scholarly journals Methodology for screening assessment of the presence of hospitalism in patients of gerontopsychiatric hospital

Author(s):  
I. A. Beltceva ◽  
N. M. Zalutskaya ◽  
N. G. Neznanov

Summary. The aim of the study was to identify nosologically nonspecific signs of hospitalism in patients of a gerontopsychiatric hospital and to develop, on their basis, a method for screening diagnostics of hospitalism.Materials and methods. We examined 194 inpatients aged 55 to 91 years, hospitalism was detected in 102 people, 92 people made up the comparison group. The survey was carried out at the stage of preparation for discharge in the form of a semi-structured interview, supplemented by the collection of anamnestic and follow-up data.Results. The most common signs of hospitalism in this sample were the deterioration of the mental and somatic state before discharge (78% of the examined patients of the main group, a confidence interval (CI) of 68–85%), a long duration of the current hospitalization (73%, CI 64–82%), violations of compliance (73%, CI 63-81%), long duration of inpatient treatment in anamnesis (71%, CI 61-80%), deterioration soon after discharge (67%, CI 52-80%), a large number of hospitalizations during the entire period of illness (67%, CI 57-76%), lack of discharge intention (62%, CI 51-72%), tendency to increase the duration of hospitalizations (54%, CI 43-64%), high level of anxiety before discharge (50% , CI 34-66%), reduction in the intervals between hospitalizations (49%, CI 38-59%), p <0.05.Conclusion. The proposed methodology is intended for screening assessment of the presence of hospitalism and identification of the circle of persons for whom an in-depth assessment of social and psychological adaptation is advisable in order to prevent the adverse effects of hospitalization.

Author(s):  
Md Tanzil Ansari ◽  
Sukumar Ghosh ◽  
Shailendra Kumar Singh

Nowadays, people are more vulnerable to metabolic disorders due to their faulty dietary and behavioural habits. One such disorder is Vatarakta which causes functional impairment due to involvement of Sandhi (joints). It is manifested by Ruk, Toda, Sparsha asahatva, Shopha, Raga, Daha and Stabdhata in Sandhi. Vatarakta can be correlated with Hyperuricaemia or Gout due to similarity in their clinical features. Hyperuricaemia is defined as abnormally high level of uric acid in blood (i.e. >6mg/dl in female and >7mg/dl in male). On the other hand, Gout is an inflammatory response to monosodium urate crystals formed secondary to hyperuricaemia. Aims and objectives: 1. To evaluate the effectiveness of Trikarshika kwatha and lifestyle modification in the management of Vatarakta. 2. To compare the effects of Trikarshika kwatha with and without lifestyle modification in the management of Vatarakta. Materials and methods: Raw herbs of the research formulation were collected after proper identification and Kwatha was prepared for oral administration. For the clinical study, total 60 patients were selected on the basis of selection criteria. Selected patients were randomly divided into two groups. (i) Group A: 30 patients were treated with Trikarshika kwatha. (ii) Group B: 30 patients were treated with Trikarshika kwatha along with Lifestyle modification. Individual patient was treated for 45 days along with follow up at the interval of every 15 days. To assess the effectiveness of treatment, scoring pattern was followed for subjective and objective parameters. They were assessed before and after treatment. The collected data were analysed statistically by using Paired t-test. Results: On the basis of all statistical data, it can be said that patients of Group B showed better results in all parameters in comparison to patients of Group A. Conclusion: Both Trikarshika kwatha and Lifestyle modification are affective but Trikarshika kwatha with Lifestyle modification is more effective than Trikarshika kwatha without Lifestyle modification in the management of Vatarakta.


