QOL Domains Research Articles

A Prospective Cross-Sectional Study of Acute Coronary Syndrome Patients' Quality of Life and Drug Prescription Patterns at Riyadh Region Hospitals, Saudi Arabia.

Acute coronary syndrome (ACS) is a leading cause of cardiovascular-related morbidity and mortality worldwide. The present study investigated the health-related quality of life (HRQOL) and drug prescribing patterns in ACS patients at Riyadh hospitals in Saudi Arabia. This study was a 12-month prospective cross-sectional study that included 356 patients with ACS. The current study showed that younger male (67.42%) and urban (75.84%) patients suffered more from ACS. Moreover, most patients with NSTEMI (51.69%) experienced Grade 1 dyspnea (33.43%) and NYHA Stage 2 (29.80%); however, STEMI patients were at greater mortality risk. The HRQOL questionnaire showed that ACS patients were significantly impaired in all QOL domains (emotional [23.0%, p = 0.001], physical [24.4%, p = 0.003], and social [27.2%, p = 0.002]). Furthermore, the most commonly prescribed medications were statins (93%), antiplatelets (84%), anticoagulants (79%), coronary vasodilators (65%), and beta-blockers (63%). Additionally, 64% of patients received PCIs or CABGs, with the majority of cases receiving PCIs (49%), whereas 9% received dual anticoagulant therapy. Thus, there is an urgent need to educate healthcare teams about the relevance of QOL in ACS control and prevention and the new ACS management recommendations. ACS is also growing among younger people, requiring greater attention and prevention.

ASSESSING THE QUALITY OF LIFE OF ELDERLY PEOPLE IN DIFFERENT SETTINGS OF CHITWAN DISTRICT, NEPAL

Background: Nepal is experiencing a notable rise in life expectancy and increase the number of elderlies as well. The significance of enhancing the quality of life for the elderly is growing within societies, yet it remains an overlooked matter, particularly in developing nations. The objective of the study was to access and compare the QOL of elderly living with their family and in old age homes. Methods: A cross-sectional analytical study was conducted among 156 elderly (≥60 years) in the Bharatpur Metropolitan, Chitwan, Nepal. A total of 78 elderly were recruited from an old age home, and an equal number from a family setting. WHOQOL-BREF questionnaire was used to assess QOL, and descriptive and inferential statistics were used to analyze the data. Results: Overall QOL among the family setting is better than old age homes (p=0.009). Except for the social relationship domain of OAH, overall QOL and overall health perception were found to be significantly correlated with all domains of QOL (p=0.05 and p=0.01). Age, gender, caste, education, land ownership, high blood sugar, taking various types of medicine, and smoking habit were statistically associated with the different domains of QOL in both groups. Conclusions: Overall QOL tends to be better within a family setting and it is notable that the social domain of QOL is specifically linked to overall health. In order to promote a healthy and fulfilling life for the elderly, it is crucial to prioritize efforts towards improving their health and addressing their physical, psychological, and social wellbeing.

Assessment of Quality of Life of Patients with Type-II Diabetes Mellitus

Background: Diabetes is a chronic metabolic disorder that negatively affects the quality of life in context of physical, psychological and social health or well-being. Objective: Current study aimed to assess the quality of life with type 2 diabetes and determine its association with demographic variations of study participants. Study Design: A descriptive cross-sectional study design was used to assess the quality of life of Diabetes patient type 2 with the structured questionnaire of the World Health Organization Quality of Life (WHOQoL-BREF) was adopted. Settings: The study was conducted in the outpatient department (OPD) of Allied Hospital, Faisalabad Pakistan. Duration: Data was collected from April 2022 to June 2022. Methods: Total of 450 patients with type 2 diabetes were recruited according to inclusion criteria. Results: A total of 450 patients with DM-2, and mean age of 53.8 ± 10.2 years and 50.7%were males and 49.3% were females. Overall, 44.2% of participants rated moderate and 40% were found satisfactory in terms of good Quality of Life. Mean stress score of QoL domains: physical (51 ± 10.8), psychological (48.04 ± 12.6), social relationship (53.3 ± 19.6), and environmental health (46.1 ± 13.9). To determine the association multiple linear regression model was used. Significant association were seen between age, marital status, Body Mass Index (BMI), and monthly income with QoL four domains(p<0.05). Fasting Glucose Sugar (FBS) was negatively associated with QoL domains, except environmental health. Conclusion: Overall, the present study has clearly shown that DM2 alters the QoL of patients and patients reported moderate level QoL, and its significant association with demographic parameters of study participants such as age, gender, and household income.

