Hospital Outpatient Clinic Research Articles

A Comparative Study of Serum Lipid Profiles in Diabetic Patients with and without Clinically Significant Macular Oedema

Abstract Background: Diabetes mellitus (DM) is a major health hazard today. Clinically significant macular oedema (CSME) is the most frequent cause of decreased vision in diabetic patients. The aim of our study was to determine whether CSME in subjects with type 2 DM is associated with lipid profile abnormalities and to compare them with lipid profiles of type 2 diabetics without CSME. Method: This was a cross-sectional case-control study. Hundred consecutive type 2 diabetic patients, 50 patients with and 50 without CSME, who attended the Retina outpatient clinic of a tertiary eye hospital over a one-year period, were included. Determination of the presence of CSME and staging of diabetic retinopathy was done according to modified Early Treatment Diabetic Retinopathy Study guidelines, by a single investigator using slit-lamp biomicroscopy. After obtaining informed consent, blood was drawn from the subjects after overnight fasting. Investigations done were lipid profile, fasting blood sugar, glycated haemoglobin (HbA1c), blood urea, and blood pressure measurement. Results: In our study, only two systemic factors weighed in as predictors of macular oedema: Systolic hypertension and serum lipids. Subanalysis of the lipid fractions yielded two significant correlates of CSME: Total cholesterol and serum triglycerides. Conclusion: A multifaceted healthcare team approach is essential for the management of diabetic patients. Ophthalmologists should evaluate the lipid profile of all diabetic macular oedema (DME) patients. Physicians should promptly refer diabetic patients with deranged lipid profiles to ophthalmologists to look for DME and provide appropriate ophthalmic care.

The relationship between postpartum mothers’ dyadic coping and adjustment and psychological well-being

This study determines the relationship between postpartum mothers’ dyadic coping and adjustment strategies and their psychological well-being. The study design was descriptive and correlational; it was conducted in the pediatric outpatient clinic of a maternity hospital in Northern Türkiye. A total of 327 1–12 month postpartum mothers participated in the study. Data were collected using a personal information form, the Dyadic Coping Inventory (DCI), the Revised Dyadic Adjustment Scale (RDAS), and the Psychological Well-Being Scale. Mothers’ behavior as an individual and as a couple in dyadic coping, their perception of their partner’s behavior, and weak dyadic harmony between partners was significantly associated with risk factors affecting mothers’ psychological well-being (p < 0.05). A weak relationship was found between the dimensions of mothers’ psychological well-being and their perception of their own behavior in dyadic coping; a positive moderate relationship was found between mothers’ perception of their partner’s behavior in dyadic coping and behaviors exhibited as a couple in dyadic coping, and the former had a weak positive relationship with the dimensions of dyadic harmony and its subdimensions (p < 0.05). Self-perceived coping behavior, perception of the partner’s behavior, and joint coping behavior in dyadic coping, and weak dyadic harmony between partners were significant risk factors affecting mothers’ psychological well-being. Awareness of these factors by health professionals and individuals will increase the effectiveness of postpartum care and help couples adapt to the transition in the postpartum period, improve mother-father-infant interaction and strengthen dyadic harmony.

The effect of Self-Regulation Based Cognitive Psychoeducation Program on emotion regulation and self-efficacy in children diagnosed with attention deficit hyperactivity disorder

IntroductionAttention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder with early onset (Christiansen, H., et al. CPR 2019, 1–11), which is characterized by several symptoms, including lack of attention, hyperactivity, and impulsivity that are incompatible with age and developmental level (Caye, A., et al. 2020 JAACAP, 990–997)ObjectivesThis study aimed to determine the effect of Self-Regulation Based Cognitive Psychoeducation Program on emotion regulation and self-efficacy in children diagnosed with attention deficit hyperactivity disorder (ADHD) and receiving medication.MethodsThe sample of this study with control group and pre-test, post-test and follow-up randomized experimental design consisted of children followed in the child and adolescent mental health outpatient clinic of a state hospital. The data were evaluated by parametric and non-parametric analyses.ResultsA statistically significant increase was determined in the internal functional emotion regulation mean scores of children, who participated in the Self-Regulation Based Cognitive Psychoeducation Program, measured before, immediately after, and 6 months after the intervention (p &lt; 0.05). A statistically significant increase was also found in their external functional emotion regulation mean scores measured before and 6 months after the intervention (p &lt; 0.05). In addition, a statistically significant difference was found between their internal dysfunctional and external dysfunctional emotion regulation mean scores measured before and 6 months after the intervention; however the mean scores of those in the control group 6 months after the intervention were higher than those in the intervention group (p &lt; 0.05). Furthermore, there was a statistically significant increase in their self-efficacy mean scores measured before and 6 months after the intervention (p &lt; 0.05).ConclusionsThe Self-Regulation Based Cognitive Psychoeducation Program was found be effective in increasing the levels of emotion regulation and self-efficacy in children with ADHD.Disclosure of InterestNone Declared

