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The co-occurrence of tumor and psycho-cardiological diseases， affecting both the physical and mental aspects of patients， is a common clinical condition that is closely related to tumor treatment and prognosis. Exploring its underlying mechanism and treatment methods can bring new ideas and strategies for clinical treatment. It is believed that heart-kidney yang deficiency is one of the common core mechanisms of psycho-cardiological diseases. Stagnation of heat and toxins is a core mechanism for tumor formation and metastasis. Additionally， cancer and drug toxicity contribute to the development of psycho-cardiological disease by impairing lung circulation. Cancerous toxins can damage the blood vessels， resulting in a diminished vitality in the heart of blood vessels. Simultaneously， lung qi failing in dispersing impairs the downward movement and causes stagnation in the heart of spirit . This process ultimately leads to the development or exacerbation of psycho-cardiological diseases. The author explores the diagnosis and treatment approach based on the “diagnosing and treating diseases according to syndroms” concept， focusing on related syndrom identification and treatment. The process begins with pattern identification， followed by comprehensive analysis of data gained by four diagnostic methods to clearly understand the core pathogenesis and basic treatment principles. After pattern identification， the focus shifts to recognizing the disease and providing additional evidence to support the diagnosis. Special attention is paid to adjusting the use of medication based on the disease's characteristics. This approach aims to achieve precise treatment for tumors and psycho-cardiological diseases， reducing the side effects of multiple medications， therefore to provide guidance for clinical application.
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Background: Coronavirus disease 2019 (COVID-19) has rapidly become a worldwide concern ever since first being reported from Wuhan, China in December 2019. With no known cure, there is widespread fear-provoking interest in studying the factors contributing to mortality. Aim and Objectives: The current study was undertaken with a view to try to understand the cause of morbidity and mortality. Materials and Methods: A retrospective study done in our Institution on COVID-19 patients admitted over a course of 3 months after approval from Institutional Ethics Committee. Results: We had 17 deaths over the period under consideration whereas 73 patients improved (mortality = 19%, n = 90). Most of the patients were in the 41–80 years age group (>70%). No gender preponderance was found with mortality in each being around 20%. A clear correlation between co-morbidities and mortality was found with no person without any comorbidity succumbing to the disease. Respiratory and Heart conditions were found to contribute most to mortality with patients presenting with shortness of breath being most at risk. Similarly, a Neutrophil: Lymphocyte ratio greater than 12 was found to significantly increase the mortality. Conclusion: Patients with comorbidities need to be monitored closely with treatment being directed at improving the respiratory outcome.
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Introduction: Sepsis has a death rate of ?25% globally and its clinical treatment presents an important clinical challenge. The rapid progression of sepsis requires correspondingly swift adjustments in therapy, and accurate identification of disease severity is therefore vitally important for predicting prognosis, treatment, preventing complications, reducing complication and mortality. With this background, the present research is aimed to study the relation of serum procalcitonin levels in cases with sepsis, to calculate APACHE II scores and to correlate the levels of serum PCT levels with APACHE II Score with the outcome. Methodology: This was a prospective observational non interventional cohort study was conducted in the Clinic of Intensive Care unit of a tertiary care hospital and medical college in western India from May 2020 to December 2020. Results: A total of 75 patients, admitted to the ICU with the diagnosis of sepsis, were included in this prospective observational study. Of them 47 (62.7%) were males and highest cases were aged between 60 to 69 years. Of the total 75 patients, 47 (62.7%) patients were survivors. Age, gender and involvement of system were not associated with mortality while lower APACHE II score and presence of co-morbidities were significantly associated with mortality. Conclusion: From this study we conclude that the lower APCHE II score and presence of co-morbidity significantly increases the mortality in ICU patients admitted with sepsis