Effect of Weight Self-Stigma on Quality of Life and Dietary Habits among Adult Students in Riyadh, Saudi Arabia.

Weight self-stigma (WSS) is a personal experience of negative self-evaluations, perceived discrimination, and shame about body weight. Studies suggested that WSS could negatively affect quality of life, eating behavior, and psychological outcomes. WSS has been linked with a number of obesogenic health outcomes that complicate weight loss interventions. Thus, this study aimed to examine the effect of WSS on the quality of life and dietary habits among adult students. A sample of 385 students from Riyadh universities participated in this cross-sectional study and completed three online questionnaires: the WSS questionnaire, the WHO quality of life questionnaire, and a dietary habit questionnaire. The average age of participants was 24 ± 6.74, and the majority were female (78.4%). Results demonstrated a negative association between all QOL domains and WSS (p < 0.001). Moreover, higher BMI is associated with increased self-devaluation and fear of enacted stigma (p < 0.001). There was also a negative link between both quality and quantity of food with WSS (p < 0.01). No significant difference was seen in study outcomes concerning gender. The findings of this study suggest the importance of increasing awareness about the negative impact of WSS and developing social policies to prevent or decrease it. Additionally, multidisciplinary teams, especially dietitians, should be more aware of WSS when dealing with overweight and obese individuals.

Preoperative Quality of Life and Mental Health Can Predict Postoperative Outcomes and Quality of Life after Colorectal Cancer Surgery.

Background and Objectives: It remains unclear which domains of preoperative health-related quality of life (HRQOL) and mental health are predictive of postoperative clinical and patient-reported outcomes in colorectal cancer (CRC) patients. Materials and Methods: A prospective cohort of 78 CRC patients undergoing elective curative surgery was recruited. The EORTC QLQ-C30 and HADS questionnaires were administered preoperatively and one month after surgery. Results: Preoperative cognitive functioning scores (95% CI 0.131-1.158, p = 0.015) and low anterior resection (95% CI 14.861-63.260, p = 0.002) independently predicted poorer 1-month postoperative global QOL. When postoperative complications were represented using the comprehensive complication index (CCI), poorer preoperative physical function scores were associated with higher CCI scores (B = -0.277, p = 0.014). Preoperative social function score (OR = 0.925, 95% CI 0.87 to 0.99; p = 0.019) was an independent predictor for 30-day readmission, while physical functioning score (OR = -0.620, 95% CI -1.073--0.167, p = 0.008) was inversely related to the length of hospitalization. The overall regressions for 1-month postoperative global QOL (R2: 0.546, F: 1.961, p = 0.023) and 30-day readmission (R2: 0.322, χ2: 13.129, p < 0.001) were statistically significant. Conclusions: Various QLQ-C30 domains were found to be predictive of postoperative outcomes, including complications, readmission, and length of hospitalization. Preoperative cognitive dysfunction and low AR were independent predictors of poorer postoperative global QOL. Future research should seek to examine the efficacy of targeting specific baseline QOL domains in improving clinical as well as patient-reported outcomes after CRC surgery.

The Effects of Spirituality on the Quality of Life Among Cancer Patients enrolled in the Out Patient Chemotherapy Clinic

Spirituality was defined as a way individuals seek and express meaning and purpose and the way they experience their connectedness to the moment. Studies showed that spiritual beliefs provided comfort to cancer patients and that different dimensions were related to the different aspects of health. The study aims to determine and correlate the effects of spirituality and the quality of life among patients enrolled in the outpatient chemotherapy clinic. An analytical cross-sectional study using a non-probability convenience sampling was done of which validated questionnaires on the Spirituality and Quality of Life were the research instruments of the study. Pearson’s correlation coefficient/Spearman rho computed on the relationship between the dimensions of spirituality and subscales of the quality of life among cancer patients. Chi-Square/Fisher’s test was used to determine the correlation between the types and stages of cancer with the quality of life and spirituality of the respondents. A total of 105 cancer patients participated in this study, This study revealed that most of the cancer patients enrolled in the outpatient chemotherapy clinic had a mean score of 3.56 +/- 0.35 indicating a moderate to high level of spirituality. It also showed a mean score of 5.41 +/- 0.53 indicating high QOLs. Dimensions of spirituality that were found to have a significant association with QOL domains (p-values &lt; 0.05) were Mindfulness and Feeling of Security which were both found to have a positive correlation with Emotional Well-being and Social Status. Spiritual care should be included as one of the non-pharmacological modalities in the comprehensive management and palliative care for Filipino cancer patients to improve the overall well-being, healthcare outcomes, and quality of life of patients and their families. Keywords: Cancer Patients, Spirituality, Quality of Life

