A study using psoriasis knowledge assessment questionnaire in psoriasis affected patients

Psoriasis is a chronic disease, which is potentially controllable but cannot be cured. Treatment is long term and requires continuous effort by the patient. Patient education is important for a chronic disease like psoriasis and this involves acquiring knowledge about the disease. With knowledge gained, the patient will be able to cope better with improved decision making and comply with treatment. To assess the knowledge about psoriasis in patients diagnosed with psoriasis attending skin outpatient department (OPD) of Sree Balaji Medical College and Hospital, Chennai. This was a cross sectional study, which was conducted at dermatology OPD in Sree Balaji Medical College and Hospital, Chennai 2021 after ethical committee approval. About 80 patients with psoriasis attending OPD were included in study to whom questionnaire with sixteen questions was asked and data was collected and analysed. A total of 80 individuals were included in this study, out of which 43 were males and 37 were females .79% of study population answered that psoriasis is a long life disease. About 75% and 71% of patients answered that climatic conditions and stress aggravates psoriatic lesions respectively. Results were taken from various questions asked in survery and tabulated. The results of the present study suggest that an educational intervention may be helpful in improving the knowledge, give psychological relief to patients with psoriasis and improves quality of their life .

ANALYSIS OF FACTORS ASSOCIATED WITH LOSS OF FOLLOW UP AFTER INITIAL CONSULTATION AMONG THE PATIENTS ATTENDING THE PALLIATIVE CARE CLINIC IN A TERTIARY CARE HOSPITAL OF RURAL AREA OF THE WESTERN INDIA-AN OBSERVATIONAL STUDY.

Aim: To determine factors responsible for loss of follow up and thereby to improve compliance and adherence to treatment in a palliative care unit. Methods: Among the data of patients maintained in our department, we found 81 patients out of 1200 OPD visits who didn't turn up for follow up after the rst outpatient department (O.P.D) visit in the study period [July 2017-June 2018] . After taking the institutional ethical committee approval we did telephonic interview of those patients and/or their relatives, took their consent to participate after explaining the study in brief. We noted the reason of not coming for follow up in our questionnaire. Out of 81, 61 patients could be contacted on phone. Results: Major reason for loss of follow up was death after the rst visit (n=31). 7 patients had started alternate medicine. Factors like exhaustion due to prolong treatment and difculty in bringing patients were noted in 3 patients and 1 patient respectively. Other factors like lack of palliative care awareness, nancial incapability, or no benet from treatment were not found in any of the patient. Conclusion: Death after the rst visit was leading cause for loss of follow up. Majority of the deaths were within one month of the visit. Early referral and early palliative care interventions of those could have helped us to serve those patients better.

P118 MORBIDITY, MORTALITY AND RECURRENCE FACTORS OF INCARCERATED FEMORAL HERNIA

Aim Aimed to search the factors affecting morbidity, mortality, and recurrence in incarcerated femoral hernia cases. Material and Methods After ethical committee approval, patients operated due to incarcerated femoral hernia between 2010 and 2020 were included in the study. Patients in the pediatric age group (0-18 years), and pregnant patients were excluded from the study. Preoperative, intraoperative, and postoperative factors of the patients were gathered. Morbidity, mortality, and recurrence factors were evaluated with Mann-Whitney U test, χ² test, and Likelihood ratio test, p value lower than 0.05 as significant. Results The mean age of 50 patients was 54.56±19.34 years (19-91) and the female to male ratio was 33/17. Right-sided hernia was present in 27 (54%) patients and recurrent hernia in 5 (10%) patients. The most common surgery type was Mc Vay repair in 33 (66%) patients. Other surgery types were as follows: Lichtenstein procedure in 9 (18%) patients and Rutkow plug procedure in 8 (16%) patients. The morbidity and mortality rates of the study were 14% and 4%, respectively. Postoperative recurrence was seen in only 3 (6%) patients. Patients with preoperative nausea (p = 0.003), vomiting (p < 0.001), and tachycardia (p < 0.001), presence of recurrent hernia (p < 0.001), surgery under general anesthesia (p < 0.001), performing both laparotomy (p = 0.007) and organ resection during surgery (p < 0.001) had more morbidity. Also, patients with preoperative tachycardia (p = 0.005) and organ resection during surgery (p = 0.029) had more mortality. However, no factors affecting recurrence were found in the study. Conclusions Morbidity and mortality probability are higher in patients with preoperative septic and obstructive symptoms.

