scholarly journals Comorbidity and clinical impacts of Attention-Deficit/hyperactivity disorder (ADHD) in child and adolescent with epilepsy

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
O S Khalifa ◽  
N S Ahmed ◽  
M A Nada ◽  
R M Amin

Abstract Aims and objectives To highlight the comorbidity and clinical impacts of ADHD in Egyptian children and adolescent with epilepsy regarding its different characteristics and effect on quality of life. Patients and Methods A cross-sectional study of 115 children with epilepsy was carried out and assessed for ADHD prevalence using the DSM5 criteria, Conner’s Parent Rating Scale for ADHD, Wechsler Intelligence Scale for Children and Quality of Life in Childhood Epilepsy Questionnaire: QOLCE-55. Results 36 founded to have ADHD (31.3%) and 79 non-ADHD (68%), the inattention type was the most common by 19 child (52.7%) , 15 (41.6%) child with combined type and only 2 (5.5%) child with hyperactive type, The factors that were significantly associated with the co-morbidity were Lower age of onset of 1st seizure with nearly statically significant ratio (P value 0.051), the seizure presence in last 3 months group (P value 0.03), epileptic EEG abnormalities in the most recent EEG (P value 0.01), lower IQs (P value 0.002).and There was no statically significant association with sex, type of epilepsy, history of febrile seizure. There was strong statically significant decrease in quality of life with ADHD comorbidity (P value 0.001), and decrease school attendance between ADHD and non-ADHD groups (P value 0.015). Conclusion ADHD is a common comorbidity in epileptic children with about 2\3 of ADHD children were not diagnosed, and severe effect on quality of life, so frequent assessment for ADHD in epileptic children is mandatory.

Author(s):  
Shazo Sana

Introduction: Menopause is the permanent cessation of menses, typically occurs in women of 45-55 years. Menopause is associated with a number of somatic, psychological and sexual symptoms due to decline in estradiol levels resulting in poor quality of life of postmenopausal females. Aims & Objectives: The purpose of the current study was to determine the effect of Nigella sativa on menopausal symptoms and estradiol levels in postmenopausal females. Place and duration of study: Department of Physiology PGMI, Lahore for 8 weeks. Material & Methods: It was an interventional study conducted on 30 postmenopausal females. Nigella sativa was administered in the dose of 1g/day after breakfast for a period of 8 weeks. Menopausal Rating Scale (MRS) was filled and blood sample was taken before and after giving Nigella sativa for estradiol and testosterone levels. Data was analyzed by paired t-test using SPSS-21 and p- value less than 0.05 was considered significant. Results: The result of the study showed that there was statistically significant reduction in the overall score of MRS (p = 0.001) and in all its domains, somatic (p=0.001), psychological (p=0.001) and urogenital (p=0.017). There was also significant improvement in blood estradiol level after 8 weeks of Nigella sativa administration (p= 0.021). Conclusion: Nigella sativa supplementation increases estradiol level and decreases menopausal symptoms severity as indicted by significant reduction in the 3 domains of MRS and may be used by postmenopausal females on regular basis to improve their quality of life.


2020 ◽  
Vol 11 (1) ◽  
pp. 1396-1400
Author(s):  
Mustopa Mustopa ◽  
Muhammad Kamaludin ◽  
Rahmawaty Neny Triatny