Assessment of the quality of life of women living with HIV/AIDS

Objective: To evaluate the quality of life of women living with HIV/AIDS. Method: This is a descriptive and analytical cross-sectional study developed in a Testing and Counseling Center, located in the city of Pinheiro-MA. A questionnaire was applied to collect sociodemographic data and the WHOQOL-HIV BREF to assess quality of life. For data normality analysis, the Kolmogorov-Smirnov test was used. In addition, the T-Student Test and ANOVA were used. Results: 100 women participated in the study. Among the quality of life domains, the highest averages were in the Environment (24.5) and Psychological (17.1) domains, while the lowest averages fell in the Level of Independence (12.5) and Physical (13.1). Conclusion: It is evident that sociodemographic factors were associated with different domains of QoL, denoting the relationship between quality of life and living conditions, requiring evaluation and continuity of care with an interprofessional team in this population.

Assessment of sleep quality, anxiety, depression, and quality of life in Behçet’s disease

BackgroundBehçet’s disease (BD) is a multi-organ disease with different systemic manifestations. While rare in the United States and Europe, it is more common in the Middle East and Asia. BD is one of the commonest encountered vasculitis in Egypt. This study aims to evaluate BD patients' sleep patterns, quality of life, and psychological aspects.MethodsPatients suffering from Behçet’s disease (thirty patients) and 30 matched age and sex-healthy control participants were recruited in our study. The assessment included the entire clinical history and laboratory investigations, including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and Oxygen saturation level. Evaluation of sleep quality and presence of sleep-disordered breathing was done using the Pittsburgh Sleep Quality Index (PSQI), Insomnia severity index (ISI), and Epworth sleepiness scale (ESS). Hamilton’s anxiety (HAM-A) and depression rating scales (HAM-D) were used for psychological assessment. The Short Form 36 Quality Of Life Scale (SF-36 QOL) assessed participants' quality of life.ResultsBehçet’s disease patients suffered significantly higher levels of anxiety and depression compared to the control group. The prevalence of insomnia and daytime sleepiness was significantly higher among BD patients. All components of PSQI, including the global score, were significantly higher among the BD group. Physical functioning, role limitation due to physical health, and emotional problems; also, general health indices were significantly lower for the BD group. Patients with active BD showed significantly higher levels of anxiety, depression, insomnia, day time dysfunction and significantly lower all domains of the SF-36 QOL Scale.ConclusionsBD is associated with low sleep quality and high levels of anxiety and depression.Disease activity directly impacts anxiety, depression levels, lower sleep quality, and lower quality of life among BD patients.Trial registrationClinicalTrials.gov. NCT05142995. Registered November 20, 2021.

PO-03-036 CARDIONEUROABLATION FOR VAGALLY-MEDIATED BRADYARRHYTHMIA: A SINGLE-CENTER EXPERIENCE

Cardioneuroablation (CNA) is a novel catheter-ablation technique for the treatment of vagally-mediated bradyarrhythmia, which aims to blunt the cardioinhibitory reflex by targeting parasympathetic ganglionated plexi (GPs). Early-phase studies have shown promising results, but clinical evidence remains limited. The aim of our study was to investigate the clinical impact of CNA on our cohort of patients with vaso-vagal syncope (VVS), symptomatic functional atrioventricular block (AVB), and sinus node dysfunction (SND). Baseline and procedural characteristics, procedure-related complications, and clinical outcomes were collected in patients who underwent CNA from December 2018 to October 2022. For GPs localization, our procedural workflow combined 3D-anatomical mapping of both atria with high-amplitude fractionated bipolar electrograms (figure). Statistical analysis was performed using Wilcoxon's -test. A total of 16 patients were included. Patients were young (42±16 years) and without structural heart disease (LVEF 58±4 ml). Ablation indication was mainly VVS (56%), followed by AVB (25%) and SND (19%). Syncope was the most common symptom, with a burden of 10 per person lifetime. Mean procedure time was 94±44 min, with minimal fluoroscopy dose (2.7±1.7 Gy/cm2). RR interval acutely decreased after ablation (1046±290ms vs. 747±133ms, p<0.0001). No major complications occurred, we observed one post-ablation pericarditis and two sinus tachycardia which required medical treatment. At a median follow-up of 523 days (IQR: 1021-228) two patients had recurrences, both cases were syncopal events without documentation at loop-recorder of sinus bradycardia or atrial bradyarrhythmia. Heart rate at last recorded ECG (331 days, IQR: 570-97) was still significantly higher than baseline (60±13 bpm vs. 81±9 bpm, p=0.0001). Patients’ physical health significantly improved after ablation (WHOQOL-BREF score 61.1% vs 75.3%, p=0.03), no significant changes were observed in the other QoL domains (psychological, social relationships, environmental health). CNA reduced the syncope burden and improved the QoL of patients with vagally-mediated bradyarrhythmia. Ablation is reasonably safe in experts’ hands, especially if compared with the long-life risk of device-related complications. Further large-scale randomized studies are needed to support these findings and validate appropriate patient selection criteria.

