Better Quality Of Life Scores Research Articles

The Androgen Deprivation Therapy Landscape in 2024 – Co-navigating the Available Options with Prostate Cancer Patients

This symposium convened during the 2024 European Association of Urology (EAU) Congress in Paris, France, focusing on the multifaceted aspects of prostate cancer (PCa) treatment from the patient’s perspective. The session delved into the nuanced needs, expectations, and treatment experiences encountered by individuals diagnosed with this condition. A pivotal aspect of the discussion centred on the imperative of ensuring patient awareness and informed consent, particularly concerning androgen deprivation therapy (ADT), given its array of potential side effects. ADT, a cornerstone in advanced PCa management, encompasses a spectrum of side effects including both physical and psychological dimensions. These include, but are not limited to, body hair loss, weight fluctuations, mood alterations, decreased libido, cognitive impairments, muscle atrophy, and bone density loss. Effective management of these side effects requires comprehensive support to be provided to patients to mitigate complications and optimise quality of life. The options for ADT were discussed, with their comparative strengths and challenges. ADT strategies take effect over different time periods (from 12 hours up to 4 weeks), exert varying effects on testosterone levels, and carry different side effect profiles. Selecting the optimal course of treatment for localised or locally advanced PCa requires consideration of whether the patient is at intermediate-, high-, or very high-risk of biochemical recurrence, and whether the intermediate-risk disease is classified as favourable intermediate-risk (FIR) or unfavourable intermediate-risk (UIR). While continuous ADT is the standard of care, intermittent ADT has been associated with significantly better quality of life scores for hot flushes, desire for sexual activity, and urinary symptoms, with a trend toward improvement in the level of fatigue. Furthermore, the interplay between PCa, ADT, and cardiovascular disease (CVD) was discussed to underscore the imperative for clinicians to assess the cardiovascular risks associated with ADT, particularly in patients with heightened cardiovascular vulnerability. Mitigating the adverse skeletal effects of ADT mandates a multifaceted approach encompassing nutritional supplementation, exercise regimens, and lifestyle modifications including alcohol cessation and smoking cessation. Integrating a prehabilitation checklist into clinical practice emerges as a pragmatic strategy to facilitate informed discussions regarding the potential adverse effects of ADT, enabling proactive support provision to optimise patient outcomes.

Quality of Life of Children After Completion of Surgical Treatment for Anorectal Malformation: A Single-centre Cross-sectional Study in South-Western Uganda

BackgroundAnorectal malformations (ARMs) range from abnormalities such as imperforate anus to complex forms such as cloaca and are often associated with other anomalies and residual functional stooling problems. The present study aimed to evaluate the quality of life (QoL) of children after surgical treatment for ARMs at Mbarara Regional Referral Hospital (MRRH) in South-Western Uganda. MethodsIn this cross-sectional study, we enrolled children who had completed surgical treatment for ARMs between 2014 and 2021 at MRRH. A 23-item PedsQL 4.0 inventory was used to evaluate health-related QoL in children using a multidimensional parent proxy reporting for children aged 3 years to 7 years and child self-reporting for children aged 8–17 years. Regression analysis was used to determine the association between sociodemographic and clinical variables and QoL. Crude and adjusted coefficients and their corresponding 95% confidence intervals (CI) were calculated. The significance level was set to a p-value <0.05. ResultsA total of 88 participants (F:M ratio = 1.15:1) aged 3 years–18 years with a median age of 4.5 years (IQR 3–7) were enrolled. The median age at diagnosis of ARM and preliminary diverting colostomy was 3 days (range: 2–30 days) and 3 days (range: 2–60 days) respectively. Rectovestibular fistulas, 47 (53.4%), were the most prevalent subtype of ARMs, and 5.7% of children had associated anomalies. Over one-third of the participants (38.6%) had definitive surgery after 3 years of age, and PSARP was the most common procedure. The average PedsQL score was 94 out of a maximum score of 100. The mean physical functioning score was 96.7 in males and 98.9 in females. The overall mean emotional functioning score was 91 ± 2. The mean social functioning score was 92 ± 3.0. The mean school functioning score was 95.7 in males and 98.5 in females. Associated anomalies and reoperation significantly predicted poor QoL. ConclusionThe overall QoL of the participants was good. Increasing years after completion of surgery was significantly associated with good QoL scores in all dormains. Associated anomalies and reoperation were associated with poor QoL, while years after definitive surgery was associated with good QoL. There is a need for increased awareness and utilization of QoL assessments as an outcome measure after definitive surgery for ARM. Level of evidence4. Type of studyCross sectional clinical study.

