Cross-sectional Study Research Articles

Effects of Parental Predictors on Postpartum Depression.

Postpartum depression (PPD) is highly prevalent and plagues a significant proportion of parents. Postpartum depression also exerts various negative consequences on infant development and parent-infant relationships. Social support is identified as an important factor influencing many parental predictors, and may affect the development of PPD. This study aimed to investigate how perceived social support can indirectly influence PPD symptoms in parents at 6 months postpartum by influencing postpartum anxiety, parental satisfaction, and parental self-efficacy (PSE). A secondary analysis of data from a randomized controlled trial was used with a cross-sectional exploratory design. A total of 400 Singaporean parents (200 couples) were included, and structural equation modeling was used to analyze the relationships between PPD and potential predictors. Findings revealed a less adequate fit between the hypothesized model and the data collected. Social support was found to be a significant predictor of postpartum anxiety, PSE, and parental satisfaction. Postpartum anxiety was a significant predictor of PPD, but PSE and parental satisfaction were not. This study provides an overview of how different parental predictors may be associated with PPD among Asian parents. Postpartum anxiety significantly predicted PPD, but social support had negative effects on postpartum anxiety, parenting satisfaction, and PSE. The findings provide further insight into how parents at risk of PPD can be identified and demonstrated how social support might negatively impact parental outcomes. More qualitative research with Asian parents is needed to further explain these findings and inform the development of future interventions.

Health-related quality of life of adults with spinal muscular atrophy: insights from a nationwide patient registry in Germany.

Spinal muscular atrophy (SMA) is a rare, autosomal-recessive disease characterized by progressive muscular atrophy and weakness resulting in substantial disability and short life expectancy. The objective of this cross-sectional study was to assess health-related quality of life (HRQoL) of adults with SMA in Germany in the era of disease-modifying therapy. Adults with SMA were recruited via the German national TREAT-NMD SMA patient registry. HRQoL was measured using the EQ-5D-5L, the Health Utilities Index Mark III (HUI), and the Short Form (36) Health Survey (SF-36). Estimates were stratified by current best motor function of the lower limb and trunk (i.e., non-sitter, sitter, and walker) and SMA type (i.e., type I, II, and III). A total of 82 adults with SMA (mean age: 42years, 51% female) self-completed the study questionnaire. The mean EQ-5D-5L utility was estimated at 0.5135 (range across subgroups: 0.31-0.99), mean EQ-VAS at 69.71 (64.67-90.00), mean HUI-derived utility at 0.3171 ( - 0.02-0.96), mean SF-6D utility at 0.6308 (0.58-0.65), and mean SF-36 Physical Component Summary and Mental Health Component Summary scores at 33.78 (9.92-53.10) and 53.49 (21.02-72.25), respectively. We show that adults with SMA experience considerable impairment across a wide range of health dimensions, including mobility, dexterity, pain, and emotional well-being. However, our results exhibit non-trivial variability across clinical subgroups and HRQoL measures. These data contribute to our understanding of the subjective impact of living with a severely debilitating neuromuscular disease, such as SMA.

Prestroke Cognitive Impairment: Frequency and Association With Premorbid Neuropsychiatric, Functional, and Neuroimaging Features.

