scholarly journals Psychiatric morbidity in newly diagnosed carcinoma cervix and its comparison with benign condition

Author(s):  
Rajnish Raj ◽  
Nisha Bhagat

Background: To study the psychiatric morbidity among newly diagnosed carcinoma cervix and its comparison with benign gynaecological diseases of cervix. Cervical cancer is the second most common cancer in the world and ranked first in India. It is mainly caused by sexually transmitted infection (STI) of human papilloma virus (HPV).Methods: It was an open labeled, cross-sectional and extended phase study that screened 158 patients in the age group of 18-70 years who fulfilled both inclusion and exclusion criteria and screened positive on liquid based cytology (LBC), as per guidelines of Bathesda system in Government Medical College, Patiala. 13 patients dropped out of study and finally 145 patients were enrolled. They were further divided after biopsy into two groups as per histopathological examination (HPE) i.e., Group-1, N=47 women HPE positive for cervical intraepithelial neoplasia (CIN) as Cases and Group-2, N=98 HPE negative as Control. and anxiety and severity on Hamilton Rating Scale for Depression (HAM-D) and Hamilton Rating Scale for Anxiety (HAM-A) and Hospital Anxiety Depression Scale (HADS) was used to screen psychiatric morbidity for depression.Results: Mean age of Group-1 was 38.45±11.22 SD years and Group-2 was 36.67±8.54 SD years. Psychiatric morbidity in Group-1 was 65.95% whereas Group-2 was 21.42%. P value obtained on comparing HADS score of two groups was significant (p <0.050). After active intervention there was a significant reduction in psychiatric morbidity of two groups (72% in Group-1 and 81.3% in Group-2).Conclusions: The study revealed that the breaking of bad news has a significant psycho-social impact on patients suffering from carcinoma cervix than benign group.

2010 ◽  
Vol 68 (1) ◽  
pp. 76-80 ◽  
Author(s):  
Sergio Monteiro de Almeida ◽  
Solange Aparecida Gurjão

Neurocysticercosis (NCC) is a common central nervous system infection caused by Taenia solium metacestodes. OBJECTIVE: To investigate the occurrence of depression in patients with calcified NCC form. The study group consisted of 114 patients subdivided in four groups: NCC with epilepsy, NCC without epilepsy, epilepsy without NCC and chronic headache. METHOD: Depression was evaluated and quantified by the Hamilton Rating Scale for Depression (HRSD-21). RESULTS: Percentage of patients with depression was as follows: group 1 (83%); group 2 (88%); group 3 (92%); group 4 (100%). The majority of patients had moderate depression. CONCLUSION: Incidence of depression in all groups was higher than in the general population. It is possible that, in a general way, patients with chronic diseases would have depression with similar intensity. NCC is associated with the presence of depression.


Doctor Ru ◽  
2021 ◽  
Vol 20 (9) ◽  
pp. 54-59
Author(s):  
M.A. Kinkulkina ◽  
◽  
Yu.G. Tikhonova ◽  
A.V. Lazareva ◽  
V.P. Sysoeva ◽  
...  

Study Objective: Comprehensive study of the clinical and psychopathologic structure and assessment of the affective disorder nosology in organic cerebropathies in elderly people. Study Design: observational comparative clinical study. Materials and Methods. We have examined 105 patients over 50 years old (mean age: 61.3 ± 7.6 years) with affective disorders and organic cerebropathies (F06; F30–39; F43). Subjects were divided into two groups: 49 patients with organic central nervous system (CNS) diseases and prevailing affective symptoms in their psychoorganic syndrome (Group 1); 56 patients with affective disorders and an organic cerebropathy late in their life (Group 2). We used the clinical psychopathologic method, Montgomery – Asberg Depression Rating Scale, Hospital Anxiety and Depression Scale, and Mini Mental State Examination. Study Results. Significant differences were found in the distribution of the primary etiological factor of organic cerebropathies. Group 1 had mostly mixed etiology (42.8%), while Group 2 had toxic CNS damages (33.9%). There were large intergroup differences in affective disease nosology: Group 1 patients had mostly organic depressions (51.2%), and recurrent depressions (36.7%). Group 2 patients had recurrent depressions and bipolar effective disorders. Significant differences were found in the age of disease manifestation (54.8 and 39.4 years, respectively, р < 0.001) and disease duration (6.5 and 19.9 years, р < 0.001). Group 1 patients had mostly chronic and recurrent depressions, while Group 2 patients had bipolar and recurrent disease (р < 0.001). The number of past depressive events differed a lot as well: 3.1 and 6.4 (р = 0.03). Group 2 patients had more cases of severe dreary and anergic depression. Conclusion. Clinical and psychopathologic features of affective disorders in organic cerebropathies in elderly people are polymorphic symptoms, including various ratios of depressive and psychoorganic syndromes. Depressions in elderly people with organic cerebropathies have their distinguishing structure, clinical course and require a number of additional diagnostic examinations and division into two types depending on the relation between the time of affective pathology onset and organic cerebropathies. Keywords: depression in elderly people, late depression, organic cerebropathies, affective disorders, cognitive disorders.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Vladimir Anatolevich Parfenov ◽  
Pavel Rudolfovich Kamchatnov ◽  
Dina Rustemovna Khasanova ◽  
Enver Ibragimovich Bogdanov ◽  
Tatiana Markovna Lokshtanova ◽  
...  

