scholarly journals Locked in: psychiatric impact on COVID-19 patients isolated in a tertiary care hospital in Lahore, Pakistan

2021 ◽  
Author(s):  
Nazish Imran ◽  
Irum Aamer ◽  
Hadia Afzal ◽  
Ali Hashmi ◽  
Bilquis Shabbir ◽  
...  
Keyword(s):  
Sleep Disturbances ◽  
Acute Stress ◽  
Psychiatric Symptoms ◽  
Tertiary Care ◽  
Adjustment Disorder ◽  
Severity Index ◽  
Care Hospital ◽  
Stress Reactions ◽  
Psychological Consequences ◽  
Patient Health

Background: Adverse psychological effects have been associated with COVID-19-related disease containment measures, but little is known about the psychiatric symptoms and distress. Aim: This study aimed to explore and understand the psychiatric symptoms and distress in suspected or confirmed COVID-19 patients isolated and quarantined in hospital. Methods: A mixed methods study was conducted in the COVID-19 units of Mayo Hospital, Lahore, Pakistan; 114 out of 160 adult patients were assessed by telephone using validated scales (Stress Reactions and Adjustment Disorder Checklist, 9-item Patient Health Questionnaire, 7-item Generalized Anxiety Disorder Scale and Insomnia Severity Index) and a few open-ended questions about expectations and anticipated areas of need during hospitalization, including experiences with isolation. Results: The prevalence of adjustment disorder, acute stress disorder, anxiety, depressive symptoms and insomnia was 67.5%, 3.5%, 16.7%, 18.4%, and 29.8% respectively. One male patient tried to commit suicide during the study period. Fear, anger, low mood, anxiety and sleep disturbances were the most notable psychological consequences in qualitative the responses. Inadequate communication, poor ward facilities, concerns about the health of family members and financial problems were the most commonly identified factors leading to distress. Conclusion: Our results show alarmingly high levels of stress-related symptoms – insomnia, depression and anxiety – among COVID-19 confirmed or suspected hospitalized patients. There is a need to incorporate psychological services in the acute phase of illness for prompt recognition and management of psychiatric problems.

scholarly journals Psychiatric co morbidities in ESRD Patients Recently Placed on Haemodialysis : A Prospective Observational Study from a Tertiary Care Hospital

2016 ◽  
Vol 4 (1) ◽  
pp. 28-32
Author(s):  
Sarwar Iqbal ◽  
Umme Salma Talukder ◽  
Tufayel Ahmed Chowdhury ◽  
Md Mostarshid Billah ◽  
Mehruba Alam Anana ◽  
...  
Keyword(s):  
Acute Stress ◽  
Tertiary Care ◽  
Adjustment Disorder ◽  
Cross Sectional Study ◽  
Maintenance Hemodialysis ◽  
Care Hospital ◽  
Newly Diagnosed ◽  
Cross Sectional ◽  
Co Morbidity ◽  
Esrd Patients

Background: Psychiatric co-morbidity especially anxiety and depression are common in patients who are recently placed on dialysis, but very little research has been done on this subject. Mental illness results in increased non-compliance in accepting dialysis and this results in increased mortality in End Stage Renal Disease (ESRD) patients.Methodology: This cross- sectional study was done on ESRD patients newly diagnosed and initiated hemodialysis in the department of Nephrology of Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, Bangladesh with informed written consent and maintaining privacy. Diagnostic and Statistical Manual of Mental Disorders (DSM-V) was used for diagnosis of psychiatric disorders. Patients on maintenance hemodialysis for more than 1 month and patients on Chronic Ambulatory Peritoneal Dialysis were excluded in this study.Results: There were total 83 patients out of whom there were 50 (62.2%) males and 33(39.38%) females. Mean age of study patients was 56.8±9.96 years. Bulk of the patients was clinically depressed (68.7%), followed by anxiety disorder (13.3%) rest were acute stress disorder, adjustment disorder and one case of psychosis. 8.4% participants denied any symptoms.Conclusion: Significant psychiatric co-morbidities developed in newly diagnosed ESRD subjects when they were prescribed hemodialysis. This study showed majority of the patients with renal failure on initiating hemodialysis who develop different psychiatric problems that need prompt diagnosis and appropriate treatment. These interventions will improve the quality of life of ESRD patientsBangladesh Crit Care J March 2016; 4 (1): 28-32

scholarly journals Sleep Disturbances in Individuals Quarantined Due to SARS-CoV-2 Pandemic in Poland: A Mixed Methods Design Study