Some patients with stroke have prestroke cognitive impairment (pre-SCI), but its etiology is not clear. The aim of this cross-sectional study was to assess the frequency of pre-SCI and its association with premorbid neuropsychiatric, functional, and neuroimaging features. Patients hospitalized in stroke unit with an informant who could complete IQCODE (Informant Questionnaire for Cognitive Decline in the Elderly) were included. Pre-SCI was diagnosed if the IQCODE score was >3.3. Prestroke assessment also included NPI-Q (Neuropsychiatric Inventory Questionnaire), the basic Activities of Daily Living and Instrumental Activities of Daily Living scales, and the Clinical Dementia Rating scale. A multivariate logistic regression model was used to evaluate the association of pre-SCI with age, sex, education, arterial hypertension, atrial fibrillation, white matter lesions, cerebral microbleeds, and pathological medial temporal lobe atrophy. IQCODE was available in 474 of 520 patients (91.2%; 45% women; mean age 75.5±13.3 years). Pre-SCI had a prevalence of 32.5% and was associated with prestroke NPI-Q (pre-SCI absent versus present, 1.7±2.3 versus 5.5±4.9; P<0.001), Activities of Daily Living scale (0.3±0.8 versus 1.8±1.9; P<0.001), Instrumental Activities of Daily Living scale (0.6±1.3 versus 3.8±4.0; P<0.001), and Clinical Dementia Rating scale score (0.7±1.7 versus 7.2±6.2; P<0.001). In the 271 patients with a magnetic resonance imaging available, the multivariate logistic regression showed that age (odds ratio [OR], 1.05 [95% CI, 1.62-9.73]), white matter lesions (OR, 1.26 [95% CI, 1.003-1.58]), and a pathological medial temporal lobe atrophy score (OR, 3.97 [95% CI, 1.62-9.73]) were independently associated with pre-SCI. In the 218 patients with ischemic stroke, white matter lesions (OR, 1.34 [95% CI, 1.04-1.72]) and medial temporal lobe atrophy (OR, 3.56 [95% CI, 1.38-9.19]), but not age, were associated with pre-SCI. One-third of patients admitted to a stroke unit have pre-SCI that is associated with preexisting neuropsychiatric symptoms and functional performance. White matter lesions and medial temporal lobe atrophy are associated with pre-SCI, suggesting that both small vessel disease and neurodegeneration might be involved in its etiology.

Relationship of Self-Reported Physical Activity with Cognition in Middle- Aged Adults.

The increasing prevalence of age-related cognitive decline highlights the importance of physical activity for cognitive health. Regular exercise has been associated with improved mental health and reduced risk of cognitive decline. This study investigated the connection between self-reported physical activity and cognitive function in middle-aged adults. This cross-sectional study included 56 Indian adults aged 30-55, selected based on a health screening questionnaire. Participants reported their physical activity using the International Physical Activity Questionnaire-Short Form (IPAQ-SF), which categorized them into low, moderate, and high activity levels. Cognitive functions, including visual memory, executive function, and attention, were assessed using the Cambridge Neuropsychological Automated Testing Battery (CANTAB). Results were statistically analyzed for relationships between cognitive domains and physical activity parameters using Pearson's correlation and linear regression analysis. The study showed a significant positive correlation of attention with moderate and vigorous physical activity, while sedentary behavior negatively impacted attention. Linear regression showed that attention is affected by moderate-intensity activity whereas executive function and visual memory are affected by age. This study supports the view that moderate and vigorous intensity activities may positively affect attention in middle-aged adults highlighting the benefits of physical activity.

Mortalidad, Secuelas Clínicas y Calidad de Vida Luego del Alta de Unidades de Cuidados Intensivos en Pacientes con COVID-19: Estudio Multicéntrico Descriptivo en Argentina

ObjectivePatients with COVID-19 who require hospitalization in an intensive care unit, in addition to being at risk of presenting premature death, have higher rates of complications. This study aimed to describe mortality, rehospitalizations, quality of life, and symptoms related to postintensive care syndrome (PICS) and prolonged COVID-19 in patients with COVID-19 discharged from the intensive care unit in hospitals in Argentina. MethodsA cross-sectional study was conducted in 4 centers in the Autonomous City and province of Buenos Aires as of December 2022. The variables of interest were mortality after discharge, rehospitalization, health-related quality of life, post-COVID-19–related symptoms, cognitive status, and PICS. Data collection was by telephone interview between 6 and 18 months after discharge. ResultsA total of 124 patients/families were contacted. Mortality was 7.3% (95% CI: 3.87-13.22) at 14.46 months of follow-up after discharge. Patients reported a reduction of the EQ-5D-3L visual analog scale of 13.8 points, reaching a mean of 78.05 (95% CI: 73.7-82.4) at the time of the interview. Notably, 54.4% of patients (95% CI: 41.5-66.6) reported cognitive impairment and 66.7% (95% CI: 53.7-77.5) developed PICS, whereas 37.5% (95% CI: 26-50.9) had no symptoms of prolonged COVID-19. ConclusionThe results showed a significant impact on the outcomes studied, consistent with international evidence.

The likelihood of detecting abnormal karyotypes in fetuses with a single major anomaly or "soft" marker on ultrasonographic scanning.

