Randomized Control
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2021 ◽  
Vol 0 ◽  
pp. 1-5
Kiran Mahendru ◽  
Anuja Pandit ◽  
Vishwajeet Singh ◽  
Nandan Choudhary ◽  
Anant Mohan ◽  

Objectives: The corona virus disease-19 (COVID-19) pandemic has affected every domain of human health be it physical or mental. The uncertainty of disease progression in patients with SARS-CoV-2 infection can lead to major psychological and psychiatric concerns that should not be overlooked. The interventions should be directed to the vulnerable population to help them mitigate the stress and anxiety caused by the infection and isolation. We evaluated the effect of meditation and breathing exercises on the well-being of patients with SARS-CoV-2 infection under institutional isolation. Materials and Methods: We conducted a randomized control trial on 84 subjects, 18 years and above, asymptomatic, or mildly symptomatic SARS-CoV-2 infected patients under institutional isolation. Subjects were randomly and equally divided into a control group and interventional group. We measured the depression, anxiety, and stress levels as well as quality of sleep in patients after 7 days of meditation and breathing exercises in the intervention group versus standard care in the control group. Results: Mediation and breathing exercises had a statistically significant effect on the depression level (P < 0.001), stress level (P = 0.004), and the quality of sleep [trouble falling asleep (P = 0.007), trouble staying asleep (P = 0.004), and feel tired after waking up in the morning (P = 0.003)]. Further, the positive effect of intervention on the level of anxiety in patients under isolation was also observed; however, the difference was not found to be statistically significant (P = 0.528). Conclusion: Meditation and breathing exercises have positive effects on depression, stress levels, and quality of sleep in COVID-19 positive patients under strict institutional isolation.

2021 ◽  
pp. 097321792110607
Chinmay Chetan ◽  
Nishant Banait ◽  
Vikramaditya Athelli ◽  
Bhvya Gupta ◽  
Prince Pareek ◽  

Introduction: World Health Organization (WHO) in 2014 recommended delayed cord clamping (DCC) in all babies who cry immediately after birth. Despite many benefits, there are concerns of increased rate of phototherapy in babies receiving DCC. This study was done to determine the increment in the rate of phototherapy required in infants managed with DCC vs infants managed with early cord clamping (ECC). Methods: A retrospective observational study was conducted in a tertiary care hospital in Pune, India. All the infants born between January 2018 and July 2018, for whom ECC was done, were compared with infants who were born between January 2019 and July 2019, after DCC policy was adopted. All the infants with birth weight ≥2 kg and gestation ≥35 weeks, who were with their mother, were included. Baseline characteristics were compared for both the groups. American Academy of Pediatrics guidelines for treatment of neonatal jaundice were used to determine the need for phototherapy. Number of infants in both the groups who required phototherapy were compared. Results: The ECC group had 565 infants while DCC group had 731 infants. There was no difference in the baseline characteristics of the 2 groups. Jaundice requiring phototherapy was noted in 31% of infants in the ECC group, compared to 45% in infants in the DCC group (relative risk: 1.47 [1.27-1.71] [ P < .001]). Conclusion: In this study, DCC increased the need for phototherapy by 47% in late preterm and term infants. Randomized control trials with larger sample size are required to confirm this finding.

Kara McTiernan ◽  
Fiona Gullon-Scott ◽  
Robert Dudley

AbstractMental health services are placing a greater emphasis on wellbeing and recovery. The current research investigated if positive psychology interventions (PPIs) increase peoples’ subjective wellbeing and reduce clinical depression. A systematic methodological review was conducted on randomized-control-trials with people attending clinical services. Five databases were searched. A hand search was then completed on the reference lists of the identified articles and the associated journals. Eleven research interventions were reviewed. PPIs were found to significantly increase wellbeing, relative to controls and there were fewer studies indicating a difference in decreasing depression. However, subsequent analysis revealed that the interventions were heterogeneous which limits the drawing of definitive systematic conclusions. A methodological evaluation also found that there were recurring issues: in delivering the interventions, measuring subjective wellbeing, and applying the design. Thus, the methodological quality of the research interventions, as measured by the current review was low. There is emerging evidence that PPIs improve peoples’ mental health. However, there is scope to standardize and to improve the quality of the research interventions.

2021 ◽  
Kia Watkins-Martin ◽  
Despina Bolanis ◽  
Stephane R. Devantoy ◽  
Marie-Helene Pennestri ◽  
Catherine Malboeuf-Hurtubise ◽  