ABSTRAKLansia banyak menghadapi berbagai masalah kesehatan yang perlu penanganan segera dan terintegrasi seperti insomnia. Insomnia merupakan suatu keadaan yang menggambarkan seseorang tidak memiliki kualitas hidup yang baik sehingga merasa tidak cukup tidur, meskipun mempunyai pola waktu tidur yang baik, akan tetapi dengan keadaan tersebut menyebabkan seseorang tidak tampak segar untuk menjalankan aktifitas sehari-hari pada siang hari. Kualitas hidup diartikan sebagai persepsi individu mengenai berfungsinya mereka di dalam bidang kehidupan. Adapun tujuan penelitian ini untuk mengidentifikasi tingkat insomnia, untuk mengetahui kualitas hidup lansia dan mencari hubungan antara tingkat insomnia dengan kualitas hidup lansia yang hidup sendiri.Metode penelitian ini adalah korelasi yang bersifat deskriptif, dengan menggunakan pendekatan crossectional. Populasi dalam penelitian ini adalah seluruh lansia yang mengalami insomnia di Wilayah Kerja Puskesmas Kaliwedi dengan jumlah sampel sebanyak 42 lansia dengan metode pengambilan data total sampling. Tingkat insomnia diukur dengan IRS (Insomnia Rating Scale) dan kualitas hidup diukur dengan WHOQOL-BREF. Hasil penelitian dengan hasil uji statistik chi-square diperoleh p value (0,001) <  =0,05 (lebih kecil dari 0,05). Hal tersebut menunjukkan bahwa H0  (Hipotesis Nol) ditolak dan Ha  (Hipotesis Alternatif) diterima.Berdasarkan hasil penelitian tersebut maka dapat disimpulkan bahwa ada hubungan antara tingkat insomnia dengan kualitas hidup Lansia yang hidup sendiri di Wilayah Kerja Puskesmas Kaliwedi Kabupaten Cirebon.Kata Kunci          : Lansia, insomnia, kualitas hidup    ABSTRACTMany elderly face many health issues that need immediate handling and integrated such as insomnia. Insomnia is a State that describes a person does not have a good quality of life so feel not enough sleep, despite having a good sleep pattern, but with the circumstances cause someone didn't look fresh to run day-to-day activities during the day. Quality of life is defined as an individual's perception about their functioning in the areas of life. As for the purpose of this research was to identify the level of insomnia, to know the quality of life of the elderly and looking for the relationship between the level of insomnia with the quality of life of the elderly who live alone.The method of this research is the correlation that is descriptive, using the crossectional approach. The population in this research is the entire elderly who experience insomnia Clinics in the region Kaliwedi with the number of samples as much as 42 elderly with total data retrieval method of sampling. The level of insomnia is measured by the IRS (Insomnia Rating Scale) and quality of life measured by the WHOQOL-BREF. Research results with the results of the statistical test of chi-square obtained p value (0.001) = 0.05 < (less than 0.05). This indicates that H0 (Zero Hypothesis) was rejected and Ha (alternative hypothesis) is received.Based on the results of the study can be concluded there is a connection between the level of insomnia with the quality of life of the elderly who live alone in the region of Cirebon district health centers Work Kaliwedi.Keywords: Elderly, insomnia, quality of life


2020 ◽  
Vol 10 (01) ◽  
pp. e163-e168
Author(s):  
Moustafa M. Ragab ◽  
Ehab M. Eid ◽  
Nahla H. Badr

AbstractAttention-deficit hyperactivity disorder (ADHD) is the most common psychiatric disorder in children and adolescents. Symptoms of ADHD and its treatment can impact an individual's quality of life (QoL). The present study aimed to evaluate the effect of atomoxetine treatment, demographic characteristics, and seasonal variation on QoL in children with a recent diagnosis of ADHD and their parents. The present study included a cohort of 200 children diagnosed with ADHD. In addition to the recruited children, one of their parents was included in the study. ADHD symptoms were assessed using Conners' Parent Rating Scale. QoL of the participants was assessed with the PedsQL, while parents' QoL was evaluated using the World Health Organization Quality of Life questionnaire (WHOQOL-Bref). There was significant improvement in pediatric and parental QoL after treatment with atomoxetine. Significant factors related to better QoL in the participants included spring season, above average Conner's score, male sex, and rural residence. However, after using multivariate regression analysis, only patients' sex and Conner's score were significant predictors of pediatric QoL at the end of treatment with atomoxetine. Medical treatment significantly improved QoL in children with ADHD and their parents. Level of improvement was affected by patients' sex and ADHD severity.


2020 ◽  
Vol 9 (4) ◽  
pp. 1003
Author(s):  
Arturo Cuomo ◽  
Marco Cascella ◽  
Cira Antonietta Forte ◽  
Sabrina Bimonte ◽  
Gennaro Esposito ◽  
...  

Objectives: To explore the effect of breakthrough cancer pain (BTcP) treatment on quality of sleep and other aspects of the health-related quality of life (HRQoL) in patients with cancer pain. Methods: In an observational, multicenter, cohort study, cancer patients from palliative care units, oncology departments, and pain clinics and affected by BTcP were included. Enrolled patients were assessed at the four visits: T0 (baseline), T7, T14, and T28. Stable chronic background pain (numeric rating scale, NRS ≤ 4) during the whole study period was mandatory. BTcP was treated through transmucosal fentanyl. Three questionnaires were used to measure the HRQoL: EORTC QLQ-C15-PAL, Pittsburgh Sleep Quality Index (PSQI), and the Edmonton Symptom Assessment System (ESAS). RESULTS: In 154 patients, the HRQoL showed a significant improvement for all physical and emotional characteristics in the EORTC QLQ-C15-PAL, except for nausea and vomiting (linear p-value = 0.1) and dyspnea (Linear p-value = 0.05). The ESAS and PSQI questionnaires confirmed these positive results (p < 0.0001 and p = 0.002, respectively). Conclusions: This prospective investigation by an Italian expert group, has confirmed that careful management of BTcP induces a paramount improvement on the HRQoL. Because in cancer patients there is a high prevalence of BTcP and this severe acute pain has deleterious consequences, this information can have an important clinical significance.