Quality of life and mental health of volunteers during COVID-19 pandemic: a cross-sectional survey in Serbia.

There is a paucity of information on the COVID-19 pandemic's impact on young volunteers. Therefore, the aim of this survey was to examine the QoL and mental health of young volunteers of the Novi Sad Voluntary Service during the COVID-19 pandemic. This cross-sectional prospective study included 255 members of the Novi Sad Voluntary Service, Serbia. The survey instrument probed into the respondents' demographic characteristics and was followed by the anonymous WHOQOL-BREF questionnaire that measured their quality of life during the COVID-19 pandemic and DASS-21 scale. All statistical analyses were carried out using IBM SPSS Statistics for Windows, vers. 24.0. The study sample consisted of 255 young volunteers (71.4% females, 28.6% males), 62.0% of whom were aged 18-25 years, and 52.2% were students. Lower Physical Capacity scores could be predicted by female gender (p < 0.01) and COVID-19 infection among friends (p < 0.05). Male gender (p < 0.05) and being employed (p < 0.05) predicted greater QoL in the Psychological domain. The only predictor of a lower QoL in the Social Relationships domain was the internet as the main COVID-19-related information source (p < 0.05). On the other hand, being female (p < 0.05) and having COVID-19-positive household members (p = 0.01) predicted lower environment domain scores. For the lower overall DASS-21 score, having COVID-19-positive household members was the only significant predictor (p < 0.01). Mental health support should pursue strategies to improve all domains of QoL, especially for vulnerable sub-groups of the population, such as young females and the unemployed. Bearing in mind the importance of public engagement and community support in pandemic circumstances, as well as generally in public health, these results are relevant for interventions far beyond the current pandemic.

Improving the quality of life of people living with HIV/AIDS: A cross-sectional study of the role of religion.

Previous studies have found religion as a useful tool in coping with chronic medical conditions including HIV/AIDS. Aim: This study assessed how religiosity and religious coping are associated with quality of life (QOL) among people living with HIV/AIDS (PLWHA). This was a cross-sectional study of 140 HIV clinic attendees of a Nigerian tertiary health facility. Religiosity, religious coping and QOL were measured with religious orientation scale-revised (ROS-R), Brief Religious Coping (Brief RCOPE) and World Health Organization Quality of Life-Bref (WHOQOL-BREF), respectively. Correlation analysis assessed the relationship between ROS-R, Brief RCOPE and WHOQOL-BREF. : Intrinsic religiosity (IR) scores had a moderate positive correlation with psychological health domain of QOL (r = 0.4, N = 140, and P 0.001), and a weak positive correlation with physical health domain of QOL (r = 0.2, N = 140, and P 0.05). Extrinsic religiosity (ER) scores moderately correlated positively with the psychological health domain of QOL (r = 0.03, N = 140, and P 0.002), but weakly correlated positively with the physical health domain (r = 0.2, N = 140, and P 0.02). Positive religious coping (PRC) scores moderately correlated positively with the psychological health domain (r = 0.03, N = 140, and P 0.05) and weakly correlated positively with physical health domain of QOL (r = 0.2, N = 140, and P 0.02). Extrinsic religiosity social (ERS) scores had a moderate positive correlation with the social relationships domain (r = 0.4, N = 140, P 0.001). Increased ER, IR orientations and Positive Religious Coping appear to improve the psychological and physical health domains ofQOL QOL Therefore, religiosity should be encouraged among PLWHA to improve QOL.

Level of Depression and Anxiety on Quality of Life Among Patients Undergoing Hemodialysis.

