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Background: Due to the COVID-19, there is an increase in psychological complaints. Healthcare and non- healthcare persons have had differential complaints like anxiety, depression, stress. Such complaints have also seen in the general public but more so in recovered patients from COVID-19. With this background, we conducted this study find out the stressful impact of COVID-19, prevalence of stress, anxiety and depression between healthcare workers and non-healthcare people. Methodology: A cross-sectional study was done in the tertiary-care COVID hospital in Ahmedabad. 50 healthcare workers (HCWs) and 50 non-healthcare people (NHCPs) who had recovered from COVID-19 were included (age 18-65 years) in the study after they consented for the same. They are assessed with a clinical socio-demographic proforma, clinical variables, Impact Of Event Scale-Revised (IES-R), Patient Health Questionnaire-9 (PHQ-9) and Anxiety-Self Rating Scale (ASRS). The results were then statistically analysed. Results: Distress by stressful life events and anxiety were not significant (14% and 32%), (14% and 30%) in HCWs and NHCPs respectively. Depression was more prevalent (44% and 38%) in HCWs and NHCPs respectively. Medical illness was more in NHCPs (50%) compared to HCWs (4%) and associated with depression (52.63%) in NHCPs as compared to HCW (4.5%). Clinical variables, O2 requirement was also more in NHCPs (20%) as compared to HCWs (4%) and also significantly associated with anxiety (40% and 12.5%) and depression (36.84% and 4.5%) in NHCPs and HCWs respectively. Conclusions: The prevalence of depression was much higher amongst HCWs and suggests more attention would be required for improving the mental health among HCWs and NHCPs and overall mental health needs attention in patients that are recovering from COVID-19.
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Background: Daytime sleepiness impairs academic performance in college students. Napping is a counter to daytime sleepiness, but often causes sleep inertia on waking up. Caffeine absorption from beverages peaks 30 minutes after their ingestion presenting a window of opportunity to have a short nap such that the time of waking up is in synchrony with onset of action of caffeine; thereby abolishing post-nap inertia and achieving synergistic mitigation of fatigue.Objective of this study to assess effect of nap, coffee, ‘coffee and nap’ and ‘wakeful break without coffee’ on daytime sleepiness using Psychomotor Vigilance Tests (PVTs) and Karolinska Sleepiness Scale (KSS) score.Methods: After Institutional Review Board clearance, 10 subjects (aged 19-21 years) were selected using their Epworth Sleepiness Scale score (ESS >5) and called to the study site 8 times on different days to be exposed to these four conditions twice - only coffee (standardized), only nap (30min), coffee immediately followed by 30min nap, wakeful break (30min) without coffee or nap. Pre and post scores were recorded for electronic PVT (Reaction Time and Motor Responsiveness) and KSS for each attempt.Results: Test outcome was associated with intervention used (p=0.00001). ‘Nap only’ group was associated with deterioration in outcomes (p=0.00001), accounting for highest percentage (41%) of all deteriorated test outcomes. ‘Coffee only’ group was associated with improvement in test scores (p=0.00001), responsible for highest share (38.8%) of all improved test outcomes. ‘Nap only’ and ‘Coffee-nap’ group showed improvement in 11.67% and 21.67% of outcomes respectively. Conclusions: Pre-nap coffee is a proactive counter-measure to post nap sleep inertia.
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Background: Malaria a tropical disease has a wide clinical spectrum ranging from uncomplicated disease to a fatal one. The objectives were to study clinical profile of Malaria with special reference to its complications and outcome. Materials and methods: A study was carried out in a tertiary care hospital including total of 50 patients diagnosed with P. Vivax or P. Falciparum Malaria. Data on patients’ clinical details with investigations, complications, and outcome was studied. Results: Out of 50 patients (37 male and 13 female), 41 had P. Vivax and 9 had P. Falciparum Malaria. Total 3 patients were complicated; two had cerebral malaria due to P.falciparum and one had multi organ failure due to P. vivax which eventually succumbed. Conclusions: Clinical profile of Malaria was studied which suggest, P.falciparum malaria was more complicated; which comprises cerebral complications, renal complication, hepato-biliary and respiratory complications leading to increased morbidity and mortality. It was observed that P. vivax had better outcome but it can also present with serious and life-threatening complication.