2019 ◽  
Vol 12 (1) ◽  
pp. 532-540 ◽  
Author(s):  
Getandale Zeleke Negera ◽  
Teshale Ayele Mega

Background: The introduction of Combined Antiretroviral Therapy (cART) shifted the perception of HIV/AIDS from a fatal to a potentially manageable chronic disease. As a result, patient-perceived health-related quality of life (HRQoL) is becoming an important outcome measure among HIV infected patients. We assessed the quality of life of admitted HIV/AIDS patients and the association of socio-demographic, clinical, and psychosocial characteristics of patients with health-related quality of life. Methods: Health facility-based cross-sectional study was conducted from April 1 to May 31, 2018 in selected tertiary care hospitals of Ethiopia. HRQoL was measured at discharge using the interviewer-administered World Health Organization’s Quality of Life HIV short-form instrument (WHOQoL-HIV BREF). Data were entered into EpiData 3.2 and exported to SPSS version 21.0 for cleaning and analysis. Descriptive analytical results were reported in text and table. Logistic regression was conducted to identify predictors of poor quality of life. Variables with p-value ≤ 0.25 in bivariate regression were considered as a candidate for multivariable regression. Multivariable logistic regression was performed to identify independent predictors. Regression coefficients and their 95% confidence intervals together with p-value < 0.05 were used to identify independent predictor of poor QoL. Results: Majority, 56 (58.9%) of the study participants, had poor general health-related quality of life. Being unemployed (AOR: 4.1, 95% CI; (1.23, 13.64); p=0.02), lack of support from family (AOR: 3.6, 95% CI: (1.05-12.6); p=0.04), and having co-morbidity (AOR: 4.2, 95% CI: (1.08, 16.65); p=0.039) were found to be independent predictors of poor quality of life. Conclusions: The study showed that the majority of the participants had poor health-related quality of life which was affected by unemployment, co-morbidity, and social support from family.


2020 ◽  
Vol 7 (9) ◽  
pp. 1837
Author(s):  
Ashish Goti ◽  
Rameshkumar Dihora ◽  
Sweta Desai

Background: Aim of the study was to assess quality of life (QOL) of parents of epileptic child and its association with various factors like demographic, clinical, therapeutic and behavioral factors.Methods: Consenting parents of 160 epileptic children were enrolled after finishing child’s visit to the pediatrician. Parents were enquired on baseline demographic variables like age, gender, socio-economic status, parental education; clinical details like type of epilepsy, duration of seizure, seizure frequency and co-morbidity and therapeutic factors like treatment of epilepsy and adverse drug reactions. QOL was evaluated using QOLCE questionnaire and Childhood Illness-related Parenting Stress Inventory and analysed.Results: Out of 160 parents, 85% belong to 30-40 years of age and 62.5% were male. Deteriorated quality of life was reported by parents as mean score 63.46±7.69. QOL was significantly poor (p<0.05) in parents of younger child (<6 yrs), education status (upto primary school only), employment status of parent (unemployed) and lower socioeconomic status. Assessment of disease related parameters revealed that type of seizure, seizure frequency, duration and co-morbidity were factors significantly affecting quality of life of parents with lower QOL scores(p<0.05). QOL of parents of child with epilepsy undergoing polytherapy with multiple AEDs treatment, particle seizure control and having adverse drug reaction were associated with poor scores of health and well being (p<0.05). It was found that parents of epileptic child had deteriorated QOL score with respect to behaviour patterns irrespective to conditions of epilepsy due to constant stress and anxiety and poor state of mind.Conclusions: QOL of parents was compromised in Indian children with epilepsy. Demographic factors like age of child, parental education, socio-economic status and clinical factors like type of seizure, frequency & duration of seizure and co-morbid conditions significantly affect the QOL of parents. Significantly poor QOL scores was also due to therapeutic factors like treatment with polytherapy and adverse drug reactions with poor behavioral patterns which was observed in parents that should be taken care and should not be overlooked.