Background: While walking in nature has been shown to improve affect in adults from the community to a greater extent than walking in urban settings, it is unknown whether such findings can be generalized to individuals suffering from depression. Using a parallel group design, this randomized controlled trial examined the effects of a single walk in nature versus urban settings on negative and positive affect in adult psychiatric outpatients diagnosed with major depressive disorder (MDD). Method: Participants recruited from a psychiatric outpatient clinic for adults with MDD were randomly assigned to a nature or urban walk condition. Thirty-seven adults (mean age=49 years) completed a single 60-minute walk. Negative and positive affect were assessed using The Positive and Negative Affect Schedule or PANAS at 6 time points: before the walk, halfway during the walk, immediately post-walk, at home before bedtime, 24 hours post-walk, and 48 hours post-walk. Results: Controlling for baseline levels of affect before the walk, individuals who walked in nature experienced overall lower levels of negative affect, F(1, 35.039)=4.239, p=.047, compared to those who walked in urban settings. Positive affect did not differ across walk conditions. Limitations: The generalizability of results are limited by the small sample size and the presence of more female than male participants. Conclusions: Walking in nature might be a useful strategy to improve the affect of adults with MDD. Future research should investigate different ways to integrate the beneficial effects of nature exposure into existing treatment plans for psychiatric outpatients with MDD. Keywords: major depressive disorder (MDD); depression; nature; greenspace; affect; randomized-control trial; physical activity

2021 ◽  
Vol 21 (1) ◽  
Shahrzad Bazargan-Hejazi ◽  
Anaheed Shirazi ◽  
Andrew Wang ◽  
Nathan A. Shlobin ◽  
Krystal Karunungan ◽  

Abstract Background The PERMA Model, as a positive psychology conceptual framework, has increased our understanding of the role of Positive emotion, Engagement, Relationships, Meaning, and Achievements in enhancing human potentials, performance and wellbeing. We aimed to assess the utility of PERMA as a multidimensional model of positive psychology in reducing physician burnout and improving their well-being. Methods Eligible studies include peer-reviewed English language studies of randomized control trials and non-randomized design. Attending physicians, residents, and fellows of any specialty in the primary, secondary, or intensive care setting comprised the study population. Eligible studies also involved positive psychology interventions designed to enhance physician well-being or reduce physician burnout. Using free text and the medical subject headings we searched CINAHL, Ovid PsychINFO, MEDLINE, and Google Scholar (GS) electronic bibliographic databases from 2000 until March 2020. We use keywords for a combination of three general or block of terms (Health Personnel OR Health Professionals OR Physician OR Internship and Residency OR Medical Staff Or Fellow) AND (Burnout) AND (Positive Psychology OR PERMA OR Wellbeing Intervention OR Well-being Model OR Wellbeing Theory). Results Our search retrieved 1886 results (1804 through CINAHL, Ovid PsychINFO, MEDLINE, and 82 through GS) before duplicates were removed and 1723 after duplicates were removed. The final review included 21 studies. Studies represented eight countries, with the majority conducted in Spain (n = 3), followed by the US (n = 8), and Australia (n = 3). Except for one study that used a bio-psychosocial approach to guide the intervention, none of the other interventions in this review were based on a conceptual model, including PERMA. However, retrospectively, ten studies used strategies that resonate with the PERMA components. Conclusion Consideration of the utility of PERMA as a multidimensional model of positive psychology to guide interventions to reduce burnout and enhance well-being among physicians is missing in the literature. Nevertheless, the majority of the studies reported some level of positive outcome regarding reducing burnout or improving well-being by using a physician or a system-directed intervention. Albeit, we found more favorable outcomes in the system-directed intervention. Future studies are needed to evaluate if PERMA as a framework can be used to guide system-directed interventions in reducing physician burnout and improving their well-being.

Taru Gupta ◽  
Divya Baruhee ◽  
Sunaina Agarwal

Background: Recent theory on ovarian malignancy suggests its origin from primary foci in fallopian tubes. Prophylactic salpingectomy may benefit in risk reduction of ovarian cancer. The aim of the study was to compare the feasibility of complete salpingectomy with bilateral tubal ligation was made during caesarean delivery in women desirous of permanent sterilisation.Methods: We conducted a prospective interventional randomized control study in department of obstetrics and gynaecology, ESI-PGIMSR Basaidarapur, New Delhi from October 2018 to February 2021. 70 women participated in this study desiring permanent sterilisation during caesarean delivery. Patients were randomized into two groups who either underwent bilateral tubal ligation [group A (N=35)] or complete bilateral salpingectomy [group B (N=35)].Results: Procedure was completed in 91% patients in group A and 77% in group B (p >0.05) making both the procedures feasible.  Total operative time (min) in group A and B were 47 and 55 respectively (p<0.01). Mean sterilisation procedure time (min) in group A was 5 and group B was 6 (p=0.13). No significant difference was seen in intra-operative blood loss (400 ml in group A vs 300 ml in group B), percentage decrease in post-op haemoglobin (g/dl) (4.56±2.96 in group A vs 3.91±2.7 in group B), post-operative serum Anti-mullerian hormone (AMH) levels (ng/ml) (group A-0.965±0.12 vs 0.7±0.09 in group B) in the two groups.Conclusions: Salpingectomy as an alternative to tubal ligation should be discussed with suitable patients desirous of permanent sterilisation during caesarean delivery. 

