ABSTRACT
BACKGROUND: Due to coronavirus disease 2019 (COVID-19), adolescents from all over the world have higher rates of anxiety, depression, and stress. This study attempts to assess the effect of the COVID-19 pandemic on adolescent mental health and lifestyle issues. The study also focuses on coping strategies adopted by the participants during the pandemic. MATERIALS AND METHODS: It was a cross-sectional study performed among school-going adolescents studying from classes VII to X of selected schools in Bhubaneswar. A semi-structured questionnaire was formed and validated by faculty members of the Departments of Pediatrics, Psychiatry and Community Medicine, IMS and SUM Hospital, Bhubaneswar, to obtain a detailed history regarding lifestyle changes, mental health issues, and coping strategies. Randomly, three schools were selected in Bhubaneswar. Permission from the principal, informed written consent from parents, and assent from students were obtained before the study. A total of 711 participants were enrolled in the study. All data were entered in an Excel spreadsheet and analyzed using Statistical package for social sciences (SPSS) version 26. RESULTS: Middle and high school students also experienced lifestyle changes; however, it was revealed that high school students experienced higher mental health problems, such as mood swings. Additionally, compared to males, girls substantially more frequently experienced academic stress, sleep difficulties, and worry, as well as the development of unhealthy habits. Various coping strategies developed by the students included development of a new hobby (45.4%), spending time with family members (12.8%), learning by playing indoor games (8.4%), computer skills (3.9%), and meditation (2.25%). CONCLUSIONS: The lockdown, apprehension of pandemic and associated morbidity, fear of losing loved ones, academic and peer pressures, and sudden adjustment to new study methods contributed to the changes experienced by adolescents physically and mentally; hence, all of these issues were addressed in this study. This study pointed toward the need for the propagation of adolescent mental health awareness during pandemics.
ABSTRACT
Granulomatosis with Polyangiitis (GPA) can present with Cerebral Venous Sinus Thrombosis (CVST), Chronic Suppurative Otitis Media, and Lower Motor Neuron (LMN) Facial Palsy. However, an association between CVST and Hyperhomocysteinemia in GPA has not previously been reported. Here, we report a case of CVST and Hyperhomocysteinemia in Proteinase 3 anti-neutrophil cytoplasmic antibody (PR3-ANCA) positive GPA without renal involvement.
ABSTRACT
BACKGROUND: Epilepsy is one of the most common problems in neurology clinical practice and currently we are in the midst of the coronavirus outbreak. The coronavirus pandemic is an epidemiological and psychological crisis, which is likely to affect persons with epilepsy. OBJECTIVES: This study was designed to evaluate the impact of COVID-19 pandemic on patients with epilepsy and effects on their mental health. MATERIALS AND METHODS: This was a cross-sectional web-based survey carried out at the department of Neurology at a tertiary care hospital. A questionnaire was designed in the local language using Google Forms to assess basic knowledge regarding epilepsy, coronavirus, effects of COVID-19 and lockdown on epileptic patients and also effects on their mental health. The link to the online survey was distributed via WhatsApp messenger to epilepsy patients. RESULTS: One hundred fifty-six cases were enrolled with 69.1% were below 34 years of age and male: female ratio was 1.2:1. Only 34.3% of the participants were employed and 50% of patients had an income of less than Rs. 3000 per month. Of the patients enrolled, 20.5% reported the "devil" and superstitions as a cause of epilepsy and only 10% of patients thought that tantric (holy priest) could treat the disease better than doctors. 53.8% of patients worried about getting COVID-19 and could not stop thoughts about being infected by coronavirus bothering them. 30.3% patients had increased seizure frequency during COVID-19 pandemic, of which the most common reason was that they forgot to take regular antiepileptic drugs (22.7%) or they had faced difficulty in obtaining medicine due to lockdown (12.1%). During the pandemic, 17% of patients reported depression symptoms and another 21% reported anxiety symptoms. CONCLUSION: The current COVID-19 pandemic negatively affected patients with epilepsy and increased seizure frequency, depression, anxiety, unemployment, and financial difficulty in obtaining medication.
ABSTRACT
BACKGROUND: Epilepsy is the second most common neurological disorder, and it may have a significant effect on sexual functions in epileptic patients. MATERIALS AND METHODS: Sexual dysfunctions were assessed in 146 male patients suffering from generalized tonic-clonic seizure (GTCS) with a seizure-free interval of at least 1 year. Out of 146 patients enrolled, 46 patients had a psychiatric impairment and were excluded from the study, after applying the General Health questionnaire12 (GHQ12) scale and detailed psychiatric evaluation. The remaining patients were evaluated for the presence of sexual dysfunction by applying Arizona Sexual Experience scale (ASEX). Sixty-six patients scoring more than 19 as a cutoff score on the ASEX scale were further interviewed by a psychiatrist, and a diagnosis of sexual dysfunction was made as per ICD 10 Diagnostic criteria. RESULTS: Sexual dysfunction was diagnosed in 66% (n = 66) of the patients. Erectile dysfunction was the most common sexual disorder diagnosed in 36% of the patients (n = 36) followed by premature ejaculation in 26% (n = 26) and decreased libido (hypoactive sexual desire) seen in 4% (n = 4) of the patients. In patients with sexual dysfunction, a significant association was observed with the duration of epilepsy and type of therapy (mono/polytherapy) (P value < 0.05). Erectile dysfunction and hypoactive desire were more common in patients taking polytherapy, whereas premature ejaculation was more common in patients on monotherapy. CONCLUSION: Significant impairment of sexual functions was observed in male epileptics with GTCS. A high index of suspicion should be kept in mind by the practicing clinician on diagnosing and treating sexual dysfunction in them.
