The Impact of Cannabis Abuse on Psychotic Symptoms and Their Severity among Cannabis Associated Psychosis Subjects: An Indian Experience

Use of cannabis for recreational, religious and cultures has been prevalent since ancient times. It is one of the commonest used illicit substance. While not all cannabis users develop psychiatric problems, heavy cannabis use may increase the risk of cognitive abnormalities, psychotic illness and mood disorders. This research aimed to evaluate severity of various psychotic symptoms in relation to variables of cannabis abuse. A cross sectional study of 30 male patients admitted at tertiary care psychiatric center with diagnosis of cannabis-associated psychosis was carried out. Cannabis abuse variables along with psychotic symptoms severity on BPRS scale were obtained. Correlation between variables of cannabis abuse and psychotic symptoms and total BPRS score were derived using Pearson correlation 2- tailed test. Hostility (83%) and excitement (77%) were most prevalent symptoms with increased severity followed by elevated mood, grandiosity, suspiciousness and motor hyperactivity. Patients with long duration and early onset of cannabis abuse presented with more severe form of psychosis. Frequency of cannabis use was not significantly correlated with total BPRS score, although amount spent over cannabis was significantly associated with total BPRS score. Family history of cannabis abuse predicted early onset of cannabis abuse.

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Stress gradation of medical practitioners during the pandemic (covid-19) along with ways to de-stress; a cross sectional study at tertiary care hospitals using Kessler’s 10 psychological distress scale.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.09.6238 ◽

2021 ◽

Vol 28 (09) ◽

pp. 1239-1244

Author(s):

Umair Toqueer ◽

Muhammad Usama Zardad ◽

Mahwish Toqueer ◽

Anila Riyaz ◽

Sana Khan ◽

...

Keyword(s):

Psychological Distress ◽

Tertiary Care ◽

Cross Sectional Study ◽

Junior Doctors ◽

Sectional Study ◽

Cross Sectional ◽

Psychological Distress Scale ◽

Tertiary Care Hospitals ◽

Distress Scale ◽

The Impact

Objectives: To determine stress grades of doctors working in tertiary care hospitals by using a standard measuring tool i.e. Kessler 10 psychological distress scale along with finding out different coping methods adopted by doctors during the COVID-19 pandemic. Study Design: Cross Sectional study. Setting: Tertiary Care Hospitals of Khyber Pakhtunkhwa (KPK), Pakistan. Period: 15 March 2020 to 20 June 2020. Material & Methods: A structured questionnaire was sent online to the junior and senior doctors working during the pandemic. The data was automatically collected with the help of Google docs and then analysed using SPSS 26. Results: Of the 219 doctors who completed the questionnaire 142 were males (64.8%) and 77 were females (35.2%). Interestingly, analysis of the score revealed that 38.8% of the doctors were found likely to be well, 16.4% of the doctors were likely to have mild disease and 20.5% were likely to have a moderate disorder while 24.2% were likely to have a severe disorder. Further analysis showed that the mean of Kessler’s score was greater for junior doctors as compared to Consultants which was found to be statistically significant (p=0.044). Conclusion: The impact of Corona virus disease (COVID-19) on the stress levels of health workers warrants considerable attention as it was declared a pandemic. Assessing the psychological impact and ways to tackle them will not only help the health care workers during this pandemic but will be beneficial in future pandemics as well.

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Maternity handover in Kerala: a cross sectional study

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20183560 ◽

2018 ◽

Vol 5 (9) ◽

pp. 3760 ◽

Cited By ~ 1

Author(s):

Aadil Sheikh ◽

Jessica Dunphy ◽

Claire Humphries ◽

Christina MacArthur ◽

Semira Manaseki-Holland

Keyword(s):