Fetuses with abnormal karyotypes often exhibit distinctive ultrasonographic markers, including major anomalies and "soft" markers, indicating potential chromosomal issues. A crucial consideration arises when a single fetal anomaly is detected, raising the question of whether karyotyping is warranted, given the associated procedural risks. Our objective was to establish correlations between single fetal anomalies identified through ultrasound and chromosomal abnormalities. A cross-sectional study analyzed the karyotype of 1493 fetuses and detected a single ultrasonographic anomaly over a 16-year period. Karyotyping was performed using the standard karyotype technique. Moreover, data regarding the type of anomaly detected ultrasonographically, karyotype results, and outcomes following interventions were collected. Among other methods, the use of positive likelihood ratios (LR+) was used to evaluate the diagnostic accuracy of ultrasound compared to karyotyping. In total, an aberrant karyotype was identified in 99 fetuses (6.6%). This was most commonly observed in cases involving a "soft" marker, occurring in 27 out of 218 fetuses (12.4%). The most frequently detected aberrant karyotype resulted from aneuploidies (80.6% of cases), notably trisomy 21 (50.5%). "Soft" markers predicted chromosomal issues (LR+ = 1.9; OR = 2.4), and isolated polyhydramnios (LR+ = 1.54; OR = 1.6) showed significance in predicting fetal chromosomal aberrations. When assessing the necessity for karyotyping in fetuses with single major anomalies or "soft" markers, it is crucial to consider individual risks for chromosomopathies, including the LR+ of the detected marker. In cases where fetuses exhibit isolated anomalies with a normal karyotype, additional diagnostic measures, such as molecular cytogenetic and molecular genetics techniques, may become necessary.

Is Just Moving Enough for Girls? The Moderation Role of Gross Motor Development Level in the Association Between Physical Activity and Cognition

Purpose: Our objective is to describe the moderating effect of the level of gross motor development on the relationship between physical activity (PA) level and visual perception/memory in girls. Methods: This is a quantitative cross-sectional study with a randomized sample of 85 girls (mean age 7.11 ± 0.74) from Chile. The following models were tested: interaction between PA (light: Model 1; moderate–vigorous: Model 2; vigorous: Model 3; and total PA: Model 4) and motor development level associated with visual perception/memory. Variables that showed interaction were tested according to the Johnson-Newman. Results: The Model 2 explains 13% of visual perception/memory and the Model 4 explains 15%, indicating that the motor development level is a moderator of this relationship. Conclusions: Collectively, our results present evidence that girls with a high level of gross motor skills have a stronger relationship between total PA (and also only moderate–vigorous activity) and visual perception/memory.

Voluntary Contraction of the Abdominal Muscles During Shoulder Exercises Increases Scapular Muscle Activation: A Critically Appraised Topic.

The fascial relationship between scapular muscles and abdominal muscles has been documented from previous studies. However, it is not yet clear whether voluntary abdominal contraction has a beneficial effect on scapular muscle activity during shoulder exercises. Do scapulothoracic muscle activation levels increase if shoulder exercises are performed with voluntary abdominal activation? Summary of Key Finding: After the literature review, 4 cross-sectional studies met the inclusion criteria and were included in this critically appraised topic. There is moderate evidence to support dynamic shoulder exercises with voluntary abdominal contraction can increase trapezius and serratus anterior muscle activation level in asymptomatic shoulders. Strength and Recommendation: Findings from 4 cross-sectional trials indicate that there is moderate evidence supporting that dynamic shoulder exercises performed with voluntary abdominal contraction can increase scapular muscle activity.

Voluntary Contraction of the Abdominal Muscles Increases Hip Muscle Activation During Lower-Extremity Exercises: A Critically Appraised Topic.

Existing studies have posited that incorporating abdominal enhancement techniques during lower-extremity exercises might mitigate compensatory pelvic motions and enhance the engagement of specific hip muscles. Does performing lower-extremity exercises with abdominal enhancement techniques increase hip muscle activation levels in healthy individuals? Summary of Key Finding: After the literature review, 4 cross-sectional studies met the inclusion criteria and were included in this critically appraised topic. There is moderate evidence to support that prone hip extension with abdominal enhancement may increase gluteus maximus and hamstring muscle activity. Gluteus medius activity may not be affected by abdominal enhancement during hip abduction exercises. Strength and Recommendation: The collective findings from the 4 cross-sectional trials indicate that the incorporation of abdominal enhancement techniques during lower-extremity exercises may have the potential to enhance targeted muscle activation levels in healthy individuals. Further research is recommended to establish more robust conclusions.

