Burden Of Care and Depression in Caregivers of Patients with Schizophrenia

Background: Schizophrenia, a chronic psychiatric disorder affecting all major domains of a patient’s life, leads to significant disability. Since the deinstitutionalization policy, the onus of care is on families espe-cially the primary caregiver who experiences physical and emotional burden. Depression among care-givers has been estimated to be higher than the general population. This cross-sectional study aimed to assess burden of care and depression in primary caregivers and associated caregiver variables. Methods: 75 consenting primary caregivers of patients with ICD-10 diagnosis of schizophrenia were as-sessed for burden of care and depression using the Burden Assessment Schedule and the Patient Health Questionnaire - 9 after collecting socio-demographic and caregiving details. Results: All the caregivers, 49 females and 26 males, had moderate to high levels of burden with a ma-jority having moderate to severe levels of depression. Spouses (p=0.0038), older caregivers (p=0.01) and those with lower educational levels (p=0.01) experienced more burden. There was a significant positive correlation between burden of care and depression (p=0.000). Conclusion: In one of India’s largest metropolitan cities, though psychiatric services are easily available, caregivers continue to feel burdened and depressed. This can impact not just the caregiver but also care being provided to the patient and illness outcome.

Adoption of hand hygiene practices among health care providers.

Background: Hand hygiene is the most important measure to avoid the transmission of harmful germs and prevent health care-associated infections. Hand washing with plain soap removes loose transient flora even though it does not remove pathogens from the hands of healthcare workers. Proper hand hygiene is cheap, most effective, easiest and foremost method of reducing health care associated infections. This study was carried out to know the present status of hand hygiene practices and the barriers to adherence. The objective of the study was to assess the adoption of appropriate hand hygiene practices among health care providers and to find out the reasons for non-adoption. Methods: A cross sectional study was done to assess the adoption of appropriate hand hygiene among health care providers (Doctors, nurses, lab technicians) in upgraded/ block PHCs of Thiruvallur district... The data was analysed by SPSS-16. Proportion & chi square test was used to assess the statistical significance at 5% α. Results: In PHC’s there were 32 doctors, 61 nurses and 17 lab technicians which constitute to 110 heath care providers. Hand hygiene practices were satisfactory among 40 (36%) Z = 9 and the difference is statistically significant p<0.05. Conclusions: Hand hygiene protocols will reduce the nosocomial infections. Hand hygiene is the most important measure to avoid the transmission of harmful germs.

Systematic review of studies comparing 24-hour and spot urine collections for estimating population salt intake / Revisión sistemática de estudios comparativos entre recolección de muestras de orina de 24 horas y puntual para calcular el consumo de sal en la población

Objective. To examine the usefulness of urine sodium (Na) excretion in spot or timed urine samples to estimate population dietary Na intake relative to the gold standard of 24-hour (h) urinary Na. Methods. An electronic literature search was conducted of MEDLINE (from 1950) and EMBASE (from 1980) as well as the Cochrane Library using the terms “sodium,” “salt,” and “urine.” Full publications of studies that examined 30 or more healthy human subjects with both urinary Na excretion in 24-h urine and one alternative method (spot, overnight, timed) were examined. Results. The review included 1 380 130 participants in 20 studies. The main statistical method for comparing 24-h urine collections with alternative methods was the use of a correlation coefficient. Spot, timed, and overnight urine samples were subject to greater intraindividual and interindividual variability than 24-h urine collections. There was a wide range of correlation coefficients between 24-h urine Na and other methods. Some values were high, suggesting usefulness (up to r = 0.94), while some were low (down to r = 0.17), suggesting a lack of usefulness. The best alternative to collecting 24-h urine (overnight, timed, or spot) was not clear, nor was the biological basis for the variability between 24-h and alternative methods. Conclusions. There is great interest in replacing 24-h urine Na with easier methods to assess dietary Na. However, whether alternative methods are reliable remains uncertain. More research, including the use of an appropriate study design and statistical testing, is required to determine the usefulness of alternative methods.

Objetivo. Analizar la utilidad de la medicion de la excrecion urinaria de sodio a partir de la recoleccion puntual o cronometrada de muestras de orina para calcular la ingesta de sodio alimentario en la poblacion, en relacion con la prueba de referencia que mide la excrecion de sodio en orina de 24 horas. Métodos. Se realizo una busqueda de bibliografia electronica en MEDLINE (desde 1950) y EMBASE (desde 1980), asi como en la Biblioteca Cochrane, empleando los terminos “sodium”, “salt” y “urine” (sodio, sal y orina). Se examinaron las publicaciones completas de los estudios que incluian 30 o mas sujetos humanos sanos en los que se hubiera determinado la excrecion de sodio mediante la recoleccion de orina de 24 horas o un metodo alternativo (recoleccion puntual, de toda la noche, cronometrada). Resultados. La revision incluyo a 1 380 130 participantes de 20 estudios. El principal metodo estadistico adoptado para comparar las recolecciones de orina de 24 horas con los metodos alternativos fue el uso de un coeficiente de correlacion (r). Las muestras de orina recolectadas de forma puntual, cronometrada y de toda la noche estaban sujetas a mayor variabilidad intra e interindividual que las recolecciones de orina de 24 horas. Se obtuvo una amplia gama de coeficientes de correlacion entre las determinaciones de sodio en orina de 24 horas y mediante los otros metodos. Algunos valores fueron elevados, lo que indica su utilidad (r de hasta 0,94), mientras que otros fueron bajos (r por debajo de 0,17), lo que indica su falta de utilidad. La mejor alternativa a la obtencion de orina de 24 horas (de toda la noche, cronometrada, o puntual) no resulto evidente, ni tampoco la base biologica de la variabilidad entre el metodo de 24 horas y los alternativos. Conclusiones. Hay mucho interes en remplazar la determinacion de sodio en orina de 24 horas por otros metodos mas faciles de evaluacion del sodio alimentario. Sin embargo, sigue habiendo incertidumbre sobre la fiabilidad de los metodos alternativos. Es preciso ampliar la investigacion, incluido el uso de un diseno de estudio y pruebas estadisticas apropiados, para determinar la utilidad de los metodos alternativos.