Author(s):  
Swapnil P. Sonune ◽  
Anil K. Gaur ◽  
Shefali Gupta

<p class="abstract"><strong>Background:</strong> Frozen shoulder is one of the most common musculoskeletal problems seen in orthopaedics. Many treatment modes are available however, it is difficult to treat and data on the comparative efficacy of various interventions are limited. Intra-articular corticosteroid injection (IASI) is a commonly used to treat frozen shoulder pain. Supra-scapular nerve block (SSNB) is also effective method to treat pain in chronic diseases that affect the shoulder. The present study was done to compare efficacy of ultrasound guided SSNB and IASI in management of painful frozen shoulder.</p><p class="abstract"><strong>Methods:</strong> 60 patients with painful frozen shoulder were divided in two groups, Group A received ultra-sound guided SSNB with 6 ml 0.5% Bupivacaine; Group B received IASI using 40 mg Triamcinolone. Outcome measures were shoulder ranges mainly lateral rotation and abduction, shoulder pain and disability index and visual analogue scale (VAS). Patients were followed-up on 2<sup>nd</sup> day, at 1<sup>st</sup>, 3<sup>rd</sup> and 6<sup>th</sup> week.<strong></strong></p><p class="abstract"><strong>Results:</strong> All baseline parameters improved significantly in both groups; however, on comparison Group A showed significant improvement in passive lateral rotation on 2<sup>nd</sup> day and 1<sup>st</sup> week follow up (P =0.038 and 0.040 respectively). VAS score showed significance at all follow-up in Group A, whereas, in Group B significance was seen after 1 week. On inter group comparison Group A shows significance on 2<sup>nd</sup> day (P =0.050), 1<sup>st</sup> week (P =0.042) and 3<sup>rd</sup> week (P =0.036).</p><strong>Conclusions:</strong>Both SSNB and IASI have efficacy in management of frozen shoulder. But supra-scapular nerve block is better than intra-articular injection and should be considered prior to steroid as it has early onset pain relief, early improvement in ranges, potentially lesser contraindications and side effects.<p> </p>


BMC Surgery ◽  
2019 ◽  
Vol 19 (S1) ◽  
Author(s):  
Vincenzo Pilone ◽  
Salvatore Tramontano ◽  
Michele Renzulli ◽  
Mafalda Romano ◽  
Angela Monda ◽  
...  

Abstract Background Gastric fistulas, bleeding, and strictures are commonly reported after laparoscopic sleeve gastrectomy (LSG), that increase morbidity and hospital stay and may put the patient’s life at risk. We report our prospective evaluation of application of synthetic sealant, a modified cyanoacrylate (Glubran®2), on suture rime, associated with omentopexy, to identify results on LSG-related complications. Methods Patients were enrolled for LSG by two Bariatric Centers, with high-level activity volume. Intraoperative recorded parameters were: operative time, estimated intraoperative bleeding, conversion rate. We prospectively evaluated the presence of early complications after LSG during the follow up period. Overall complications were analyzed. Perioperative data and weight loss were also evaluated. A control group was identified for the study. Results Group A (treated with omentopexy with Glubran®2) included 96 cases. Control group included 90 consecutive patients. There were no differences among group in terms of age, sex and Body Mass Index (BMI). No patient was lost to follow-up for both groups. Overall complication rate was significantly reduced in Group A. Mean operative time and estimated bleeding did not differ from control group. We observed three postoperative leaks in Group B, while no case in Group A (not statistical significancy). We did not observe any mortality, neither reoperation. Weight loss of the cohort was similar among groups. In our series, no leaks occurred applying omentopexy with Glubran®2. Conclusion Our experience of omentopexy with a modified cyanoacrylate sealant may lead to a standardized and reproducible approach that can be safeguard for long LSG-suture rime. Trial registration Retrospective registration on clinicaltrials.gov PRS, with TRN NCT03833232 (14/02/2019).


1975 ◽  
Vol 6 (3) ◽  
pp. 349-358 ◽  
Author(s):  
Richard H. Rahe ◽  
Terry O'Neil ◽  
Arthur Hagan ◽  
Ransom J. Arthur

Sixty post-myocardial infarction (MI) subjects have been followed for up to eighteen months' time following their MI. Thirty-eight of these subjects completed a brief series of four to six group therapy sessions during their early rehabilitation phase; the others received no group therapy. Both groups were placed on otherwise identical schedules of outpatient follow-up. Group therapy patients have, to date, experienced significantly fewer cardiac complications than controls. Only one death has occurred, and that one patient was in the control group. A coronary heart disease teaching evaluation questionnaire was given to a sample of group therapy patients, a sample of controls, and a comparison group of men without MI. Following their group therapy sessions, these men demonstrated significantly greater knowledge of their disease and its optimal rehabilitation than did control or comparison subjects. Control patients' questionnaire results proved to be insignificantly different from those of the comparison group.