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Background: COVID-19 is a major global health challenge that has affected all age groups and gender, with over 5 million deaths reported worldwide to date. The objective of this study is to assess available information on COVID-19 in children and adolescents with respect to clinical characteristics, co-morbidities, and outcomes, and identify gaps in the literatures for appropriate actions. Methodology: Electronic databases including Web of Science, PubMed, Scopus, and Google Scholar were searched for observational studies such as case series, cross-sectional and cohort studies published from December 2019 to September 2021, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guide. Data extracted included (i) patient demography (age and gender), (ii) clinical characteristics including vaccination status and presence of co-morbidities, (iii) clinical management including the use of sequential organ failure assessment (SOFA) scores, oxygen requirement, use of mechanical ventilation, and (iv) disease outcomes including length of hospital and intensive care unit (ICU) admission, recovery, complications with sequelae, or death. Data were analyzed using descriptive statistics. Results: A total of 11 eligible studies were included with a total of 266 children and adolescents; 137 (51.5%) females and 129 (48.5%) males. The mean age of the children was 9.8 years (range of 0 19 years), and children ≥ 6 years were more affected (40.7%) than age groups 1 5 years (31.9%) and < 1 year (27.4%). The major co-morbidities were respiratory diseases including pre-existing asthma (3.4%), neurologic conditions (3.4%) and cardiac pathology (2.3%). Majority (74.8%, 199/266) of the patients were discharged without sequelae, 0.8% (2/266) were discharged with sequalae from one study, and mortality of 1.9% (5/266) was reported, also from one study. SOFA scores of patients at admission were not stated in any of the study, while only one study reported patient vaccination status. Conclusion: It is recommended that safe vaccines for children < 1 year of age should be developed in addition to other preventive measures currently in place. SOFA scores should be used to assess risk of COVID-19 severity and monitor prognosis of the disease, and vaccination status of children should be documented as this may impact the management and prognosis of the disease.
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Humans , Child, Preschool , Comorbidity , Diagnostic Tests, Routine , COVID-19 , Intensive Care Units, Pediatric , Child , Treatment OutcomeABSTRACT
Background: Alcohol dependence syndrome (ADS) and major depressive disorder are highly prevalent. Much less is known about the expectancy of alcohol use in depressed patients with ADS. Few studies had compared the expectancy of alcohol use in ADS patients with and without co-morbid depression. Assessing the above factors may help to formulate effective prevention strategies. This study was designed to assess the difference in expectancy of alcohol use and functioning in patients with ADS with and without co-morbid depression.Methods: The difference in expectancy of alcohol use in 96 alcohol dependent patients, of which 24 had co-morbid depression and 72 without co-morbid depression was studied using drinking expectancy questionnaire. In addition, we compared the difference in functioning between the two groups using GAF.Results: Prevalence of depression in alcohol dependent patients was 25%. ADS patients with co-morbid depression had less expectancy about alcohol use for sexual enhancement and had lower level of functioning compared to ADS patients without depression.Conclusions: Less expectancy on sexual enhancement in patients with ADS and co-morbid depression could be possibly due to reduced libido in depressed patients. The observed lower functioning in ADS patients with co-morbid depression despite no difference in severity of alcohol use may be possibly explained by the added burden of both the diseases.
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Background: Few studies have compared the pattern of alcohol use in Alcohol dependence syndrome (ADS) patients with and without co-morbid depression. Assessing the pattern may throw light into prevention of relapses more effectively in alcohol dependent patients with co-morbid depression. This study was undertaken to assess the difference in pattern of drinking of alcohol in patients with alcohol dependence with and without co-morbid depression.Methods: A descriptive comparative study was designed to compare the difference in pattern of alcohol use in alcohol dependent patients with co-morbid depression and without co-morbid depression. Severity of dependence on alcohol was assessed using Alcohol Use Disorders Identification Test (AUDIT). Drinking pattern was assessed using Timeline Follow back Calender and Drinking Pattern Questionnaire. The data were statistically analysed.Results: Total 96 alcohol dependent patients (24 had co-morbid depression and 72 without co-morbid depression) were included in the study. There were no significant differences in alcohol use in both the groups in terms of AUDIT scores, amount of drinking, abstinence days or binge drinking. More frequent drinking was observed in circumstances related to emotional, physiological, financial and children related situations in patients with co-morbid depression (p<0.05).Conclusions: Drinking circumstances like emotional, physiological, financial and children related situations require more attention while assessing, treating and aiming at relapse of prevention in ADS patients with co-morbid depression.