Quality of Life of Healthcare College Students in Riyadh, Saudi Arabia.

The aim of this study was to assess the quality of life (QOL) and its influencing factors among healthcare college students in Riyadh, Saudi Arabia. A cross-sectional study was conducted among healthcare students at King Saud University. A modified version of the Arabic World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire, including 25 questions, was used to assess students' QOL. Data were collected through an online survey and analyzed using IBM SPSS Statistics version 26 (IBM Corp., Armonk, NY). Descriptive and regression statistics were used. A total of 547 healthcare students completed the questionnaire during the data collection period. Of all the students, 39.7% were from applied medical college, 62.5% were females, 98.9% were single, and 91.8% were non-smokers. Regarding academic status, 58.3%did not participate in any extracurricular activity, 42.6% had an academic advisor, and 80.4%had a grade point average (GPA) higher than 4.1. The average QOL score across all domains was moderately good (60.30 ± 16.0), whereas the physical domain showed the poorest score (46.89 ± 14.8) while the environmental domain had the greatest score (68.04 ± 20.6). The environmental domain was the only domain that showed significant differences between healthcare colleges (p <0.001). Moreover, students who were male (p = 0.009), non-smokers (p = 0.023), reported living with family/friends (p =0.031), and from families with high monthly income (p < 0.001) had significantly higher environmental QOL scores than their counterparts. The study found that healthcare students had moderately good mean QOL scores. The environmental domain was the only QOL domain that showed significant differences between healthcare colleges with the greatest scoreamong medical college students. Gender, smoking status, residence status, and family monthly income were found to have a strong association with students' environmental QOL scores. Institutions need to focus on the regular measurement of students' QOL, which facilitates implementing strategies that can promote their overall QOL and subsequently positively impact their performance academically and practically.

Anterior cervical discectomy and fusion with and without plating versus laminectomy with and without fusion for multilevel cervical spondylotic myelopathy: a prospective observational study

BackgroundCervical spondylotic myelopathy (CSM) is a chronic progressive spinal compression that usually accompanies age-related degeneration of the cervical spine and represents one of the most common causes of spinal cord dysfunction. Surgical intervention is the foundation of management in symptomatic cases, but the approach of choice is constantly contentious. The aim of this study is to evaluate and appraise different surgical approaches for multilevel cervical spondylotic myelopathy (anterior cervical discectomy and fusion (ACDF) with or without plating and laminectomy with and without fusion) regarding the perioperative data, clinical outcomes, complications rates and radiographic parameters.ResultsIn this prospective study, sixty patients in four matched cohorts were followed up. The first group (n = 15) underwent ACDF only, the second group (n = 15) underwent ACDF with anterior plate, the third group (n = 15) underwent laminectomy alone, and the fourth group (n = 15) underwent laminectomy with lateral mass fusion. Patients were followed up for twelve-month duration using modified Japanese orthopedic score (mJOA), neck disability index (NDI), visual analogue scale (VAS) and short form 36 (SF-36) in addition to measurement of C2-C7 cobb`s angle to evaluate postoperative cervical sagittal alignment. All the four groups were associated with functional clinical improvement with no statistically significant differences between them. Postoperative cervical lordosis and its change were highest in anterior groups, both plated (11.1 ± 5.2a, 5.1 ± 4.0a) and non-plated (12.0 ± 5.3a, 4.4 ± 3.2a) (p value < 0.001) with no significant difference between them. Postoperative quality of life score and its change were significantly better in plated anterior approach (55.8 ± 4.8a, 21.6 ± 4.9a) and in non-plated (55.6 ± 3.2a, 21.3 ± 4.0a) (p value < 0.001) with no significant difference between both techniques. Operative time was statistically higher in plated anterior approach (202.1 ± 55.9b) and in laminectomy with fusion (229.2 ± 92.9b) (p value < 0.001) with no statistically significant difference between either group. Posterior approaches were associated with significantly higher intraoperative blood loss (280.0 ± 52.3b for laminectomy and 310.0 ± 60.3b for laminectomy with fusion) (p value < 0.001) with no difference between both techniques. Hospital stay was higher in posterior groups as well, but it was not statistically significant (p value = 0.127).ConclusionsBoth anterior and posterior approaches were associated with significant functional improvements with no difference in complications severity or frequency. Anterior surgery had shorter hospital stay and less blood loss with better quality of life scores and more successful restoration of cervical lordosis.