Phase-Specific Healthcare Costs Associated With Giant Cell Arteritis in Ontario, Canada.

To estimate the additional healthcare system costs associated with giant cell arteritis (GCA) in the 1-year prediagnosis and postdiagnosis periods and over long-term follow-up compared to individuals with similar demographics and comorbidities without GCA. We performed a population-based study using health administrative data. Newly diagnosed cases of GCA (between 2002 and 2017 and aged ≥ 66 years) were identified using a validated algorithm and matched 1:6 to comparators using propensity scores. Follow-up data were accrued until death, outmigration, or March 31, 2020. The costs associated with care were determined across 3 phases: the year before the diagnosis of GCA, the year after, and ongoing costs thereafter in 2021 Canadian dollars (CAD). The cohort consisted of 6730 cases of GCA and 40,380 matched non-GCA comparators. The average age was 77 (IQR 72-82) years and 68.2% were female. A diagnosis of GCA was associated with an increased cost of CAD $6619.4 (95% CI 5964.9-7274.0) per patient during the 1-year prediagnostic period, $12,150.3 (95% CI 11,233.1-13,067.6) per patient in the 1-year postdiagnostic phase, and $20,886.2 (95% CI 17,195.2-24,577.2) per patient during ongoing care for year 3 onward. Increased costs were driven by inpatient hospitalizations, physician services, hospital outpatient clinic services, and emergency department visits. A diagnosis of GCA was associated with increased healthcare costs during all 3 phases of care. Given the substantial economic burden, strategies to reduce the healthcare utilization and costs associated with GCA are warranted.

The Effect of Menopause Symptoms on Female Genital Self-Perception in Postmenopausal Women

Objective: This study aimed to investigate the effects of menopausal symptoms on Female Genital Self-Perception (FGSP) in postmenopausal women.&#x0D; Methods: This descriptive and relationship-seeking study was conducted with women aged 40 and above who applied to the Family Medicine Outpatient Clinic of a tertiary hospital between June and December 2022, who have not had a menstrual period for at least 12 months, and who met the inclusion criteria. The Patient Information Form, The Menopause Rating Scale (MRS), Vulvovaginal Symptom Questionnaire (VSQ), and the Female Genital Self-Image Scale (FGSIS) were used to obtain the data.&#x0D; Results: The mean age of 203 women included in the study was 57.53±6.70. The total mean scores obtained from the scales was 15.40±7.7 for MRS, 3.75±3.96 for VSQ, and 18.99 ±4.34 for FGSIS. An inverse and statistically significant relationship were found between MRS and VSQ total and sub-dimension scores and FGSIS scores (p:0.001 for all). A significant relationship was found between FGSIS score and body mass index and parity (r:-0.154, p:0.028 and r:-0.258, p:0.001). University graduates, those who had regular gynecological examinations, and people with a very good perception of general health status had significantly higher FGSIS scores (p:0.001 for all).&#x0D; Conclusion: According to the scale scores, the FGSP of postmenopausal women was moderate and negatively affected by the increase in menopausal symptoms. Obesity, an increase in the number of parities, low education level, and poor health perception were the factors that negatively affected FGSP.

Do complaints related to vitiligo affect sexual quality of life and marital adjustment?