Nalbuphine versus dexmedetomidine for attenuation of haemodynamic response to laryngoscopy and intubation: A randomised double blind comparative study

Laryngoscopy and intubation are noxious stimuli which result in marked sympathetic response. However, literature search did not reveal any study comparing nalbuphine and dexmedetomidine for attenuation of haemodynamic response to laryngoscopy and intubation. After Institutional Ethical Committee approval and written informed consent, 80 ASA I and II patients were randomised in two groups of 40 each. Group N received 0.2 mg/kg of nalbuphine; group D received 1 µg/kg dexmedetomidine over a period of 10 min. Anaesthesia was induced as per standard general anaesthesia practice. Haemodynamic parameters [Heart Rate (HR), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), & Mean Arterial Pressure (MAP)] were recorded at baseline, 0, 1, 3, 5, 10, and 15 min following intubation. Patients were also observed for any side effects of the study drugs.There was a significant decrease (p<0.001) in mean HR in group D compared to group N, after administration of drug and 1 min after intubation. Both group N and group D showed no significant increase in mean HR at any time point compared to baseline values. There was no significant increase in mean SBP at any time interval in both the groups when compared to baseline. There was a significant increase (p<0.001) in mean DBP and MAP at the time of intubation in group N whereas no significant increase in mean DBP, and MAP was observed in group D at any time point. Dexmedetomidine was found to be more effective in attenuating haemodynamic response to laryngoscopy and intubation as compared to nalbuphine.

Efficacy of adipose-derived stromal vascular fraction cells in the management of chronic ulcers: a randomized clinical trial

Background: Cell therapy is a promising method for improving healing in chronic ulcers through delivery of isolated adipose-derived stromal vascular fraction. Objectives: This study investigates the autologous stem cell yield of adipose tissue and its efficacy in chronic ulcers compared with conventional methods. Methods: This study was a randomized controlled trial. After the study design and protocol were established and ethical committee approval was obtained, we enrolled 100 patients divided into study and control groups. In the study group, we performed debridement and autologous stem cells injection every 3 weeks. The control group was treated with debridement and conventional dressing. Assessments included clinical and histological parameters. Results: The study group showed improved healing. Conclusion: Using autologous adipose-derived stromal vascular fraction cells is an effective treatment method for chronic ulcers. This study was registered on the Pan-African Clinical Trial Registry and the number of the registry was PACTR201709002519185 .

Comparative Study Between Bupivacaine 0.5% Versus Bupivacaine 0.5% with Fentanyl in TAP Block for Post-Operative Analgesia After Appendectomy

Background Post operative pain and stress is a very known complication of many surgical procedures which represents a burden for the patient and associated with many complications including stress, myocardial ischemia, prolonged hospital stay and the need of extensive post operative analgesia. Objective to compare the effectiveness of US guided TAP block using 0.5% bupivacaine versus 0.5% bupivacaine with Fentanyl for postoperative analgesia in patients undergoing appendectomy. Patients and Methods After ethical committee approval and informed consent from the patients, this prospective randomized control study, randomization done by closed envelope method & was performed on total 60 patients who underwent surgical appendectomy in Ain Shams University hospitals for 3 months from January to March 2019. Results In our study, 60 patients were randomly divided into 2 equal groups. Control group received bupivacaine only while the fentanyl group in which 50 ug of fentanyl were added to bupivacaine. All patients received equal volumes. Our study showed that addition of a 50 microgram of fentanyl to bupivacaine in ultrasound-guided TAP block has statistically significant effect on the onset of sensory block and prolonged the duration of the sensory block. In addition, fentanyl prolonged the duration of analgesia significantly, as proved by the time of request of first analgesia. Moreover, in fentanyl group, postoperative analgesic requirements were greatly lesser than that of bupivacaine groups. Addition of fentanyl also did not affect the hemodynamics to a significant level. This makes fentanyl with bupivacaine more superior than the use of bupivacaine alone. Conclusion Fentanyl as an adjuvant to bupivacaine in Ultra-sound guided TAP block reduced post-operative pain scores, porolonged the duration of analgesia and decreased demand for rescue analgesics.