Surgical and/ or conservative treatment improves quality of life (EHP-30) in patients with endometriosis.

To investigate the quality of life of women with endometriosis before treatment and 3 months after the start of surgical and/or conservative treatment. The sample comprised of 38 patients, of whom 26 underwent surgical treatment, 6 had pharmacological treatment, and 6 had both surgical and pharmacological treatment. The Endometriosis Health Profile (EHP-30) questionnaire in the Czech version and the Numeric Rating Scale (NRS) were used to assess quality of life. The questionnaires were completed before treatment and 3 months into the treatment. When comparing quality of life with the EHP-30 questionnaire, 3 months after the start of treatment, significantly better quality of life scores were found in all domains except the domain "Infertility." Statistically significant improvement was observed in the domains of "Control and powerlessness," "Emotional well-being," and "Pain" (P &lt; 0.0001). Pain assessment using NRS showed subjective improvement in pain during menstruation, outside menstruation, during intercourse, micturition, and defecation. Statistically significant improvement was reported in pain during menstruation and outside menstruation (P &lt; 0.0001). Treatment of endometriosis improves the quality of life and also leads to a subjective reduction of pain intensity as one of the main symptoms of the disease.

Correlations of university students' feelings during the COVID-19 pandemic with academic adaptation and quality of life

This study aimed to identify the feelings experienced by university students during the COVID-19 pandemic and its correlation with academic adaptation and quality of life (QoL). Through a cross-sectional and correlational design, 90 university students completed a questionnaire about feelings, academic adaptation, and QoL during the pandemic. Spearman's correlation was used to identify the correlation between the feelings of academic adaptation and quality of life. Multiple linear regression models were used to identify the predictors of feelings of academic adaptation and the physical and mental components of the quality of life. Good academic adaptation and good QoL scores were identified in the sample. During the pandemic period, students experienced feelings of exhaustion, discouragement, irritation, exhaustion, insecurity, drowsiness, anxiety, worry, and tiredness with greater intensity. Positive feelings, such as energy and willingness, were reported as well. The feelings could predict variations in academic adaptation and physical and mental health. Additionally, a greater correlation of feelings was identified with the QoL domains related to the individual's perception of mental health. The results of this study highlight that, in the context of public health emergencies, investments are needed in institutional policies to support students, avoid difficulties in academic adaptation that impact dropout, and avoid the emergence or worsening of disorders such as anxiety and depression.

Effects of Prostatic Inflammation on Clinical Outcomes in Patients with Benign Prostate Hyperplasia