The authors aimed at evaluating the effect of vitiligo on female sexual function and Dyadic Adjustment in a hospital-based study as gender negatively affected the marital quality of vitiligo patients, more in women. A total of 153 patients who applied to the dermatology outpatient clinic of a tertiary university hospital were interviewed. However, 120 vitiligo patients who were married and had a sexually active partner and suitable the inclusion criteria were included in the study. It is seen that the mean score of the DAC is 43.13±5.11, and the mean score of the SQOL-F is 52.57±5.39. Vitiligo has a negative effect on a woman’s sexual life and Dyadic Adjustment. Early identification of sexual problems in vitiligo patients and planning their future course of management can aid in improving the marital adjustment and quality of life.

Use of Integrative Medicine Practices by Pregnant Women with Restless Legs Syndrome

Objective: To determine the use of integrative medicine practices in pregnant women with restless legs syndrome. Methods: This cross-sectional descriptive study was conducted in the perinatology service and outpatient clinic of a university hospital between 2 February-11 May 2022. The study included 148 pregnant women with restless legs syndrome who met the inclusion criteria. Data were collected using the Restless Legs Syndrome Diagnostic Criteria Questionnaire, the Restless Legs Syndrome Severity Rating Scale, a Personal Information Form, and an Integrative Medicine Use Form. Results: The pregnant women of the 61.4% were in their last trimester, and 75.7% had no information about restless legs syndrome. Symptoms started at an average of 20.29 ± 8.65 weeks of gestation and 81.1% of the pregnant women did not consult a physician. Of those who did consult a physician, 57.7% consulted a gynecologist and 81.0% were recommended vitamins/minerals as a treatment. For syndrome symptoms, 50.7% of pregnant women used integrative medicine practices. The four most commonly used methods were taking vitamins (55.9%), prayer (51.9%), brisk walking (45.2%) and massage (33.3%). There was no statistically significant difference between the use of integrative medicine practices and the severity of restless legs syndrome (P&amp;gt; .05). Conclusion: Restless legs syndrome is a condition that is not widely recognized by pregnant women. About half of pregnant women try to manage the condition by using integrative medical practices for syndrome. Nurses and other health professionals should provide information to pregnant women to raise awareness of the disease and provide effective treatment options.

Standard and Extend High-Frequency Audiometry in Sudden Sensorineural Hearing Loss: Impacts on Tinnitus and Mental Health.

To analyze the results of auditory assessment in standard (SA) and extended high-frequency (EHF) audiometry, associating the findings with sudden tinnitus and mental health of patients with unilateral sudden sensorineural hearing loss (SSNHL). Prospective, cohort study. Outpatient otology clinic in a tertiary care hospital. Patients experiencing unilateral SSNHL were evaluated with pure-tone audiometry performed at frequencies of 250 to16,000 Hz, tinnitus pitch and loudness matching tests, Tinnitus Handicap Inventory (THI), Analog and Visual Scale (AVS) for bothersome tinnitus, and the Hospital Anxiety and Depression Scale (HADS). Eighteen patients with unilateral SSNHL were assessed. After starting treatment, there was a significant improvement in the SA (71.1 dB to 50 dB; p < 0.001*) and EHF audiometry (64.5 dB to 54.4 dB; p < 0.001*) thresholds at 15 days, and this persisted at 30 days of follow-up. Significant improvements were seen for tinnitus in loudness, VAS, and THI and for mental health in the realms of anxiety and depression by HADS. Despite improvements in SA, persistent EHF hearing loss was accompanied by persistent tinnitus, but it was of diminished loudness. Despite improvement in pure-tone thresholds by SA, a subset of unilateral SSNHL patients did not experience hearing recovery in EHF thresholds and reported persistent tinnitus. We postulate that their diminished anxiety and better mental health may be related to both hearing improvement in standard audiometry and reduction in tinnitus loudness. This pilot prospective study investigates the utility of performing EHF audiometry to better understand outcomes in patients with SSNHL.

Coping styles for sexual dysfunction and stress among married women of reproductive age: a cross-sectional study from Turkiye.