2021 ◽  
Vol 10 (6) ◽  
pp. 1302 ◽  
Author(s):  
Franck Nevesny ◽  
Olivier Chevallier ◽  
Nicolas Falvo ◽  
Kévin Guillen ◽  
Alexandre Malakhia ◽  
...  

Percutaneous sclerotherapy is used to treat venous and lymphatic vascular malformations, which can cause significant discomfort and/or disfigurement. The purpose of this study is to describe the bleomycin sclerotherapy technique and to evaluate its clinical and radiological efficacy and safety. We retrospectively identified consecutive patients with venous malformations (VMs) and lymphatic malformations (LMs) who underwent bleomycin sclerotherapy in 2011–2020 at our institution. We collected the clinical and radiological success rates, complications and recurrences separately in the VM and LM groups. We identified 26 patients, 15 with VMs and 11 with LMs. The significant volume reductions obtained were 45% in the VM group and 76% in the LM group (p = 0.003 and p = 0.009, respectively). Significant reductions in discomfort/pain and in cosmetic disfigurement were obtained in both groups. An overall improvement was reported by 69% and 82% of patients in the VM and LM groups, respectively. No major complications occurred during the mean follow-up of 51 ± 34 months in the VM group and 29 ± 18 months in the LM group. A recurrence developed within 2 years in 23% of patients. Bleomycin is clinically and radiologically effective for the treatment of venous and lymphatic malformations, with a high level of patient safety.


VASA ◽  
2015 ◽  
Vol 44 (6) ◽  
pp. 451-457 ◽  
Author(s):  
Vincenzo Gasbarro ◽  
Luca Traina ◽  
Francesco Mascoli ◽  
Vincenzo Coscia ◽  
Gianluca Buffone ◽  
...  

Abstract. Background: Absorbable sutures are not generally accepted by most vascular surgeons for the fear of breakage of the suture line and the risk of aneurysmal formation, except in cases of paediatric surgery or in case of infections. Aim of this study is to provide evidence of safety and efficacy of the use of absorbable suture materials in carotid surgery. Patients and methods: In an 11 year period, 1126 patients (659 male [58.5 %], 467 female [41.5 %], median age 72) underwent carotid endarterectomy for carotid stenosis by either conventional with primary closure (cCEA) or eversion (eCEA) techniques. Patients were randomised into two groups according to the type of suture material used. In Group A, absorbable suture material (polyglycolic acid) was used and in Group B non-absorbable suture material (polypropylene) was used. Primary end-point was to compare severe restenosis and aneurysmal formation rates between the two groups of patients. For statistical analysis only cases with a minimum period of follow-up of 12 months were considered. Results: A total of 868 surgical procedures were considered for data analysis. Median follow-up was 6 years (range 1-10 years). The rate of postoperative complications was better for group A for both cCEA and eCEA procedures: 3.5 % and 2.0 % for group A, respectively, and 11.8 % and 12.9 % for group B, respectively. Conclusions: In carotid surgery, the use of absorbable suture material seems to be safe and effective and with a general lower complications rate compared to the use of non-absorbable materials.


Author(s):  
Gili Curiel-Levy ◽  
Laura Canetti ◽  
Esti Galili-Weisstub ◽  
Myrna Milun ◽  
Eitan Gur ◽  
...  

This study examines the expression of selflessness – the tendency to ignore one’s own needs and serve others’ needs – in Rorschach protocols of women suffering from anorexia nervosa. The protocols of 35 women suffering from anorexia nervosa were compared to 30 protocols of a psychiatric comparison group. A multivariate analysis of variance over five variables (AG, PER, PHR, COP, and GHR) was significant: Anorexic patients showed higher characteristics of selflessness compared to the psychiatric comparison group. These findings contribute to the validation of the Rorschach technique and to the clinical observation of selflessness in anorexic patients, and they emphasize specific characteristics in the treatment of anorexia nervosa patients.