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Background: Diabetes affects all segments of the population and is one of the leading causes of premature morbidity and mortality and requires life-long healthcare services. The National Rural Health Mission launched in 2005 and the new pilot National Programme for Prevention and Control of Diabetes, Cardiovascular diseases and Stroke offer opportunities for improving care for diabetes and other non-communicable diseases through service provision at the primary and secondary levels of care. This article describes the health services related factors and ascertains the physical status of adult diabetic patients.Methods: It is an institution based, cross-sectional, descriptive study. Complete enumeration of all patients attending diabetic clinic of Bankura Sammilani Medical College and hospital, Bankura, West Bengal was done. Eligible consenting adult patients, who were diagnosed as a case of diabetes and on treatment were interviewed with review of medical record. The study was preceded after obtaining ethical clearance. Data were entered in MS Excel spread sheet. Calculation was done with the help of software SPSS 22.0 free version.Results: Only 5.3% of study subjects had drug supply from hospital fully but rest of them had to buy from the shop. 79.3% of study subjects skipped the drug when it was finished. Diabetic complication was found to be more when distance of home from hospital was more.Conclusions: Antidiabetic drug were not regularly available in hospital so all most all had to purchase drug from the shop when not available at hospital.
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Background: Assessment of quality of life (QOL) helps to find out factors associated with disease progression and response to treatment, identify vulnerable groups. The objective of this study was to assess the QOL (based on physical, mental, social, emotional and spiritual dimensions) of oral and oropharyngeal cancer patients.Methods: A hospital based cross sectional study was conducted among 126 oral and oropharyngeal cancer patients attending radio therapy department of Calcutta Medical College. QOL was assessed by using validated Bengali version of two self-administered questionnaires: European Organization for the Research and Treatment of Cancer (EORTC)-30 and EORTC-35.Results: Among total 81 patients, most of the patients (45.67%) had stage III diseases. Median global health score (GHS) for all patients were 41.67. GHS deteriorated with advancement of the diseases (p=0.000), GHS significantly improved with increasing level of education (p=0.019). GHS was poorer among female patients (median for male was 45.66 and for female was 36.45; p=0.178) and patients with oropharyngeal cancer (median for oral cancer was 50.00, oropharyngeal cancer was 41.67, p=0.215). As per EORTC-35, pain was the major symptom for both type of cancer and was more among patients with oropharyngeal cancer.Conclusions: QOL deteriorates with advancement of the disease and is poorer among females. Co-morbidity status does not affect the QOL. Pain is a major problem of cancer patients, which is more with oropharyngeal cancer patients. Early detection of the cancer and proper pain management and counselling with special focus on females can improve the quality of life.
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This study aimed to obtain the first national estimate of the prevalence of autism spectrum disorder (ASD) in Chinese children. We targeted the population of 6 to 12-year-old children for this prevalence study by multistage convenient cluster sampling. The Modified Chinese Autism Spectrum Rating Scale was used for the screening process. Of the target population of 142,086 children, 88.5% (n = 125,806) participated in the study. A total of 363 children were confirmed as having ASD. The observed ASD prevalence rate was 0.29% (95% CI: 0.26%-0.32%) for the overall population. After adjustment for response rates, the estimated number of ASD cases was 867 in the target population sample, thereby achieving an estimated prevalence of 0.70% (95% CI: 0.64%-0.74%). The prevalence was significantly higher in boys than in girls (0.95%; 95% CI: 0.87%-1.02% versus 0.30%; 95% CI: 0.26%-0.34%; P < 0.001). Of the 363 confirmed ASD cases, 43.3% were newly diagnosed, and most of those (90.4%) were attending regular schools, and 68.8% of the children with ASD had at least one neuropsychiatric comorbidity. Our findings provide reliable data on the estimated ASD prevalence and comorbidities in Chinese children.