To identify sexual dysfunction in married women of reproductive age, and to examine its relationship with stress coping styles. The cross-sectional, descriptive study was conducted between February and June 2019 at the obstetrics and gynaecology outpatient clinic of Gulhane Training and Research Hospital in Ankara, Turkiye. The sample comprised married women aged 18-49 years who had an active sexual life over the preceding month, and were neither pregnant nor in the postpartum phase. Data was collected using the Female Sexual Function Index, and the Stress Coping Styles Scale. Data was analysed using SPSS 22. There were 216 women with mean age 33.58±6.77 years. The mean Female Sexual Function Index score was 22.29±6.08. The mean Stress Coping Styles Scale subscale scores were: self-confident 20.71±3.53, helpless 18.07±4.27, submissive 12.13±3.00, optimistic 13.70±2.35, and seeking social support 11.89±2.01. The total Female Sexual Function Index score had a positive, significant correlation with self-confidence (r=0.15; p=0.03) and seeking social support subscales (r=0.18; p=0.01) and a negative, significant correlation with submissive subscale (r=-0.17; p=0.02) of the Stress Coping Styles Scale. Establishing awareness among women about sexual dysfunction and improving effective coping styles may contribute to improved sexual health among women.

Efficacy of cerebroxin capsules combined with aspirin in prevention of post-ischemic stroke in patients treated with thrombolysis

Purpose: To analyze the efficacy of Cerebro-Cardiac capsules combined with aspirin for secondary prevention in post-ischemic stroke patients treated with thrombolysis, and also to explore its clinical application value. &#x0D; Methods: 224 ischemic stroke patients in the outpatient clinic of Changsha First Hospital, China from June 2022 to December 2022 were randomly divided into treatment and control groups, with 112 patients per group. Both groups were given oral aspirin (100 mg/daily) but treatment group received cerebroxin capsules (four capsules, three times daily) in addition. The types of recurrent strokes, clinical efficacy, NIHSS score scale, modified Barthel index, levels of fibrinogen and plasma viscosity, total cholesterol and triacylglycerol were assessed and compared between the groups. &#x0D; Results: During the 6-month follow-up, 10 patients in treatment group and 12 patients in control group experienced dislodgment, and 202 cases completed treatment, but the difference was not statistically significant (p &gt; 0.05). Treatment group showed a higher effective rate (92 %) compared to control group (75 %), with a statistically significant difference in clinical symptom efficacy (p &lt; 0.05). Hemodynamic parameters were significantly better in treatment group than in control group (p &lt; 0.05). Both groups exhibited improved total cholesterol levels, triacylglycerol levels and modified Barthel index post-treatment. Treatment group had better NIHSS scores and Barthel index than control group (p &lt; 0.05), while their triacylglycerol levels were lower (p &lt; 0.05). &#x0D; Conclusions: Cerebroxin capsules combined with aspirin improve the symptomatic effect of thrombolytic therapy in patients after ischemic stroke with high safety profile. Analysis of the effect of this combination in an increased sample size and a longer follow-up period will be required in the future.

Determinants of Smoking Cessation Outcomes and Reasons for Relapse in Patients Admitted to a Smoking Cessation Outpatient Clinic in Turkey.

The aim of this study was to identify the determinants of smoking cessation outcomes and reasons for relapse following smoking cessation treatment. Using a mixed-method design, 179 patients were recruited from the Smoking Cessation outpatient clinic of Ankara Numune Training and Research Hospital between May 2016 and May 2017. Quantitative data were collected via questionnaires or from patient files and qualitative data were obtained via 5 focus group interviews with 28 patients who relapsed to smoking following treatment. The success rate of the smoking cessation clinic at the end of one year was 26%. The number of applications to the clinic was significantly higher in the group who quit smoking. Treatment success was found to be higher in the group that applied behavioral recommendations. In focus group interviews with patients who relapsed, the most common causes were stressful events, especially workplace problems and serious health problems experienced by relatives. The presence of smokers in the immediate vicinity increased the risk of relapse. It was concluded that not stopping treatment before the recommended period, continuity in follow-up appointments, support of the environment, support of pharmacotherapy with cognitive behavioral therapy and improving patients' coping skills were important.

