scholarly journals Psychological distress and its associated factors in the hypertensive patient (HTN-Pt) in Ludhiana, Punjab: A questionnaire-based retrospective study

2021 ◽  
Vol 12 (3) ◽  
pp. 2132-2138
Author(s):  
Maninder Singh ◽  
Bikram Singh ◽  
Arshvir Kaur

An elevation in blood pressure is an important risk factor of cardiovascular disease and several factors that can contribute to hypertension induce psychological distress. This study was aimed at estimating the prevalence of psychological distress and to assess general awareness regarding disease, concomitant substance abuse, and use of herbal drugs among hypertensive patients (HTN-Pt) at Satguru Pratap Singh (SPS) Hospitals, Ludhiana.  The psychological distress was assessed using the standard Kessler-10 scale  along with face-to-face interview among 275 outpatient department (OPD) HTN-Pt on follow-up. 15.30% (n=33) of total participants (n=213) had alcohol use disorders and 8.80% (n=19) of them were addicted to smoking habits. K10 scale results in patients, showed 46.9% (100) patients were suffering from psychological distress out of which 26% (n=56) were having mild, 17% (n=36) moderate and 4% (n=8) patients were having severe psychological distress. Highest percentage (33.80%) of patients with psychological distress were from age group 31-60 years of age (p value=0.003, COR= 0.240, 95% CI 0.072, 0.584). Many HTN-Pt were consuming the herbal supplements out of which 92 % of patients consuming grapes were found to have psychological distress (p value=0.034, COR= 0.380, 95% CI 0.155, 0.930).  The results of the study indicated that there was a high prevalence of psychological distress in HTN-Pt belonging to age group of 31-60 years of age and patients involved in the consumption of grapes. This study asks for supervision on the concomitant administration of herbal supplements with allopathic medicines in HTN-Pt to avoid psychological distress.

Author(s):  
Sabrina R Raizada ◽  
Natasha Cleaton ◽  
James Bateman ◽  
Diarmuid M Mulherin ◽  
Nick Barkham

Abstract Objectives During the COVID-19 pandemic, face-to-face rheumatology follow-up appointments were mostly replaced with telephone or virtual consultations in order to protect vulnerable patients. We aimed to investigate the perspectives of rheumatology patients on the use of telephone consultations compared with the traditional face-to-face consultation. Methods We carried out a retrospective survey of all rheumatology follow-up patients at the Royal Wolverhampton Trust who had received a telephone consultation from a rheumatology consultant during a 4-week period via an online survey tool. Results Surveys were distributed to 1213 patients, of whom 336 (27.7%) responded, and 306 (91.1%) patients completed all components of the survey. Overall, an equal number of patients would prefer telephone clinics or face-to-face consultations for their next routine appointment. When divided by age group, the majority who preferred the telephone clinics were <50 years old [χ2 (d.f. = 3) = 10.075, P = 0.018]. Prevalence of a smartphone was higher among younger patients (<50 years old: 46 of 47, 97.9%) than among older patients (≥50 years old: 209 of 259, 80.7%) [χ2 (d.f. = 3) = 20.919, P < 0.001]. More patients reported that they would prefer a telephone call for urgent advice (168, 54.9%). Conclusion Most patients interviewed were happy with their routine face-to-face appointment being switched to a telephone consultation. Of those interviewed, patients >50 years old were less likely than their younger counterparts to want telephone consultations in place of face-to-face appointments. Most patients in our study would prefer a telephone consultation for urgent advice. We must ensure that older patients and those in vulnerable groups who value in-person contact are not excluded. Telephone clinics in some form are here to stay in rheumatology for the foreseeable future.


2020 ◽  
Vol 16 (12) ◽  
pp. 1060-1068
Author(s):  
Faazila Fathima ◽  

Occlusal changes were important factors in temporomandibular disorder (TMD). It is of interest to evaluate the association of occlusal wear facets in TMD patients. We used a dataset of 49 patients with and without TMD for this study. Occlusal wear facets were evaluated using Smith and Knight tooth wear index. Data shows that teeth wear was present more in patients with TMD (55%). The age group 26-40 years showed high prevalence of teeth wear (grade1) in TMD patients (P value = 0.034). TMD was present more in females than males. Female (54%) patients with TMD showed more teeth wear compared to males. Most patients with TMD showed posterior teeth wear (61%) than generalized teeth wear. Thus, association was present between occlusal teeth wear and TMD patients especially in the age group of 26-40 years. Hence, proper evaluation of occlusal factors will aid in early diagnosis of TMDs.


