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The Journal of the Association of Physicians of India, 2018
Background Psychiatric illness is often a neglected issue in patients with Tuberculosis (TB) in I... more Background Psychiatric illness is often a neglected issue in patients with Tuberculosis (TB) in India. Depression among TB patients is a common comorbidity which is often unrecognised and untreated. It constitutes a major risk factor for higher default rates due to non-adherence to the treatment, thereby affecting the treatment outcome. Aim of the study This study was carried out to assess the prevalence of depression and it's severity among TB patients. Materials and methods It was a cross-sectional, prospective and observational study conducted in TB patients, diagnosed and registered under directly observed treatment system (DOTS) at a tertiary care hospital in Bangalore from June 2016 to October 2016. Depression was assessed using Patient Health Questionnaire (PHQ-9). Results Out of the total two hundred sixty two (262) TB patients, 107 patients were found to have depression. The prevalence was found to be 40.83%. Mild to moderate depression was observed in 71.02% of the pat...
Journal of Evolution of Medical and Dental Sciences, 2016
BACKGROUND There are very few events which affect a person's entire lifestyle as profoundly as a ... more BACKGROUND There are very few events which affect a person's entire lifestyle as profoundly as a spinal cord injury (SCI) and more so the traumatic injuries. The victims in their young and productive years face multiple medical, social and vocational complications. This causes burden and suffering not only to the victim but also to their families, the health care system and the community. Despite this, a comprehensive rehabilitation program including assessment of caregiver burden can often enable these individuals to function adequately. Objectives 1. To assess the burden in caregivers of traumatic spinal cord injured patients. 2. To correlate caregiver burden with patient's disability, handicap status and quality of life. MATERIALS AND METHODS A cross-sectional observational study was carried out on 50 primary caregivers of SCI patients one year post injury. Caregivers were assessed with Zarit Burden Inventory (ZBI) after screening with General Health Questionnaire (GHQ-28). RESULTS Two-thirds of caregivers were aged below 40 years. Majority of them (62%) were females. Three-fourths of caregivers perceived higher scores of burden. Significant correlations noted between patient's functional outcomes and ZBI scores. CONCLUSION This study shows that caregiver burden is an important factor to be considered as a part of every rehabilitation effort for traumatic SCI patients. Assessment of burden would guide medical professionals to prevent burnout of caregivers and help them to provide long-term care for their patients.
Journal of Evidence Based Medicine and Healthcare, 2016
BACKGROUND Traumatic myelopathies account for significant proportion of people with spinal cord i... more BACKGROUND Traumatic myelopathies account for significant proportion of people with spinal cord injuries admitted to rehabilitation unit and it becomes important to assess the functional outcome of these individuals for formulating the treatment plan. The studies incorporating all the measures of outcome i.e., impairment, disability, handicap and quality of life with appropriate instruments in this population are sparse and very few studies have been done from our country. Hence in this study an attempt was made to evaluate the above through International Classification of Functioning, Disability and Health (ICF) model. OBJECTIVES 1. To assess the Quality of Life (QOL) in traumatic SCI individuals 2. To study the correlation between QOL and impairment/disability/handicap. METHODOLOGY A cross-sectional study was carried out on fifty patients of traumatic SCI visiting our centre over a period of one year and one year post injury. Patients were assessed by ASIA impairment scale, Functional Independence Measure (FIM), Craig's Handicap Assessment and Reporting Technique (CHART) and WHOQOL-BREF after screening with MMSE. RESULTS 90% of patients were males, more than half were in their productive years of life; 82% had incomplete SCI injuries and 76% had higher grades of impairment. Younger patients had better scores on FIM and all domains of CHART except economic selfsufficiency. All domains of QOL were negatively affected by SCI. There were significant positive correlations between impairment and disability, disability and QOL, disability and handicap. Different domains of CHART had variable correlations with QOL domains. CONCLUSIONS This study shows that SCI negatively influences all the conceptual components of ICF model. SCI affects QOL, activity and participation of an individual. Various factors like age, completeness of injury, marital status, etc., affects QOL of an SCI individual. This finding highlights the need for vigilance among rehabilitation personnel to look at these in every SCI individual and plan for appropriate interventions.
Asian Pacific Journal of Health Sciences, 2019
Background: Suicide is a psychiatric emergency. It contributes for substantial portion of prevent... more Background: Suicide is a psychiatric emergency. It contributes for substantial portion of preventive deaths. Medical professionals bear responsibility of providing optimal primary care to a suicidal person and reducing stigma towards suicide. Their attitudes towards suicide or a suicidal person determines the quality of care given to them. This study attempts to quantitatively assess attitudes of undergraduate medical students towards suicide and a suicidal person. Materials and methods: This cross-sectional study was conducted in a medical college hospital of Kerala. Total 287 first& second year medical students who were not exposed to psychiatry teaching were recruited for the study by total enumeration method. Eskin's attitude towards suicide scale (E-ATSS) and Eskin's Social Reactions to Suicidal Persons Scale (E-SRSPS) were administered. Responses were collected in 5 point likert scale ranging from 'completely disagree' to 'completely agree'. Results: On E-ATSS, Communicating psychological problems had a high mean score with minimal standard deviation(4.25+/-0.35) & acceptability of suicide scored the least(1.46+/-0.62) while the social acceptance of a suicidal person & helping had high scores (4.34+/-0.82, 4.28+/-0.23) on E-ATSPS. Conclusion: Students participated in this study have more of rejecting attitudes towards suicide. But less than half of them take it as a sign of mental illness. When it comes to attitude towards a suicidal person, our medical students have a very high acceptance score and also are ready to help them. Studies involving students who complete undergraduate psychiatry training will help to know about the change that the training brings into the attitudes.