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Background: Depression, a common mental disorder characterized by persistent unhappiness and lack of interest in daily activities, is one of the major important public health problems that are often comorbid with other chronic diseases like diabetes and can worsen the effect of the disease outcomes. Depression alone and/or as a comorbidity with diabetes is a common condition in the community. Aim of the study: To identify the prevalence of Depression among Type 2 Diabetes Mellitus patients and relationship between Depression and its effect on Drug Compliance among Type 2 Diabetes Mellitus patients, to determine the severity of Depression among Type 2 Diabetes Mellitus patients and the extent to which it affects Drug compliance. Materials and methods: The study was to be conducted in Rajah Muthiah Medical College and Hospital, Chidambaram in the year 2018-2019. A hundred patients with diagnosis of T2DM attending Diabetic OPD above 20 years of age were randomly selected. The Hamilton rating scale for depression by Hamilton is the most widely used rating scale to assess the symptoms of depression. The Ham-D is an observer-rated scale consisting of 17-21 items. Ratings are based on clinical interview. The items are rated on either a 0 to 4 spectrum or a 0 to 2 spectrum. The HAM-D also relies quite heavily on the clinical interviewing skills and the experience of rater in evaluating individuals with depressive illness. The strength of HAM-D is its excellent validation/research base, K.H. Mohamed Ibrahim, R. Gandhi Babu, M. Senthil Velan. Prevalence of psychiatric morbidity (depression) and its effect on drug compliance among patients attending diabetic outpatient clinic. IAIM, 2019; 6(11): 19-28. Page 20 and case of administration. Its use is limited in individuals who have psychiatric disorders other than primary depression. Results: Analyzing with HAMD score, 40 had no depression, mild depression in 24 cases, moderate depression in 21 cases, severe depression in 15 cases. MAQ score scale- low adherence in 41 cases, medium adherence in 37 cases, high adherence in 22 cases. MMAQ score scale and HAMD scorelow adherence with no depression were 9 cases (22.5%) mild depression were 6 cases (25%) moderate were 11(52.4%) severe depression were 15 cases (100%). MMAQ score scale and HAMD score - medium adherence with no depression were 23 cases (57.5%) mild depression were 9 cases (37.5%) moderate were 5(23.8%) severe depression were not seen. MMAQ score scale and HAMD score - Medium adherence with no depression were 8 cases (20%) Mild depression were 9 cases (37.5%) Moderate were 5(23.8%) severe depression was not seen. Pearson Chi-Square = 35.344**, p<0.001. Conclusion: Further, there was a significant association between the depression in Type 2 diabetes patients and medication adherence, where patients with depression had poor medication adherence as compared to those without depression and severity of depression correlates with worse adherence to diabetic medications
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Background: WHO announced influenza A H1N1 as pandemic (commonly known as swine flu) in 2009; but every year there is increase in influenza A H1N1 positive cases causing epidemics of febrile respiratory illness due to genetic re-assortment in influenza virus. This study aimed for clinical profile of patient with influenza A H1N1 and its outcome admitted at civil hospital Ahmedabad. Materials and methods: Present study was included 50 patients with influenza A H1N1; admitted in B.J. Medical College and Civil Hospital, Ahmedabad. This study was carried out for one year from June 2018 to June 2019. Patients were studied and managed as per standard Government of India protocol. Results: Total 50[19 (38%) males and 31 (62%) females] patients were studied for clinical spectrum, complications and outcome. All patients had fever (100%), dry cough in 92% of patients, throat pain in 88% of patients, breathlessness in 54% of patients, headache in 48% of patients, sputum production in 40% of patients and hemoptysis in 6% of patients. 35 (70%) patients had comorbidity. Total13 (26%) patients were complicated; out of which 4 (8%) patients required ventilatory support. Conclusion: Early case detection, categorizations according to symptoms prevention of treatment has better outcome and decreases disease related morbidity and mortality and burden of disease in community and voluntary early reporting should be encouraged through various health campaigns.
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Introduction: Dengue fever is one of the most common arboviral mediated outbreaks reported with increased prevalence year after year with considerable morbidity and mortality. This study was designed to assess the clinical and biochemical parameters of dengue fever patients. Materials and methods: Prospective observational study was undertaken among adult patients in a Civil Hospital, Ahmedabad. Fifty patients were studied and analyzed. All patients who were NS1 antigen/ IgM dengue positive were included in the study. Clinical features, hematological and biochemical parameters were noted. Results: Of the 50 patients studied, majority were males (64%). Fever was the major symptom (100%) followed by headache (96%), myalgia (94%), retro-orbital pain (64%), conjunctival injection (24%), rash (38%), abdominal pain (74%), pleural effusion (30%) and ascites (26%). Significant derangements in platelet (70%), leucocyte counts (78%) and serum transaminases (74%) were noted. Mortality rate was zero. Conclusion: Fever associated with headache, retro-orbital pain, erythematous morbilliform rash, conjunctival suffusion and itching in palms and soles along with thrombocytopenia, leucopenia, elevated liver transaminases should prompt a clinician on the possibility of dengue infection. Platelet transfusions have little role in management of dengue patients.
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Introduction: Pediatric seizures are a common occurrence and frequent presentation to emergency department (ED). Seizures result from paroxysmal involuntary disturbance of brain function. The history and physical examination guide us to manage and assist in differentiating seizures from nonepileptic disorders. Methodology: This study was carried out to know the trends of paediatric seizures and their management in ED. We had included all patients less than 12 years of age with seizures, admitted to our hospital's pediatric ED between May and August 2012. All demographic findings, seizure characteristics and laboratory findings were recorded. Results: A total of 53 children were enrolled in the study of which 38 (71.7%) children were male and 15 (28.3%) were female. The mean age of presentation was 2.42 years. 66.7% of patients had generalized seizures and 33.3% of patients had partial seizures. Out of total study population, 49% had febrile seizures and 20.8% had afebrile seizures. The majority of seizures (69.8%) lasted less than 10 minutes of which 54% were afebrile. Status epilepticus (SE) was found most commonly in 30.2% children. Out of 16 patients with SE 10 (62.5%) were less than two years of age. The common causes of SE were fever, Central Nervous System (CNS) infection, and epilepsy, accounting for 31.3%, 37.5% and 31.2% respectively. The children with underlying CNS abnormalities (cerebral palsy) had poorer outcomes. Mortality found in SE (9.4%) was related to an acute neurologic insult or a chronic CNS condition. Metabolic abnormalities were detected in 28.3% patients. The frequency of metabolic abnormalities was significantly higher in patients under two years of age (66.7%). 53.7% had hypocalcemia, 33.3% had hypoglycaemia and 20% had hyponatremia. MRI (Magnetic resonance imaging) of brain or EEG (electroencephalogram) or both was carried out in only 13.2% patients. 85% of patients had undergone laboratory investigations. Lumbar puncture was performed in 26.4% patients.