Preoperative Anxiety among Patients Undergoing Elective Surgery in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Preoperative anxiety is universal in patients before surgery. It is mostly unaddressed by health professionals due to a lack of time. The objective of this study was to find out the prevalence of preoperative anxiety among patients undergoing elective surgery in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted on 385 surgical patients in the Department of Anaesthesia, from 27 November 2021 to 20 April 2022 in a tertiary care hospital posted for elective surgery. Ethical approval was obtained from the Institutional Review Committee (Reference number: MEMG/481/IRC). A convenience sampling was used. The level of anxiety and need for information was assessed using the Amsterdam Preoperative Anxiety and Information Scale questionnaire in a preoperative holding area. Point estimate and 95% Confidence Interval were calculated. Results: Out of 385 patients posted for elective surgery, preoperative anxiety was present in 88 (22.85%) (18.66-27.04, 95% Confidence Interval) patients. The mean Amsterdam Preoperative Anxiety and Information Scale score for total anxiety and need for information was 13.59±2.47 and 5.91±3.06 respectively. Anxiety was present in 60 (68.18%) females, 45 (51.13%) young patients aged <30 years and 50 (56.81%) patients without prior experience with surgery and anaesthesia. Conclusions: The prevalence of preoperative anxiety among surgical patients was lower than in previous studies done in similar settings. Preoperative anxiety was common in females, young patients and patients without previous experience with anaesthesia and surgery. Keywords: anxiety; patient; preoperative; surgical.

Psychiatric Morbidities of Elderly Out-patients Attending Various Outreach Clinics in Gandaki Province of Nepal: A Descriptive Cross-sectional Study.

INTRODUCTION: Dramatic growth of the aging population resulted in an increased number of mental disorders and such data are limited in Nepal. The objective is to find out the psychiatric morbidities of elderly out-patients attending Baglung, Kusma, Walling, and Dumre out-reach clinics in Gandaki Province of Nepal. METHODS: This was a descriptive cross-sectional study conducted in 392 patients attending out-reach clinics of Baglung, Kusma, Walling, and Dumre of Gandaki Province for one year with the convenient sampling method. Ethical approval was taken from the Institutional Review Committee of Manipal College of Medical Sciences, Pokhara. The diagnosis was done according to the International Classification of Disease-10 guidelines. Epi-info 7 was used and point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data and the analysis was done. RESULTS: The prevalence of neurotic, stress-related, and somatoform disorders 145 (37.0%) was maximum followed by mood disorders 111 (28.3%). Maximum cases were in between 66 and 75 years, Brahmin and Chhetri caste, females, married, and from an extended nuclear family. There is more prevalence of female gender in all psychiatric diagnoses except in mental and behavioral disorders due to psychoactive substance use. There is more prevalence of age groups of patients less than or equal to 75 years in all the psychiatric diagnosis. CONCLUSIONS: Neurotic, stress-related, and somatoform disorders were the most common diagnosis. The risk of development of certain disorders based on gender and age group of the patients would be helpful for case identification.

Psychiatric Comorbidities in Patients with Migraine in a Tertiary Hospital.

BACKGROUND: Psychiatric disorders are common in the migraine patients and affect the quality of the life of the individual. The objective of the study was to study the different psychiatric comorbidities and its relationship in migraine patients. METHODS: This was hospital based cross-sectional study. Seventy patients attending psychiatric outpatient department of Manipal Teaching Hospital, Pokhara with a diagnosis of migraine headache were included. The proforma was used to record socio-demographic variables. The patients were administered Mini International Neuropsychiatric Interview to find out the comorbid psychiatric disorder. RESULTS: The migraine was found more in the age group between 26 to 35 years, female gender and in the Brahmin caste. The migraine was also noticed to be higher in the homemakers, higher secondary educated and middle class patients and the patients living in the urban area. The comorbid psychiatric illness was found in 38 cases (54.3%) among which mild depressive disorder was the most common diagnosis (14.3%). The patients of migraine with aura had high risk of developing the psychiatric comorbidities as compared to the patients without aura (Odds Ratio = 1.22), although this relationship was insignificant (p value = 0.7688). CONCLUSIONS: Mild depressive episode was the most common comorbid psychiatric condition. Migraine with aura have high risk of developing psychiatric comorbidities.