The study examined the prevalence, sociodemographic, and clinical correlates of chronic pain among primary care patients in the state of Kerala, India. It also examined the patterns and relationships ...of chronic physical and mental health conditions with chronic pain.
This study is a cross-sectional survey conducted among 7165 adult patients selected randomly by a multi-stage stratified design from 71 primary health centers. The questionnaires administered included Chronic pain screening questionnaire, self-reported Chronic physical health condition checklist, Patient Health Questionnaire-SADS, The Alcohol Use Disorders Identification Test, Fagerström Test for Nicotine Dependence, WHO Disability Assessment Schedule and WHOQOL- BREF for Quality/Satisfaction with Life. The prevalence and comorbid patterns of chronic pain were determined. Logistic regression analysis and generalized linear mixed-effects model was employed to examine the relationship of chronic pain to socio-demographic variables and examined physical and mental health conditions.
A total of 1831 (27%) patients reported chronic pain. Among those with chronic pain, 28.3% reported no co-occurring chronic mental or physical illness, 35.3% reported one, and 36.3% reported multi-morbidity. In the multivariate analysis, patients with chronic pain when compared to those without had higher odds of being older, female, having lower education, not living with their family, greater disability, and poor satisfaction with life. Chronic pain was independently associated with both medical (hypertension, diabetes mellitus, tuberculosis, arthritis, and other medical illnesses) and mental health conditions (depressive disorders, anxiety disorders, and tobacco dependence). It showed a varying strength of association and additive effect with increasing number of co-occurring physical and mental illnesses.
Chronic pain is a common condition among primary care attendees associated with significant burden of medical and mental health comorbidity. The findings highlight the need to incorporate treatment models that will ensure appropriate management to improve outcomes within the resource constraints.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
•Study reports on mental health issues among health care workers during COVID-19.•Anxiety/depression is highest among HCWs with frontline responsibilities.•Female HCWs, older, unmarried, those with ...family stress have higher mental distress.•Mentally distressed HCWs have greater alcohol use and suicidal thoughts.•This group also has a history of receiving mental health care in the past.
Mental health issues among health care workers (HCWs) in treatment settings during COVID-19 remains understudied in India. This study examines its prevalence and correlates among HCWs in Karnataka State, India. HCWs who attended a workshop to improve mental health well-being during COVID-19 completed an anonymous online questionnaire. In addition to socio-demographics, domains assessed include occupational characteristics, COVID-19 related concerns, anxiety/depression, substance use, suicidality, lifestyle and family functioning. Of the 3083 HCWs who completed the survey (response rate-51.4 %), anxiety disorder and depression was highest among those with frontline COVID-19 responsibilities (anxiety disorder-26.6 %, depression-23.8 %). Prevalence was significantly higher among those with clinical responsibilities compared to those with supportive responsibilities (anxiety disorder: 23.9 % vs 15.5 %), (depression: 20.0 % vs 14.2 %). In the backward step-wise logistic regression analysis, HCWs with anxiety disorder were more likely to be doctors/nurses/hospital assistants, older, female, unmarried, without a leisure activity, report increased alcohol use and suicidal thoughts after pandemic onset, and having a history of receiving mental health interventions. Participants with depression additionally had family distress and hardly ever exercised. To conclude, mental health issues are common among HCWs in India. Interventions need to ensure that HCWs are protected from mental health consequences of working in COVID-19 treatment settings.
Background: Patients with Parkinson's disease (PD) commonly use complementary and alternative medications. Yoga is a mind-body intervention that is being increasingly explored as a tool in the ...therapeutic armamentarium of PD.
Objective: To critically evaluate the studies and summarize the utility of Yoga in PD.
Material and Methods: We performed a systematic literature search in the Medline and Cochrane databases and included randomized controlled trials (RCT) of Yoga in PD. The studies were evaluated for internal validity and the relevant data were extracted.
Results: A total of seven studies were included in the analysis. We collated the data on the changes in motor function, gait and balance parameters, anxiety, depression and quality of life scores observed after intervention (Yoga) in patients with PD and highlighted the limitations of these studies.
Conclusion: Anxiety, depression, and balance issues in PD may benefit from Yoga. Yoga has potential as an add-on therapy in PD.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Impaired mother-infant bonding (MIB) is associated with inadequate maternal skills and pose a higher risk for impaired learning, child abuse, and psychiatric disorders in children. There are ...approximately 24 million births annually in India; however, community data on MIB from India is lacking.
The study reports the findings of a cross-sectional survey of 8189 mothers with children of age between 13 and 15 months from the state of Kerala, India. Bonding was assessed using the Mother-infant bonding scale (MIBS). Other correlates assessed include obstetric and birth history, chronic pain, postpartum depression and temperamental issues in the infant.
The prevalence of impaired MIB in our sample was 12.3%. Those in extended/joint family, experiencing postpartum complications, supplementary breastfeeding in the first 6 months, postpartum depression and temperamental issues in infant were found to be associated with increased MIBS scores in a multivariate mixed-effect zero-inflated poisson model.
Experience of impaired MIB is not uncommon among mothers in India. More needs to be done to explore these issues, especially among those with higher risk to ensure appropriate interventions to mitigate long-term consequences.
Adult ADHD is a prevalent yet underdiagnosed and undertreated condition. Assessment of ADHD is critical to understanding and managing ADHD comprehensively.
Method:
Scholarly articles on adult ADHD ...between 1996 and 2022 were reviewed using the PRISMA guidelines. ADHD rating scales with multiple citations were selected and their psychometric properties and symptom coverage were analyzed.