"Scleroderma" and "Scleroderma-like" Capillaroscopic Pattern-Differences and Similarities.

The "scleroderma" type capillaroscopic pattern is a reference pattern in rheumatology that is a diagnostic sign for systemic sclerosis (SSc) in an appropriate clinical context and is observed in more than 90% of scleroderma patients. Similar microvascular changes, the so-called "scleroderma-like", have been described albeit in a lower proportion of patients with other rheumatic diseases, such as dermatomyositis (DM), undifferentiated connective tissue diseases (UCTD), systemic lupus erythematosus (SLE), etc. Three distinct stages of "scleroderma" pattern have been suggested by Cutolo et al., i.e., "early", "active", and "late". However, disease duration is just one of the factors that contributes to the progression of microvascular changes, and in this regard, "active" or even "late" pattern could be observed in patients with shorter disease duration. In addition, stable microvascular changes could be found for long periods in other cases. The aim of the study was to assess the presence of differentiating features between "scleroderma" pattern in SSc and "scleroderma-like" pattern in other rheumatic diseases. 684 capillaroscopic images demonstrating a "scleroderma" and "scleroderma-like" pattern have been analysed in the current retrospective cross-sectional study. 479 capillaroscopic pictures were obtained from 50 SSc patients, 105 from 7 DM patients, 38 from 10 rheumatoid arthritis (RA) patients, 36 images from 5 patients with SLE, and 26 images from 9 patients with UCTD. All capillaroscopic images used in the current analysis have fulfilled the criteria for "sclerderma/scleroderma-like" pattern, as the pathological changes in the capillaroscopic parameters have also been confirmed by quantitative measurement of capillary diameters, capillary density, and intercapillary distance. All the images have been categorized into one of the following groups, i.e., "early", "active" and "late" phases (according to the definition of Cutolo et al.), or "other" findings, the latter being specifically described as they could not be attributed to one of the other three categories. 479 capillaroscopic pictures were obtained from 50 scleroderma patients. 31 of them showed an "early", 391 an "active" phase, and 57 a "late" phase "scleroderma" type microangiopathy. In 69 images assessed as an "active" pattern, neoangiogenesis was found. In 43 out of 105 capillaroscopic pictures from DM patients, an "active" phase was detected; in 2 of the images, a "late" pattern was found, and in 60 capillaroscopic pictures, neoangiogenesis in combination with giant capillary loops was observed. Early microangiopathy was not found in this group. Among capillaroscopic images from SLE patients, "late" phase microangiopathy was not found. "Early" phase was present in 3 images, "active" phase in 29, neoangiogenesis in "active" phase in 4 pictures. Early microangiopathy was detected in 11 capillaroscopic pictures from RA patients (8 out of 9 patients), an "active" phase in 4 images (3 patients), and in 23 capillaroscopic images, neoangiogenesis with mild capillary derangement and capillary loss and single giant capillaries ("rheumatoid neoangiogenic pattern") were observed. Classic "late" type microangiopathy was not found in RA patients as well as among patients with UCTD. The predominant capillaroscopic pattern in UCTD patients was early microangiopathy (n = 23). The rest images from UCTD exhibited features of the "active" phase. In conclusion, early microangiopathy was observed in RA, SLE, and UCTD patients, but not in patients with DM. An "active" phase "scleroderma" type capillaroscopic pattern was detected in all patient groups other than SSc, i.e., DM, SLE, RA, and UCTD. "Late" phase "scleroderma" type microangiopathy was present in patients with scleroderma and DM and was not observed in SLE, RA, and UCTD. Despite the fact that in some cases, microangiopathy in scleroderma and other rheumatic diseases may be indistinguishable, the results of the current research have shown the presence of some differentiating features between "scleroderma" and "scleroderma-like" microangiopathy that might be a morphological phenomenon associated with differences in the pathogenesis and the degree of microvascular pathology in various rheumatic diseases.