2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Fassikaw Kebede ◽  
Birhanu Kebede ◽  
Tsehay Kebede ◽  
Melaku Agmasu

The human immune deficiency virus (HIV) is the strongest risk factor for the incidence of tuberculosis (TB) by way of reactivation of latent or new infection. The provision of isoniazid preventive therapy (IPT) is one of the public health interventions for the prevention of TB. To date, there have been limited clinical data regarding the effectiveness of isoniazid preventive therapy (IPT) on TB incidence. This study aimed to assess the effect of isoniazid preventive therapy on the incidence of tuberculosis for seropositive children in Northwest Ethiopia. Methods. A facility-based retrospective follow-up was employed for reviewing 421 files from 1 January 2015 up to 30 December 2019. EpiData version 3.2 and Stata/14 software were used for data entry and analysis, respectively. Categorical variables at bivariable Cox regression were assessed for candidates transferred at P value <0.25 for multivariable Cox regression to claiming predictors associated with TB incidence rate at 95% CI at P < 0.005 . Result. The overall incidence of TB was found to be 4.99 cases per 100 person-years at 95% CI (3.89–6.53). Missed IPT (AHR = 7.45, 95% CI: 2.96, 18.74, P < 0.001 ), missed cotrimoxazole preventive therapy (CPT) (AHR = 2.4, 95% CI: 1.84–4.74, P < 0.022 ), age ≥ 11 years (AHR = 4.2, 95% CI: 1.04–7.03, P < 0.048 ), MUAC ≤ 11.5 cm (AHR = 4.36, 95% CI: 1.97–9.97, P < 0.001 ), WHO stages III and IV (AHR = 2.04, 95% CI: 1.12–3.74, P < 0.022 ), and CD4 count ≤100 cells/μl (AHR = 3.96, 95% CI: 1.52–10.34, P < 0.005 ) were significantly associated with TB incidence. Conclusion. Concomitant administration of ART with IPT had demoted more than ninety-six percent of new TB incidences for this report. Undertaking in-depth TB screening and frequent follow-up among all these children is critical in order to prevent and control tuberculosis.


2020 ◽  
Vol 27 (5) ◽  
pp. 539-555 ◽  
Author(s):  
Elina Järvelä-Reijonen ◽  
Sampsa Puttonen ◽  
Leila Karhunen ◽  
Essi Sairanen ◽  
Jaana Laitinen ◽  
...  

Abstract Background Psychological processes can be manifested in physiological health. We investigated whether acceptance and commitment therapy (ACT), targeted on psychological flexibility (PF), influences inflammation and stress biomarkers among working-age adults with psychological distress and overweight/obesity. Method Participants were randomized into three parallel groups: (1) ACT-based face-to-face (n = 65; six group sessions led by a psychologist), (2) ACT-based mobile (n = 73; one group session and mobile app), and (3) control (n = 66; only the measurements). Systemic inflammation and stress markers were analyzed at baseline, at 10 weeks after the baseline (post-intervention), and at 36 weeks after the baseline (follow-up). General PF and weight-related PF were measured with questionnaires (Acceptance and Action Questionnaire, Acceptance and Action Questionnaire for Weight-Related Difficulties). Results A group × time interaction (p = .012) was detected in the high-sensitivity C-reactive protein (hsCRP) level but not in other inflammation and stress biomarkers. hsCRP decreased significantly in the face-to-face group from week 0 to week 36, and at week 36, hsCRP was lower among the participants in the face-to-face group than in the mobile group (p = .035, post hoc test). Age and sex were stronger predictors of biomarker levels at follow-up than the post-intervention PF. Conclusion The results suggest that ACT delivered in group sessions may exert beneficial effects on low-grade systemic inflammation. More research is needed on how to best apply psychological interventions for the health of both mind and body among people with overweight/obesity and psychological distress. Trial Registration ClinicalTrials.gov Identifier: NCT01738256, Registered 17 August, 2012