Healthcare Provider ◽

Tertiary Care ◽

Obstetric Care ◽

Tertiary Hospital ◽

Cross Sectional Study ◽

Community Health Services ◽

High Rate ◽

Sectional Study ◽

Cross Sectional ◽

The Impact

Background: The objective of the study was to explore the referral system from the community to hospital obstetric care in Kerala, India.Methods: Cross-sectional study. A total of 206 obstetric inpatients in 3 hospitals in Kerala, India completed an orally-administered questionnaire regarding referral and attitudes towards healthcare information.Results: Among 206 respondents, 19 (9%) had been referred from another healthcare provider. In multivariate analysis, referral was independently associated with being in a tertiary hospital (p<0.001). At total of 17 referred women received a document containing hand-written notes from their previous healthcare provider. Just 3 of the documents available to view were formal referral documents; others were test results and/or hospital notes. A total of 170 (86%) of the 206 women thought that receiving documents such as referral letters was important; mostly because it helped them understand their condition and explain it to others (91%).Conclusions: A high rate of self-referral (91%) was reported by obstetric inpatients. It appears that some women who are referred do not receive a formal referral document. Participants thought that receiving referral documents was important. A strong health system requires transfer of information between primary and secondary/tertiary care services, which India is seeking to develop. Further research is needed into why women are not accessing community health services and the impact of the content of referral documents on patient care.

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A study of metabolic syndrome in patients of HIV on ART in India

10.1101/2020.12.28.20248924 ◽

2021 ◽

Author(s):

V K Sashindran ◽

Anchit Raj Singh

Keyword(s):

Metabolic Syndrome ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Cross Sectional Study ◽

Noncommunicable Diseases ◽

Care Hospital ◽

Cross Sectional ◽

High Prevalence ◽

Hiv Morbidity ◽

The Impact

AbstractMetabolic syndrome is a risk factor for cardiovascular disease. With improvement in therapy for HIV, morbidity related to metabolic syndrome becomes a focus of interest. Change in nutritional status and introduction of newer regimens of ART are changing the impact of metabolic syndrome on patients of HIV. Few studies in recent times from developing countries have addressed this question. This is a cross sectional study to study the prevalence of Metabolic Syndrome in patients of HIV on ART from clinics in a tertiary care hospital in India. Data from 1208 patients of HIV on ART was analyzed and metabolic syndrome was seen in 257(21.3%) patients.The high prevalence of metabolic syndrome in patients of HIV in India found in this study gives an insight on the morbidity of noncommunicable diseases in patients with HIV in India in recent times.

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Impact of COVID Pandemic and Hybrid teaching on Final year MBBS students’ End of clerkship Exam performance

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.38.1.4645 ◽

2021 ◽

Vol 38 (1) ◽

Author(s):

Sahira Aaraj ◽

Fareeha Farooqui ◽

Nadia Saeed ◽

Sabeen Khan

Keyword(s):

Online Teaching ◽

Pearson Correlation ◽

Cross Sectional Study ◽

Exam Performance ◽

Cross Sectional ◽

Creative Commons ◽

Hybrid Teaching ◽

Novel Coronavirus ◽

The Impact ◽

One Way Anova

Background & Objectives: The novel coronavirus (SAR-CoV-2) pandemic has revolutionized medical education worldwide. Most medical schools have adopted the online teaching and assessments. Students attending modified clerkships and assessments under the stress of the pandemic, perform and score differently when compared to normal clerkships. We aimed to identify the impact of COVID-19 on final year MBBS students’ EOC (End of Clerkship) examination by comparing them with their scores prior to the COVID and with scores of the previous final year. Methods: This cross-sectional study was conducted at Shifa College of Medicine. Final year MBBS students’ scores of years 2019 and 2020 were included. Students’ EOC MCQ and OSCE scores were compared in pre-COVID and COVID affected rotations of the same year and with the previous year (2019). Data were analyzed in SPSS version 21, means scores were calculated, and one-way ANOVA was applied. Pearson correlation was calculated for correlation assessment of MCQ and OSCE scores. Results: There were 118 students. The mean EOC, OSCE, and MCQ scores in rotations one to four were 72.8±6.4, 73.3±8.1, 71.6±7.4, 72.7±6.7 and 44.4±8, 47.2±8.4, 46.1±8.2, 48.8±8.1, respectively. One-way ANOVA results before and after COVID lockdown were statistically insignificant (p=0.3) for OSCE and significant for MCQ in the final year class of 2020 (p=0.001). The Pearson correlation assessment between MCQ and OSCE scores (n=416) had a significant positive correlation (r=0.42, p=0.000). The overall comparison between scores of the final year class of 2019 and 2020 showed significant improvement in Surgery and Obstetrics/Gynae scores in 2020. Conclusion: During the COVID pandemic, the final year students’ performance in EOC MCQ and OSCE over all remained unaffected. doi: https://doi.org/10.12669/pjms.38.1.4645 How to cite this:Aaraj S, Farooqi F, Saeed N, Khan S. Impact of COVID Pandemic and Hybrid teaching on Final year MBBS students’ End of clerkship Exam performance. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.4645 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Pediatric emergency department utilisation during Ramadan: a retrospective cross-sectional study

