People leaving hospital after medical illness do not benefit from extended clot reducing treatment

Background: Drugs with anticholinergic properties are known to be associated with deleterious effects on cognition in older adults. There is a paucity of literature in this aspect in older adults with psychiatric disorders. Objective: To examine the anticholinergic cognitive burden and its predictors in hospitalised older adults having psychiatric disorders. Methods: Case records of older adults who sought inpatient care under the Geriatric Psychiatry Unit from January, 2019 to June, 2019 were reviewed. The anticholinergic burden was assessed with Anticholinergic Cognitive Burden (ACB) scale updated version, 2012. Results: Sample included 129 older adults with an almost equal number of males (53.48%) and females (46.52%) having a mean age of 67.84 (SD = 6.96) years. The diagnostic spectrum included depression (34.89%), dementia (31.01%), mania (10.85%), psychosis (13.95%), delirium (6.20%) and others (3.1%). 60.47% of the patients had more than one medical illness. 48.84% of the older adults had clinically relevant anticholinergic cognitive burden ( ACB score ≥ 3). Use of 3 or more psychotropic drugs (OR = 4.88), diagnosis of psychosis/ mania (OR = 7.62) and dementia/ delirium (neurocognitive disorders group) (OR = 5.17) increased the risk of ACB score ≥ 3. Conclusion: Nearly half of the older adults in psychiatry in-patient setting had clinically relevant anticholinergic burden, which was associated with higher use of psychotropics. Our study highlights the importance of monitoring for anticholinergic effects of psychotropics in older adults.

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Depression – Let’s Talk - Role of Aashwasan Chikitsa

Journal of Ayurveda and Integrated Medical Sciences (JAIMS) ◽

10.21760/jaims.v2i3.8234 ◽

2017 ◽

Vol 2 (3) ◽

Author(s):

Priya Vishal Naik ◽

Prachi Datta Dalvi U.

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Positive Attitude ◽

Medical Intervention ◽

Medical Illness ◽

Suicidal Tendency ◽

Major Depressive ◽

Curative Therapy ◽

Personal Interaction

The WHO theme for the year 2017 is Depression. Depression (major depressive disorder) is a common and serious medical illness that negatively affects how a person feels, thinks and behaves. Psychotherapy if incorporated along with medications can be of substantial help in depression. It is also called ‘talking therapy’ and is based on personal interaction with the patient. Patients suffering from this disorder do not easily accept it and hence do not feel the need to seek medical intervention or counselling. In this process the symptoms might get aggravated and suicidal tendency (which is the worst effect of this disease) may develop. So it is extremely essential for the patient, family and society to accept, talk, discuss and seek treatment for this disease. This ‘talking therapy’ is of utmost importance in today’s life where concept of privacy is taking its toll. This therapy is mentioned in Ayurveda as Aashwasan Chikitsa. Aashwasan Chikitsa consists of good, pleasing and benevolent thoughts, spiritual ideas, positive attitude, ethics and communication with near ones. So in the treatment of psychological disorders, along with medications counselling therapy plays a very important role. Finally counselling can act as a part of preventive, curative therapy and also aids to avoid recurrence in the patients of depression.

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Knowledge, attitude, and practice of healthcare workers toward COVID-19 and its prevention in Ethiopia: A multicenter study

SAGE Open Medicine ◽

10.1177/20503121211034389 ◽

2021 ◽

Vol 9 ◽

pp. 205031212110343

Author(s):

Bedru Jemal ◽

Zemedu Aweke ◽

Simeneh Mola ◽

Sileshi Hailu ◽

Sileshi Abiy ◽

...

Keyword(s):