Chronic obstructive pulmonary disease burden, grades and erythrocytosis at a tertiary hospital in western Uganda

BackgroundChronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide among people over 40 years of age, and erythrocytosis is one of the major complications associated with increased mortality among COPD patients. The study aimed to determine the proportion of COPD, associated factors, and the burden of erythrocytosis among COPD participants.Methods and materialsA descriptive cross-sectional study design was used. A consecutive sampling technique was used to obtain study participants at the Fort Portal Regional Referral Hospital outpatient clinic. Focused history and physical examination were carried out to select eligible participants. Participants were screened using the COPD population screener for spirometry after consenting to participate. The study enrolled all adults at risk of having COPD based on the COPD population screener and able to undergo spirometry. Spirometry was carried out according to the Global Chronic Obstructive Lung Disease and European Respiratory Society guidelines, and haemoglobin concentration was measured.ResultsOne hundred eighty participants were enrolled in the study, most of whom were females.The modal and mean age of participants was 60 years with 139 (77.2%) females and primary as the highest education level 149(82.8%). The proportion of COPD was 25% (45) [95% CI 18.9 – 32] and highest among females (68.9%) and those aged 60 years and above (70%). The combined COPD assessment tool groups had a proportion of 55.6%, 37.8%, 4.4%, and 2.2% for groups A, B, C, and D, respectively. Age < 50 years was protective against COPD, while for every additional year of smoking, there was an associated 6.5% increased risk compared to the general population. Additionally, the proportion of erythrocytosis among COPD participants was 6.7%.Conclusions and recommendationsThere was a high proportion of COPD among study participants (25%), with a 6.7% proportion of erythrocytosis. We recommend a complete blood count for every patient in groups C and D of the ABCD COPD GOLD groups.

Content and Duration of Doctor-Patient Communication in Outpatient Oncology Follow-Up Consultations in China.

Purpose This study aimedto analyze the content of counseling between cancer patients and physicians during outpatient follow-up, assess the duration of different communication content, and explore the influencing factors. Patients and methods We observed consecutive cancer patients without a first diagnosis of malignancy who presented to the oncology outpatient clinic of a public hospital from October through December 2023. A structured observation form was used to record the content and duration of doctor-patient communication. All variables were electronically recorded and stored on a data management platform. Multiple linear regression was used to examine the determinants of consultation duration. Results Our study included 620 cancer patients, of whom 281 individuals had distant metastasis. The average consultation duration for 620 cancer patients was 4.85 minutes (standard deviation of 3.09 minutes). The category of doctor-patient communication was routine outpatient follow-up, involving 182 patients, with an average consultation duration of 3.81 minutes (standard deviation of 2.24 minutes). The main communication content for 51 patients was about the admission procedures, with an average consultation duration of 3.00 minutes (standard deviation of 1.92 minutes). For 67 patients, the primary communication involved the prescription of anti-tumor medications, with an average consultation duration of 3.70 minutes (standard deviation of 2.30 minutes). Symptom control discussions were the main communication content with 107 patients, with an average consultation duration of 5.91 minutes (standard deviation of 3.44 minutes). The main communication content of 24 patients involved medical insurance reimbursement, with an average duration of 7.75 minutes (standard deviation of 4.63 minutes). Consultations accompanied by caregivers and the presence of metastatic tumors were positively associated with consultation duration, whereas female patients with genital malignancies were negatively associated with consultation duration. Communication about symptom management and communication about medical insurance reimbursement waspositively associated with the duration of medical consultations. Communication about administering the formalities requisite for patient admission was negatively associated with the consultation duration. Conclusion We classified the main contents of doctor-patient communication in the oncology outpatient clinic and found that the contents of doctor-patient communication tended to be monotone and systematized. Oncology outpatient models should consider the integration of caregiver involvement. The reason for the shorter outpatient consultation duration in female patients of cancer primary in the reproductive system needs further investigation. The intricate medical insurance reimbursement process poses an increasing time challenge for outpatient clinicians. In addition, the adequacy and effectiveness of symptom management services provided to cancer patients during oncology outpatient follow-up requirefurther evaluation and review.

(202) Comparative Study of the Efficacy of Avanafil and Atorvastatin Daily Dose in Management of Vasculogenic Erectile Dysfunction