Archives of Disease in Childhood ◽

10.1136/archdischild-2020-319173 ◽

2020 ◽

pp. archdischild-2020-319173

Author(s):

Rasha D Sawaya ◽

Cynthia Wakil ◽

Sami Shayya ◽

Moustafa Al Hariri ◽

Alik Dakessian ◽

...

Keyword(s):

Emergency Department ◽

Tertiary Care ◽

Pediatric Emergency ◽

Cross Sectional Study ◽

Peak Time ◽

Work Efficiency ◽

Sectional Study ◽

Tertiary Care Centre ◽

Cross Sectional ◽

The Impact

ObjectiveTo investigate the impact of Ramadan on patient characteristics, diagnoses and metrics in the paediatric emergency department (PED).DesignRetrospective cross-sectional study.SettingPED of a tertiary care centre in Lebanon.PatientsAll paediatric patients.ExposureRamadan (June 2016 and 2017) versus the months before and after Ramadan (non-Ramadan).Main outcome measuresPatient and illness characteristics and PED metrics including peak patient load; presentation timings; length of stay; and times to order tests, receive samples and report results.ResultsWe included 5711 patients with mean age of 6.1±5.3 years and 55.4% males. The number of daily visits was 28.3±6.5 during Ramadan versus 31.5±7.3 during non-Ramadan (p=0.004). The peak time of visits ranged from 18:00 to 22:00 during non-Ramadan versus from 22:00 to 02:00 during Ramadan. During Ramadan, there were significantly more gastrointestinal (GI) and trauma-related complaints (39.0% vs 35.4%, p=0.01 and 2.9% vs 1.8%, p=0.005). The Ramadan group had faster work efficiency measures such as times to order tests (21.1±21.3 vs 24.3±28.1 min, p<0.0001) and to collect samples (50.7±44.5 vs 54.8±42.6 min, p=0.03).ConclusionsRamadan changes presentation patterns, with fewer daily visits and a later peak time of visits. Ramadan also affects illness presentation patterns with more GI and trauma cases. Fasting times during Ramadan did not affect staff work efficiency. These findings could help EDs structure their staffing to optimise resource allocation during Ramadan.

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Pediatric HIV Disclosure in Northern India: Evaluation of Its Prevalence, Perceptions amongst Caregivers, and Its Impact on CLHIV

AIDS Research and Treatment ◽

10.1155/2018/2840467 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Rajesh Meena ◽

Alok Hemal ◽

Shilpa Khanna Arora

Keyword(s):