AbstractThe existing treatments for somatoform dysfunction (SfD), reaction to severe stress (RSS), and adjustment disorders (AjD) are insufficiently effective and safe. Anxiolytic drug Tenoten proved effective in clinical trials (CT). The aim of this multicenter double-blind placebo-controlled randomized CT was to investigate the safety and efficacy of Tenoten in the treatment of anxiety in adults with SfD, RSS, AjD and other neurotic disorders (oNDs). 390 adult patients with SfD, RSS and AjD or oNDs with the Hospital Anxiety and Depression scale-anxiety (HADS-A) score ≥ 11 were randomized into 4 groups (n = 127 in Tenoten group 1 (4 tablets/day); n = 131 in Tenoten group 3 (8 tablets/day), n = 132 in combined Placebo group 2 + 4). The changes from baseline in the mean Hamilton Anxiety Rating Scale (HAM-A) score in groups 1 and 3 after 12 weeks were the primary outcome. The decrease of the HAM-A score from 18.81 ± 5.81 to 7.26 ± 4.63 (in group 1) and from 18.38 ± 4.3 to 6.40 ± 4.02 (in group 3) was observed post-treatment (pgroup 1/placebo = 0.0055, pgroup 3/placebo < 0.0001). Overall, 46 adverse events (28 in the Tenoten groups and 18 in the Placebo) were reported without any difference between the study groups. Tenoten performed significantly more effective than placebo in the anxiety treatment of adults with SfD, RSS, AjD and oNDs (clinicaltrials.gov NCT03036293).


2009 ◽  
Vol 67 (2b) ◽  
pp. 407-412 ◽  
Author(s):  
Antonio Luiz dos Santos Werneck ◽  
Ana Lucia Rosso ◽  
Maurice Borges Vincent

OBJECTIVE: To test the ability of a 5HT2a/c (trazodone) antagonist, to improve depression and motor function in Parkinson' disease (PD). METHOD: Twenty PD patients with and without depression were randomly assigned to receive trazodone (group 1) or not (group 2). They were evaluated through UPDRS and Hamilton Depression Rating Scale (HAM-D). RESULTS: For the UPDRS the mean score of group 2 was 33.1 ± 19.7 and 37.1 ± 18.0 at the end. For the group 1, the corresponding scores were 31.4 ± 11.3 and 25.9 ± 13.7. The variations in the Mann-Whitney test were 0.734 at the initial moment and 0.208 at the final moment. The variation in the comparison of the initial moment with the final moment was 0.005 providing statistical significance. For the HAM-D, the mean score went up 4 points in group 2, contrary to a 5.5 points decrease in group 1. CONCLUSION: Data analysis shows that this agent significantly improves depression, but the motor function improved only in the depressed patients. Because of the known anti-dopaminergic property of the 5-HT2c receptors, a possible approach for depression in PD could be the use of 5-HT2c antagonists, similarly to the use of atypical neuroleptics in case of psychotic symptoms.


2011 ◽  
Vol 26 (S2) ◽  
pp. 677-677 ◽  
Author(s):  
R.U. Rahman ◽  
A. Nisar ◽  
N. Hussain ◽  
I. Chaudhary

ObjectivesTo determine the frequency of Depressive Disorder among patients with breast cancer in an outpatient department of a tertiary care hospital in Pakistan.BackgroundCancer not only affects body physically but can also affect the mind in the form of psychiatric disorder. Proper identification and treatment of these conditions can be beneficial and cost-effective.MethodologyThis cross-sectional descriptive study was conducted on patients of breast cancer attending OPD of oncology department of Civil Hospital Karachi. The sample consisted of ninety three diagnosed patients of breast cancer who were screened for psychiatric morbidity through Hospital Anxiety and Depression Scale (HAD Scale). Screened patients were interviewed and diagnosed as depressive disorder according to ICD criteria. The level of depression in these diagnosed patients was quantified through ZUNG'S Depression Rating Scale.ResultsEighty two percent (n = 76) of the sample (n = 93) were found to have psychiatric morbidity on HAD scale. Out of these screened sample sixty percent (n = 46) were found to be depressed on Zung self rating depression scale. Majority of these patients were suffering from mild to moderate depression. Half of the female in this sample were undergone mastectomy that was not found to have any statistically significant impact on psychiatric morbidity of the patient.ConclusionThis study shows high prevalence of depression in patients with breast cancer. The health professional involve in care of breast cancer should screen routinely their patients for symptoms of depression.