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This study aimed to obtain the first national estimate of the prevalence of autism spectrum disorder (ASD) in Chinese children. We targeted the population of 6 to 12-year-old children for this prevalence study by multistage convenient cluster sampling. The Modified Chinese Autism Spectrum Rating Scale was used for the screening process. Of the target population of 142,086 children, 88.5% (n = 125,806) participated in the study. A total of 363 children were confirmed as having ASD. The observed ASD prevalence rate was 0.29% (95% CI: 0.26%-0.32%) for the overall population. After adjustment for response rates, the estimated number of ASD cases was 867 in the target population sample, thereby achieving an estimated prevalence of 0.70% (95% CI: 0.64%-0.74%). The prevalence was significantly higher in boys than in girls (0.95%; 95% CI: 0.87%-1.02% versus 0.30%; 95% CI: 0.26%-0.34%; P < 0.001). Of the 363 confirmed ASD cases, 43.3% were newly diagnosed, and most of those (90.4%) were attending regular schools, and 68.8% of the children with ASD had at least one neuropsychiatric comorbidity. Our findings provide reliable data on the estimated ASD prevalence and comorbidities in Chinese children.
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Background: Chronic obstructive pulmonary disease (COPD) is a common preventable and treatable disease that is characterised by persistent respiratory symptoms and airflow limitation. COPD is characterised by an intense inflammatory process in the airways, parenchyma, and pulmonary vasculature. It is possible in some cases that the inflammatory process may overflow into the systemic circulation, promoting a generalised inflammatory reaction. Patient with COPD often have concomitant chronic illness (co-morbidities). The aim of this study is to know the pattern of co-morbidities in COPD patients.Methods: This study was a cross sectional observational study conducted on 172 COPD patients (IPD and OPD) diagnosed on the basis of GOLD guideline 2017. Co morbidities were diagnosed as per standard defined criteria laid down in the respective guidelines.Results: 55.3% of the patients with COPD had co morbidities. 18/88(20.5%) patients presented with multiple co-morbidities. 49/88, 55.7% COPD patients were affected with cardiac (either only cardiac or had multiple organs affected besides cardiac), the commonest co-morbidity. Amongst cardiac, hypertension and congestive heart failure (CHF) was the commonest (n=19/49, 38.8% each) followed by CAD/CSA/IWMI/IHD/AF. Others were metabolic (n=14/88, 15.9%), GERD (n=13/88, 14.8%), Depression (n=11/88, 12.5%). Less prevalent co-morbidities were Osteoporosis (n=8/88, 9.1%), Lung cancer (n=6/88, 6.8%), Bronchiectasis (n=5/88, 5.6%) and OSA (n=3/88, 3.4%).Conclusions: Urban indwelling, advancing age and duration of illness, presentation with low mood, loss of pleasure/ interest, appetite disturbances and heart burn with relief on taking proton pump inhibitor can be predictors of co-morbidities in COPD patients. Chance of finding co-morbidities may be multifactorial. Thus, it is important to look out for co morbidities in each and every COPD patients.
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Background: In spite of advances in neonatal care, infant mortality is still high in India. Regular follow up of discharged newborns could bring down infant mortality and reduce long term disability by early identification and intervention. The primary objective of the study is evaluating the Special Newborn Care Unit(SNCU) graduates for Comorbidities, feeding and immunization practices, growth assessment and outcome during follow up.Methods: The discharged neonates from SNCU, GRMC were examined for their morbidity and growth monitoring done. Feeding and immunization practices were observed.Results: Among 100 neonates observed, 2 neonates were excluded and 41(41.8%) were females and 57(58.1%) were males. Major causes of indication of admission were prematurity (25.5%) and birth asphyxia (22.4%). During follow up, 23(23.4%) neonates had respiratory infections followed by 19 cases (19.3%) of diarrhea. Around 45(45.9%) infants' weight fall between -1 to +1 SD which was around 55 infants during admission. Length monitoring showed that around 68(69.3%) infants length fall between -1 to +1 SD which was 72 during admission. Exclusive breast feeding was observed in 68(69.3%) infants, 7 infants (7.1%) were exclusively top fed, and 19 infants (19.3%) were mixed fed. Immunization was appropriately done in only 51 infants (52%). Retinopathy of prematurity was observed in 2 infants during follow up. Hearing difficulty was observed in 1 infant.Conclusions: Most common indication of admission in SNCU was prematurity. Most common comorbidity during follow up was respiratory infection. Weight monitoring of infants showed the reduction in weight during follow up than admission whereas length and head circumference was relatively static during admission and follow up.