Abstract Introduction Erectile dysfunction (ED) is defined as the “consistent inability to attain or maintain a penile erection, or both, sufficient for adequate sexual relations”. ED is not only a medical problem but affects the marital relations and patient's self-esteem and causes the quality of life to decrease. which in turn causes the patient to go into depression or develop anxiety. In the past, erectile dysfunction was considered, in most cases, to be a purely psychogenic disorder, but current evidence suggests that more than 80% of cases have an organic aetiology. Causes of organic erectile dysfunction can now be broadly divided into nonendocrine and endocrine. Of the nonendocrine aetiologies, vasculogenic (affecting blood supply) is the most common and can involve arterial inflow disorders and abnormalities of venous outflow (corporeal veno-occlusion). Avanafil is a second-generation phosphodiesterase type 5 inhibitor approved for erectile dysfunction by the FDA on 2012 and by EMA in 2013. With a high selectivity for phosphodiesterase type 5 isoform AND faster onset of action compared with other PDE5 inhibitors, it offers more tolerability and less adverse events. Atorvastatin is 3-hydroxy-methylglutaryl (HMG)-CoA reductase inhibitor act on the rate-limiting step in cholesterol biosynthesis (the conversion of HMG-CoA to mevalonate) and are effective in treating dyslipidemia. statins reverse endothelial dysfunction by decreasing the action of oxidized low-density lipoprotein (LDL) on endothelial cells, resulting in an increase of NO activity. Objective is to evaluate and compare the efficacy of avanafil and atorvastatin daily dose in management of patients with vasculogenic erectile dysfunction. Methods A 60 adult heterosexual males complaining of vasculogenic erectile dysfunction proven by penile duplex were collected from outpatient andrology clinics of Al-Azhar University Hospitals. The patients were divided into two treatment groups: (Group A): 30 patients received daily dose of 100 mg avanafil. (Group B): 30 patients received daily dose of 40 mg atorvastatin, The main outcome measures and the difference in penile duplex ultrasound results and IIEF-EF scores between the two groups are evaluated and compared at the end of the study, Age of patients between 20 and 50 years, established diagnoses of Vasculogenic erectile dysfunction, Normal lipid profile, Normal Total and Free testosterone levels and No contraindications to the study medications were included criteria. However patients who failed to fulfill any of the inclusion criteria, psychogenic or neurogenic erectile dysfunction, dyslipidemia Patients with Renal or Hepatic insufficiency and Patients with advanced cardiovascular diseases such as heart failure and coronary artery disease on antianginal drugs especially nitrates were excluded. Results Our study revealed statistically significant improvement in Penile Doppler ultrasonography parameters (PSV, EDV&amp; RI) and IIEF-EF scores in avanafil group compared to atorvastatin group. Conclusions avanafil 100 mg daily dose leads to significant improvement in men with vasculogenic erectile, while atorvastatin 40 mg caused no significant differences, neither positively nor adversely. In summary, avanafil at dose of 100 mg can be a therapeutic appropriate choice in cases of vasculogenic ED. Disclosure No.

Clinical, biochemical, and genotypical characteristics in urea cycle mitochondrial transporter disorders.

This study aimed to evaluate clinical, biochemical, and genotypic findings of patients diagnosed with urea cycle mitochondrial transporter disorders. In this study, patients followed up with the diagnosis of urea cycle mitochondrial transporter disorders in the pediatric metabolism outpatient clinic of Diyarbakir Children's Hospital were retrospectively examined. Height, weight, head circumference, gender, age at diagnosis, follow-up period, consanguinity history between parents, and treatments of the patients included in the study were evaluated. Eight patients suffering from urea cycle mitochondrial transporter disorders were enrolled in the study. Five patients were found to have biallelic variants of the SLC25A15 gene. Two patients were found to have biallelic variants of the SLC25A13 gene. Two of our patients presented with gait disturbances and were diagnosed with HHH syndrome. One patient presented with liver failure and was diagnosed with HHH syndrome. The other three patients were identified by family screening. Citrin deficiency was detected in two patients with cholestasis and hepatomegaly in the infantile period. Ornithine levels increased in three of our patients with HHH syndrome during the first month of treatment despite a protein-restricted diet and adequate caloric intake. Increasing patients' caloric intake with HHH syndrome improves their ornithine levels. Our patients with citrin deficiency recovered clinically and biochemically before seven months.

The Mediating Role of Family Functions Between Pregnancy-Related Anxiety and Sleep Quality: A Cross-Sectional Study.