Author(s):  
Ümit Işık ◽  
Büşra Bağcı ◽  
Faruk Kılıç ◽  
Evrim Aktepe ◽  
Mustafa Özgür Pirgon

Abstract Objectives The present study assessed the obese adolescents’ health-related quality of life (HRQoL) based on both adolescent-reported and maternal-reported questionnaires to clarify adolescent-related psychiatric factors, maternal psychiatric factors, and body mass index (BMI) percentile variables that independently affect the quality of life (QoL). Methods A total of 190 adolescents (120 females and 70 males) were included in the study. The impact of clinical and psychiatric factors on the Pediatric Quality of Life Inventory-Child Version (PedsQL-C) scores was analyzed using hierarchical linear regression methods. Results The final models showed that only the Revised Child Anxiety and Depression Scale-Child Version major depressive disorder scores negatively predicted the physical, psychosocial, and total health scores of the PedsQL-C. The psychosocial scores of the PedsQL-P were negatively predicted by the Strengths and Difficulties Questionnaire emotional, and Conners’ Parent Rating Scale-Revised-Short Form (CPRS-R-S) attention-deficit/hyperactivity disorder (ADHD) index scores. The PedsQL-P total scores were negatively predicted by the CPRS-R-S ADHD index scores. Conclusions The findings of this study indicate that the adolescents’ psychiatric symptoms and BMI percentile played a significant role in the PedsQL subscale functioning of obese adolescents compared to maternal psychiatric symptoms.


Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Sinead Maguire ◽  
Finbar O'Shea

Abstract Background/Aims  Previous research in axial spondyloarthropathy (axSpA) has shown this population to have a high prevalence of depression. This co-morbidity has been previously shown to impact disease activity in patients with rheumatic disease. The purpose of this study was to screen for signs of depression using two validated tools, the Patient Health Questionaire-9 (PHQ-9) and the Hospital Anxiety and Depression Scale for depression (HADs-D) in axSpA patients. Methods  AxSpA patients attending the rheumatology department in St James’ Hospital between February and October 2020 were invited to take a self-administered survey which included the PHQ-9 and the HADs-D. Scores from the HADs-D yielded a numerical result which was then categorised as normal, borderline or abnormal. PHQ-9 numerical results were categorised as normal, mild, moderate, moderate/severe or severe. Patients with a known diagnosis of depression were excluded. In addition to baseline demographics, patient reported outcomes were also recorded. Data analysis was performed using IBM SPSS version 26. Continuous variables were recorded as means, categorical variables as frequencies with percentages. A one-way analysis of variance analysis (ANOVA) determined significance of variation in outcomes between patient outcomes as determined by the HADs-D and PHQ-9. A p-value of &lt; 0.05 was deemed significant. Consent was obtained prior to participation. Approval was received from the St James’/Tallaght Hospital Joint Ethics Committee. Results  In total 71 axSpA patients took part in the survey. The population was 70.4% (50) males and 29.5% (21) female, with an average age 47.9 years and mean disease duration 19.7 years (mean outcomes: BASDAI 4.08, BASFI 3.62, BASMI 3.54, ASQoL 6.79). Overall, 7 (9.9%) participants recorded abnormal HADs D scores, while 17 (23.9%) recorded moderate to severe PHQ-9 scores indicative of underlying depression. AxSpA females had higher mean HADs-D scores (7.5 vs 4.8, p = 0.01) than males, with abnormal scores in 19% (4) of females and 6% (3) of males. No significant differences were found in PHQ-9 scores between genders. Analysis revealed significantly worse BASDAI (6.27 vs 3.42, p &lt; 0.01) and AQoL scores (12.57 vs 5.26, p &lt; 0.01) in axSpA patients with abnormal compared to normal HADs D scores. No significant differences were noted in BASFI, BASMI or baseline demographics. A similar pattern was noted on analysis of PHQ-9 scores, with significantly worse BASDAI (7.9 vs 2.55, p &lt; 0.01), BASFI (8.05 vs 2.33, p &lt; 0.01) and ASQoL (19.5 vs 2.62, p &lt; 0.01) noted in those scoring as severe compared to normal. No significant differences were detected in BASMI scores or baseline demographics. Conclusion  A high percentage of axSpA patients recorded high HADs D and PHQ-9 scores for undiagnosed depression. These patients had significantly worse disease activity and quality of life as compared to patients with normal scores. Clinicians treating axSpA should consider screening for depression in this population. Disclosure  S. Maguire: None. F. O'Shea: None.