2021 ◽  
Vol 10 ◽  
pp. 216495612110207
Author(s):  
Sabina Krupa ◽  
Witt Paweł ◽  
Wioletta Mędrzycka-Dąbrowska ◽  
Agnieszka Lintowska ◽  
Dorota Ozga
Keyword(s):  
Mixed Methods ◽  
Sleep Disturbances ◽  
Acute Stress ◽  
Sleep Problems ◽  
Severity Index ◽  
Structured Interview ◽  
Mixed Methods Design ◽  
Design Study ◽  
Insomnia Severity Index ◽  
Insomnia Severity

Objectives The study aimed to assess sleep disturbances in patients subjected to home quarantine due to suspected SARS-CoV-2 infection. The study used a mixed methods design study as a research methodology. Methods A semi-structured interview and the scale for Insomnia Severity Index (ISI) were used to achieve the aim of the study. The survey was conducted from 16 to 20 April 2020 and 1 to 2 September 2020 in Poland, at the during of SARS-CoV-2 epidemic in this country. The data were coded and cross-processed. The (COREQ) checklist was followed. Results Interviews with patients and a thorough analysis of recordings revealed commonly used phrases in the following categories: “anxiety”, “ Am I going crazy?”, “Sleep problems”. 10 out of 11 respondents reported sleep disorders of varying severity according to the Insomnia Severity Index scale. Patients presented a fear related to the return to society and normal functioning after quarantine. Additionally, some study participants voiced concerns related to their mental health; some cases of hallucinations were reported. Conclusions Further global population studies should be conducted to analyse this phenomenon. Acute Stress Disorder should be understood as a threat to life and health of an isolated society in quarantine. Further research in this area should be promoted and the need for global guidelines for the entire population should be developed.

Assessing the Severity of Acute Pancreatitis with CT Severity Index and Other Conventional Methods in a Tertiary Care Hospital in Tamil Nadu, India – A Comparative Cross-Sectional Study

2021 ◽  
Vol 8 (41) ◽  
pp. 3541-3546
Author(s):  
Jayaprakash Subramani ◽  
Rajesh Prabhu ◽  
Jagadeesapandian Palpandi
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Predictive Value ◽  
Tamil Nadu ◽  
Objective Assessment ◽  
Tertiary Care ◽  
Severity Index ◽  
Apache Ii ◽  
Care Hospital ◽  
Male Predominance

BACKGROUND Acute pancreatitis is not uncommon in surgical practice with variable clinical presentation. Because of its potential notable catastrophic complications, it is mandatory to assess the severity at the earliest. In recent times, the decision making in the management is quite difficult due to its complications and outcome. So, an objective assessment of severity based on clinical and laboratory scoring verses computed tomography (CT) severity is still debate, hence the need for study. The purpose of this study was to compare the efficiency of CT severity index verses APACHE II and Ranson criteria in predicting the severity of acute pancreatitis. METHODS A total number of 36 consecutive cases of acute pancreatitis who were admitted between January 2013 and December 2014 in Apollo Specialty Hospitals – Madurai were included in the study. Written informed consent was obtained from all study participants. RESULTS In our study, out of 36 patients, 30 (83.33 %) were males and 6 (16.66 %) were females. The sex distribution shows a clear male predominance. Most of the patients in the present study belonged to the middle age group. Alcohol was the most common cause accounting for 41.7 % of the cases followed by the billiary pathology. CT severity index was the superior tool for prediction of the prognosis and early complications. CONCLUSIONS When using contrast enhanced computed tomography, it was found that there was a significant correlation between the development of organ failure and severity of pancreatitis. The specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of Ranson and acute physiology and chronic health evaluation – II (APACHE II) at 48 hours of admission with acute pancreatitis does not correlate in determining the severity of acute pancreatitis. KEYWORDS Acute Pancreatitis, Severity Markers, CT Severity Index

VALIDATION OF QUICK COVID SEVERITY INDEX IN COVID PATIENTS ADMITTED THROUGH EMERGENCY DEPARTMENT OF A PRIVATE TERTIARY CARE HOSPITAL IN WEST BENGAL, INDIA

2021 ◽  
pp. 53-55
Author(s):  
Harsimran Singh Das
Keyword(s):  
Emergency Department ◽  
Respiratory Failure ◽  
Tertiary Care Hospital ◽  
Clinical Status ◽  
Tertiary Care ◽  
Severity Index ◽  
Adult Patients ◽  
Care Hospital ◽  
Oxygen Requirement ◽  
Clinical Tool