To examine the relationship between pregnancy-related anxiety, family functions, and sleep quality, and to determine whether family functions mediate the relationship between pregnancy-related anxiety and sleep quality. A cross-sectional survey was conducted on pregnant women between April to August in 2022 in the obstetrics outpatient clinic of a tertiary care hospital in the Ningxia Hui Autonomous Region of China. A total of 1014 pregnant women aged 18 years and older were surveyed. They completed questionnaires, including: general demographic characteristics, the Pregnancy-related anxiety scale (PAQ), the Family Adaptation, Partnership, Growth, Affection, and Resolve (APGAR), and the Pittsburgh Sleep Quality Index Questionnaire (PSQI). Model 4 in PROCESS was used to analyze the relationships among pregnancy-related anxiety, family functions, and sleep quality, with family functions as a mediator. Among the 1014 pregnant women, the pregnancy-related anxiety scale score was (21.84 ± 5.64). The total score of the family functions scale was (8.10±2.26), and the overall sleep quality scale score was (7.89±2.99). When participants were grouped according to different socio-demographic characteristics, the study showed that all variables differed from anxiety, family functions or sleep quality, except for age, pre-pregnancy BMI and whether or not they had a first birth, which was not associated with anxiety, family functions, or sleep quality (P<0.05). The pregnancy-related anxiety was positively associated with sleep quality (P<0.01), while family functions were negatively associated with sleep quality (P<0.01). In addition, family functions mediate the relationship between pregnancy-related anxiety and sleep quality during pregnancy, on the first and second trimesters, intermediation rate is 9.31% (P<0.05), and on the third trimesters, intermediation rate is 21.38% (P<0.05). Pregnancy- related anxiety is a risk factor for sleep quality, however, family functions are protective factors for sleep quality. Family functions play an intermediary role in sleep quality caused by pregnancy-related anxiety, especially on the third trimesters. This finding may provide a scientific basis for developing intervention strategies to improve the sleep quality of pregnant women.

Look after the COVID-19 pandemic: Mortality rates among patients with rheumatic diseases.

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection may have a more severe course in patients with underlying disease or who have had immunosuppression. In this study, it was aimed to determine the frequency of coronavirus disease 2019 (COVID-19) and the mortality rates related to COVID-19 among patients with rheumatic disease. The patients who were followed up with rheumatic disease in the rheumatology outpatient clinic in a tertiary hospital were retrospectively assessed if they had COVID-19 infection or not between March 2020 and January 2022. A total of 10 682 patients were evaluated. There were 2928 (27.4%) COVID-19-positive and 7754 (72.6%) COVID-19-negative patients. The mean age of COVID-19-positive patients was 46.2 ± 14.6 years, and 65.8% were female. Forty-two (1.4%) patients died due to COVID-19. Among COVID-19-negative patients, 192 patients died. The most common rheumatic disease among patients with COVID-19 was spondyloarthritis (SpA) (30.4%). Corticosteroids were the most common treatment agent in COVID-19-positive patients regardless of mortality. Thirty-one (73.8%) patients were receiving corticosteroids, and 35 (83.3%) patients were receiving immunosuppressive agents among patients with mortality. According to the logistic regression analysis, older age, male gender, and receiving corticosteroid, hydroxychloroquine, mycophenolate mofetil, tofacitinib, rituximab, and cyclophosphamide were found to be related to increased mortality. COVID-19 is a serious infection and the current study emphasized that patients with rheumatic diseases had increased mortality rates, particularly in patients who were old, male, and on immunosuppressive treatments.

Health Disparities in Young Adults: A Direct Comparison of Distress and Unmet Needs Across Cancer Centers.

Information on concerns that young adults (YAs) with cancer face when receiving care outside of specialized treatment centers is needed to increase equitable care to YAs at greater risk of marginalization by the health care system. The current study compared distress and unmet needs at the time of clinic visit between YAs receiving care from three different cancer clinics: (1) a National Cancer Institute-designated center, (2) a community-based clinic, and (3) a county hospital outpatient clinic. The Adolescent and Young Adult Psycho-Oncology Screening Tool (AYA-POST) was administered to measure distress and cancer-related concerns of YAs in active treatment. A one-way analysis of variance (ANOVA) compared distress scores by treatment site. A Fisher's exact test compared the number of participants endorsing each item on the Needs Assessment Checklist from each site. A simple linear regression determined the association between distress and number of items endorsed on the Needs Assessment Checklist. Ninety-seven participants completed the AYA-POST, endorsing, on average, 11 concerns. Fisher's exact test showed significant differences between sites in the proportion of participants endorsing eight items: boredom (P < .001), eating/appetite (P < .001), nausea/vomiting (P < .001), financial concern (P = .002), hopelessness/helplessness (P = .03), confidentiality (P = .04), sibling concern (P = .04), and insurance (P = .05). The simple linear regression model was significant (F(1, 94) = 39.772, P < .001, R2 = 0.297), indicating the number of unmet needs accounted for almost 30% of the variance in distress. The one-way ANOVA was not significant (F(2, 93) = 1.34, P = .267). Social determinants of health can influence the number and type of unmet needs experienced, affecting distress and other outcomes and underscoring the importance of timely, effective, age-appropriate screening and intervention for distress and unmet needs in YAs with cancer.