Maternal-infant and paternal-infant attachment levels after successful infertility treatment and affecting factors: A descriptive cross-sectional study

PurposeThis study aimed to determine the levels of maternal and paternal attachment and the factors that affect them in individuals who had a baby after infertility treatment. MethodsThis study followed a descriptive cross-sectional design in accordance with STROBE guidelines. The research was conducted in the infertility clinic of a university hospital and included 128 participants, consisting of 64 mothers and 64 fathers. Data were collected using the ‘Personal Information Form-Mother’, ‘Personal Information Form-Father’, ‘Maternal Attachment Inventory (MAI)’, and ‘Postnatal Paternal-Infant Attachment Questionnaire (PPAQ)’. ResultsThe study found that the mothers had an average MAI score of 102.35 ± 3.05, while the fathers had an average PPAQ score of 82.21 ± 4.27. A significant correlation was observed between the mothers' MAI score and the duration of their marriage. Similarly, a significant correlation was observed between the fathers' PPAQ score and the duration of their marriage, the duration of their infertility diagnosis, and the duration of their infertility treatment (p < 0.05). The correlation analysis between the MAI score and the mean score of the PPAQ's subscale of pleasure in interaction was weakly significant and positive (r = 0.26; p = 0.032). However, there was no significant relationship between the MAI score and the PPAQ score (r = 0.18; p = 0.146). ConclusionsThe study findings indicate that parents who conceive through infertility treatment exhibit high levels of attachment to their babies. Healthcare professionals should assess the attachment levels of both mothers and fathers who have undergone infertility treatment and be mindful of the factors that influence it.

Perceived Barriers to Physical Activity Among Youth Living in Rural and Urban Canadian Communities: A Nationally Representative Cross-Sectional Study.

We used nationally representative data to explore associations among location of residence (rural/urban) and perceived barriers to physical activity (PA) in Canadian youth. We analyzed the 2017 Canadian Community Health Survey, Barriers to Physical Activity Rapid Response data for 12- to 17-year-old youth. Nine items from the survey assessing perceived barriers to PA were combined into 3 barrier domains: resources, motivational, and socioenvironmental. The likelihood of reporting barriers to PA based on rural-urban location was examined using survey-weighted binary logistic regression following a model fitting approach. Sociodemographic factors were modeled as covariates and tested in interaction with location. For each barrier domain, we derived the best-fitting model with fewest terms. There were no location-specific effects related to reporting any barrier or motivation-related PA barriers. We found a sex by location interaction predicting the likelihood of reporting resource-related barriers. Rural boys were less likely to report resource-related barriers compared with urban boys (odds ratio [OR] = 0.42 [0.20, 0.88]). Rural girls were more likely to report resource-related barriers compared with boys (OR = 3.72 [1.66, 8.30]). Regarding socioenvironmental barriers, we observed a significant body mass index by location interaction demonstrating that rural youth with body mass index outside the "normal range" showed a higher likelihood of reporting socioenvironmental barriers compared with urban youth (OR = 2.38 [1.32, 4.30]). For urban youth, body mass index was unrelated to reporting socioenvironmental barriers (OR = 1.07 [0.67, 1.71]). PA barriers are not universal among Canadian youth. Our analyses highlight the importance of testing interactions in similar studies as well as considering key sociodemographic characteristics when designing interventions.

Microalbuminuria and Functional Iron Deficiency are Risk Factors for Hearing Loss in Adolescents.

Renal impairment and some systemic diseases are associated with hearing loss (HL) in adults. However, studies of these relationship in adolescents are rare. The objective of this study was to determine the association between HL and renal or systemic disease in adolescents. Subjects were extracted from the 5th Korea National Health and Nutrition Examination Survey from 2011 to 2012. We included adolescents aged 10-19 years old with normal tympanic membrane and those who underwent a physical and laboratory examination and pure tone audiometry. HL, high-frequency hearing loss (HFHL), albuminuria, impaired glomerular filtration rate, hypertension, diabetes, and obesity were evaluated based on the data. Individuals with microalbuminruia (MIA) exhibited higher prevalence of HL (p = 0.003) and HFHL (p = 0.012) than those without MIA. The prevalence of HL and HFHL appeared to increase according to the severity of albuminuria. Additionally, individuals with HL or HFHL showed lower transferrin saturation (TSAT) than individuals without HL (p = 0.002) or HFHL (p = 0.001). And, HFHL was associated with lower ferritin levels (p = 0.017). HL and HFHL were related to MIA (p = 0.004 and p = 0.022, respectively) and TSAT (p = 0.005 and p = 0.011, respectively) after controlling other factors. MIA and TSAT level were independently associated with the HL and HFHL. Since MIA can be easily detected by dipstick test and urine analysis, hearing evaluations for individuals with MIA might be helpful to identify hearing impairments earlier in adolescents. 3 (individual cross-sectional study) Laryngoscope, 134:3329-3334, 2024.