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Background: Diabetes management requires a fundamentalchange in the lifestyle of a patient and quality of life is one ofthe core consequences. This analysis attempted to determinethe Diabetes Quality of Life (DQoL) score; a measurementdeveloped for WHOs Diabetes Control and Complications Trial(DCCT) and analyzed the factors related to it in diabetes.Objectives: The main objective of the study is to assess theimpact of physiological, biological, medical and co-morbiditymeasures on the quality of life of patients with diabetes.Methods: This was a cross sectional method conducted inBirdem, Hospital, and the study duration was from October2018 to September 2019. The research site was at BIRDEM,where the study population was available. A total of 750sample of patients were chosen for the study using a statisticalmethod. Patients with diabetes diagnosed for at least 1 yearperiod were considered for the research. Severely ill patientswith numerous co-morbid conditions have been removed.Results: In this sample, 51% of patients were female and 49%were male. About 96% patients had type 2 diabetes, 65% hadcompleted their graduation and 70% were from lower middle tomiddle class families. Approximately 76.9% of patients wereeither overweight or obese, 52% had mobility problems, 27%had self-care issues, 49.2% had normal activities, 74.4% hadpain and 76.3% had depression problems. Results showedthat age, gender, lower - middle income, and HbA1c weresignificantly (p<0.05) associated with mobility. Self-care wassignificantly linked (p<0.05) to age, family history and period ofdiabetes mellitus (DM).Conclusions: Most patients had problems with pain /discomfort and anxiety / depression; half had problems withmobility and usual activities; and three in ten had problems withself-care. Age, gender, employment, education, family historyand length of DM and prescription care are important factorsassociated with diabetes quality of life in diabetes.
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Background: The current study compared severity of anxiety and depression patients of NCCP and other medical conditions in male adults.Methods: Sample consisted of consenting male patients from cardiology OPD with symptom of chest pain, whereas control group consisted of patients without symptoms of chest pain, aged between 18 to 60 years. Exclusion criteria for both groups included unstable or life-threatening medical conditions, psychosis, substance use disorders, or any psychiatric illness. Both experimental and control group were evaluated with history, clinical examinations and indicated investigations. The socio demographic data sheet and Hospital Anxiety and Depression Scale (HADS) was applied, patients were asked to read all 14 question and place a tick against the reply representing their feelings, the answers were rated with Likert pattern of scoring. The collected data statistically analyzed.Results: A total of 51 patients of experimental group with mean age of 44.82±7.63years and 76 control with mean 46.30±8.45 years were participated for this study. The mean HADS anxiety score for NCCP was 13.29±3.42 and for the group of other patients it was 11.06±3.54 (t value=-3.517, df=125 and p value=0.001). Whereas the mean HADS depression score for NCCP was 12.58±2.76 and for the group of other patients it was 10.90±2.26 (t value=-3.743, df=125 and p value=0.000).Conclusions: NCCP is associated with significantly higher anxiety and depression in comparison to other medically ill patients.