Introduction:qCSI (Quick COVID severity index) is a clinical tool established recently post pandemic to predict respiratory failure within 24 hours of admission in COVID-19 patients; respiratory failure being explain as increased oxygen requirement greater than 6L/min by low ow device, high ow device, noninvasive or invasive ventilation to maintain spO2 of greater than or equal to 94%, or death. Aim:To verify and validate the application of the qCSI in Emergency Department in Indian demographic for evidence-based guidance to aid physician decision making in safely dispositioning adult patients with COVID-19 with oxygen requirement less than or equal to 6L/min via low ow devices including nasal cannula and oxygen mask Materials and methods:This is an observational, retrospective study from Emergency Department in a private tertiary care hospital of admitted adult patients with COVID-19 disease. Clinical parameters in qCSI and disposition of 210 patients admitted through Emergency Department included in this study selected randomly was sought on admission and clinical status with level of care 24 hours following admission was recorded and compared with prediction based on qCSI from a period of 1 May 2020 to 31 October 2020. Result:We found that19(9.0%) patients Initial qCSI Score was Low, 80(38.1%) patients Initial qCSI Score was Low-intermediate, 84(40.0%) patients Initial qCSI Score was High-intermediate and 27(12.9%)patients Initial qCSI Score was High.qCSI Score after 24 hours 16(11.4%) patients were Low, 43(30.7%) patients were Low-intermediate, 63(45.0%) patients was High-intermediate and 18(12.9%) patients was High.Out of 210(100.0%) patients, 70 (33.3%) patients were critically ill. Conclusion:In conclusion these data show that the quick COVID-19 Severity Index provides easily accessed risk stratication relevant to Emergency Department provider.

scholarly journals The prevalence of psychiatric symptoms of pregnant and non-pregnant women during the COVID-19 epidemic

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yongjie Zhou ◽  
Hui Shi ◽  
Zhengkui Liu ◽  
Songxu Peng ◽  
Ruoxi Wang ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Psychiatric Symptoms ◽  
Severity Index ◽  
Cross Sectional Study ◽  
Post Traumatic Stress ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Symptoms Of Depression ◽  
Patient Health ◽  
Post Traumatic

Abstract Coronavirus disease 2019 (COVID-19) is rapidly spreading worldwide, with a staggering number of cases and deaths. However, available data on the psychological impacts of COVID-19 on pregnant women are limited. The purposes of this study were to assess the prevalence of psychiatric symptoms among pregnant women, and to compare them with non-pregnant women. From February 28 to March 12, 2020, a cross-sectional study of pregnant and non-pregnant women was performed in China. The online questionnaire was used to collect information of participants. The mental health status was assessed by patient health questionnaire, generalized anxiety disorder scale, insomnia severity index, somatization subscale of the symptom checklist 90, and post-traumatic stress disorder (PTSD) checklist-5. Totally, 859 respondents were enrolled, including 544 pregnant women and 315 non-pregnant women. In this study, 5.3%, 6.8%, 2.4%, 2.6%, and 0.9% of pregnant women were identified to have symptoms of depression, anxiety, physical discomfort, insomnia, and PTSD, respectively. However, the corresponding prevalence rates among non-pregnant women were 17.5%, 17.5%, 2.5%, 5.4%, 5.7%, respectively. After adjusting for other covariates, we observed that pregnancy was associated a reduced risk of symptoms of depression (OR = 0.23; 95% CI: 0.12–0.45), anxiety (OR = 0.26; 95% CI: 0.16–0.42), insomnia (OR = 0.19; 95% CI: 0.06–0.58), and PTSD (OR = 0.15; 95% CI: 0.04–0.53) during the COVID-19 epidemic. Our results indicate that during the COVID-19 epidemic in China, pregnant women have an advantage of facing mental problems caused by COVID-19, showing fewer depression, anxiety, insomnia, and PTSD symptoms than non-pregnant women.

scholarly journals A prospective randomised open labelled comparative study of anti inflammatory effects of topical 5% benzoyl peroxide gel vs topical 4% nicotinamide gel for grade I-II acne in a tertiary care hospital