Despite the growing concern worldwide regarding the quality of life (QoL) and mental well-being among chronic kidney disease (CKD), a few research has been done to address this issue. The study aims to measure depression, anxiety, and QoL prevalence among Jordanian patients with End Stage Renal Disease (ESRD) on hemodialysis and how all of these variables are correlated. This is a cross-sectional, interview-based study on patients at the Jordan University Hospital (JUH) dialysis unit. Sociodemographic factors were collected, and the prevalence of depression, anxiety disorder, and QOL was assessed using the Patient Health Questionnaire 9 (PHQ9), the Generalized Anxiety Disorder 7-item (GAD7), and the WHOQOL-BREF, respectively. In a study of 66 patients, 92.4% had depression, and 83.3% had generalised anxiety disorder. Females had significantly higher depression scores than males (mean = 6.2 ± 3.77 vs 2.9 ± 2.8, p < 0.001), and single patients had significantly higher anxiety scores than married patients (mean = 6.1 ± 6 vs 2.9 ± 3.5, p = 0.03). Age was positively correlated with depression scores (rs= 0.269, p = 0.03), and QOL domains showed an indirect correlation with GAD7 and PHQ9 scores. Males had higher physical functioning scores than females (mean = 64.82 vs 58.87, p = 0.016), and patients who studied in universities had higher physical functioning scores than those with only school education (mean of College/University = 78.81 vs mean of School Education = 66.46, p = 0.046). Patients taking <5 medications had higher scores in the environmental domain (p = 0.025). The high prevalence of depression, GAD, and low QOL in ESRD patients on dialysis highlights the need for caregivers to provide psychological support and counselling for these patients and their families. This can promote psychological health and prevent the onset of psychological disorders.

Quality of Life in Caregivers of Patients with Brain Tumours: A Systematic Review and Thematic Analysis

Objective. (1) Examine QoL of caregivers of patients with brain tumours compared to population norms and other cancer caregiver groups, (2) appraise the content of quantitative QoL outcome measures utilised, and (3) assess to what extent QoL measures used in research align with caregivers’ priorities. Methods. Systematic literature search of studies including caregivers of brain tumour patients using self-completed assessments of QoL. Extracted data from included studies included quantitative QoL outcome data, QoL outcome measures utilised, and the included QoL domains. The impact of brain tumour patient caregiving was assessed by summarising included data comparing brain tumour caregivers to other cancer caregivers and normative population data. QoL measures utilised by the studies and their domains were extracted, coded, and analysed by themes. The rates of investigation by theme were then compared to existing data on caregiver-own preference in relation to QoL. Results. 49 studies, including 57 outcome measures, incorporating a combined 124 QoL domains. Brain tumour caregivers reported lower QoL outcomes than population norms but similar to other cancer caregiver groups. Thematic analysis of QoL domains generated 7 themes: caregiving burden and adaptation, existential and self, family and social support, finances, information needs, physical symptoms and functioning, and psychological symptoms and wellbeing. The most investigated themes were physical and psychological symptoms, the most important for caregivers themselves were family and social support. Conclusions. Caregiving for brain tumour patients is shown to negatively affect QoL, particularly mental health, burden, and social life. Existing QoL research in caregivers of brain tumour patients predominantly utilises generic QoL measures designed for use in patients and draws a medicalised view of QoL priorities. The few studies using caregiver-specific QoL measures demonstrated closer alignment to caregiver preferences such as family and social support.

Mobile health platform for self-management of pediatric cystic fibrosis: Impact on patient-centered care outcomes

Previously, we adapted a mobile health platform (Genia) to the needs of patients and families in a pediatric CF center in the United States. In this feasibility study, we tested the impact of Genia on measures of patient-centered care. In a one-group pre-post study with adolescents with CF and caregivers of children with CF, we tested Genia's effect over 6 months on patient satisfaction with chronic illness care (PACIC) and shared decision-making (CollaboRate). Feasibility and acceptability were assessed with exit interviews and app analytics. The intervention included 40 participants: 30 caregivers of children with CF age ≤14 years and 10 patients with CF age ≥15 years. The use of Genia was associated with increased satisfaction with care (p=0.024), including delivery system and decision support (p=0.017), goal setting (p=0.006), and shared decision-making (p<0.001). The use of Genia was associated with nominal improvements in all QOL domains and symptom scales. The platform was feasible, with participants recording more than 4,400 observations (mean 84.2) and submitting 496 weekly reports (mean 13.8) and 70 quarterly reports (mean 1.8), and acceptable (95% retention rate). For participants, the most useful app feature was pre-visit reports (66.7%), and the top symptom trackers were those for cough (23.7%), appetite (21.1%), energy (18.4%), and medicines (18.4%). The use of Genia over 6 months was feasible, acceptable, and associated with improved measures of patient-centered care. Study results support wider use of Genia in clinical settings. Efficacy for clinical outcomes should be assessed in a randomized clinical trial.