Background: Benign prostate hyperplasia (BPH), a non-cancerous enlargement of the prostate gland, prevalently impacts the aging male population, often disrupting the quality of life with its accompanying urinary symptoms. The intersection between BPH and prostatic inflammation has emerged as a focal point in urological research, with inflammation speculated to exacerbate BPH progression and symptoms. Understanding this relationship is pivotal in refining therapeutic approaches and improving patient outcomes. Objective: This study aimed to elucidate the effects of prostatic inflammation on the clinical outcomes of patients with BPH, focusing on symptom progression, treatment efficacy, and long-term complications. Methods: This Study Conducted at Gajju Khan Medical College Swabi, KPK, Pakistan, in the duration from January, 2023 to June, 2023. This prospective cohort study involved 126 men with BPH, categorized into two groups based on the presence (n=63) or absence (n=63) of prostatic inflammation. Data were collected over three years, with assessments including demographic information, clinical histories, and prostate examinations. Primary outcomes measured were the progression of BPH symptoms, urinary function, and prostate size. Secondary outcomes included quality of life, acute urinary retention, the need for surgical intervention, medication efficacy, and long-term complications. Statistical analyses employed included Chi-square tests, t-tests, and ANOVA, with SPSS software. Results: The group with prostatic inflammation showed significantly more severe symptom progression (p &lt; 0.01), impaired urinary function (p &lt; 0.01), and increased prostate size (p &lt; 0.01) compared to the non-inflamed group. Secondary outcomes also favored the non-inflamed group with better quality of life scores (75.2 ± 5.2 vs. 78.8 ± 4.8, p &lt; 0.01), lower rates of acute urinary retention (20.3% vs. 15.5%, p &lt; 0.01). Conclusion: Prostatic inflammation significantly worsens the clinical outcomes of BPH, affecting symptom progression, treatment response, and the likelihood of long-term complications. These findings suggest the need for integrated therapeutic strategies that address both BPH and prostatic inflammation to optimize patient care.

Quality of life and associated factors among patients with cancer receiving chemotherapy at Dessie Comprehensive Specialized Hospital, North-East Ethiopia: a cross-sectional study.

Cancer is a major public health problem around the world. Cancer by itself and its treatment modalities affect the quality of life (QoL) of patients with it. However, there were a paucity of studies about the QoL of patients receiving chemotherapeutic treatment in Ethiopia. This study was aimed at addressing such a gap. Accordingly, we investigated QoL and associated factors among cancer patients receiving chemotherapy at Dessie Comprehensive Specialized Hospital (DCSH), North East Ethiopia, in 2023. We employed a cross-sectional study from April 1 to May 30, 2023. The data was collected using the European Organization for Research and Treatment of Cancer Core QoL Questionnaire, version 3.0 (EORTC QLQ-C30). The data was entered and cleaned using EpiData version 4.6 and exported to Statistical Package for Social Sciences (SPSS) version 27 for analysis. The association between the dependent and independent variables was determined using Odds Ratios (ORs) at a p value < 0.05 with a 95% CI. Data was collected from 394 patients. Their mean summary QoL score was 36.3 ± 9.0. About 39.3% demonstrated a good QoL summary score, whereas 60.7% were impacted by symptoms. A good functional QoL score was observed in 42.6% of the participants. About 54.8% and 31.7% reported good overall health status and good overall QoL, respectively. The most impacted functional domain was social functioning, affecting 64.5% of participants. The most common symptom was diarrhea, affecting 65.5% of the participants. Secondary school education level (Adjusted Odds Ratio-AOR = 3.16, 95% CI: 1.14-8.81), diploma and above education level (AOR = 4.90, 95% CI: 1.29-18.62), and urban residency (AOR = 1.74, 95% CI: 1.07-2.82) had a significant positive association with QoL, while being a civil servant (AOR = 0.13, 95% CI: 0.04-0.49), having stage III cancer (AOR = 0.14, 95% CI: 0.05-0.39), and stage IV cancer (AOR = 0.16, 95% 0.06-0.44) had a significant negative association with it. The QoL for cancer patients undergoing chemotherapy was significantly low and associated with their level of education, occupational status, area of residence, and stage of cancer. Incorporating psychosocial support is thus crucial in their treatment plans.

Long-term Sexual Function and Quality of Life in Women Following Substitution Urethroplasty.