Health Care Providers ◽

Tertiary Care ◽

Cross Sectional Study ◽

Hiv Disclosure ◽

Pediatric Hiv ◽

Smooth Transition ◽

Standards Of Care ◽

Care Providers ◽

Cross Sectional ◽

The Impact

Background. With improving standards of care of children living with HIV (CLHIV), pediatric HIV related mortality rates are declining. New challenges like HIV status disclosure are emerging which need to be addressed to ensure their smooth transition into adulthood. Poor disease disclosure rates are observed in CLHIV globally. Aims. This study was done to assess the prevalence of HIV disclosure in North Indian CLHIV, know the perceptions of caregivers regarding disclosure, and evaluate the impact of disclosure on CLHIV. Methods. It was a questionnaire based cross-sectional study carried out amongst 144 caregivers of CLHIV aged 6-16 years attending the pediatric HIV clinic of a tertiary care teaching hospital. Results. Though the majority (93.8%) caregivers felt that it is important to disclose but only 33% of the children were actually disclosed. Eighty five percent felt that disclosure must be done by one of the family members and correspondingly 73% of the disclosed children were actually disclosed by their parents. Forty seven percent believed that the most appropriate age for disclosure is 10-12 years. The mean age at which disclosure was actually done was 11.06 ± 1.62 years. Comparison of the disclosed and undisclosed CLHIV revealed that the disclosed group had significantly higher age, longer duration of taking ART, and higher proportion of paternal orphans. Age of the CLHIV was the only significant factor for disclosure. Several reasons were cited by the caregivers for nondisclosure. The caregivers observed improved drug adherence in 47.9% of the children following disclosure. Conclusions. There is a need to develop region specific pediatric HIV disclosure guidelines keeping in mind the caregivers’ perceptions. The guidelines must be age appropriate, systematic, and socioculturally acceptable. The most suitable age for disclosure appears to be 10-12 years. Involvement of caregivers and health care providers in the process is a must.

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Impact of the Novel Coronavirus 2019 (COVID-19) Pandemic on Head and Neck Cancer Care

Otolaryngology ◽

10.1177/01945998211004544 ◽

2021 ◽

pp. 019459982110045

Author(s):

Joshua Adam Thompson ◽

Joshua E. Lubek ◽

Neha Amin ◽

Reju Joy ◽

Donita Dyalram ◽

...

Keyword(s):

Head And Neck ◽

Tertiary Care ◽

Care Facility ◽

Cross Sectional Study ◽

Tumor Board ◽

Secondary Outcome ◽

Cross Sectional ◽

Tertiary Care Facility ◽

Procedural Volume ◽

The Impact

Objective The study aimed to assess the impact of the coronavirus disease 2019 (COVID-19) pandemic on head and neck oncologic care at a tertiary care facility. Study Design This was a cross-sectional study conducted between March 18, 2020, and May 20, 2020. The primary planned outcome was the rate of treatment modifications during the study period. Secondary outcome measures were tumor conference volume, operative volume, and outpatient patient procedure and clinic volumes. Setting This single-center study was conducted at a tertiary care academic hospital in a large metropolitan area. Methods The study included a consecutive sample of adult subjects who were presented at a head and neck interdepartmental tumor conference during the study period. Patients were compared to historical controls based on review of operative data, outpatient procedures, and clinic volumes. Results In total, 117 patients were presented during the review period in 2020, compared to 69 in 2019. There was an 8.4% treatment modification rate among cases presented at the tumor conference. There was a 61.3% (347 from 898) reduction in outpatient clinic visits and a 63.4% (84 from 230) reduction in procedural volume compared to the prior year. Similarly, the operative volume decreased by 27.0% (224 from 307) compared to the previous year. Conclusion Restrictions related to the COVID-19 pandemic resulted in limited treatment modifications. Transition to virtual tumor board format observed an increase in case presentations. While there were reductions in operative volume, there was a larger proportion of surgical cases for malignancy, reflecting the prioritization of oncologic care during the pandemic.

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Final Validation of the Pediatric Tracheotomy Health Status Instrument (PTHSI)

Otolaryngology ◽

10.1067/mhn.2002.122634 ◽

2002 ◽

Vol 126 (3) ◽

pp. 228-233 ◽

Cited By ~ 10

Author(s):

Christopher J. Hartnick ◽

Barbara K. Giambra ◽

Cynthia Bissell ◽

Cynthia M. Fitton ◽

Robin T. Cotton ◽

...

