays showed varying results. There is a significant relationship in several pathways, namely: family support with late referrals, family support for late decision making, referral procedures with delays in decision making, delays in decision making with late referrals, referral procedures with delays in referrals, and family support and referral procedures for late referrals through delays in decision making with a value of p<0.05. Meanwhile, in several other pathways, no significant relationship (p>0.05) was obtained, namely: predisposing factors (age, education, income, parity, frequency of pregnancy examinations) to late referrals Keywords: Family Support Referral Procedures Emergency Referral Delays
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Baloch, Pari Gul, Erum Ilyas, Shazia Ramzan, Pinkey Kumari, Paras Mangi, and Sabita Devi. "Outcome of Fetus and Mother in Covid-19 Positive Pregnancies: A Retrospective Study." Pakistan Journal of Medical and Health Sciences 16, no. 5 (May 30, 2022): 1316–18. http://dx.doi.org/10.53350/pjmhs221651316.
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Aim:To assess the Feto-Maternal Outcome in Covid-19 Positive Pregnancies Study design: A retrospective study Place and duration: This study was conducted at Sheikh khalifa bin Zayed hospital Quetta, Pakistan from February 2020 to Feburary2021 Methodology:After ethical committee approval for the study, all medical records were evaluated for symptomatic and asymptomatic COVID-19 positive pregnant females. After admission to the hospital, an experienced healthcare worker validated the SARS-COV-2 status of all afflicted women by taking nasopharyngeal swabs for real-time RT-PCR following WHO criteria.Bothfeto-maternal outcomes were observed, including psychological stress, fever, cough, sore throat, dyspnea, ICU hospitalizations, pneumonia, maternal transfer of COVID to newborn. SPSS version 22 was used to analyze the data. Results:The present study investigated 72 COVID-19 positive pregnant women. The mean age of females was 28 ± 5.6 years, and the mean gestational age was 37 weeks. The common symptoms were anxiety (18.1%), runny nose with fever (12.5%), cough and fever (9.7%), and sore throat (8.3), whereas 48.6% of cases were asymptomatic. Co-Morbidities include Hypertension (19.7), Anemia (8.3%), Diabetes Mellitus (5.6%), and Hypothyroidism (2.8%). Conclusion: The clinical course of COVID-19 infection in pregnant women appears similar to that of non-pregnant women. There was no vertical transmission of COVID-19, nor was there any neonatal mortality. Keywords: COVID-19, feto-maternal transmission, pandemic, pregnancy outcome
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Ullah, Rahman, Mashal Nazir, Farooq Khan, Muhammad Asim Fazal, Nazia Shahana, Asim Khan Yousafzai, and Kainat Nazir. "Comparative Evaluation of Bedside Index of Severity in Acute Pancreatitis Bisap) & Modified Computed Tomography Severity Index (MCTSI) in Assessing Severity of Acute Pancreatitis." Pakistan Journal of Medical and Health Sciences 16, no. 5 (May 30, 2022): 1444–46. http://dx.doi.org/10.53350/pjmhs221651444.
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Objective: To compare diagnostic accuracy of BISAP and MCTSI in predicting the severity of Acute pancreatitis. Study design: cross sectional study. Setting: Surgical department Khyber Teaching Hospital, Peshawar and Bacha Khan Medical Complex, Swabi. Duration: 6 months Jan, 2021 to June, 2021 Material and Methods: In this study a total of 246 patients were observed. The demographic, clinical and laboratory data of all consecutive patients with a primary diagnosis of AP admitted/transferred to our ward were prospectively collected and then this data were retrospectively analyzed. The day of admission is defined as the first 24hr of hospitalization in our ward or in the referring hospital/ward. Contrast enhanced CT(CECT) and BISAP score were calculated after 72hrs in all patients and they were categorized into three severity grades of Acute pancreatitis based on Atlanta classification 2012 as discussed in operational definition. BISAP score greater than 4 and MCTSI score greater than 8 were considered severe acute pancreatitis. Results: In this study mean age was 45 years with SD ± 16.21. Forty three percent patients were male while 57% patients were female. MCTSI had sensitivity 89.83%, specificity 60%, Positive predictive value was 98.14%, Negative predictive value was 20% and the overall diagnostic accuracy was 88.61%. While BISAP had sensitivity 82.05%, specificity 70%, Positive predictive value was 98.49%, Negative predictive value was 14.89% and the overall diagnostic accuracy was 82.52%. Conclusion: Our study concludes that the diagnostic accuracy of MCTSI is better than BISAP score in predicting the severity of acute pancreatitis. Keywords: MCTSI, BISAP score, severe acute pancreatitis.