To assess the long-term quality of life (QOL) and sexual function (SF) in women who underwent either dorsal on-lay (DO) or ventral inlay (VI) urethroplasty for urethral stricture disease. Between January 2016 and September 2022, women who underwent either dorsal on-lay (DO) or ventral inlay (VI) urethroplasties and had at least a six-month follow-up been included. Using the Female Sexual Function Index (FSFI) and WHO-QOL bref questionnaires, the QOL and SF were evaluated. Scores were compared between the two groups after being examined for internal validity. A sub-group analysis was carried out based on the procedure's success. With follow-up periods ranging from 6 to 86months, 25 patients who received VI urethroplasty and 10 patients who underwent DO urethroplasty were included. Both scores demonstrated strong internal consistency. The cumulative QOL and FSFI scores were comparable in both groups (p = 0.53 and p = 0.83, respectively). Significantly high scores were noted in the physical health domain (76.5 ± 9.9 vs 62.33 ± 10.97; p = 0.03; (95% CI = 0.72-24.4)) and the environmental domain (75.75 ± 3.84 vs 66.00 ± 4.24; p = 0.01 (95% CI = 2.64-16.85) in patients with successful VI and DO urethroplasties respectively. Addictions, low socioeconomic status and protracted symptom duration were associated with low QOL scores. Old age was related to low FSFI scores. Substitution urethroplasty, despite the approach, showed good QOL and SF scores. Long symptom duration, addictions, and poor socioeconomic status were associated with low QOL whereas old age independently influenced low FSFI scores.

Preditores de Qualidade de Vida, Ansiedade e Aceitação em Pacientes com Cardioversor-Desfibrilador Implantável

Abstract Background An implantable cardioverter-defibrillator (ICD) can cause high levels of anxiety and depression, resulting in negative effects on quality of life. Objectives To evaluate the quality of life, anxiety, and acceptance of the ICD using standardized measurement instruments and identify predictors of better responses for each of the outcomes studied. Method This is a prospective cohort study with patients undergoing initial ICD implantation or reoperation to maintain the device. The study outcomes included quality of life, anxiety, and acceptance of the ICD. The change in scores (30 and 180 days) was assessed using the minimal important difference (MID). Univariate analysis and the multivariate logistic regression model were used to identify predictors of better responses, adopting a significance level of 5%. Results A total of 147 patients were included between January/2020 to June/2021, with a mean age of 55.3 ± 13.4 years and a predominance of males (72.1%). The MID for quality of life, anxiety, and ICD acceptance were observed in 33 (22.4%), 36 (24.5%) and 43 (29.3%) patients, respectively. Age equal to or greater than 60 years (OR=2.5; 95%CI=1.14-5.53; p=0.022), absence of atrial fibrillation (OR=3.8; 95%CI=1.26-11.63; p=0.017) and female gender (OR=2.2; 95%CI=1.02-4.97; p=0.045) were independent predictors of better responses to quality of life, anxiety and acceptance of the ICD, respectively. Conclusion The identification of predictors for better quality of life scores, anxiety, and acceptance of the device can support the implementation of specific care for patients with a greater chance of presenting unfavorable results.

Predictors of Quality of Life, Anxiety and Acceptance in Patients with Implantable Cardioverter-Defibrillator.

An implantable cardioverter-defibrillator (ICD) can cause high levels of anxiety and depression, resulting in negative effects on quality of life. To evaluate the quality of life, anxiety, and acceptance of the ICD using standardized measurement instruments and identify predictors of better responses for each of the outcomes studied. This is a prospective cohort study with patients undergoing initial ICD implantation or reoperation to maintain the device. The study outcomes included quality of life, anxiety, and acceptance of the ICD. The change in scores (30 and 180 days) was assessed using the minimal important difference (MID). Univariate analysis and the multivariate logistic regression model were used to identify predictors of better responses, adopting a significance level of 5%. A total of 147 patients were included between January/2020 to June/2021, with a mean age of 55.3 ± 13.4 years and a predominance of males (72.1%). The MID for quality of life, anxiety, and ICD acceptance were observed in 33 (22.4%), 36 (24.5%) and 43 (29.3%) patients, respectively. Age equal to or greater than 60 years (OR=2.5; 95%CI=1.14-5.53; p=0.022), absence of atrial fibrillation (OR=3.8; 95%CI=1.26-11.63; p=0.017) and female gender (OR=2.2; 95%CI=1.02-4.97; p=0.045) were independent predictors of better responses to quality of life, anxiety and acceptance of the ICD, respectively. The identification of predictors for better quality of life scores, anxiety, and acceptance of the device can support the implementation of specific care for patients with a greater chance of presenting unfavorable results.