2019 ◽  
Vol 14 (2) ◽  
pp. 141-146
Author(s):  
Simone Zanella ◽  
Enrico Lauro ◽  
Francesco Franceschi ◽  
Francesco Buccelletti ◽  
Annalisa Potenza ◽  
...  

Background: Laparoscopic Incisional and Ventral Hernia Repair (LIVHR) is a safe and worldwide accepted procedure performed using absorbable tacks. The aim of the study was to evaluate recurrence rate in a long term follow-up and whether the results of laparoscopic IVH repair in the elderly (≥65 years old) are different with respect to results obtained in younger patients. Methods: One hundred and twenty-nine consecutive patients (74 women and 55 men, median age 67 years, range = 30-87 years) with ventral (N = 42, 32.5%) or post incisional (N = 87, 67.5%) hernia were enrolled in the study. Patients were divided into two groups according to their age: group A (N = 55, 42.6%) aged <65 years and group B (N = 74, 57.4%) aged ≥65 years. Results: The mean operative time was not significantly different between groups (66.7 ± 37 vs. 74 ± 48.4 min, p = 0.4). To the end of 2016, seven recurrences had occurred (group A = 3, group B = 4, p = 1). Complications occurred in 8 (16%) patients in group A and 21 (28.3%) patients in group B. Conclusion: In conclusion, our results confirm that the use of absorbable tacks does not increase recurrence frequency and laparoscopic incisional and ventral repair is a safety procedure also in elderly patients.


Author(s):  
Praveenkumar H. Bagali ◽  
A. S. Prashanth

The unique position of man as a master mechanic of the animal kingdom is because of skilled movements of his hands and when this shoulder joints get obstructed, we call it as Apabahuka (Frozen shoulder), we do not find satisfactory management in modern medical science. Various effective treatment modalities have been mentioned which reverse the pathogenesis, Shodhana is advised initially followed by Shamana therapies. In the present study 30 patients were selected incidentally and placed randomly into two groups A and B, with 15 subjects in each group. Group A received Amapachana with Panchakola Churna, Jambeera Pinda Sweda and Nasya Karma. Group B received Amapachana with Panchakola Churna, Jambeera pinda Sweda and Nasaapana. In both the groups two months follow up was done. Both groups showed significant improvement in the signs and symptoms of Apabahuka as well as the activities of daily livings, thereby improving the quality of life of the patients. Nasya Karma and Nasaapana provided highly significant results in all the symptoms of Apabahuka. In the present study as per the clinical data, Nasaapana is found to be more effective than Nasya Karma.


Author(s):  
Renuka M. Tenahalli

Shweta Pradara (Leucorrhoea) is the disease which is characterized by vaginal white discharge. Vaginal white discharge this symptom is present in both physiological and pathological condition, when it becomes pathological it disturbs routine life style of the woman. Most of the women in the early stage will not express the symptoms because of hesitation and their busy schedule. If it is not treated it may leads to chronic diseases like PID (Garbhashaya Shotha etc.) Charaka mentioned Amalaki Choorna along with Madhu and Vata Twak Kashaya Yoni Pichu Dharana. This treatment is used in Shweta Pradara shown positive results, hence a study was under taken to assess its clinical efficacy. 30 diagnosed patients of Shweta Pradara were randomly selected, allocated in three groups. Group A and Group B received Amalaki Choorna with Madhu and Vata Twak Kashaya Yoni Pichu Dharana respectively and Group C received Amalaki Choorna with Madhu followed by Vata Twak Kashaya Yoni Pichu Dharana for 15 days. The patients were assessed for the severity of the symptoms subjectively and objectively before and after the treatment and at the end of the follow up. Data from each group were statistically analyzed and were compared. No side effects were noted and it may be considered as an effective alternative medicine in Shweta Pradara (leucorrhea). Amalaki is rich in natural source of vitamin C and contains phosphorus, iron and calcium. Honey contains carbohydrate, vitamin C, phosphorus iron and calcium. All together these help to increase Hb% and immunity. Vata Twak Kashaya contains tannin which helps to maintain normal pH of the vagina.


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