Relationships Between Age of Onset, Seizure Frequency, And Disease Duration with Cognitive Function in Epilepsy Patients at the Neurology Clinic of H. Adam Malik Central Hospital, Medan

Background: Cognitive function disorders often occur in individuals with epilepsy. The decline in cognitive function in epilepsy patients can be caused by various factors, including age of onset, seizure frequency, and duration of the disease. This study aims to investigate the relationship between the age of onset, seizure frequency, and disease duration on the cognitive function of epilepsy patients at the Neurology Outpatient Clinic of Haji Adam Malik General Hospital in Medan Method: The chosen research design is a cross-sectional analytic. The study was conducted at the neurology outpatient clinic of the Adam Malik Central General Hospital in Medan. The samples used were patients diagnosed with epilepsy at the Neurology Outpatient Clinic of Adam Malik Central General Hospital in Medan, aged 18-65 years, and without any other medical conditions aside from epilepsy. The study involved 35 subjects.Result: The majority of the research subjects are aged 18-45 years (94.3%), with more males (51.4%) than females. Most have a high school education background (48.6%), and the largest group is unemployed (62.9%). The most common age group at onset is 0-18 years (48.6%). The majority of subjects experience seizures in the rare category (less than 1 time per month) at 62.9%. Most subjects have a disease duration of less than 15 years (65.7%). The majority of epilepsy patients at the Neurology Outpatient Clinic of H. Adam Malik Hospital (52.1%) have abnormal cognitive function based on the MoCA-Ina test results. Statistical analysis was conducted using the chi-square test and multivariate analysis with logistic regression. The chi-square test results revealed a significant relationship between age of onset and cognitive function (p=0,008), a significant relationship between seizure frequency and cognitive function (p=0,004), and a significant relationship between disease duration and cognitive function (p=0,012). The multivariate analysis results indicated that disease duration had a significant relationship with cognitive function, with an odds ratio of 0,081 (p-value=0,037, 95% CI 0,008-0,862).Conclusion: There is a relationship between age of onset, seizure frequency, and disease duration with the cognitive function of epilepsy patients at the Neurology Outpatient Clinic of Haji Adam Malik General Hospital in Medan

Examination of Complementary Treatment Use of Individuals with Interstitial Cystitis: Descriptive Study

Objective: The aim of this study was to examine the use of complementary therapy in individuals with interstitial cystitis. Material and Methods: This study, which was carried out in a descriptive research design, was carried out with 80 female patients over 18 years of age with interstitial cystitis, who applied to the Urology Outpatient Clinic of a city hospital in Istanbul between January and July 2023. The data were collected by face-to-face (onsite) interview method using a form prepared by the researchers in line with the literature to determine the socio-demographic characteristics of the patients and their use of complementary therapy. Data were analyzed using SPSS 22 statistical software for Windows. Results are reported as mean ± SD. Ethics committee and institutional permission were obtained before starting the study. Results: When the characteristics of the individuals included in the study were examined; The mean age was 42.80±10.68 years, 60% did not have a chronic disease, 65% used any complementary treatment method, 43.2% used herbal treatment method, 50% did not receive complementary treatment. 55% received this information from the physician, 50% used complementary therapy to reduce their pain, 61.5% did not experience any side effects after using complementary therapy, 80.8% believed that complementary therapy was effective. It was determined that 53.8% of them did not share the complementary treatment methods they used with the physician or nurse. Conclusion: It was seen that the majority of individuals with interstitial cystitis used any complementary treatment, half of them did not get information before using the treatment, and more than half did not share the complementary treatment methods they used with the physician or nurse.