Sustaining Quality of Life with Education-Based Treatment for Hypertension Patients During COVID-19 Adaptation.

Purpose: Determine the impact of education-based treatment on sustaining quality of life during COVID-19 adaptation. Designs: A randomized, 2-group, structured, holistic education-based intervention within eight weeks in preserving total quality of life (QoL) for hypertension patients with conventional care. Methods: Utilizing randomized controlled trials, 380 patients with hypertension are separated into two groups and evaluated. The patients are separated into two groups totaling 190 individuals each group. The intervention group is treated with a holistic education-based intervention. After two months, the EQ-5D-5L is used to evaluate the quality of life. Findings: The QoL pretest for the intervention group revealed that 25 (13.2%) patients had good QoL (Score = 1), while the QoL posttest revealed that the number of patients with good QoL had grown to 48 (25.3%). Using Kolmogorov-Smirnov for data analysis yielded non-normally distributed data. The p-value for the Wilcoxon signed ranks test is .001. Conclusions: The intervention group is better equipped to deal with COVID-19 and has a higher quality of life. Education-based hypertension treatment can sustain a high quality of life.

Pediatric Tracheostomy: A Quality-of-Life Assessment Study in Saudi Arabia.

The pediatric population undergoes tracheostomy for a variety of reasons. For a child and their family, having a tracheostomy means learning a new way of life and facing several social, psychological, medical, and economic challenges.Our analysis of the literature indicates that this is the first study of its kind, using the Pediatric Tracheotomy Health Status Instrument (PTHSI) tool to assess the quality of life (QoL) following tracheostomy in pediatric patients and their caregivers in the Kingdom of Saudi Arabia (KSA). This was a descriptive cross-sectional study for tracheostomized children's QoL evaluation. The medical records of the Maternity and Children Hospital, Dammam, KSA, were used to identify the patients and their caregivers. A higher score on the validated PTHSI indicated a better result. From a total of 56 patients, 24 were included in this study. Based on the PTHSI tool, the overall mean score was 93.3/150 (62.28%) and this indicated a good QoL score. Analysis of the correlation between the PTHSI score and other variables indicated no association between the total PTHSI score and the age or gender of the patient or the duration of the tracheostomy (p-value > 0.05). However, we found families of children with major medical comorbidities had lower scores (p-value = 0.03) and their QoL was affected much more than families of patients who did not have major medical comorbidities. Tracheostomy care for pediatric patients can significantly affect the QoL of patients and their families. Our findings using the validated PTHSI tool showed poorer QoL compared to other studies, suggesting the need for future home care training programs to support tracheostomized children and their families, particularly those with comorbidities, who tend to have lower QoL scores and require more organized support.

Physical activity assessment among patients with multiple sclerosis in Saudi Arabia.

To measure and assess the physical activity (PA) of patients with multiple sclerosis (MS) and its association with the quality of life (QoL). This cross-sectional study included patients with MS in Kingdom of Saudi Arabia from August, 2022 to November, 2022. Data were collected via social media platforms using a questionnaire that included 3 sections: sociodemographic data, International PA Questionnaire (IPAQ), and the Health Status Questionnaire Short Form-36 (SF-36). In total, 145 eligible patients with MS were included. The patients' ages ranged from 18 to 60 years, with a mean age of 33.2±13.9 years. Females were predominantly affected, and most of the patients were either not working or retired. Relapsing-remitting MS constituted the majority (66.2%) of patients. Additionally, most patients (75.9%) were free from co-morbidities. Approximately 41.7% of patients with high PA levels had good QoL scores. Higher PA levels was significantly associated with better QoL in patients with MS. High PA can improve the QoL by taking into consideration several factors that could influence readiness for exercise and its effect on MS symptoms.