Investigating Factors Affecting Preterm Delivery from the Viewpoint of Physicians and Midwives in Mashhad

Background: Premature delivery is a significant risk factor for mortality in both developed and developing nations, causing long-term adverse effects on families in terms of physical, psychological, and economic consequences. Objective: This research aimed to examine the elements influencing preterm delivery from the perspectives of obstetrics, gynecology specialists, and midwives in Mashhad, Iran's metropolis. Method: This study was a descriptive cross-sectional study. A questionnaire was used to collect data from 30 medical professionals working in clinics, hospitals, and health facilities in Mashhad in 2020. In this study, 30 medical professionals participated, including 10 obstetrics and gynecology specialists with a mean age of 50±8.0, and 20 midwives with a mean age of 34±4 years. The survey found that premature rupture of the amniotic sac (water sac) was the most frequent factor contributing to preterm delivery, with a frequency of 96.7%. This was followed by uterine abnormality, preeclampsia, and chorioamnionitis, each with a frequency of 93.3%. Other factors such as a history of preterm delivery and multiple pregnancies were also found to impact preterm delivery, with a frequency of 90%. Additionally, the study revealed that stress factors had the highest frequency in the high-impact spectrum, with a frequency of 86.7%. Results: This study is a survey of caregiver’s opinions about preterm birth from one location. The findings revealed that the main causes of preterm delivery were premature rupture of the amniotic sac, uterine abnormalities, preeclampsia, and chorioamnionitis. Conclusion: Furthermore, background factors, such as stress factors and domestic violence in mothers can affect this phenomenon. Overall, these findings highlight the critical role of clinical and lifestyle factors in preterm delivery.

Ethnicity and refractive errors in Peruvian children aged 7–11 years: A five-year analysis of the Demographic and Health Survey

ObjectiveTo assess the association between ethnicity and self-reported refractive errors (REs) among Peruvian children aged 7–11 years. Materials and methodsWe conducted a cross-sectional study incorporating a secondary data analysis of 2017–2021 data from the Peruvian Demographic and Health Survey (DHS). REs and ethnicity were obtained from focal child's mother's report. Four outcomes were assessed: hyperopia, myopia, astigmatism and any RE. We included potential confounders, such as age, sex, wealth index, area of residence, region of origin, frequency of watching TV and watching screens at less than 30 cm distance. Generalised linear models with the Poisson family and log link function were used to calculate crude prevalence ratio and adjusted prevalence ratio (aPR) with 95% confidence intervals (95% CI). ResultsData from a total of 52,753 children were included. The prevalence of RE in children aged 7–11 years was 10.90% (95% CI 10.49–11.33), of which 5.19% were hyperopia, 3.35% myopia and 2.36% astigmatism. Those of the Aymara ethnicity were less likely to suffer from any RE and astigmatism (aPR = 0.68, 95% CI 0.46–0.99, p = 0.046; aPR = 0.70, 95% CI 0.53–0.92, p = 0.012, respectively), Members of Amazon groups were more likely to have hyperopia (aPR = 1.95, 95% CI 1.14–3.36, p = 0.015) and Quechuas were more likely to have myopia (aPR =1.29, 95% CI 1.02–1.62, p = 0.028), where all were compared to Mestizos. ConclusionAbout 1 in 10 Peruvian children suffer from a RE. The most frequent RE in this study was hyperopia. Ethnic differences were seen in the frequency of RE.

