ABSTRACT
Background: The chronic hemodialysis imposes various limitations on patients that may affect their quality of life. However, Tunisian studies on this matter remain scarce
Aims: To assess the quality of life among hemodialysis patients and to identify the factors influencing their quality of life
Methods: We performed a cross-sectional study which included 71 outpatients, during the month of January 2013, in the department of Nephrology at Hedi Chaker Sfax university hospital in Tunisia. We used the specific scale Kidney Disease Quality of Life Short-Form [KDQOL-SF[Trade Mark sign]] to assess the patient's quality of life. This instrument combines the short form 36 health survey questionnaire [SF-36] and a specific module adapted to renal function. Regression analysis was used to adjust for confounding factors
Results: The global average score, according to KDQOL-SF and the SF-36 were respectively 51.6 and 38.2. The QOL was impaired in 90% of the cases. The logistic regression identified six variables to be correlated with impaired QOL. These six factors in descending order of importance were: lack of autonomy, a dialysis rhythm of thrice a week, an age over 60 years, a comorbid diabetes, low social economic level and living in rural areas
Conclusion: Our study highlights the high frequency of QOL impairment upon patients on hemodialysis underlining the interest of a systematic effort to assess the quality of life in those patients. It also shows the interest of acting upon modifiable factors correlated with the alteration of the quality of life. In this way, the professional integration of the patients should be favored as well as peritoneal dialysis
ABSTRACT
Background: Stress of the higher studies leads to various disorders, especially eating ones. Such disorders, once present, may influence body image and self-esteem of young students
Aim: to assess the prevalence of eating disorders among a group of Medicine students and to study its links with stress level and selfesteem
Methods: It was a descriptive and analytic cross-sectional study, including 60 medicine students that were investigated during their revision for the final year exam. The participants had filled the perceived stress scale, the eating attitude test EAT-40 and The Rosenberg self-esteem scale
Results:The eating disorders were found in 11% of the participants. Those had a low to a very low self-esteem in 40% of cases and a high perceived stress level in 36, 4% of cases. The eating disorders were significantly more frequent among the female students [p=0, 03], the more sedentary [p=0,019], having a low to a very low self-esteem [p=0,032] and a high perceived stress level [p=0,001]
Conclusion: Our study shows that the prevalence of eating disorders is not negligible among medicine students. Their presence depends on certain personal aspects [physical activities, body image satisfaction] and contextual aspects [period of exams, stress]. If existing, they would affect negatively the self-esteem, especially of the girls. These various results pave the way for a multidisciplinary approach to students particularly vulnerable to eating disorders
ABSTRACT
The co-occurrence of emotional disorders [alexithymia, depression and anxiety] and inflammatory bowel disease [IBD] is reported in the literature. There are several possible explanations for this co morbidity. To evaluate the prevalence of alexithymia, anxiety and depression among patients with IBD and to compare them with a control group of healthy individuals and to discuss the relation between emotional disorders and IBD. We built a case - control study of 50 patients with IBD [ulcerative colitis [UC] and Crohn's disease [CD]]. The control group compounded 50 subjects without IBD and paired according sex, age, and school level. Alexithymia was assessed with the 20-item version of the Toronto Alexithymia Scale [TAS -20]. Participants completed the Hospital Anxiety and Depression Scale [HADS], which is a 14-item self-report scale providing separate subscale scores for anxiety [HADS-A] and depression [HADS-D]. Among the group of patients, the rates of anxiety, depression and alexithymia were, respectively, 52%, 44% and 54%. In this group, there were significantly more anxious, depressed, and alexithymic subjects than in the control group [p respectively, 0, 007, 0, 015 and 0, 002]. The anxiety and the depression were more frequent among patients who had active disease or symptoms than those in remission [p respectively, 0, 011 and 0, 035]. The comorbidity of emotional disorders and IBD seems to be frequent. Therefore, clinicians should look for those disorders in patients with IBD, by using specific scales. The adjunction of emotional disorder treatment, if needed, would allow optimizing the management of MICI
ABSTRACT
In the Sfax area and the south of Tunisia, epileptics are not all followed by neurologist. Some are addressed to psychiatrist. This fact raises the question of the motivations of such an orientation. The objectives of our survey were to point out the socio-cultural, clinical and psycho [patho] logical profile of the epileptic consulting in adult psychiatry, in Sfax teaching hospital, and to confront it to literature data coming from the studies dealing with the epileptic treated in neurological wards. It was a retrospective survey assesing the epileptic whose first consultation occurred from the 1st January 1999 to 31st December 2003. The studied sample included 197 cases. The sex-ratio [male/female] was 2.18. The rate of generalised seizures was 84.4%. The aetiology was known or presumed to be genetic in 48.2%. Sixty-nine per cent of the epileptics had mental disorders Our results and literature data showed that, compared with the epileptic treated in neurological wards, the consultants in psychiatry had epilepsy treated in a more classical way, more difficult to stabilise and frequently associated with mental disorders. By another way, we point out that in the area of our survey, although a department of neurology does exist, some epileptics without mental disorder are still addressed to psychiatrist, at least up to the period of the survey. Anyway, what seems to be more important is that the treatment should have realistic objectives. Psychotherapeutic support is fundamental to help epileptics to lead a decent life