Results:
Ten rating scales, with sound psychometric properties, were identified. Out of those reviewed two (BADDS and BAARS-IV) load on the inattentive domain of ADHD, while the rest focus on a comprehensive assessment of ADHD. Only one scale (BARRS-IV) incorporates an assessment of functional impairment. Some scales though widely utilized have not been adequately examined for their sensitivity.
Conclusions:
Rating scales are reliable and valid, in the assessment of adult ADHD. We present a review of recent scales, with an expanded focus, to help clinicians make informed decisions on diagnosis, identifying targets and planning interventions accordingly.
Purpose
MRI is a useful method for discriminating low- and high-grade glioma using perfusion MRI and susceptibility-weighted imaging (SWI). The purpose of this study is to evaluate the usefulness of ...T1-perfusion MRI and SWI in discriminating among grade II, III, and IV gliomas.
Methods
T1-perfusion MRI was used to measure relative cerebral blood volume (rCBV) in 129 patients with glioma (70 grade IV, 33 grade III, and 26 grade II tumors). SWI was also used to measure the intratumoral susceptibility signal intensity (ITSS) scores for each tumor in these patients. rCBV and ITSS values were compared to seek differences between grade II vs. grade III, grade III vs. grade IV, and grade III+II vs. grade IV tumors.
Results
Significant differences in rCBV values of the three grades of the tumors were noted and pairwise comparisons showed significantly higher rCBV values in grade IV tumors as compared to grade III tumors, and similarly increased rCBV was seen in the grade III tumors as compared to grade II tumors (
p
< 0.001). Grade IV gliomas showed significantly higher ITSS scores on SWI as compared to grade III tumors (
p
< 0.001) whereas insignificant difference was seen on comparing ITSS scores of grade III with grade II tumors. Combining the rCBV and ITSS resulted in significant improvement in the discrimination of grade III from grade IV tumors.
Conclusion
The combination of rCBV values derived from T1-perfusion MRI and SWI derived ITSS scores improves the diagnostic accuracy for discrimination of grade III from grade IV gliomas.
•GNE myopathy gait analysis.•Pattern and severity of lower limb muscles involvement.•Gait deterioration more in women as compare to men with similar illness duration.
GNE myopathy is a rare, ...predominantly distal myopathy, involving mainly the lower limbs and presenting with gait disturbances. In this cross-sectional study gait evaluation of 23 (14 men) genetically confirmed GNE myopathy patients was done using Instrumented walkway analysis (GAITRite®) along with video gait capture. We recorded the topographical pattern of muscles involvement in lower limbs and correlated Functional Ambulation Profile-FAP and Medical Research council-MRC grading of lower limb scores with duration of illness. Early foot flat, foot drop gait with wider out-toed stance and higher perturbations with increased pressure at heel and decreased arm swing were noted. Muscle topography showed predominant weakness in ankle dorsi-flexors, flexor hallucis longus, extensor hallucis longus, hip adductors and knee flexors with stark sparing of quadriceps and relative sparing of hip- abductors, extensors, flexors and ankle plantar-flexors. Gait parameters in women were significantly more affected than men (p < 0.05) for the same duration of illness. FAP score and MRC grading of lower limb scores correlated significantly with duration of illness (p < 0.05). We observed that ankle dorsiflexors were affected earliest with sparing of quadriceps muscles in these patients.
Quality of life in children with cerebral palsy Nanjundappa, Nalina; Krishna, Pushpa; B, Sujaya ...
National journal of physiology, pharmacy and pharmacology,
2023, Letnik:
13, Številka:
6
Journal Article
Odprti dostop
Background: Cerebral palsy (CP) is the most common motor disability in childhood. Quality of life (QOL) has emerged as an important concept in childhood, especially for children with disabilities. CP ...has an impact on a child’s capacity to do activities of daily living thus affecting QOL of patients and their families.
Aims and Objectives: The objective of present study was to assess the QOL in children with CP.
Materials and Methods: In this study, 29 children with CP in the age group of 4–12 years were evaluated for QOL was assessed using CPQOL-Child Primary Caregiver Questionnaire (4–12 years). The questionnaire was completed by one of the parents or their caregiver. Scores for each domain of QOL were converted to a scale ranging from 0 to 100 and analyzed.
Results: The scores as reported by the parents were low for each of the domains with maximum effect seen in functioning domain and least in pain domain. Girls had better QOL than boys. The QOL scores were negatively related to the severity of CP which was assessed by gross motor function classification system suggesting that severity of disability had negative impact on QOL.
Conclusion: QOL of children with CP was found to be poor and was influenced by age, sex and motor functioning
Cognitive behaviour therapy (CBT) is an effective treatment for depression. However, culture can influence engagement and treatment efficacy of CBT. Several attempts have been made in Asian countries ...to develop a culturally adapted CBT for depression. However, research in the Indian context documenting the views on cultural influence of CBT is limited. The present study is an attempt to explore the views of patients and therapists in India by following an evidence-based approach that focuses on three areas for adaptation: (1) awareness of relevant cultural issues and preparation for therapy; (2) assessment and engagement; and (3) adjustments in therapy techniques. Semi-structured interviews with three consultant clinical psychologists/therapists, a focused group discussion with six clinical psychologists, and two patients undergoing CBT for depression were conducted. The data were analysed using a thematic framework analysis by identifying emerging themes and categories. The results highlight therapists’ experiences, problems faced, and recommendations in all three areas of adaptation. The findings highlight the need for adaptation with understanding and acknowledging the culture differences and clinical presentation. Culturally sensitive assessment and formulation with minor adaptation in clinical practice was recommended. Therapists emphasised the use of proverbs, local stories and simplified terminologies in therapy. The findings will aid in providing culturally sensitive treatment to patients with depression in India.
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