The Relationship Between Stigma and Social Support to Quality of Life in Indonesia and the Philippines During the COVID-19 Pandemic

Abstract: The importance of quality of life (QoL) was magnified as countries faced the COVID-19 pandemic. This study aimed to determine the relationship between COVID-19-related stigma and preferred social support to QoL in two Southeast Asian countries. This paper examined (1) the differences in the physical and psychological dimensions of QoL (QoL-PSY, QoL-PHL), COVID-19 perceived stigma (PcS) and public stigma (PS), and preferred social support (PSS) between Indonesia (IDN) and the Philippines (PHP); (2) the associations between PS and PcS with QoL; (3) the associations between PSS and QoL; and (4) the role of the country as a moderator between the relationship of PcS and PSS to QoL. Data were collected from 992 participants (PHP = 564; IDN = 428) through an online survey (April–June 2022) and analyzed through multivariate analysis of covariance (MANCOVA), hierarchical multiple regression, and multiple-group path analysis. After controlling for potential covariates, we found significant country differences in QOL and PSS, where Indonesia's estimated means for these two measures were significantly higher than the Philippines. Both domains of PSS had significant positive associations with both QOL domains in the merged sample; similarly, PcS had significant negative associations with both domains of QOL. Path analysis also showed similar significant predictors (PSS and PcS) associated with QoL for both countries with minor coefficient variations, except PS and PSS-ST. The findings show a similar relationship pattern between perceived stigma and social support (strong ties) to the QoL in Indonesia and the Philippines. Cultural interventions to mitigate perceived stigma were suggested in healthcare settings.

MP62-03 DECISIONAL REGRET AND PATIENT-REPORTED OUTCOMES AFTER PENILE PROSTHESIS SURGERY

You have accessJournal of UrologyCME1 Apr 2023MP62-03 DECISIONAL REGRET AND PATIENT-REPORTED OUTCOMES AFTER PENILE PROSTHESIS SURGERY Michael Schumeister, Kevin Labagnara, Mustufa Babar, Justin Loloi, Emely Tejeda, Mukhlisa Zakirova, Lindsay Kramer, Nick Winokur, Bryan Nolasco, Matthew Wysocki, Nitya Abraham, Pedro Maria, and Susan Macdonald Michael SchumeisterMichael Schumeister More articles by this author , Kevin LabagnaraKevin Labagnara More articles by this author , Mustufa BabarMustufa Babar More articles by this author , Justin LoloiJustin Loloi More articles by this author , Emely TejedaEmely Tejeda More articles by this author , Mukhlisa ZakirovaMukhlisa Zakirova More articles by this author , Lindsay KramerLindsay Kramer More articles by this author , Nick WinokurNick Winokur More articles by this author , Bryan NolascoBryan Nolasco More articles by this author , Matthew WysockiMatthew Wysocki More articles by this author , Nitya AbrahamNitya Abraham More articles by this author , Pedro MariaPedro Maria More articles by this author , and Susan MacdonaldSusan Macdonald More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003320.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Few studies have explored patient-reported outcomes and decisional regret after penile prosthesis implantation. In this study we explore decisional regret after penile prosthesis surgery in a high volume, racially diverse urban center. METHODS: Patients who underwent penile prosthesis surgery from 2016 to 2022 at a single center were identified using CPT codes 54400, 54405, 54410, 54411, and 54415. After IRB approval, patients were called to administer the Quality of Life and Sexuality with Penile Prosthesis (QoLSPP) questionnaire along with questions evaluating decisional regret. We defined regret as being unsatisfied/ambivalent about one’s decision to get the prosthesis or unsure about undergoing the procedure again. Demographic, medical, and implant characteristics were collected through chart review. Statistics were performed using SPSS. RESULTS: Out of 676 patients, 381 were successfully contacted and 182 completed the survey (response rate 50%). 41 (23%) patients experienced regret while 177 (78%) did not. The regret group was less likely to have rear tip extenders (RTE) (29% vs 51%, p=0.015) and more likely to have had a post-operative infection (12% vs 4%, p=0.032), 30-day ED visit/readmission (27% vs 11%, p=0.014), and be a revision (42% vs 16%, p<0.001). (Table 1) The regret group had significantly lower mean scores in all of the QoL domains compared to the no regret group (p<0.001). (Table 2) On multivariate analysis, obesity (OR: 0.16, CI 0.05-0.57), RTE (OR: 0.33, CI 0.13-0.83), and infrapubic approach (OR: 0.09, CI 0.03-0.26) were associated with less regret after adjusting for age, preferred language, BMI, approach, and revision. CONCLUSIONS: One out of 4 men in this study reported decisional regret after penile prosthesis surgery. These men more frequently experienced post-operative infection or required surgical revision. Obesity, RTE use, and infrapubic approach were associated with less regret. Pre-operative counseling to ensure understanding of potential complications and manage patient expectations may reduce decisional regret. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e861 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Schumeister More articles by this author Kevin Labagnara More articles by this author Mustufa Babar More articles by this author Justin Loloi More articles by this author Emely Tejeda More articles by this author Mukhlisa Zakirova More articles by this author Lindsay Kramer More articles by this author Nick Winokur More articles by this author Bryan Nolasco More articles by this author Matthew Wysocki More articles by this author Nitya Abraham More articles by this author Pedro Maria More articles by this author Susan Macdonald More articles by this author Expand All Advertisement PDF downloadLoading ...