2019 ◽  
Vol 2 (1) ◽  
pp. 34-39
Author(s):  
Shankar Raut ◽  
Yogendra Man Shakya ◽  
Yagya Laxmi Shakya ◽  
Tirtha Man Shrestha ◽  
Ram Prasad Neupane

Background: Minor surgical procedures are surgeries that can be performed in the clinic under local anesthesia and doesn’t require preoperative and postoperative admission. In most of the institutions in our country, we advised patients to follow up within 7 to 10 days following minor surgical procedures. Unnecessary follow up increases stress to the patients in terms of not being able to manage daily routine work and would be costly as well. As a General Practitioner, majority of the cases done are the minor surgical procedures. Methods: The study was a prospective cross sectional study conducted in General Surgery Department at United Mission Hospital, Palpa from Dec 2013 to May 2013. 228 patients were divided in two groups of “No follow up” group and “Follow-up” group. No Follow-up Group was asked pre-formed questionnaires by telephone where as Follow-up group were asked to follow up routinely on day 7 to 10 days of surgery and asked the same questions. Statistical analysis was done using SPSS program and Microsoft excel. P value of <0.05 was considered statistically significant. P-value was determined by using Chi Square test. Result: The overall wound infection among 228 patients was found to be 14.5 percent with infection rate of 16.4 percent in No Follow up group and 12.7 percent in Follow-up group. The infection rate was found to be higher among the older age group of patient maximum being 36.4% in the age group of 50-59 years with p value of 0.053. Other risk factors like age, sex, residence, duration of surgery, socio economic status, history of medical illness and BMI didn’t have significant association with rate of infection following minor surgical procedure. Conclusion: The routine postoperative follow up in minor surgery is unnecessary unless there are any signs suggestive of infection.


2020 ◽  
Author(s):  
Luna Habtamu Degife ◽  
Yoseph Worku ◽  
Muse Tadesse

Abstract Immunization is an effective and proven tool for controlling and eliminating life-threatening vaccine preventable infectious diseases. In Ethiopia 5% of childhood mortalities are due to measles. Despite the availability of a safe and effective vaccine, measles outbreaks secondary to non-vaccination are occurring in southern Ethiopia especially in Yirgachefe district. This study was done to assess the risk factors associated with non-vaccination against measles. A Community-based unmatched case control study was conducted in Yirgachefe district from December 1-31, 2016.Cases were children in the age group of 12- 23 months of age who did not take measles vaccination and controls were children in the same age group who took at least one dose of measles vaccine. The study was done in 6 randomly selected kebeles and cases and controls were selected randomly by probability proportional to size sampling. A structured questionnaire was used for data collection. Statistical significance was interpreted using Odds ratio with 95% confidence interval and P value <0.05.A total of 320 individuals (107 cases and 214 controls) were approached for interview with a response rate of 93.75%. Of the cases, 57% were males and more than half fall in the 12-18 months age group. Knowledge regarding measles vaccination was also asked and among cases 72% heard about measles, 26% knew that all children should be vaccinated, 31% had awareness about the right age of vaccination, 60% agrees that measles is vaccine preventable and 65% knew that it is contagious. In multivariable logistic regression, Lack of Ante Natal Care follow up(ANC) (Adjusted Odds Ratio (AOR) =3.57; 95% Confidence Interval (CI): 1.22-10.44), lack of knowledge on the importance of vaccination, who should be vaccinated and if measles is contagious with an AOR and CI of (AOR=6.81; 95% CI: 1.56-29.64), (AOR=4.29; 95% CI: 1.83-10.04) and (AOR=8.97; 95%CI: 3.15-25.58) respectively were independent risk factors.Education and awareness about measles and its immunization should be given to the community. Additionally, ANC follow up should also be strengthened.


PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e4570 ◽  
Author(s):  
Lisa Ljungman ◽  
Martin Cernvall ◽  
Ata Ghaderi ◽  
Gustaf Ljungman ◽  
Louise von Essen ◽  
...  