The Journal of the Association of Physicians of India, 2018
Background Psychiatric illness is often a neglected issue in patients with Tuberculosis (TB) in I... more Background Psychiatric illness is often a neglected issue in patients with Tuberculosis (TB) in India. Depression among TB patients is a common comorbidity which is often unrecognised and untreated. It constitutes a major risk factor for higher default rates due to non-adherence to the treatment, thereby affecting the treatment outcome. Aim of the study This study was carried out to assess the prevalence of depression and it's severity among TB patients. Materials and methods It was a cross-sectional, prospective and observational study conducted in TB patients, diagnosed and registered under directly observed treatment system (DOTS) at a tertiary care hospital in Bangalore from June 2016 to October 2016. Depression was assessed using Patient Health Questionnaire (PHQ-9). Results Out of the total two hundred sixty two (262) TB patients, 107 patients were found to have depression. The prevalence was found to be 40.83%. Mild to moderate depression was observed in 71.02% of the pat...
Journal of Evolution of Medical and Dental Sciences, 2016
BACKGROUND There are very few events which affect a person's entire lifestyle as profoundly as a ... more BACKGROUND There are very few events which affect a person's entire lifestyle as profoundly as a spinal cord injury (SCI) and more so the traumatic injuries. The victims in their young and productive years face multiple medical, social and vocational complications. This causes burden and suffering not only to the victim but also to their families, the health care system and the community. Despite this, a comprehensive rehabilitation program including assessment of caregiver burden can often enable these individuals to function adequately. Objectives 1. To assess the burden in caregivers of traumatic spinal cord injured patients. 2. To correlate caregiver burden with patient's disability, handicap status and quality of life. MATERIALS AND METHODS A cross-sectional observational study was carried out on 50 primary caregivers of SCI patients one year post injury. Caregivers were assessed with Zarit Burden Inventory (ZBI) after screening with General Health Questionnaire (GHQ-28). RESULTS Two-thirds of caregivers were aged below 40 years. Majority of them (62%) were females. Three-fourths of caregivers perceived higher scores of burden. Significant correlations noted between patient's functional outcomes and ZBI scores. CONCLUSION This study shows that caregiver burden is an important factor to be considered as a part of every rehabilitation effort for traumatic SCI patients. Assessment of burden would guide medical professionals to prevent burnout of caregivers and help them to provide long-term care for their patients.
Journal of Evidence Based Medicine and Healthcare, 2016
BACKGROUND Traumatic myelopathies account for significant proportion of people with spinal cord i... more BACKGROUND Traumatic myelopathies account for significant proportion of people with spinal cord injuries admitted to rehabilitation unit and it becomes important to assess the functional outcome of these individuals for formulating the treatment plan. The studies incorporating all the measures of outcome i.e., impairment, disability, handicap and quality of life with appropriate instruments in this population are sparse and very few studies have been done from our country. Hence in this study an attempt was made to evaluate the above through International Classification of Functioning, Disability and Health (ICF) model. OBJECTIVES 1. To assess the Quality of Life (QOL) in traumatic SCI individuals 2. To study the correlation between QOL and impairment/disability/handicap. METHODOLOGY A cross-sectional study was carried out on fifty patients of traumatic SCI visiting our centre over a period of one year and one year post injury. Patients were assessed by ASIA impairment scale, Functional Independence Measure (FIM), Craig's Handicap Assessment and Reporting Technique (CHART) and WHOQOL-BREF after screening with MMSE. RESULTS 90% of patients were males, more than half were in their productive years of life; 82% had incomplete SCI injuries and 76% had higher grades of impairment. Younger patients had better scores on FIM and all domains of CHART except economic selfsufficiency. All domains of QOL were negatively affected by SCI. There were significant positive correlations between impairment and disability, disability and QOL, disability and handicap. Different domains of CHART had variable correlations with QOL domains. CONCLUSIONS This study shows that SCI negatively influences all the conceptual components of ICF model. SCI affects QOL, activity and participation of an individual. Various factors like age, completeness of injury, marital status, etc., affects QOL of an SCI individual. This finding highlights the need for vigilance among rehabilitation personnel to look at these in every SCI individual and plan for appropriate interventions.
Asian Pacific Journal of Health Sciences, 2019
Background: Suicide is a psychiatric emergency. It contributes for substantial portion of prevent... more Background: Suicide is a psychiatric emergency. It contributes for substantial portion of preventive deaths. Medical professionals bear responsibility of providing optimal primary care to a suicidal person and reducing stigma towards suicide. Their attitudes towards suicide or a suicidal person determines the quality of care given to them. This study attempts to quantitatively assess attitudes of undergraduate medical students towards suicide and a suicidal person. Materials and methods: This cross-sectional study was conducted in a medical college hospital of Kerala. Total 287 first& second year medical students who were not exposed to psychiatry teaching were recruited for the study by total enumeration method. Eskin's attitude towards suicide scale (E-ATSS) and Eskin's Social Reactions to Suicidal Persons Scale (E-SRSPS) were administered. Responses were collected in 5 point likert scale ranging from 'completely disagree' to 'completely agree'. Results: On E-ATSS, Communicating psychological problems had a high mean score with minimal standard deviation(4.25+/-0.35) & acceptability of suicide scored the least(1.46+/-0.62) while the social acceptance of a suicidal person & helping had high scores (4.34+/-0.82, 4.28+/-0.23) on E-ATSPS. Conclusion: Students participated in this study have more of rejecting attitudes towards suicide. But less than half of them take it as a sign of mental illness. When it comes to attitude towards a suicidal person, our medical students have a very high acceptance score and also are ready to help them. Studies involving students who complete undergraduate psychiatry training will help to know about the change that the training brings into the attitudes.