ABSTRACT
Background: Depression is one of the commonest neuropsychiatric disorders in patients with diabetes mellitus (DM). Diabetes with depression is associated with a low quality of life (QoL). Complications in DM and depression still remain poorly identified and inadequately treated. But treatment of depression among DM patients is almost totally ignored and the QoL is poor. Materials and methods: A prospective observational study was conducted on 100 type 2 Diabetes mellitus patients diagnosed with clinical depression (ICD-10) at a tertiary care hospital. They were treated for depression along with DM medications and followed up till 6 months was assessed by WHO Quality Of Life (WHOQOL) – BREF scales. Results: There was a statistically significant improvement in overall WHO QOL scale from 5.96±1.23 at baseline to 6.71±1.15 at 6 months (P value < 0.001). Among various domain, the mean Physical health domain was 17.72±2.281 at baseline, which has improved to 25.56±3.367 at 6 months follow up and the mean Psychological domain score was 16.32±2.174 at baseline and has improved to 22.64±2.343 at 6 months follow up. Conclusion: QoL is a domain of major importance and it affected in patients with DM and depression. Treatment of depression in DM patients is almost ignored. In the current study, treating Sivabackiya C, Srinivasan B, Maignana Kumar, Sabari Sridhar OT, Kailash S, Shabeeba Kailash, Gopalakrishnan. Impact of treatment of depression on quality of life among diabetic patients with depression. IAIM, 2018; 5(11): 63-69. Page 64 depression in DM patients enhanced the quality of life (P value < 0.001). Hence diagnosis and treatment of depression in these patients is particularly important in order to reduce complications and improve quality of life
ABSTRACT
Background: The National Institute of Health asthma guidelines recommend assessing PEF during hospitalization including improvement to a PEF of >70% of the predicted value before discharge. The Global Initiative for asthma recommends monitoring of PEF in hospitalized patients. Current guidelines for correct PEF maneuver include standing, but it has been observed that many respiratory therapists and patients use supine position. Aim: To determine which one of the 3 different positions i.e. standing, lying back at 450 angle on pillows and sitting up slumped forward 100 with legs extended generates higher peak expiratory pressure and can be used as optimal position for generating peak expiratory flow in asthmatics. Materials and methods: A cross sectional study was performed in 20 asthmatic subjects aged 18-50 years in whom correct instructions for PEF technique were given according to guidelines of National Institute of Health. The steps were repeated 3 times in each position and the best of 3 attempts in each of the 3 positions were used for analysis. Level of significance kept at 5%. Results: Mean and SD of lying back at 450 was 254.5±29.28, sitting up with slumped forward 100 was 281±28.26 and that of standing was 302.5±27.88. Statistically significant result was found using nonparametric test i.e. Friedman test where χ2 =40 and p=0.0001. Conclusion: There is significant difference between PEFR values in standing, sitting with slump forward 100 and lying back 450 position. Standing position is the best option for adult asthmatics to measure their PEF values as it generated maximum PEF.