ABSTRACT
Background: The study was done with the aim to determine the clinical profile of patients with hollow viscous perforation and to compare MPI and APACHE II scoreMethods: This study was a prospective and retrospective observational study conducted in the department of General Surgery, Gandhi Medical College and associated Hamidia Hospital from the June 2017 to August 2019The possible score ranges from 0-47. All necessary preoperative data was recorded. Blood sample was taken and relevant blood investigations were done. Patients were resuscitated with iv fluids. Nasogastric tube and urinary cather insertion were done. The parameters of modified APACHE II score and Manheim’s peritonitis index were recorded at the time of admission. Patients underwent emergency laprotomy and correction of pathology was done.Results: Out of total 100 patients 79% were males, 21% were females, majority 45% belonged to the age group 26-35 years. To calculate the cut off point for mortality ROC curve was constructed. ROC curve analysis predicted that Manheim’s score of 22 or more would predict mortality. Out of total 16 deaths, 14 cases had Manheim’s score of 22 or more thus, giving the score a sensitivity of 87.5% and specificity of 77.38% and overall accuracy of 79% in our study. ROC also predicted that APACHE II score of 15 or more would predict mortality. Thus, giving APACHE II score a sensitivity of 93.75%, specificity of 100% and accuracy of 99%.Conclusions: We consider MPI to be a more simpler prognostic indicator than APACHE II score.
ABSTRACT
Acute onset CIDP(A-CIDP) is an often unrecognized CIDP variant which needs differentiation from Guillain -Barre syndrome(GBS) due to its different prognostic and treatment outcomes. METHODS: We report clinical course and investigations including electrophysiology of 4 patients of A-CIDP and comparison with Electrophysiology of 20 GBS patients. RESULTS: Four patients with initial GBS like clinical presentation were later diagnosed as A-CIDP. Three patients improved with immunotherapy but had exacerbation of weakness more than 8 weeks later while one patient had subacute onset progressive weakness. These patients were further managed with steroids and maintenance immunotherapy. CONCLUSION: GBS is diagnosed on the basis of clinical and electrophysiological criteria and managed with IVIg. Although some clinical features and initial electrorophysiology can suggest the possibility of A- CIDP, the diagnosis is conrmed on follow up only.
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Background: Chronic mental illnesses can impact the life of the partners who care for the patients. Aims: The present study examined the quality of life (QOL) of respondents who were giving care to their spouses with schizophrenia. It also aimed to explore gender and age related differences in various dimensions of their QOL. Methods: The respondents (n=304) were so selected that for half of them wives were diagnosed with schizophrenia (hence, the husbands were the caregivers), while for the other half, husbands were diagnosed with schizophrenia (hence, the wives were the caregivers). The type of study is cross sectional. Results: QOL was assessed through four domains of well-being, satisfaction of basic needs, self-care activities and marital happiness. Data analysis using basic statistics and 2x4 ANOVA supported the first hypothesis that predicted gender difference in the QOL. Male caregivers of wives with schizophrenia were found to report higher wellbeing (Mean=37.75 and 33.28), greater satisfaction of basic needs (Mean=45.37 and 38.98) than female caregivers. Results failed to support the second hypothesis that predicted better QOL for younger respondents. The main effect of age was significant with respect to only one out of the four domains of QOL - satisfaction of basic needs. Respondents in the two middle age groups (36-45, 46-55) reported greater satisfaction of basic needs (M=42.17 – 43.76) than those in the younger and the older age groups (25-35, 56-65) (M=41.32 and 41.45 respectively). Conclusion: Chronic illness of a spouse in the marital dyad may be one factor confounding the complications, particularly if the partner giving care to an ill spouse is a woman. Key message: Specific interventions sensitive to gender differences, gender ideologies and gender needs therefore need to be devised and implemented in the context of spousal chronic illness.
ABSTRACT
Objectives: Perceived self-efficacy is a belief centers on appraisal vs. misappraisal of capabilities within the individual to produce designated level of performance. It mediates the relationship between functional decline, health condition and the need for formal care services. The present stduy aimed to study the impact of perceived self efficacy on mental health and to explore the predictor of mental health among elderly population. Method: The study consisted of 160 elderly respondents. Half of these were males and the other half females. They were further sub-divided into eight groups on the basis of their gender and age. Each of eight subgroups consisted of 20 respondents and assessed on the measures of Perceived Self Efficacy (PSE) and Mental Health i.e. General Health Questionnaire (GHQ). Results: The mean differences showed that the elderly males scored higher on the measure of PSE and GHQ and showed better meatal health than elderly females. Again the younger elderly groups scored higher on the measures of PSE and GHQ and reported better mental health than the elderly of advanced age groups. Conclusion: The present study revealed that the problem of elderly is emerging not only due to their increasing proportion of age but also due to their own faulty cognitions and perceptionof aging. Perceived self efficacy emerged as an imjportant predictor of mental health among elderly males and females i.e. elderly who perceive themselves self efficacious to have control over their environment reported better mental health and vice versa.