Assessment of Respiratory Functions, Activities of Daily Living, and Quality of Life of the Post-mechanical Ventilated Patients

Background: The fundamental goal of mechanical ventilation is to restore and improve respiratory functions and relieve respiratory distress, thus permitting lungs and airways to heal in acute and chronic respiratory failure conditions. Associated post-mechanical ventilation complications may increase the chance of re-intubation, poor quality of life, hospital stay and hospital costs, and so on. Objective: To assess the respiratory functions, activities of daily living, and quality of life of the post-mechanical ventilated patients. Methods: Using a purposive sampling technique, 72 patients after 24 h of weaning from the ventilator were enrolled in the study. Their socio-demographic profile, respiratory functions, activities of daily living, and quality of life were assessed using validated tools. Results: The mean respiratory rate per minute and oxygen saturation were 21.69 ± 4.10 and 93.58 ± 3.73, respectively. A total of 58.9% of the patients had dyspnea, 18.1% had abnormal breathing sound, 22.3% were using accessory muscles during breathing, 20.9% had pain during breathing, and 18.1% had cough with sputum production after extubation. Three fourth of the patients had complete dependency (75%) to perform activities of daily living. More than half (59.8%) of the patients had good quality of life scores as per the SF-36 item scale. Conclusion: There is a need to plan nursing interventions for patients in order to decrease post-mechanical ventilation complications.

Impact of JME on quality of life: Does a well-controlled epilepsy also hamper the psychological wellbeing?

PurposeEpilepsy is a stigmatizing disorder and its diagnosis can have important psychosocial consequences on individuals, severely impacting their quality of life(QOL). There are numerous studies which have seen an adverse impact on the psychosocial aspects of life in patients with intractable epilepsy. The aim of this study was to assess the QOL in adult and adolescent patients with JME, which is largely a well-controlled form of epilepsy. MethodologyThis was a hospital based cross-sectional observational study comprising of 50 JME patients. QOLIE-31-P and QOLIE–AD-48 questionnaires were used to assess QOL in adults & adolescents(11–17 years) respectively. The Mini international neuropsychiatric interview-version 7.0.2 and Brief psychiatric rating scale were used for screening of underlying psychopathology and if, the screening tests were positive then they were further evaluated and classified using DSM V and ICD 10. ResultsThe mean QOLIE-31-P score was 64.65 ± 15.74. Majority of the adult patients had fair QOL (poor, fair and good QOL scores in 18 %, 54 % and 28 % respectively). Subscale scores in poor category were for the medication effects and pertaining to seizure worry.Among adolescent patients, the mean QOLIE 48 AD score was 69.15 ± 13.13. 50 % had fair QOL. Amongst those with poor QOL, majority of poor scores were for the attitude towards epilepsy. The QOL scores were significantly poorer in patients with uncontrolled seizures. 78 % of the patients had comorbid anxiety and depression, however syndromic psychiatric diagnosis was seen in 10.25 % and 2.56 % for anxiety and depression respectively. Presence of psychiatric symptoms did not influence QOL scores. ConclusionQOL, in well controlled JME, is fair in majority of patients. QOL might improve if seizure worry is addressed and patients are educated about medication effects at the time of initial diagnosis. Vast majority of patients may experience minor psychiatric issues, which do need addressal for formulating a holistic and individualized treatment plan.

Association of treatment regimens with quality of life and overall survival in patients with metastatic colorectal cancer in Peru.