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Introduction: Physical and mental issues related with loss ofsemen or "dhat" results in a disorder called as Dhat syndrome.It is a culture-bound disorder portrayed by unseemly and overthe top pain of losing semen from one's body. Aim: The aimof the study was to find the socio-demographic determinantsassociated with this disorder along with finding out variousphysical complaints and co-morbid psychiatric disorders. Thestudy also focused on evaluating the quality of life of patients.Material and Methods: 100 patients were included in thisstudy with selective sampling technique. Diagnosis of Dhatsyndrome was made according to ICD-10 DCR criteria.Socio-demographic determinants, physical complaints werenoted down. HAM-A, BDI II inventory and SF36 scales wereapplied.Results: Age less than 24 years, illiteracy, marriage andpeople living in rural area were strong factors associated withDhat Syndrome. Generalized weakness and body pain weretwo complaints which were present in all the patients. Almostall the patients had moderate to severe score on HAM-A andBECK’s II inventory. SF36 PCS and MCS showed scores lessthan 11.Conclusion: Socio-demographic variables play a pivotal rolein Dhat syndrome. Physical symptoms and mental disorderwere common amongst people suffering from Dhat syndrome.The quality of life of these patients were hampered. It is aserious entity which affects the whole body and mind. It alsodisrupts the quality of life
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Background :Alcohol is a ordinary commodity, used since time immemorial. Psychiatric co morbidities have a high prevalence among patients of alcohol dependence and often pose challenges in their diagnosis and treatment and are found to be a major contributor to relapses. They raise a challenging question of how to provide the best integrated treatment to address both.Aim : To study the socio demographic profile and psychiatric co morbidity in patients of alcohol dependence syndrome.Objectives: 1. To study the socio demographic profile of alcohol dependence patients2. To determine the prevalence and type of psychiatric co-morbidity in alcohol dependent patients.Methodology : Aconsecutive sample of 100 Alcohol Dependence Syndrome patients attending outpatient were selected. Aquestionnaire was administered to collect sample and alcohol dependence characteristics. psychiatric co-morbidity evaluation was done using Mini International Neuropsychiatric Interview (MINI Plus) and the diagnosis was confirmed by using ICD-10.Results :Majority of the subjects were young adults with a mean age of 42 years, were illiterates, married, employed, belonged to rural background and from lower socio-economic status. psychiatric co-morbidities were present in 33% of population. More of affective spectrum (18%) as compared with lesser numbers of patients in the anxiety (11%) or psychotic spectrum (4%). psychiatric co-morbidity is significantly greater in those who are unemployed.Conclusions:The psychiatric co-morbidity was present in 33% of the population studied. More of affective spectrum, followed by anxiety spectrum and less number of them in psychotic spectrum. All psychiatric co-morbidities may need to be identified for patients diagnosed as alcohol dependence who present with longer duration of drinking and unemployed for effective and comprehensive management
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Introduction: Type-2 diabetes mellitus is a common, chronic metabolic disorder with multiple complications if not well controlled. Depression is a very common psychiatric comorbidity in these patients. Multiple environmental and patient related factors are linked with this co-morbidity. It is important to address depression and related factors in these patients for a better outcome. This study aimed to assess depression and distribution of various socio-demographic and clinical details in patients of type-2 diabetes mellitus. Material and Methods: Using a purposive sampling technique, a total of 118 patients of type-2 diabetes mellitus who fulfilled the inclusion and exclusion criteria of this study were enrolled. They were administered Hamilton Depression Rating Scale to assess depression. Overall 66.1% of the patients had co-morbidity of depression. Results: Significantly more number of patients of type-2 diabetes mellitus with co-morbid depression were unmarried (41% vs 15%, χ2=9.029, df=2, p<.05), unemployed/unskilled workers (21.8% vs 5% / 73.1% vs 55%, χ2=24.893, df=2, p<.01), from lower socio-economic status (71.8% vs 52.5%, χ2=4.342, df=1, p<.05), joint family (33.3% vs 7.5%, χ2=9.519, df=1, p<.05) and rural background (82.1% vs 62.5%, χ2=5.453, df=1, p<.05), and had poor control of the level of HbA1c (55.1% vs 2.5%, χ2=41.022, df=2, p<.01) than those without co-morbid depression. There was a significant negative correlation of years in education with HAM-D total score (r=-.471, p<0.01). Conclusion: A co-morbidity of depression is very common in patients of type-2 diabetes mellitus and various sociodemographic and clinical factors are linked to this comorbidity. It is important to address these issues for the sake of overall better outcome in type-2 diabetes mellitus.
