Study to Assess Level of Preoperative Anxiety in Patients Scheduled for Surgery.

BACKGROUND: Pre-operative anxiety is unpleasant state of tension or uneasiness that results from patient doubt and fear before an operation. This study aims at assessing level of state and trait anxiety and other associated factors among preoperative patient. METHODS: A descriptive cross-sectional study was done among 195 patients above 18 years of age planned for elective surgery the following day in different departments in tertiary care center. State and Trait Anxiety Inventory and self-designed semi structured pro-forma was used to assess anxiety and patient particulars respectively. RESULTS: There were 195 patients in study among which 93(47.7%) underwent major surgery and 102 (52.3%) underwent minor surgery. The mean State Anxiety Score was 45.89±12.502. The mean Trait Anxiety Score was 43.17±9.342. State and Trait anxiety differed significantly in male and female patients. Trait Anxiety was associated with education and marital status. CONCLUSIONS: There was no significant difference in anxiety level in patient undergoing major and minor surgery. Male and female patients differed significantly in both State and Trait Anxiety.

Anxiety and Depression among Patients with Chronic Kidney Disease Undergoing Haemodialysis in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Chronic kidney disease is a global public health problem with psychological issues and other adverse issues like renal failure, cardiovascular disease, and premature deaths. This study aimed to find out the prevalence of anxiety and depression among patients with chronic kidney disease undergoing haemodialysis in a tertiary care centre. Methods: A descriptive cross-sectional study was done among patients with chronic kidney disease undergoing haemodialysis in the Department of Medicine, Nephrology unit of a tertiary care centre from December 2020 to June 2021. Ethical approval was taken from the Institutional Review Committee (Reference number: 1712202003). The whole sampling method was used. The diagnosis of anxiety and depression was made using the Nepali version of the Hospital Anxiety and Depression Scale with a cut-off of ≥8 scores. Results: Among 96 patients, the prevalence of anxiety was 66 (68.75%) and that of depression was 74 (77.08%) patients. Conclusions: The prevalence of anxiety and depression was similar to other studies done in similar settings. Keywords: anxiety; chronic kidney disease; depression; hemodialysis.

Effect of lockdown on mental health during the COVID-19 pandemic among individuals attending services at a tertiary care center.

BACKGROUND: Lockdown is an emergency measure or condition in which people are temporarily prevented from entering or leaving a restricted area or building during a threat or danger. Since the start of COVID-19 till date, almost one-third of the world's population is under some degree of restriction and lockdown, and the mental health effect of which is something that is being discussed widely. AIM: The study aimed to assess the effect of lockdown on mental health among individuals (patients or accompanying person) seeking services at a tertiary care center. MATERIALS AND METHODS: Kathmandu Medical College is a tertiary care center and a medical college in Kathmandu, Nepal. In this study, we enrolled every 4th individual coming to the hospital's outpatient department registration counter to seek service and giving consent, for the duration of 1 month during the ongoing lockdown period. A semi-structured questionnaire was developed and approved by the department and was used to collect sociodemographic details and to rate the stress level. The General Health Questionnaire (GHQ-12) Nepali version was used to assess psychological well-being of the participants and a score of ≥3 by binary method was taken as positive case. RESULTS: The total number of cases enrolled in the study was 204, out of them 62.2% were male and 32.8% were female and the mean age was 32.03 years. Twenty-three percent (23.5%) had preexisting health conditions. Out of the 204 participants, 67.6% said they were stressed following the lockdown and the mean rated stress was 2.90 in a scale ranging from 1 to 7. The frequently identified stressors were fear of contamination, restricted movement, and for inadequate supplies. Twenty-seven percent said they had some psychological symptoms and the most common symptoms were palpitation and sleep disturbance. Seventy-three individuals (36.5%) were found to have psychiatric problem according to their scores in GHQ-12. Rated stress and GHQ-12 scores were found to be strongly correlated (P = 0.000). Similarly, those who stated "Yes" in psychological symptoms significantly scored higher on GHQ-12 and stress (both P = 0.000). CONCLUSION: The lockdown has caused stress in majority of cases, and a significant number of individuals have diagnosable mental health conditions. Mental health impact of the lockdown is something that needs to be addressed seriously.

Knowledge of Alzheimer's Disease Among Medical Students of a Medical College.

INTRODUCTION: Dementia is a public health concern as the prevalence is increasing worldwide with significant increase being in low-middle income countries. However these countries appear to be less prepared in handling this rise in terms of diagnosis and management. METHODS: This cross-sectional study was conducted in Kathmandu medical College, from June 2017 to July 2017. Purposive sampling was done and the medical students who were in their first and final year of study were included in the study after obtaining an informed consent. RESULTS: Total 185 students were included in the study, 80 (43.24%) from first year and 105 (56.75%) from final year of medical study. The mean score of knowledge among the students was 17.44±2.46; 15.32±1.22 among first year and 19.06±1.87 among the final year students. Majority of the students said they have heard about dementia however, only 3 (3.75%) of first year and 43 (41.9%) from final year students have either attended a class or continuing medical education on dementia Conclusions: The knowledge about dementia was found to be average among medical students but better among final year medical students in comparison to first year. The knowledge was found to be better statistically among those who had either attended a class or continuing medical education on dementia or had exposure through different medias.

Assessing Caregiver Burden in Caregivers of Patients with Schizophrenia and Bipolar Affective Disorder in Kathmandu Medical College.

BACKGROUND: Schizophrenia and bipolar affective disorder are chronic psychiatric illness that requires long term care. This study tends to measure psychological burden and factors associated with it among caregivers of these two illnesses. METHODS: This is a cross- sectional study that included participants by purposive sampling method. Self designed performa was used to collect the socio-demographic details of the caregivers. Modified caregiver strain index was used to assess the overall stress. Beck`s depression inventory and Beck`s anxiety inventory was used to assess depression and anxiety respectively. RESULTS: Hundred caregivers, 50 each of schizophrenia and bipolar affective disorder were enrolled. Seventy-two percent of caregivers were found to have higher level of stress. Twenty-five percent had depression and 29% anxiety related problems. Stress was found to be significantly associated with being in debt, longer duration of illness, education level, marital status, subjective feeling of psychological stress and self- acknowledgement of need of professional help. Caregivers of both group experienced similar level of stress. CONCLUSIONS: Psychological burden is seen to be high in caregivers of patients of Schizophrenia and Bipolar Affective Disorder.