e15617 Background: Colorectal cancer is a significant public health concern in Peru. Metastatic colorectal cancer patients have limited treatment options, and the prognosis is generally poor. In recent years, treatment regimens for metastatic colorectal cancer have evolved significantly, with the emergence of targeted therapies and immunotherapy. However, little is known about the impact of these treatment regimens on quality of life and overall survival in the Peruvian population. The objective of this study is to investigate the association between treatment regimens and quality of life and overall survival (OS) in Peruvian metastatic colorectal cancer patients. Methods: This retrospective study included patients diagnosed with metastatic colorectal cancer between 2010 and 2020 at the AUNA clinic. Patients were included if they received chemotherapy as first-line treatment and were followed up for at least 6 months. Quality of life was assessed using the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) questionnaire, which includes subscales for physical, social/family, emotional, and functional well-being, as well as colorectal cancer-specific concerns. Treatment regimens considered were: FOLFOX, FOLFIRI and others. Univariate and multivariate analyses were performed to identify factors associated with quality of life and overall survival. Results: A total of 193 patients were included in the study, and the median follow-up time was 14 months. The majority of patients were male (60.6%) and the median age was 57 years. The most common first-line chemotherapy regimens were FOLFOX (52.7%), FOLFIRI (23.5%), and capecitabine plus oxaliplatin (16.4%). The median overall survival was 14 months, and the 1-year overall survival rate was 52.8%. Patients treated with FOLFOX had significantly better quality of life scores than those treated with FOLFIRI or capecitabine plus oxaliplatin (p = 0.012). The difference in quality of life scores was most pronounced in the emotional and social/family well-being subscales. However, there was no significant difference in overall survival among the different treatment regimens (p = 0.344). Multivariate analysis showed that the presence of liver metastases and higher FACT-C scores were independent predictors of OS. Conclusions: Our study has shown that the choice of treatment regimen in Peruvian metastatic colorectal cancer patients can have a significant impact on their quality of life. Patients treated with FOLFOX as first line had better quality of life scores than those treated with FOLFIRI or capecitabine plus oxaliplatin, particularly in emotional and social/family well-being subscales. However, there was no significant difference in OS among the different treatment regimens. The presence of liver metastases and higher quality of life scores were found to be independent predictors of overall survival.

The quality of life of non-valvular atrial fibrillation patients in the national hospital and associated factors

Non-valvular atrial fibrillation (NVAF) is a health burden worldwide. This paper outlines the hypothesis that demographic and medical history factors could affect the Quality of life (QoL) score among Vietnamese Non-Valvular Atrial Fibrillation (NVAF) patients. In general, themeanwere 55 (36.2%) patients had good QoL scores. The number of patients with good scores at physical health was 34 (22.4%) and mental health was 87 (57.3%). The factors that were statistically significant were smoking status, hypertension and stroke history. In conclusion, our study showed the prevalence and associated factors with QoL of Vietnamese NVAF patients.

Ambulatory Laparoscopic Appendectomy: Does the Conventional Approach Need a Reappraisal?

A Deucalione, acute abdomen remains significant in abdominal pain. The entity of acute abdomen accounts for up to 10% of all emergency admissions. The differences between countries' income and level of prosperity are pertinent, particularly in terms of severity, radiological modalities, and surgical management of the condition. Of note, surgical modalities have been the most widely used treatment modality, and current evidence indicates that the laparoscopic approach, per se, is the most effective surgical therapy with a lower incidence of wound infection, post-intervention morbidity, shorter hospital stay, and better quality of life scores compared to the conventional method. In light of this, the present study aimed to evaluate ambulatory appendectomy in a series of sequential laparoscopic appendectomies (LApp), which included both complicated and uncomplicated cases.

Quality of Life and Psychological Wellbeing of Breast Cancer Survivors in the Kingdom of Saudi Arabia.

Breast cancer is the most common cancer among Saudi population. Breast cancer patients suffer from several negative consequences after treatment and these include pain, fatigue, sexual problems, appearance and body image concerns, with psychological dysfunction. This could affect the patient quality of life and psychological well-being. a multicenter cross-sectional study to assess quality of life and psychological wellbeing and their predictors for female breast cancers survivors diagnosed between 1 January 2015 and May 2017 with the assessment conducted at 12 to 36 months after initial diagnosis. Assessment was performed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the Breast Module (QLQ-BR23) and the Hospital Anxiety and Depression Scale (HADS). 246 Breast cancer patients participated in the study with a mean age of 49.5±10.9. The mean global health status has a mean of 72.7±23.5. The worst domain of the functioning scales was physical functioning (mean score of 62.14±26.03, while the best scores were for social functioning of 80.06±29.18. For the symptom scales, the worst scores were reported for fatigue and pain. Results of HADS scale showed that 57% had moderate to severe depression, while 44% had moderate to severe anxiety. Only 6.8% of the participants reported receiving psychosocial support. Breast cancer survivors in the KSA have overall good quality of life scores when compared with patients from Western countries. However, their psychological wellbeing is more impaired. There is an urgent need for psychosocial support programs and psychological screening and consultation for breast cancer patients at cancer care centers in the KSA.