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Tariq, Afrah, Qaiser Shehzad Humayoun, Muhammad Hafeez, Israr Liaquat, Irum Tauhidi, and Asad Shabbir. "Usefulness of Peak Flow Meter in Monitoring of Asthma Management in Pediatric Age Group." Pakistan Journal of Medical and Health Sciences 16, no. 5 (May 30, 2022): 1430–31. http://dx.doi.org/10.53350/pjmhs221651430.
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Objective: Toassess the incidence of usage of peak flow meter in the monitoring of asthma management in pediatric age group. Study Design: Descriptive case study Settings: Out Patient Department and Medical Ward of the Children's hospital and The Institute of Child Health Lahorefor duration of six months from 1st October 2016 to 31st March 2017. Methodology: Patients admitted in the hospital fulfilling the criteria of inclusion were enrolled in the analysis. After taking informed consent from parents and approval from ethical committee their demographic information was recorded. The proforma was completed by the researcher. Follow up was done after one-week to label PFM usage. Results: Out of 210 cases, 55.24%(n=116) were between 8-12 years of age while 44.76%(n=94) were between 13-16 years of age, 50.95%(n=107) were male while 49.05%(n=103) were females with mean age 12.0+2.30 years. Frequency of usage of peak flow meter in the monitoring of asthma treatment was recorded in 18.57%(n=39) whereas 81.43%(n=171) had no PFM usage. Conclusion: We concluded that the frequency of usage of peak flow meter in the monitoring of asthma treatment in pediatric age group is similar to other studies but very few data on practices of asthma management in Pakistan and different protocols are used for asthma self-management which needs some-other studies so that more appropriate and evidenced based data may be collected for developing the local guidelines of self-management of asthma. Keywords: Asthma, Monitoring, Usage of peak flow meter
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Zl., Randimbinirina, Rajaobelison T., Randrianandrianina Hf, and Rakotoarisoa Ajc. "Vascular Surgery of Limbs in Antananarivo: Indications and Outcomes." Pakistan Journal of Medical and Health Sciences 16, no. 5 (May 30, 2022): 1358–61. http://dx.doi.org/10.53350/pjmhs221651358.
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Background : The aim of this study was to describe the indications and outcomes for vascular surgery of limbs in Antananarivo. Methods: This was a retrospective and descriptive study for a period of 6 years (01 January 2015 to 31 December 2020), performed at Joseph Ravoahangy Andrianavalona Teaching Hospital Antananarivo, including all patients underwent arterial procedures of limbs. Demographic data, surgical indications, cardiovascular risk factors and history of cardiovascular disease, reason of admission, diagnostic imaging, surgical procedures and outcomes were analyzed. Results : One hundred eighty-nine patients were recorded, including 141 males (74.60%) and 48 women (25.39%). The average age was 48.27years old. The commonest indications of surgical vascular procedures were trauma (33.86%), diabetic peripheral arteriopathy (38.09%) and peripheral arterial disease (12.16%). The most common modifiable risk factors for cardiovascular disease were diabetes mellitus (53.43%), high blood pressure (51.85%), smoking (33.86%). Fourty-one patients (21.69%) had a history of cardiovascular disease. Gangrene (46.03%) and external bleeding (32.27%) were the commonest reason of admission. Surgical procedures were amputation (51.85%), arterial repair (32.80%), Fogarty thromboembolectomy (8.99%), ligation (13.15%) and popliteal cyst excision (3.17%). All revascularization procedures were performed by an open surgery. The overall limb salvage rate was 96.82%. Conclusion: Trauma and diabetic peripheral arteriopathy were the commonest indication of vascular surgery of limbs. Open repair surgery remain the surgical procedure to perform vascular surgery of limbs in our context. Keywords: Peripheral arterial. Trauma. Gangrene. Amputation. Revascularization. Surgery
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Babar, Shah Muhammad, Khawar Abbas Kazmi, Javed Majid Tai, and Faraz Farooq Memon. "Contrast Induced Nephropathy in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention." Pakistan Journal of Medical and Health Sciences 16, no. 5 (May 30, 2022): 1362–64. http://dx.doi.org/10.53350/pjmhs221651362.