MP15-09 TADALAFIL VERSUS COMBINED TAMSOLUSIN AND CIPROFLOXACIN FOR TREATMENT OF CHRONIC PELVIC PAIN SYNDROME: A RANDOMIZED CONTROLLED TRIAL

You have accessJournal of UrologyCME1 Apr 2023MP15-09 TADALAFIL VERSUS COMBINED TAMSOLUSIN AND CIPROFLOXACIN FOR TREATMENT OF CHRONIC PELVIC PAIN SYNDROME: A RANDOMIZED CONTROLLED TRIAL Marwan Anas, Ahmed EL-Hefnawy, and Ahmed Shoma Marwan AnasMarwan Anas More articles by this author , Ahmed EL-HefnawyAhmed EL-Hefnawy More articles by this author , and Ahmed ShomaAhmed Shoma More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003235.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Chronic prostatitis /Chronic pelvic pain syndrome (CP/CPPS) is still presenting true considerable challenge to urologists .It is characterized by confluence of symptoms including mainly suprapubic or deep perineal pain, and voiding symptoms. The exact etiology and pathogenesis of CP/CPPS remain unknown up till now. A specific diagnostic test for CP/CPPS is still not yet determined. Until now, there are no proven therapies for CP/CPPS. A wide variety of pharmacologic and non-pharmacologic therapies have been studied in clinical trials, but most have shown limited curative efficacy in symptom alleviation. Our aim To assess the efficacy and safety of PDEI-5 (Tadalafil) for treatment of CP/CPPS. METHODS: It is a prospective randomized controlled single blinded phase III clinical trial. Between May 2020 and April 2022, 97 patients with a diagnosis of type IIIa chronic non-bacterial prostatitis were enrolled in the final analysis at the end of study. Forty-nine for tadalafil (group A), who received combined tadalafil 5 mg once daily before bed time and placebo (sugar pills) after meal once daily for 12 weeks and forty-eight for combined tamsulosin and ciprofloxacin (group B) who received ciprofloxacin 1000 mg once daily PO after meal and tamsulosin 0.4 mg before bed time for the same period. Patients were followed for 12 weeks after administration of treatment. Primary end point was pain relief which was assessed by NIH-CPSI at 12 weeks after treatment. RESULTS: Patients baseline characteristics were comparable in both groups. At the end of RCT, tadalafil-group patients showed significant improvement in total, pain, urinary and Qol domains of NIH-CPSI compared to baseline (17.92±2.3, 7.41±1.56, 4.96±0.86, 5.55±0.79 vs. 30.88±3.62, 14.67±2.2, 6.67±1.17, 9.53±1.15 respectively, p<0.0001). When compared to combined tamsulosin and ciprofloxacin, all 12th week NIH-CPSI domains scores, except for urinary, were significantly better in tadalafil group (p<0.0001). Side-effects among group B were much higher than in group A. The most common side-effects in group A were dyspepsia (8.2%) and back pain (6.1%) while in group B were retrograde ejaculation (18.8%) and dizziness (16.7%). By the end of 12th week, 39 (79.6%) patients in group A showed marked improvement in GRA, while in group B, 41 (85.4%) patients showed moderate improvement. CONCLUSIONS: Tadalafil is effective and safe treatment modality for CP/CPPS. It has the advantage of giving more pain relief and improvement of sexual function compared with combined tamsulosin and ciprofloxacin. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e195 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Marwan Anas More articles by this author Ahmed EL-Hefnawy More articles by this author Ahmed Shoma More articles by this author Expand All Advertisement PDF downloadLoading ...