Characteristics and health problems of cancer patients admitted to palliative care service at the Oncology Hospital in Ho Chi Minh City, Vietnam: a cross-sectional study

Vietnam has very few study on health problems of cancer patients receiving palliative care. Therefore, this study aimed to estimate the prevalence of characteristics and health problems of cancer patients who admitted to the palliative care department of the Ho Chi Minh City Hospital of Oncology. A cross-sectional study was conducted in cancer patients newly admitted to the palliative care department. Descriptive statistics and multivariable linear regression models were performed to estimate the prevalence and factors associated with patient’s health problems. The main outcome is the severity of health problems, as measured with the African Palliative Care Outcomes Scale (APCA African POS). This validated questionnaire measures health outcomes of people severely affected by diseases such as cancer. A total of 134 patients enrolled in the study showed a mean total APCA African POS score of 32.2±10.8 of 67. The most common symptoms of severe intensity were pain (57.5%), mobility difficulties (45.5%) and weakness (42%). The study determined that inpatient status, the patient’s health condition, and the extent of caregivers’ involvement in social activities were significantly associated with increased APCA African POS score. Pain, weakness, mobility issues, reduced peace of mind, a sense of life’s value, lack of information, and financial constraints are prominent problems in cancer patients receiving palliative care in Vietnam. The initial assessment of the patient’s symptoms and problems prior to palliative care is essential to inform treatment discussions regarding medical prognosis in order to improve the patient’s quality of life and treatment outcomes.

A Study of Prevalence of Anxiety in Patients with Cardiac Disorders

Background: Anxiety is commonly experienced among patients with cardiovascular disease. Psychiatric disorders such as depression and anxiety, represent an additional risk for cardiovascular disease besides contributing to impaired functions. To date, depression has received the most attention in the population, given its high prevalence and association with poor cardiac health, especially in patients who have experienced a major cardiac event, such as an Acute Coronary Syndrome (ACS). However, anxiety has recently emerged as another important psychological construct that is highly prevalent, frequently co-occurs with depression and impedes response to depression treatment, and may ultimately influence the course of cardiovascular disease independent of depression. Objectives: To assess the prevalence of anxiety among patients diagnosed with cardiac disorders. Methods: A cross sectional study was done among 100 cardiac patients. A self-designed semi structured questionnaire consisting of demographic details, relevant cardiac and psychiatric history and General Anxiety Disorder (GAD-7) scale was used. The obtained data was entered in MSexcel and analysed using SPSS software. Results: 43% patients were recognised to have anxiety. Among them 21% had mild anxiety, 12% had moderate anxiety and 10% had severe anxiety. A significant association of 0.002 was found in females having cardiac illness. A significant association of 0.043 was found between coronary artery disease and anxiety. Conclusion: These analyses confirm that anxiety is associated in patients with cardiac disorders; however, this relationship is not as strong as that of depression and may be explained partly by other clinical factors

A Study of Prevalence of Sexual Dysfunction in Patients Receiving Psychotropic Drugs

Background: Sexual dysfunction is the most common side effect associated with psychotropic drugs. It is a threat to patient’s quality of life and a major reason for non –compliance. Psychotropic agents can impair the sexual response in different ways due to their neurobiological mode of action. Prevalence rates of sexual side effects are extraordinarily difficult to estimate due to a variety of factors, such as the effect of the disorder being treated, co morbid disorders and baseline sexual dysfunction. Objectives: To study the association between sexual dysfunction and psychotropic drugs in patients using various psychotropic drugs like antidepressants, anti-psychotics, anti-cravings and anxiolytics. Methods: A cross sectional study was done among 200 patients. A self-designed semi structured questionnaire consisting of socio demographic details, relevant psychiatric history and Psychotropic – Related Sexual dysfunction questionnaire (PR Sex DQ – SALSEX) was used. The obtained data was entered in MS excel and analysed using SPSS software Results: Among 200 patients ,62.5% of males and 38.5% of females felt that their psychiatric medications were causing sexual side effects. Out of them 41.7% of men and 30.03 % of women. Conclusion: The most relevant groups for impairment are antidepressants and antipsychotics due to the serotonin agonistic and anti – dopaminergic properties as well as the prolactin increasing characteristics. The treatment of psychiatric disorders should follow a comprehensive treatment plan that anticipates a likely sexual dysfunction at the initiation of treatment.

Internet Gaming Disorder and Mental Health of Pakistani Adolescents: A Cross-Sectional Study

Internet Gaming Disorder and Mental Health of Pakistani Adolescents: A Cross-Sectional Study

Compliance to International Guidelines and Rational Use of Antibiotics in Urinary Tract Infections in a Country without National Guidance: A Cross-Sectional Study

Compliance to International Guidelines and Rational Use of Antibiotics in Urinary Tract Infections in a Country without National Guidance: A Cross-Sectional Study