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Background: Perceived health (PH) is a subjective assessment of the health and it is a strong, independent and reliable predictor of morbidity, mortality. It includes so many aspects that are difficult to capture clinically such as incipient disease, physiological, psychological reserves. We assessed the impact of diabetes mellitus (DM), hypertension (HTN), co-morbidity and other associated factors on the general health (GH) dimension of the PH of the patients attending the outpatient department (OPD), Inpatient department (IPD), rural health training centre (RHTC) and urban health training centre (UHTC) of Shri Ram Murti Smarak Institute of Medical Sciences (SRMS, IMS), Bareilly.Methods: PH status of the patients was assessed by the GH dimension of the physical component summary of PH using the 36-Items short form health survey (SF-36).Results: The impact of morbidity deteriorate the GH score but hypertensive patients scored poor results as compared to those with DM and comorbid patients (p>0.05). Age was inversely related with GH scores but male gender, higher education (p<0.05) and good occupation were all associated with higher GH score. There was not much influence of geographical area on the GH scores but urban score slightly better and the association was insignificant (p>0.05).Conclusions: Male young patients from urban area, educated and good job performed better score for GH and association was significant for education and occupation. The presence of morbidity and co-morbid condition deteriorate the GH of the patients. The impact of various socio-demographic factors on the PH status was also evident in the study.
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RESUMEN El trastorno bipolar es un trastorno crónico y recurrente que se caracteriza por fluctuaciones patológicas del estado del ánimo. Las fases de la enfermedad incluyen episodios hipomaniacos, maniacos y depresivos. Estos episodios interfieren de forma significativa en la vida cotidiana del paciente y en su entorno, con importante repercusión en su salud y calidad de vida. Para los psiquiatras es de suma importancia el diagnóstico precoz de esta enfermedad para proporcionar un tratamiento oportuno a los pacientes, teniendo en cuenta la severidad de los síntomas y las complicaciones a las que lleva esta enfermedad. Ante esta realidad se decidió describir las características generales de este desorden mediante una revisión bibliográfica donde se exponen sus principales manifestaciones clínicas, clasificación, aspectos epidemiológicos, curso de la enfermedad, complicaciones y comorbilidad. Para ello se realizó una revisión de los trabajos más relevantes publicados y con ello contribuir al proceso de educación médica continuada para los profesionales de la salud.
ABSTRACT Bipolar disorder is a chronic and recurrent disorder characterized by pathological fluctuations of the mood states. The stages of the disease include hypomanic, maniac and depressive episodes. These episodes interfere in a significant way in the patient´s daily life and his surroundings, with an important repercussion on his health and life quality. For the psychiatrists, the precocious diagnosis of this disease is very important, in order to provide a timely treatment to patients, taking into account the severity of the symptoms and the complications of this disease. Due to this reality, the authors decided to describe the general characteristics of this disorder through a bibliographic review where they exposed the main clinical manifestations, classification, epidemiological aspects, the course of the disease, complications and co-morbidity. The most relevant published works were reviewed to contribute to the process of continued medical education of the health professionals.
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Humans , Bipolar Disorder/diagnosis , Bipolar Disorder/etiology , Bipolar Disorder/epidemiology , Bipolar Disorder/complications , Bipolar Disorder/drug therapy , ComorbidityABSTRACT
Objective: To study the association between asthma control and serum 25OH Vitamin Dlevels in children with moderate persistent asthma on preventer therapy. Methods:Children aged 6-18 years, with moderate persistent asthma, on preventer therapy for ?2months were included. Control was categorized as good, partial or poor as per GINAguidelines. Serum 25 (OH) Vitamin D levels were measured and their relationship with thelevel of control was studied. Results: Out of 50 children enrolled, 22 had well-controlledasthma, and 21 had partially controlled asthma. Vitamin D was deficient in 30 children andinsufficient in 18 children. Children with vitamin D deficiency had significantly less well-controlled asthma as compared to those with insufficient or sufficient levels of 25 (OH)vitamin D (13.3% vs 88.9 % vs 100%). Conclusion: Vitamin D deficiency is associated withsuboptimal asthma control.