Social Relations and Contact With General Practitioner in a Middle-aged Danish Population: A Prospective Register- and Survey-Based Cohort Study

Background: Findings about the relationship between individuals’ social relations and general practitioner (GP) contact are ambiguous as to whether weak social relations are associated with an increased or decreased consultation pattern. Furthermore, social relations may affect GP contact differently for men compared to women, between socioeconomic groups and according to perceived need. The overall aim of the study is to examine the association between functional aspects of social relations, perceived emotional and instrumental social support, the tendency to consult a GP and the frequency of GP contact. Methods: The study comprised 6911 individuals aged 49–61 at baseline from the Copenhagen Aging and Midlife Biobank (CAMB). We conducted a two-part regression to explore the association between perceived emotional and instrumental social support and GP contact (tendency and frequency), controlling for age, sex, occupational social class, cohabitation status and number of morbidities. Conclusions: Results show no overall effect of the perceived social support aspects of social relations on GP contact. Trial registration: The study has been registered and approved by the Danish Data Protection Agency and the local ethical committee (approval No.H-A-2008-126 and No. 2013-41-1814).

Assessment of Disease Knowledge, Medication Adherence, HRQOL in COPD Patients at a South Indian Tertiary Care Hospital

Introduction: Chronic obstructive pulmonary disease (COPD) is a progressive, life-threatening disease of the lungs, gradually causes breathlessness and predisposes to exacerbations and serious illness. The main objectives of the study are to evaluate disease knowledge, medication adherence, and health-related quality of life among COPD patients. Methodology: A Hospital-based, single-entered prospective observational study was conducted at a government general hospital, Andhra Pradesh. India after ethical committee approval. This study was conducted for 6 months with a sample size of 80 patients. Results: According to our study, the majority of the patients 36 (45%) don’t have disease knowledge, where a few numbers of patients 7 (8.75%) is having disease knowledge as per BCKQ score values. 11.25% of patients have the lowest MMAS scores whereas 58.75% were found to have higher MMAS scores and 37.5% of total patients have higher CAT scores, and 12.5% of patients have lower CAT scores. Conclusion: We found that majority of the patients have poor disease knowledge, lower adherence to medication regimens, and substandard HRQOL. Keywords: COPD knowledge, medication adherence, and HRQOL.

Knowledge, attitude and behaviour study of vitiligo among general population

Vitiligo is an acquired skin disorder caused due to destruction of melanocytes which clinically presents with well defined depigmented macules and patches with or without white hairs. The present study is an attempt to document the prevalent knowledge and attitude in the general public regarding this disease and to identify the determinants of good/poor knowledge and attitude. To assess Knowledge, attitude and behaviour study of vitiligo among general population attending skin outpatient department (OPD) of Sree Balaji Medical College and Hospital, Chennai. This was a cross sectional study, which was conducted at dermatology OPD in Sree Balaji Medical College and Hospital, Chennai 2021 after ethical committee approval. About 80 patients attending OPD were included in study to whom questionnaire was asked and data was collected and analysed.

PRE-EMPTIVE EFFECT OF INTRAVENOUS PARACETAMOL VERSUS INTRAVENOUS KETOROLAC ON POST-OPERATIVE PAIN AND SHIVERING AFTER SEPTOPLASTY UNDER GENERAL ANESTHESIA: A COMPARATIVE STUDY

Objective: To observe the pre-emptive effect of intravenous paracetamol versus intravenous ketorolac in preventing postoperative shivering and pain after septoplasty in postoperative care unit. Study Design: Prospective comparative study. Place and Duration of Study: Main Operation Theatre of Frontier Corps Hospital Quetta, from Sep to Dec 2019. Methodology: After ethical committee approval, 90 American Society of Anaesthesiologist (ASA-I patients, aged between 18-45 years, scheduled for septoplasty, were recruited and divided into three equal groups, Paracetamol (PA), Ketorolac (KE) and Placebo (PL) as per computer generated table. The paracetamol (PA) group (n=30) received 1gm intravenous paracetamol, ketorolac (KE) group (n=30) received 30mg intravenous ketorolac and group placebo (PL) received 100ml normal saline, 20 minutes before completion of surgery. Postoperative shivering and pain was assessed via four-point scale and visual analogue scale (VAS) respectively, in post-anesthesia care unit at 10 and 30 minutes post-extubation. Results: Mean visual analog scale (VAS) score in paracetamol group was 2.7 ± 1.41, ketorolac group was 2.3 ± 1.24 and in placebo group was 3.6 ± 1.44, with a p-value of 0.002. Mean four point shivering score in paracetamol group was 0.3 ± 0.55, ketorolac was 0.7 ± 0.78 and placebo group was 1.4 ± 1.00, with a p-value of <0.001. Conclusion: The effect of paracetamol is better than ketorolac in preventing pain and shivering after septoplasty under general anesthesia.