2019 ◽  
Vol 11 (1) ◽  
pp. 9-18
Author(s):  
Abdul Wakhid ◽  
Ana Puji Astuti ◽  
Maya Kurnia Dewi

Logoterapi merupakan terapi untuk menemukan makna positif dibalik sebuah kejadian yang tidak diharapkan. Logoterapi dilaksanakan secara individu maupun berkelompok dalam bentuk konseling dan berorientasi pada pencarian makna hidup individu. Tujuan logoterapi meningkatkan makna pengalaman hidup individu yang diarahkan kepada pengambilan keputusan yang bertanggung jawab. Penelitian ini dilakukan dengan menggunakan rancangan pre-experiment dengan metode pre and post test group, artinya pengumpulan data dilakukan terhadap responden untuk membandingkan kualitas hidup sebelum dan sesudah dilakukan intervensi. Teknik pengambilan sampel dilakukan dengan metode total sampling yaitu pengambilan seluruh sampel dengan tetap memperhatikan kriteria yang telah ditetapkan. Jumlah pasien yang menjalani hemodialisis di RSUD Ungaran sebanyak 21 orang dan di RSUD Ambarawa sebanyak 25 pasien. Analisis data dilakukan dengan menggunakan uji t test dependent. Hasil penelitian didapatkan bahwa dari 46 responden didapatkan rata-rata skor kualitas hidup pasien yang mejalani hemodialisis sebesar 60.22 dengan skor terrendah 55 dan skor tertinggi 69. Bahwa dari 46 responden didapatkan rata-rata skor kualitas hidup pasien yang mejalani hemodialisis sebesar 88.72 dengan skor terrendah 79 dan skor tertinggi 103. Hasil uji statistik dengan uji t test dependent diketahui ada pengaruh logoterapi terhadap kemampuan memaknai hidup pada klien yang menjalani hemodialisis di RSUD Kabupaten Semarang (p value: 0,0001). Saran perlunya peningkatan kemampuan perawat dalam memberikan layanan kesehatan termasuk pemberian atau pemanduan penemuan makna hidup bagi pasien hemodialysis, agar selain dengan hemodialysis, ada faktor internal dari pasien yang dapat dijadikan sebagai motivasi untuk sembuh dari penyakit.   Kata Kunci: Logoterapi, kualitas hidup   IMPROVE THE QUALITY OF LIFE OF PATIENTS WITH RENAL FAILURE WHO UNDERWENT HEMODIALYSIS   ABSTRACT Logotherapy is a therapy to discover the positive meaning behind an unexpected event. Logotherapy is carried out individually or in groups in the form of counseling and oriented to the search for the meaning of individual life. This study aims to improve the quality of life of patients with renal failure who underwent hemodialysis. This research was conducted by using pre-experiment with pre-post test study. The sampling technique was done by the convenience sampling. The number of patients undergoing hemodialysis as many as 46 respondents. Data analysis was done by using test t test dependent. The result showed that from 46 respondents got the mean of quality of life of patients who had hemodialysis 60.22 with lowest score 55 and highest score 69. Whereas from 46 respondents got the mean score of life quality of patients who had hemodialysis 88.72 with score the lowest score 79 and the highest score 103. The result of statistical test with t test dependent is known there is influence of logoterapi to the ability of meaningful life on client who undergo hemodialysis at Semarang Regency hospitals (p value: 0.0001). Advice on the need to improve the nurse's ability to provide health services, including the provision or guidance of the discovery of the meaning of life for hemodialysis patients, in addition to hemodialysis, there are internal factors of the patient that can be used as a motivation to recover from illness.   Keywords: Logotherapy, quality of life, kidney failure.  


2018 ◽  
Vol 5 (2) ◽  
pp. 56-63
Author(s):  
Abdul Wakhid ◽  
Estri Linda Wijayanti ◽  
Liyanovitasari Liyanovitasari

Background: Self efficacy can optimize the quality of life of clients who undergo the healing process due to chronic diseases. Individuals with higher self-efficacy move their personal and social resources proactively to maintain and improve the quality and length of their lives so that they experience a better quality of life. Objectives: the purpose of this study was to find the correlation between self efficacy and quality of life of patients with chronic kidney disease who undergo hemodialysis at RSUD Semarang Regency. Metode: This type of research was descriptive correlation with cross sectional approach. The samples in this study more 76 people with total sampling technique. The data collection tool for self efficacy was measured by General Self-Efficacy scale, for quality of life with WHOQoL-BREF. Statistical test used Kolmogorov-smirnov. Result: The result showed that self efficacy in patients with chronic kidney disease was mostly in moderate category (53,9%), quality of life in patients with chronic kidney disease was mostly in good category (68,4%). There was a correlation between self efficacy and quality of life of patients with chronic kidney disease who undergo hemodialysis at RSUD Semarang Regency, the result obtained p-value of 0.000 <α (0,05). Suggestion: Patients with chronic kidney disease can maintain good quality of life by helping to generate positive self-esteem and high self efficacy.


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