Social Media ◽

Confidence Interval ◽

Odds Ratio ◽

Healthcare Workers ◽

Medical Illness ◽

Chronic Medical Illness ◽

Attitude And Practice ◽

Route Of Transmission ◽

History Of ◽

Knowledge Attitude And Practice

Background: An emerging respiratory disease abbreviated as coronavirus disease 2019 was first reported in December 2019 in Wuhan city of China. The virus is zoonotic and tends to be transmitted between animals to humans and humans to humans. The major route of transmission of coronavirus disease 2019 is droplet and close contact. The Ethiopian Ministry of Health has initiated training for health care workers at a different level. Thus, the main objective of this study is to assess the knowledge, attitudes, and practices of health workers in Ethiopia toward coronavirus disease 2019 and its prevention techniques. Method: An institution-based multicenter cross-sectional study was conducted in each of eight teaching and referral hospitals. A total of 422 Ethiopian healthcare workers were selected for the assessment of knowledge, attitude, and practice toward coronavirus disease 2019. Data were collected using a structured questionnaire. A logistic regression model was used to identify factors associated with the attitude and knowledge of healthcare workers toward coronavirus disease 2019 at a significance level of p < 0.05. Result: Three hundred ninety-seven healthcare workers participated in the study, with a response rate of 94%. Among these, 88.2% and 94.7% of respondents had good knowledge and positive attitudes, respectively. A respondent with a history of chronic medical illness (odds ratio: 0.193, 95% confidence interval: 0.063–0.593), social media, telecommunication, and television/radio as a source of information were significantly associated with knowledge (odds ratio: 3.4, 95% confidence interval: 1.5–7.4, OR: 4.3, 95% confidence interval: 1.3–14.3 and odds ratio: 3.2, 95% confidence interval: 1.4–7.2). In addition, respondents with a history of chronic medical illness were significantly associated with a negative attitude toward coronavirus disease 2019. Conclusion: The knowledge and attitude were good while; the practice was relatively low. Sources of information such as social media, telecommunication, and television/radio were positively associated with healthcare workers' knowledge about coronavirus disease 2019.

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Evaluation of association of fragility fracture and bone mineral density in Nepalese population

Nepal Journal of Medical Sciences ◽

10.3126/njms.v2i2.8956 ◽

2013 ◽

Vol 2 (2) ◽

pp. 130-134

Author(s):

Md. Farid Amanullah ◽

BP Shrestha ◽

GP Khanal ◽

NK Karna ◽

S Ansari ◽

...

Keyword(s):

Bone Mineral Density ◽

Risk Factor ◽

Alcohol Consumption ◽

Bone Mineral ◽

Fragility Fracture ◽

High Energy ◽

Medical Illness ◽

Mineral Density ◽

T Score ◽

Study Results

Background: Fragility fractures are one of the major health problems. Many factors are associated with it some of which are modifiable and some are not. If we know the value of T-score at which fragility fracture occurs and associated factors responsible for fragility fracture than we will be able to control this burden to the society. The objective of this study is to determine association between fragility fracture and bone mineral density (BMD) using bone densitometry and to know the value of T-score at which fragility fracture occurs. Methods: Patients presenting to B.P. Koirala Institute of Health Sciences with fragility fracture of distal end of radius, fracture around hip and vertebral fractures were included in the study to know the value of T-score at which fragility fracture occurs and their associated risk factor. Patients less than 50 years of age, high energy trauma fracture and pathological fractures were excluded from the study. Results: We found that being multipara, smoking, alcohol consumption, post-hysterectomized patients and steroid intake had significant association with fragility fracture. There was no association with religion, geographic location, associated medical illness, age, sex, associated injury and site of injury. Conclusion: The patients with risk factor for fragility fracture like smoking, alcohol consumption, multipara women, post-hysterectomized women and those who are on long term steroid therapy should undergo BMD test and the value at -3.254 are prone to fragility fracture and should be treated accordingly. Nepal Journal of Medical Sciences | Volume 02 | Number 02 | July-December 2013 | Page 130-134 DOI: http://dx.doi.org/10.3126/njms.v2i2.8956

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Professional judgements of risk and capacity in situations of self-neglect among older people

Ageing and Society ◽

10.1017/s0144686x10000139 ◽

2010 ◽

Vol 30 (6) ◽

pp. 1055-1072 ◽

Cited By ~ 12

Author(s):

SHANNON MCDERMOTT

Keyword(s):

Critical Theory ◽

Older People ◽

Cultural Context ◽

Sociological Theory ◽

Qualitative Interviews ◽

Medical Illness ◽

The Past ◽

The Social ◽

Professional Intervention ◽

Sydney Australia

ABSTRACTOver the past 50 years, self-neglect among older people has been conceptualised in both social policy and the academy as a social problem which is defined in relation to medical illness and requires professional intervention. Few authors, however, have analysed the concept of self-neglect in relation to critical sociological theory. This is problematic because professional judgements, which provide the impetus for intervention, are inherently influenced by the social and cultural context. The purpose of this article is to use critical theory as a framework for interpreting the findings from a qualitative study which explored judgements in relation to older people in situations of self-neglect made by professionals. Two types of data were collected. There were 125 hours of observations at meetings and home assessments conducted by professionals associated with the Community Options Programme in Sydney, Australia, and 18 professionals who worked with self-neglecting older people in the community gave in-depth qualitative interviews. The findings show that professional judgements of self-neglect focus on risk and capacity, and that these perceptions influence when and how interventions occur. The assumptions upon which professional judgements are based are then further analysed in relation to critical theory.

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