Keyword(s):

Health Status ◽

Pearson Correlation ◽

Cross Sectional Study ◽

Physical Symptoms ◽

Validity And Reliability ◽

Cross Sectional ◽

Specific Criterion ◽

Health Status Instrument ◽

Related Quality ◽

The Impact

OBJECTIVE: We sought to describe the development and final testing of an instrument designed to evaluate the impact of tracheotomy on the health-related quality of life of affected families in whom a child has had a tracheotomy (the Pediatric Tracheotomy Health Status Instrument [PTHSI]). STUDY DESIGN: This cross-sectional study designed to analyze a disease-specific health status instrument to establish validity and reliability. RESULTS: The PTHSI was initially pilot tested in 130 families during a 3-month period from September through November 2000. After initial analysis and revision, from January 2001 through July 2001, 154 different families completed the revised instrument. The overall Cronbach's α coefficient for the instrument was 0.91, with domain-specific coefficients ranging from 0.66 for physical symptoms to 0.87 for caregiver stress and coping. Specific criterion validity analysis produced a Pearson correlation coefficient of 0.8 ( P < 0.0001). Construct validity testing via Wilcoxon matched sum testing suggested statistically significant differences between subpopulations ( P < 0.001). CONCLUSION: After initial testing and revision of the PTHSI, final instrument administration and analysis reveal the instrument to be valid and reliable. Future studies are planned to evaluate its responsiveness in longitudinal application.

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The Economy of Projects: Analyzing Project Management Resilience, Stress Management and Project Sustainability

Global Economics Review ◽

10.31703/ger.2018(iii-i).06 ◽

2018 ◽

Vol III (I) ◽

pp. 50-61

Author(s):

Syed Ali Naqi Kazmi ◽

Asia Baig ◽

Muhammad Zia-Ur Rehman

Keyword(s):

Project Management ◽

Stress Management ◽

Banking Sector ◽

Pearson Correlation ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Team Working ◽

Project Sustainability ◽

The Impact

The due economy of projects is a catchword nowadays in the world. Advancement in project sustainability has reshaped the banking across the globe forcing companies to perform tasks and activities in the form of projects; resilience, stress management are some of the factors that redesign project sustainability. This cross-sectional study investigates the impact of resilience and stress management on project sustainability also making a contribution by analyzing the association of resilience and stress management. The beta values and results show in favor of acceptance of the entire hypothesis. The data was collected from the members of the project team working on a diverse project in the banking sector of Pakistan. The instrument used to collect the data was questionnaires to measure each variable. Pearson correlation and stepwise hierarchal regression were used to analyze the data. The study at the end highlights valuable findings and recommendations for the future and the researchers offer practical guidance further professionalizing Project Management.

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To explore the impact of following the pre-operative fasting guidelines by ASA (American society of anesthesiologists), in improving patient outcome.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.07.4783 ◽

2021 ◽

Vol 28 (7) ◽

pp. 1018-1021

Author(s):

Maqsood Ahmed Siddiqui ◽

◽

Ashok Perchani ◽

Hamid Raza ◽

Ahmeduddin Soomro ◽

...

Keyword(s):

Tertiary Care ◽

Cross Sectional Study ◽

Care Hospital ◽

Start Time ◽

Time Duration ◽

Cross Sectional ◽

Emergency Procedures ◽

The Mean ◽

The Impact ◽

Mean Time

Objective: To analyze the occurrence and consequences of a prolonged preoperative-fasting. Study Design: Cross-sectional study. Setting: Large tertiary care hospital in Pakistan. Period: October 2018 to October 2019. Material & Methods: We collected data for all the procedures that occurred during the study period and divided the cases into emergency procedures, add-on procedures and elective cases. We excluded the first cases of the day and excluded the emergency and add-on cases. We studied the patients NPO duration and their scheduled start time of the procedure and compared with their actual start time of the procedure. Results: The study population was n= 434 cases. Of these 434 cases n= 164 cases were performed on time and n= 270 cases were delayed by 60 minutes or more from their scheduled time. The most frequent reason was a previous cases running longer than expected in 59.25% of the cases, the second most common reason was a change in sequence and order of the procedures which was the case for delay in 14.44% of the cases. The overall mean time of NPO for the patients was found to be 770.1 +/- 130.6 minutes, for the delayed cases the mean time duration of NPO was 812.3 +/- 105.3 minutes. The mean time of case delay was 155.2 +/- 102.7 minutes for overall cases and for the significantly delayed case the mean time period of delay was 190.2 +/- 92.1 cases. Conclusion: Our results showed that 60% of the cases have a prolonged NPO status due to delays in start of their surgical procedure as compared to the scheduled times.

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