2018 ◽  
Vol 6 (01) ◽  
pp. 37-40
Author(s):  
Rıza Altunbaş ◽  
Mehmet Eren ◽  
İbrahim Altıparmak ◽  
Hüseyin Karaaslan ◽  
Tevfik Sabuncu

Abstract Background Although hyperthyroidism may be associated with atherosclerosis, its pathogenesis is not well known. TSH receptor antibody (TRAb) has been shown to be responsible for increased orbital fat tissue in Graves ophthalmopathy. Epicardial fat tissue thickness (EFT) has been found to be increased in case of overt hyperthyroidism. In our study, we aimed to investigate if TRAb is associated with the increased EFT in newly diagnosed hyperthyroidism. Methods Twenty six TRAb positive (group 1) and 26 TRAb negative (group 2) newly diagnosed patients with hyperthyroidism, and 26 healthy control subjects (group 3) were enrolled. EFT was measured by the same cardiologist using an echocardiography device. Serum TRAb levels were measured by the radio-receptor assay and levels above 1.75 IU/L were considered as positive. Results There was no difference among groups in terms of age, gender and body mass index. Although there was no significant difference between group 1 and 2, both group 1 (0.38±0.15 cm) and group 2 (0.4±0.17 cm) had significantly higher EFT levels when compared to group 3 (0.25±0.06 cm) (p=0.004 and p=0.001, respectively). However we did not find any correlation between TRAb and EFT levels. Conclusion The results of our study suggested that EFT was increased in hyperthyroidism and this increasing was not dependent of TRAb level. EFT elevation might be depending directly to the cardiovascular effects of hyperthyroidism.


1993 ◽  
Vol 163 (6) ◽  
pp. 802-805 ◽  
Author(s):  
Arthur Dorman ◽  
Art O'Connor ◽  
Eamonn Hardiman ◽  
Aideen Freyne ◽  
Helen O'Neill

In this comparative study with a control group of prisoners, psychiatric morbidity was measured in two groups of sentenced prisoners, each group completing the GHQ-30 and 21-item Beck Depression Inventory (BDI). Group 1 consisted of 40 segregated HIV-positive prisoners and group 2 a matched control group in the main prison who had no history of HIV seropositivity. All members of group 1 had a history of intravenous drug abuse. The mean GHQ-30 and BDI scores were significantly higher in group 1, and 90% of group 1 were psychiatric ‘cases’ compared with just over 42% of group 2. Levels of psychiatric morbidity present in a third group, consisting of HIV-positive prisoners who had not been segregated (prison authorities were unaware of their seropositivity) are an interesting pointer for further research.


2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Arun Kr. Mahat ◽  
Ram Yadav ◽  
Anjani Kr. Yadav ◽  
Pradeep Acharya ◽  
Ashok Dongol ◽  
...  

Objective. To compare the effect of sutureless versus multiple sutures technique on postoperative variables such as pain, swelling, and trismus after surgical removal of the third molar in Nepalese subpopulation. Materials and Methods. Forty-eight patients were equally grouped into multiple sutures (group 1) and sutureless (group 2) groups using a computer-generated random table. The same operator performed all the surgical procedures. Postoperative variables such as pain, swelling, and trismus were measured by a single concealed observer using a 10 cm Numerical Rating Scale (NRS), flexible plastic measuring tape, and vernier caliper preoperatively and on 1st, 2nd, and 7th postoperative days. Results. This study showed significantly more swelling measured from the gonion to lateral canthus in group 1 than in group 2 on all postoperative periods (P<0.05). The mean NRS score was significantly higher in group 1 on the 1st postoperative day (P=0.01). Though mean duration of surgery, swelling as measured from tragus to commissure, trismus, NRS score except on the 1st postoperative day, total number of analgesics consumed, and complications were noted more in the multiple sutures group, the difference was not statistically significant. Conclusion. Our results support the use of sutureless technique after third molar surgery to minimize postoperative morbidity and the overall operative time and reduce the cost within the Nepalese subpopulation.