Barbara Ying-Jung Chen ◽  
Mei-Yi Wu ◽  
Mei-Yun Chin ◽  
Mai-Szu Wu ◽  
Jiun-Rong Chen

High dietary phosphate intake and poor adherence to phosphate-binding-therapy elevate the risk of hyperphosphatemia in maintenance hemodialysis (HD; MHD) patients. Therefore, chronic kidney disease-related mineral and bone disorder (CKD-MBD) indicators increase; consequently, risks of CKD-MBDs and inflammation are elevated. This double-blind, randomized control trial intervention study was designed to investigate the possibility of reducing blood CKD-MBD indicators and modulating inflammatory indicators by consuming low-phosphate (LP) meals accompanied by a minimum dose of a calcium-based phosphate binder (CaCO3). MHD patients were recruited and randomly assigned to an LP meal group (LP group) or a control group. After initial data collection, blood collection, and dietary counseling, subjects were asked to consume a washout diet for 1 week. During the washout diet period, subjects consumed their usual diet but took 1 tablet of calcium carbonate (1CaCO3) as a phosphate binder with each meal. After the washout diet period, subjects in the LP group and control group respectively consumed LP meals and regular meals twice a day for 1 week. Meat in the LP meals was boiled before the regular cooking process, but meat in control meals was not. All meals were supplied by a central kitchen so that the contents of phosphate and other nutrients could be identified. In total, 40 MHD patients completed the study program. After 1 week of the dietary intervention, the blood Ca x P product and dietary phosphate had significantly decreased in the LP group compared to the control group (p&amp;lt;0.05). The LP group had significantly lower variations in dietary phosphate intake, blood calcium, Ca x P product, and tumor necrosis factor (TNF)-&alpha; than the control group by comparing differences between after the dietary intervention and the baseline (△after intervention - baseline, p&amp;lt;0.05). The increase in dietary phosphate intake (△3rd - 2nd dietary phosphate intake) augmented the increase in the TNF-&alpha; level by 6.24-fold (odds ratio [95% confidence interval]: 6.24 [1.12~34.92], p&amp;lt;0.05). These results highlighted the conclusion that LP meals accompanied by a minimum dose of CaCO3 downregulated pro-inflammation by reducing CKD-MBD indicators which was triggered by decreasing dietary phosphate intake.

2021 ◽  
Eniola Oladejo Awolola ◽  
Sonill Sooknunan Maharaj

Background: Interferential therapy (IFT) is the application of two medium frequency currents to the skin to stimulate and activate different systems in the body using specific frequencies and frequency ranges. IFT aims to reduce myalgia in the chest and upper back, reduce muscular fatigue and induce mucus expectoration. This study is designed to test the efficacy of IFT on asthma patients recently exposed to SARS-CoV-2 virus. Methods: Twenty-eight (28) patients aged 18 and above with bronchial Asthma attending the respiratory clinic at the Lagos State University Teaching Hospital, Ikeja (LASUTH) will be assessed for the study eligibility. The study design will be a double-blinded, randomized control trial with two intervention groups and two parallel placebo control groups. IFT will be administered as an intervention to asthma patients with and without a history of COVID-19 exposure for 20 minutes. Six continuous outcome variables at different points will be utilized as an outcome measure. Selected Baseline Pulmonary Function Test (PFT) and Cardiopulmonary Variables (CVS) will be assessed on entry into the study, Quality of life and asthma control will be evaluated every two (2) weeks of the study. Data obtained will be analyzed using descriptive and inferential statistics of repeated ANOVA; P<0.05. Discussion: The study outcome will compare the efficacy of IFT on Bronchial Asthma patients with Post COVID-19 exposure, identify the relationship between the Intervention on Asthma patients with or without COVID-19 exposure.

2021 ◽  
Vol 42 (6) ◽  
pp. 438-444
Khadije Ezzati Rastegar ◽  
Babak Moeini ◽  
Forouzan Rezapur-Shahkolai ◽  
Asadollah Naghdi ◽  
Manoochehr Karami ◽  

Background: Intimate partner violence is a severe life-threatening criminal and public health problem affecting the well-being of individuals, families, and society. Planning interventions to reduce the burden of this persistent and criminal violence should be relevant culturally and socially.Methods: In this randomized control trial, 150 pregnant women residing in slum areas of Hamadan were randomly assigned to two groups (intervention group: n=50 and control group: n=100). Interventional strategies included educating the victims based on local cultural norms, culturally sensitive individual and group counseling, and educating health care providers. Data were collected via face-to-face interviews at baseline and again at 3 months after the intervention. We used a paired t-test to evaluate the effect of the intervention by comparing changes in the outcomes measured.Results: There were no statistically significant differences between the two groups at baseline in terms of sociodemographic characteristics. Post-test scores of knowledge (7.50±2.65 vs. 5.14±3.51, P=0.001), communication skills (18.38±4.25 vs. 16.2±3.83, P=0.04), and family support and social expectation of obedience (15.79±4.45 vs. 13.40±4.57, P=0.005) of the victims were statistically significantly higher in the experimental group compared to the control group. Moreover, physical (0.74±2.28 vs. 1.20±2.60, P=0.06), psychological (2.80±4.10 vs. 4.52±5.43, P=0.06), and sexual (0.11±0.58 vs. 0.61±1.22, P=0.04) violence reduced in the experimental group compared to the control group.Conclusion: Culturally relevant interventions can reduce intimate partner violence.

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