Effect of multidisciplinary interventions on the quality of life of individuals with multiple sclerosis: a systematic review

Introduction: The study aims to review published literature on multidisciplinary interventions and their effect on quality of life of individuals with multiple sclerosis to produce state-of-the-art recommendations and consistent discipline combinations for optimal holistic patient car Methods: The study thoroughly analyzed papers published between January 2010 and February 2022. The publications are gathered from five critical databases: Cochrane, JSTOR, PEDro, PubMed, and ScienceDirect. With Rayyan, the data is analyzed. Independent reviewers evaluate the quality of the papers included in the review using the PEDro Scale and the Cochrane Collaboration tool. Results: The review includes ten studies with an average of 129 participants for each of the 513 identified articles. In QOL domains, multidisciplinary rehabilitation programs address limits in physical role (p = 0.016), emotional role (p = 0.010), mental wellbeing composite (p = 0.017), and cardiorespiratory fitness (p = 0.017). In addition, it improves Fatigue, as measured by the Chalder Fatigue Scale, the SF-36 vitality subscale, and Fatigue self-efficacy. Only one study found no statistically significant differences in its primary outcome. With 19 individuals, the Level of Activity improved, notably the Timed 50 Meter Walk (p = 0.014), walking speed (p = 0.034), 2- (p = 0.204), and 6-Minute Walk (p = 0.027). Discussion: In terms of quality of life and decrease in fatigue, multidisciplinary interventions have a remarkable impact on the activity level of MS patients. Findings suggest that Multidisciplinary interventions and other treatment combinations are best recommended in patients with MS to improve multicomponents of QoL and different outcomes such as fatigue.

The Exercise Intervention as Part of Rehabilitation in Intracranial Myxoid Chondrosarcoma: A Case Report

Malignant tumors after surgical trauma are frequently presented with unavoidable complications, such as physical dysfunction, decreased motor endurance, bowel disorders and cognitive impairment, and other symptoms. Due to the presence of malignant tumors, patients suffer from not only physical discomfort but also the presence of psychological and mental stress. Trauma often leads to poor emotional control and cannot cooperate with treatment. Exercise can not only change the function of the limbs but also have a positive effect on emotions. This case reports a 28-year-old male who experienced a decline in cognitive function and activities of daily living after undergoing tumor resection and radiotherapy. A year later, he was hospitalized and completed a four-week activity of daily living and exercise rehabilitation training. What’s more, his mood was managed along with the reintegration therapy. As the patient's mood improved, training coordination increased, quality of life and daily living ability gradually improved, and he recovered well during the follow-up period. Given this single case, multi-modal exercise rehabilitation can maintain or improve functional performance and QOL domains even during heavy treatments. When the patient is undergoing exercise rehabilitation, he also needs emotional management, and emotional intervention is required for the patient. Therefore, exercise and the emotional management of patients with malignancy are of great importance.

Post COVID-19 pandemic assessment of quality of life of dental students using the WHOQOL-BREF questionnaire.

COVID-19 bitterly jolted the lives of masses around the globe, and affected the physical, mental, health, and quality of life of majority of individuals. The aim of the study was to assess the quality of life of dental students of public and private colleges and those residing in college accommodation and own home using the WHOQOL-BREF questionnaire. This cross-sectional study was conducted amongst 402 dental students of a private and public university. Students' t-test was used to compare the data. Relationship between gender, institute and accommodation (college accommodation or own home) was assessed by multiple linear regression. P-value of < 0.05 was taken significant. The participants rated their quality of life to be good (mean Score 3.99±SD 0.93) during the post COVID-19 pandemic, while satisfaction with health was neutral to satisfactory (mean Score 3.77±SD 0.87). A significant difference regarding physical health and social relationship domains was observed between the private and public university students. Significant differences in all domains of QOL was also reported among students living in own homes versus those students utilizing college accommodation. The post COVID-19 quality of life of dental students in both private and public institutes differed with respect to physical and environmental domains. The difference was more significant among the student living in college accommodation than those living at home, which underscores that effort should be made to facilitate the students to improve their the quality of life post pandemic so that they may be more focused on studies and perform better.