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Objective: To determine the frequency of contrast induced nephropathy in patients with acute coronary syndrome undergoing percutaneous coronary intervention. Material & Methods: This study was conducted on all patients underwent percutaneous coronary intervention between the age of 20 years to 70 years at the Department of Cardiology, Aga Khan University Hospital, Karachi. Percutaneous coronary intervention was performed as per latest ESC guidelines and frequency of CIN was observed among all patients through comparing renal function test from baseline to post-procedure. Results: A total of 237 patients were included. 180 patients (75.9%) were males & 57 (24.1%) were females, with mean age of 58.94±11.49 years. The mean BMI was 26.76±5.40 kg/m2. 107 patients (45.1%) had DM, 153 (64.6%) were hypertensive and 100 (42.2%) had left ventricular dysfunction. 205 (86.1%) were in Killip class 1 and 33 (13.9%) were in Killip class 2. The mean pre PCI creatinine was 0.88±0.20 mg/dl. Type of contrast was non-ionic in 235 patients (99.2%). The mean volume of contrast was 201.18±79.15 ml. The mean post PCI (48 hours) creatinine was 0.95±0.27 mg/dl. Contrast induced nephropathy was seen in 5 patients (2.1%) Conclusion: The frequency of Contrast induced nephropathy in our study was much lower but measures should be taken to further minimize such complication in which patient's quality of life and may be compromised with subsequently higher mortality rates. Keywords: contrast induced nephropathy, acute coronary syndrome, Primary PCI
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Ganisia, Ainun, Yahya Irwanto, Diadjeng Setya Wardani, Karmanis ., Ineke Permatasari, Aliesya Patricia, Aswin Rafif Khairullah, Ristaqul Husna Belgania, and Karjono . "Survival Analysis of Clinicopathology Profile and Risk Factor in Cervical Cancer with Surgery." Pakistan Journal of Medical and Health Sciences 16, no. 5 (May 30, 2022): 1319–23. http://dx.doi.org/10.53350/pjmhs221651319.
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Introduction: Cervical cancer is one of the most preventable types of cancer compared to all cancer cases , but it is also deadly. Objective: This study aimed to determine the five year survival rate of surgical cervical cancer at Saiful Anwar Hospital Malang and to know the effect of clinicopathological profile and risk factors on survival rate. Methods: Our method is analytic observational with a retrospective cohort type using medical records of surgical cancer cervix from January until December 2017. The analysis used the Log-rank test, Kaplan Meier, and Cox regression. Results: The total of the 144 study samples, found 92 alive and 52 dead. This research of clinicophatology profile showed significant affect in stage (p .001), histopathology (p .006), degree of differentiation (p .000), and lymph node metastases (p .000). While the research of risk factor showed significant affect in age (p- value 0.000), total of parity (p .000), marital history (p .000), occupation (p .003), menstrual history (p .003), and type of contraception (p 0.000), type of therapy (p .001). And then, it was found no significant affect in BMI (p .471) area of residence (p .475). Conclusion:. The survival rate of cervical cancer patients in five years with surgery is 90 %. Based on the clinicopathological profile, it was found that that stage variable, histopathology, degree of differentiation, and lymph node metastases significantly affect the survival rate. In the characteristics of risk factors, The variables of age, parity, marital history, occupation, menstrual history, contraception, type of therapy, and place of residence) have a significant effect on survival. Keywords: Cervival Cancer; Clinicopathological Profile; Survival Analysis