ObjectiveA subgroup of parents of children who have been treated for childhood cancer report high levels of psychological distress. To date there is no empirically supported psychological treatment targeting cancer-related psychological distress in this population. The aim of the current study was to test the feasibility and preliminarily evaluate the effect of individualized face-to-face cognitive behavior therapy (CBT) for parents of children after the end of treatment for childhood cancer. A secondary aim was to present a cognitive behavioral conceptualization of cancer-related distress for these parents.MethodsAn open trial was conducted where 15 parents of children who had completed successful treatment for cancer three months to five years earlier and who reported psychological distress related to a child’s previous cancer disease were provided CBT at a maximum of 15 sessions. Participants were assessed at baseline, post-intervention, and three-month follow-up using self-reported psychological distress (including posttraumatic stress symptoms (PTSS), depression, and anxiety) and the diagnostic Mini-International Neuropsychiatric Interview. Feasibility outcomes relating to recruitment, data collection, and delivery of the treatment were also examined. Individual case formulations for each participant guided the intervention and these were aggregated and presented in a conceptualization detailing core symptoms and their suggested maintenance mechanisms.ResultsA total of 93% of the participants completed the treatment and all of them completed the follow-up assessment. From baseline to post-assessment, parents reported significant improvements in PTSS, depression, and anxiety with medium to large effect sizes (Cohen’sd= 0.65–0.92). Results were maintained or improved at a three-month follow-up. At baseline, seven (47%) participants fulfilled the diagnostic criteria for major depressive disorder and four (29%) fulfilled the criteria for posttraumatic stress disorder, compared to none at a post-assessment and a follow-up assessment. The resulting cognitive behavioral conceptualization suggests traumatic stress and depression as the core features of distress, and avoidance and inactivity is suggested as the core maintenance mechanisms.ConclusionThe treatment was feasible and acceptable to the participants. Significant improvements in distress were observed during the study. Overall, results suggest that the psychological treatment for parents of children after end of treatment for childhood cancer used in the current study is promising and should be tested and evaluated in future studies.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1475.3-1476
Author(s):  
S. M. Hernández-Zambrano ◽  
R. A. Castiblanco-Montañez ◽  
J. Chavez-Chavez ◽  
D. P. Rivera-Triana ◽  
A. Aza ◽  
...  

Background:The Covid-19 pandemic has generated restrictions in the mobility of people, affecting the face-to-face care of patients with chronic diseases, including autoimmune. The health emergency has created the need to establish follow-up alternatives, giving rise to telemedicine.Objectives:To evaluate the level of attendance to teleconsultation and the face-to-face usual care in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) who underwent to a developed innovative telemedicine program after the declaration of quarantine due to the Covid-19 pandemic.Methods:The present cross-sectional descriptive study reports retrospective data collected from patients with RA and SLE from March to June, 2020;. Since the beginning of March 2020 when Covid-19 was declared in Colombia as a health emergency establishing specific standards for outpatient care, our center has made the necessary legal and technical adjustments to develop an innovative telemedicine service to prevent the epidemiological risk. To all contacted patients were offered the option of teleconsultation or face-to-face consultation; a standardized protocol was set with clinimetry measures evaluated in both groups. Continuous variables were described using mean and standard deviation, and categorical variables were described using numbers and percentages. We performed chi-square tests of independence to determine differences between teleconsulting and conventional face-to-face consultation.Results:A total of 5745 RA patients were followed-up, 5292 (92.1%) by teleconsulting and 453 (7.9%) by conventional face-to-face consultation; among the group of SLE patients, a total of 646 were assessed, of which there were 386 (60%) by teleconsultation and 260 (40%) by face-to-face consultation; this highlights an important difference in the level of acceptance of the teleconsultation between patients with RA and SLE, being much lower in patients with SLE (p value< 0.0001). Regarding gender differences, in men, there were 33 (12.7%) SLE and 89 (19.6%) RA face-to-face consultations, while in women there were 227 (87.3%) SLE and 364 (80.4%) RA in a face-to-face consultation. Regarding patients who were attended through telemedicine, 45 (11.7%) SLE and 966 (18.3%) RA were men, while 341 (88.3%) SLE and 4326 (81.7%) RA were women; that means, in the RA cohort, a greater number of men prefer the face-to-face consultation than in the SLE cohort (p value< 0.0185). 10 RA patients were diagnosed with the Covid-19 in teleconsultation; in all cases, close contact with infected relatives was verified as the probable cause.Table 1.Differences by gender in the level of teleconsultation acceptance and face-to-face assistance in patients with SLE and RARA PatientsGenderTeleconsulting (%a)Face-to-face consultation (%a)Male105596691,57%898,43%Female4690432692,23%3647,77%SLE PatientsGenderTeleconsulting (%a)Face-to-face consultation (%a)Male784557,69%3342,31%Female56834160,03%22739,97%a Total percentage of patients by gender. RA: Rheumatoid arthritis; SLE: Systemic lupus erythematosus.Conclusion:Telemedicine may provide a viable option for the follow-up of patients with rheumatological diseases even beyond the pandemic. But unexpectedly, data showed an important difference in the acceptance of teleconsultation between patients with RA and SLE, being much higher in older and/or male patients with RA compared to patients with SLE; however, further studies are needed to support this conclusion.Disclosure of Interests:None declared


Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1744
Author(s):  
Fabiola Mabel Del Razo-Olvera ◽  
Angélica J. Martin-Vences ◽  
Griselda X. Brito-Córdova ◽  
Daniel Elías-López ◽  
María Victoria Landa-Anell ◽  
...  

Purpose: To describe the primary barriers to adequately adhering to a structured nutritional intervention. Patients and methods: A total of 106 participants diagnosed with dyslipidemia and without a medical nutrition therapeutic plan were included in this two-year study conducted at the INCMNSZ dyslipidemia clinic in Mexico City. All patients were treated with the same structured strategies, including three face-to-face visits and two telephone follow-up visits. Diet plan adherence was evaluated at each site visit through a 3-day or 24-h food recall. Results: Barriers to adhere to the nutritional intervention were: lack of time to prepare their meals (23%), eating outside the home (19%), unwillingness to change dietary patterns (14%), and lack of information about a correct diet for dyslipidemias (14%). All barriers decreased significantly at the end of the intervention. Female gender, current smoking, and following a plan of more than 1500 kcal (R2 = 0.18 and p-value = 0.004) were associated with good diet adherence. Participants showed good levels of adherence to total caloric intake at visit 2 and 3, reporting 104.7% and 95.4%, respectively. Adherence to macronutrient intake varied from 65.1% to 126%, with difficulties in adhering to recommended carbohydrate and fat consumption being more notable. Conclusion: The study findings confirm that a structured nutritional intervention is effective in reducing barriers and improving dietary adherence and metabolic control in patients with dyslipidemias. Health providers must identify barriers to adherence early on to design interventions that reduce these barriers and improve adherence.


2020 ◽  
Author(s):  
Luna Habtamu Degife ◽  
Yoseph Worku ◽  
Muse Tadesse

Abstract Immunization is an effective and proven tool for controlling and eliminating life-threatening vaccine preventable infectious diseases. In Ethiopia 5% of childhood mortalities are due to measles. Despite the availability of a safe and effective vaccine, measles outbreaks secondary to non-vaccination are occurring in southern Ethiopia especially in Yirgachefe district. This study was done to assess the risk factors associated with non-vaccination against measles. A Community-based unmatched case control study was conducted in Yirgachefe district from December 1-31, 2016.Cases were children in the age group of 12- 23 months of age who did not take measles vaccination and controls were children in the same age group who took at least one dose of measles vaccine. The study was done in 6 randomly selected kebeles and cases and controls were selected randomly by probability proportional to size sampling. A structured questionnaire was used for data collection. Statistical significance was interpreted using Odds ratio with 95% confidence interval and P value <0.05.A total of 320 individuals (107 cases and 214 controls) were approached for interview with a response rate of 93.75%. Of the cases, 57% were males and more than half fall in the 12-18 months age group. Knowledge regarding measles vaccination was also asked and among cases 72% heard about measles, 26% knew that all children should be vaccinated, 31% had awareness about the right age of vaccination, 60% agrees that measles is vaccine preventable and 65% knew that it is contagious. In multivariable logistic regression, Lack of Ante Natal Care follow up(ANC) (Adjusted Odds Ratio (AOR) =3.57; 95% Confidence Interval (CI): 1.22-10.44), lack of knowledge on the importance of vaccination, who should be vaccinated and if measles is contagious with an AOR and CI of (AOR=6.81; 95% CI: 1.56-29.64), (AOR=4.29; 95% CI: 1.83-10.04) and (AOR=8.97; 95%CI: 3.15-25.58) respectively were independent risk factors.Education and awareness about measles and its immunization should be given to the community. Additionally, ANC follow up should also be strengthened.


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