2018 ◽  
Vol 7 (5) ◽  
pp. 952
Author(s):  
Ashok Kumar S. N. ◽  
Madan Mohan N. T. ◽  
Shwetha H. ◽  
Shanmukananda P. ◽  
Veena D. R. ◽  
...  
Keyword(s):  
Benzoyl Peroxide ◽  
Acne Vulgaris ◽  
Tertiary Care ◽  
Severity Index ◽  
Care Hospital ◽  
Global Severity Index ◽  
Total Percentage ◽  
Group I ◽  
Anti Inflammatory ◽  
Inflammatory Effect

Background: Acne vulgaris is a dermatological disorder characterised by formation of comedones and inflammatory lesions. The treatment of acne basically involves reduction of lesions. Benzoyl peroxide, in concentrations of 5%, 10%, and 20%, has been used effectively in the treatment of acne for more than 20 years. Nicotinamide/ Niacinamide is a newly-approved anti-acne drug with a potent anti-inflammatory effect. The present study assessed the efficacy of 5% Benzoyl peroxide gel in comparison to 4% Nicotinamide gel for topical treatment of mild to moderate acne vulgaris.Methods: In this study, the patients with mild to moderate acne vulgaris with inflammation were divided into two groups, group I was treated with topical 5% Benzoyl peroxide gel whereas topical Nicotinamide gel was given to the group II. Assessment of efficacy was done by total lesion counting according acne global severity index, the results were compared at the end of 2 weeks and 4 weeks with the baseline values.Results: At the end of this study, it was found that the reduction of inflammatory and total percentage of decrease in counts of lesions from baseline were highly significant in both the groups (p<0.001), between the groups, differences were statistically significant (p<0.001), therefore 5% Benzoyl peroxide gel has better efficacy than 4% Nicotinamide gel.Conclusions: Benzoyl peroxide is more efficacious than 4 % Nicotinamide gel in mild to moderate acne.

scholarly journals Psychiatric morbidity among the patients with acne Vulgaris in a tertiary care Hospital

2019 ◽  
Vol 18 (4) ◽  
pp. 773-778
Author(s):  
Fahmida Ahmed ◽  
Anwar Husain ◽  
Meherunnessa Begum ◽  
Mohd Nurul Alam ◽  
Muhammad Ayaaz Ibrahim
Keyword(s):  
Anxiety Disorders ◽  
Tertiary Care Hospital ◽  
Psychiatric Symptoms ◽  
Acne Vulgaris ◽  
Tertiary Care ◽  
Psychiatric Morbidity ◽  
World Health ◽  
Care Hospital ◽  
Compulsive Disorder ◽  
Self Reporting Questionnaire

Background: Acne vulgaris is a chronic inflammatory skin disorder which has a high prevalence among adolescence and young adults. Although acne does not cause direct physical impairment, it can produce a significant psychosocial burden. As the face is almost always the site of involvement of acne, its presence can alter one’s perception of body image. Increased levels of anxiety, anger, depression, and frustration are also observed in patients with acne. Acne affects social, vocational, and academic performance of teenagers & young adult. Objective: To identify socio-demographic profile and to evaluate the psychiatric morbidity in patients with acne vulgaris in a tertiary care hospital. Materials and Methods: This cross sectional study was conducted from June 2017 to December 2017 among the patients of acne vulgaris attending outpatient department of Dermatology in Ibn Sina Medical College Hospital, Dhaka. Purposive sampling technique was used. The sample size of the study was 181. Data were collected by using semi structured socio-demographic questionnaire and the SRQ to screen psychiatric symptoms. The Self Reporting Questionnaire (SRQ), is a psychiatric case finding instrument, was developed by World Health Organization (WHO) to screen for psychiatric disturbance especially among developing countries. The data obtained was collected, tabulated and subjected to statistical analysis using the Statistical Package for Social Sciences (SPSS), for windows version 20. Results: Study was conducted on 181patients comprising 135(74.6%) were female & 46(25.4%) were male. Age group between 16 to 22 years carried maximum incidence 100(55.2%). Among the patients Psychiatric morbidity was found in86(48%) of the study population. Psychiatric morbidity was found more in young and females patients. Among the types of psychiatric morbidity Anxiety disorders were 57(66.3%) & Major Depressive Disorder(MDD) was 29(33.7%).Anxiety disorders were included social phobia (26.7%), generalized anxiety disorder (GAD) (18.6%), panic disorder (14%) and obsessive compulsive disorder (OCD)(7%). Conclusion: Patients with acne vulgaris in whom psychiatric morbidity is present, should be routinely evaluated and their psychiatric morbidity need to be treated adequately for maximize their health. Bangladesh Journal of Medical Science Vol.18(4) 2019 p.773-778

scholarly journals Evaluation of Psychiatric Morbidity in COVID-19-Positive Inpatients Referred to Consultation Liaison Psychiatry in a Tertiary Care Hospital