2018 ◽  
Vol 16 (2) ◽  
pp. 40-43
Author(s):  
Bimarsh Adhikari ◽  
Sunil Kumar Yadav ◽  
S. N. Gupta

Background: Anal fissure is a common benign condition presenting as severe pain, constipations and bleeding per rectum. It is defined as longitudinal tear or defect in anal canal skin. Surgical treatment of this conditions requires hospital admission and complications, like bleeding, infection and to its severe extent continence disturbances. That warrants a new treatment modality as pharmacological sphincterotomy i. e topical GTN (glycerine trinitrate) whose effects are reversible, cost effective and simple. Objective: The objective is to compare the effectiveness of topical GTN over lateral sphincterotomy in terms of pain management and healing of fissure. Method: This was a comparative study carried out in the department of Surgery at Nepalgunj Medical College, Teaching Hospital. Two groups were created and 25 patients in each group were put randomly. First group (Group 1) used topical GTN whereas second group(Group 2) underwent lateral sphincterotomy for treatment of fissure. The two groups were reassessed at 4 and 8 weeks for pain and fissure healing. Result: Total number of patients was 50. Each group consisted of 25 patients. The male to female ratio in group 1 was 1:1.5 and in group 2 it was 1: 1.8. In group 1 patients after 4 weeks of application of GTN pain reduced from the mean of 80±15 at the time of presentation to 50±9.27. When these patients were seen after 8 weeks, the pain reduction on VAS was nil in 21 patients out of 25. In group 2 the mean score fell from 75±15 to 20±10 after 4 weeks and at 8weeks 23 out of 25 patients didn't have any pain. It was observed that the pain reduction and healing were faster in group 2 patients when evaluated after 4 weeks (p=0.0029). but at the end of 8 weeks both group patients were similar in terms of pain reduction and healing of fissure (p=.28). Conclusion: According to study local GTN application is as effective as lateral sphincterotomy with cost effectiveness, simple with tolerable side effect and no continence disturbances.


Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 3956-3956
Author(s):  
Murtadha K. Al-Khabori ◽  
Mark Minden ◽  
Vikas Gupta ◽  
Aaron D. Schimmer ◽  
Andre C. Schuh ◽  
...  

Abstract T cell acute lymphoblastic leukemia (T-ALL) accounts for 14–22% of adult ALL. No prospective comparisons between different chemotherapy protocols have been done. Since 2000 a modified DFCI protocol (Silverman et al, Blood2001;97:121–1218) has been used as standard treatment for all newly diagnosed patients with T-ALL at Princess Margaret Hospital (PMH). This protocol includes a remission induction phase, a CNS prophylaxis phase with intrathecal chemotherapy and 12 Gy cranial irradiation, a 30-week intensification phase including weekly asparaginase, and a 72-week maintenance phase. We compared outcomes using this regimen to previous results for all newly diagnosed T-ALL from 1990 – 2000 at PMH using the standard institutional protocol in use at the time. Between 1990–2000, 44 patients (Group 1) were treated with a variety of protocols, including 9203ALL PMH protocol (11 patients), L10 (2 pts), Protocol C (7 pts), HyperCVAD (15 pts) and ECOG E2993 (9 pts). From 2000–2007, 33 T-ALL patients were treated with modified DFCI protocol (Group 2). The median age for all patients was 31 years (range 14–69 years). There was no significant difference between the two groups with respect to age at diagnosis, presenting WBC (median or percent &gt; 100 ×109/L), CSF positivity, or cytogenetics. More patients from Group 1 underwent allogeneic stem cell transplantation (BMT) in CR-1 (54%) as compared to those in Group 2 (54% vs. 14%, P = 0.001), primarily due to a change in BMT policy in 2002. The median follow up was 23 months (range 1–161 months) for the entire group and 53 months (range 14–161 months) for the surviving patients. Sixty-nine patients (90%) achieved complete remission, and 37 patients have relapsed. The CR rates were not significantly different between the two groups. The 3-year failure-free survival (FFS) was significantly higher in Group 2 (DFCI protocol) as compared with Group 1 (other protocols) (89% vs. 27%, P = 0.0001). Multivariate analysis using Cox proportional hazard model showed only the treatment regimen received (DFCI vs. others) to have a statistically significant impact on FFS (P = 0.0001). The 3-year overall survival (OS) was significantly higher in the DFCI group compared to the group receiving the other protocols (81% vs. 45%, P = 0.0006). On multivariate analysis, only the treatment regimen received (P=0.001) and the CSF status (P=0.014) had a significant impact on OS; BMT did not have a significant impact on OS. When patients were censored at the time of transplant, the FFS and OS analyses still showed statistically significant benefit for patients treated on DFCI protocol (P = 0.0001 and 0.03, respectively). In summary, treatment outcomes have markedly improved from 2000 onward as compared to the previous decade. Although improvements in supportive care and reduced use of allogeneic BMT may have been factors, it is likely that the institution of the DFCI pediatric protocol was the primary factor in the improved outcome. These results support the use of such pediatric asparaginase-intensive pediatric protocols for adult T-ALL.


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