2021 ◽  
pp. 025371762110221
Author(s):  
Nisha K. Prajapati ◽  
Nimesh C. Parikh ◽  
Nilima D. Shah ◽  
Vinodkumar M. Darji ◽  
Heena B. Jariwala ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Psychiatric Morbidity ◽  
Adjustment Disorder ◽  
P Value ◽  
Fisher Exact Test ◽  
Care Hospital ◽  
Liaison Psychiatry ◽  
Exact Test ◽  
Consultation Liaison Psychiatry

Background: The COVID-19 pandemic has led to the risk of common mental illnesses. Consultation liaison psychiatry has been one of the most requested services in the face of this pandemic. We aimed to assess (a) the prevalence of psychiatric illness, (b) different types of psychiatric diagnoses, (c) presenting complaints, (d) reasons for psychiatric referrals, and (e) psychiatric intervention done on COVID-19 positive inpatients referred to consultation liaison psychiatry at tertiary care hospital. Method: This was a retrospective study of data collected from April 1, 2020, to September 15, 2020. Total 300 patients were referred and diagnosed with clinical interview and Diagnostic and Statistical Manual for Mental Disorder Fifth Edition criteria. Analysis was done using chi-square test, Kruskal–Wallis test, and fisher exact test. Results: Out of 300 patients, 26.7% had no psychiatric illness. Adjustment disorder was the commonest psychiatric diagnosis (43%), followed by delirium (10%). Statistically significant differences were found for parameters like Indian Council of Medical Research Category 4 of the patient, (hospitalized severe acute respiratory infection) (P value < 0.001), medical comorbidity (P value = 0.023), and past history of psychiatric consultation (Fisher exact test statistic value <0.001). Behavioral problem (27.6%) was the commonest reason for psychiatric referral. Worrying thoughts (23.3%) was the most frequent complaint. A total of 192 (64.3%) patients were offered pharmacotherapy. Conclusions: Psychiatric morbidity was quite high (73.3%) among them and adjustment disorder was the commonest (43%) psychiatric diagnosis followed by delirium (10%). Pharmacotherapy was prescribed to 64.3% patients and psychosocial management was offered to most of the referred patients.

scholarly journals Stress, Stress Reactions, Job Stressors and Coping among Nurses Working in Intensive Care Units and General Wards of a Tertiary Care Hospital: A Comparative Study

2016 ◽  
Vol 50 (1) ◽  
pp. 9-17
Author(s):  
Sukhpal Kaur ◽  
Karobi Das ◽  
Ruchi Saini
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Workplace Stress ◽  
Care Hospital ◽  
Stress Reactions ◽  
Job Stressors ◽  
General Wards ◽  
And Coping

ABSTRACT Literature has presented nursing as a stressful profession. The present study was conducted to compare stress level and job stressors operating in two different units, i.e. intensive care units (ICU) and general wards of a tertiary care hospital of North India. This is a cross-sectional study involving 285 nurses (general wards = 176; ICU = 109). The nurses were selected conveniently. Demographic profile sheet, modified workplace stress scale (WSS), workplace stress symptom scale (WSSS) and coping checklist (CCL) of Rao, Subbakrishna and Prabhu (1989) was used in the study. Findings of the study revealed moderate to high stress level among general wards and ICU nurses with young female nurses experiencing more stress. Further, workload, role ambiguity and lesser social support accounted for significant amount stress among nurses working on both the units while external factors, such as physical environment and resources hardly contributed to stress. It was also found that the ICU nurses experienced stress more in the form of exhaustion (11.9%); irritation (11.9%) and reduced self-confidence (0.9%) that those working in general wards. However, the nurses on both the units use distraction, positive coping, problem-solving and religious strategies to manage and handle their stress. The findings of the study give insight into stress and stressors related to job which can be buffered using various stress management strategies by the nurse managers. How to cite this article Saini R, Kaur S, Das K. Stress, Stress Reactions, Job Stressors and Coping among Nurses Working in Intensive Care Units and General Wards of a Tertiary Care Hospital: A Comparative Study. J Postgrad Med Edu Res 2016; 50(1):9-17.

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