Reduction In Mean Score Research Articles

Improvement in psychological wellbeing among adolescents with a substance use disorder attending an outpatient treatment programme.

Adolescents with substance use disorders (SUDs) exhibit high rates of comorbid psychological problems. This study aimed to examine the impact of an outpatient substance use treatment programme upon the psychological wellbeing of adolescents. A prospective study was carried out examining psychological symptoms in a group of adolescents attending the Youth Drug and Alcohol (YoDA) Addiction Service in Dublin. Participants were treated with evidenced based psychological models such as cognitive behavioural therapy, motivational interviewing and systemic family therapy. The Becks Youth Inventory was utilised to assess psychological symptoms at treatment entry and repeated three months later at follow up. Among 36 adolescents who were included in this study, poly-substance misuse was the norm. Almost three-quarter had a cannabis use disorder (CUD). There were significant reductions in mean subscale scores of depression (56.0 to 50.8, p = 0.003), anger (55.2 to 49.5, p < 0.001) and disruptive behaviour (61.6 to 56.5, p = 0.002) at follow up. Although there wasn't a statistically significant reduction in mean scores for anxiety, we observed a significant proportion of participants (p = 0.008) improving and moving out of a moderate to severe symptom range when examined by category. This was also the case for self-concept (p = 0.04). Furthermore this study revealed a positive correlation between the reduction in days of cannabis use and reduction in depressive scores (Pearson correlation 0.49, p = 0.01) among those with a CUD. The findings indicate that substance use treatment for adolescents is associated with important psychological and behavioural improvements.

A Comparison of Genicular Nerve Blockade With Corticosteroids Using Either Classical Anatomical Targets vs Revised Targets for Pain and Function in Knee Osteoarthritis: A Double-Blind, Randomized Controlled Trial

Compare the effectiveness of genicular nerve blockade (GNB) using classical anatomical targets (CT) versus revised targets (RT) in patients suffering from chronic knee osteoarthritis pain. Double-blinded randomized controlled trial. Pain medicine center of a teaching hospital. We randomly assigned 55 patients with chronic knee osteoarthritis pain to receive a GNB (using a fluid mixture of 2 mL: lidocaine 1% + 20 mg triamcinolone) with either classical targets (CT-group, n = 28) or revised targets (RT-group, n = 27). Numeric rating pain scale (NRS), Oxford knee score (OKS), Western Ontario and McMaster Universities osteoarthritis index score (WOMAC), Quantitative analgesic questionnaire (QAQ) and global perceived effects were assessed at baseline, and at 1-hour, 24-hours, 1, 4, and 12 weeks post-intervention. The RT-group showed greater reduction in NRS mean score at 1-hour post-intervention (2.4 ± 2.1 vs 0.4 ± 0.9, 95% confidence interval (CI) [.0-.8] vs [1.6-3.2], P < .001). The proportion of patients achieving more than 50% knee pain reduction was higher in the RT-group at each follow up interval, yet these differences were statistically significant only at 1-hour post intervention (82.1% [95% CI = 63.1-93.9] vs 100% [95% CI = 97.2-100] P = .02). Both protocols resulted in significant pain reduction and joint function improvement up to 12 weeks post-intervention. The revised technique allowed more pain relief as well as greater proportion of successful responders at 1-hour post intervention. The large volume injected during therapeutic GNB could have compensated the lack of precision of the classical anatomical targets, mitigating differences in outcomes between both techniques.

Occlusal Outcome of Orthodontic Treatment for Patients With Complete Cleft Lip and Palate.

To assess occlusal outcomes of orthodontic treatment for patients with complete cleft lip and palate. Retrospective assessment using the Peer Assessment Rating (PAR) index. Consecutive patients treated by one consultant orthodontist at a tertiary care cleft center. One hundred twenty-seven patients with either complete unilateral cleft lip and palate (UCLP) or bilateral cleft lip and palate (BCLP) consecutively treated with fixed appliances. Fixed orthodontic appliance treatment and orthognathic surgery when required. The PAR index assessment was carried out by a calibrated-independent assessor. Treatment duration, the number of patient visits, and data on dental anomalies were drawn from patient records and radiographs. One hundred two patients' study models were assessed after exclusions. Mean start PAR score for UCLP (n = 71) was 43.9 (95% CI, 41.2-46.6, SD 11.5), with a mean score reduction of 84.3% (95% CI, 81.9-86.7, SD 10.1). The UCLP mean treatment time was 23.7 months with 20.1 appointments. Mean start PAR score for BCLP (n = 31) was 43.4 (95% CI, 39.2-47.6, SD 11.4), with a mean score reduction of 80.9% (95% CI, 76.3-85.5, SD 12.5). The BCLP mean treatment time was 27.8 months with 20.5 appointments. These results compare well with other outcome reports, including those for patients without a cleft, and reflect the standard of care provided by an experienced cleft orthodontist. As with high-volume surgeons, orthodontic treatment for this high need group is favorable when provided by a high-volume orthodontist. These findings may be used for comparative audit with similar units providing cleft care.

Efficacy of Vortioxetine Monotherapy for Posttraumatic Stress Disorder: A Randomized, Placebo-Controlled Trial.

There are few efficacious pharmacological treatments for posttraumatic stress disorder (PTSD) and many patients fail to benefit from existing treatments. Vortioxetine, a recently developed antidepressant, acts as a serotonin modulator through inhibition of the serotonin transporter and actions at multiple types of serotonin receptors. Its unique pharmacodynamic profile suggests it may have efficacy for the treatment of PTSD. We conducted a 12-week placebo-controlled, randomized clinical trial of vortioxetine (flexibly dosed from 10 to 20 mg/d) versus placebo in adults with PTSD. The primary outcome was change from baseline in the past-month version of the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), analyzed using a mixed-model repeated-measures analysis of variance. Forty-one patients were randomized, and 32 (78%) completed the 12 weeks of treatment. The mean reduction in CAPS-5 scores at week 12 did not significantly differ between the 2 arms; the effect size for the difference in changes between vortioxetine and placebo on CAPS-5 total scores at week 12 was Cohen d = 0.29. However, at week 8, the drug-placebo difference was d = 0.78, which met the multivariate criteria for statistical significance, P = 0.014. In this study of 41 patients, vortioxetine did not demonstrate superiority over placebo for adults with PTSD. Future PTSD trials may benefit from stratifying the randomization based on number of years since the index traumatic event and a history of failure to respond to treatment.

Text4Hope: Receiving Daily Supportive Text Messages for 3 Months During the COVID-19 Pandemic Reduces Stress, Anxiety, and Depression.

This study reports on the changes in stress, anxiety, and depressive symptoms of subscribers after 3 months using Text4Hope, a supportive text messaging program designed to provide support during the pandemic. Standardized self-report measures were used to evaluate perceived stress (measured with the Perceived Stress Scale-10 [PSS-10]), anxiety (measured with the General Anxiety Disorder Scale 7 [GAD-7]), and depressive symptoms (measured with the Patient Health Questionnaire [PHQ-9]), at baseline and 3rd month (n = 373). After 3 months of using Text4Hope, subscribers' self-reports revealed significant (p< 0.001) mean score reductions compared with baseline on: the GAD-7 by 22.7%, PHQ-9 by 10.3%, and PSS-10 scores by 5.7%. Reductions in inferred prevalence rates for moderate to high symptoms were also observed, with anxiety demonstrating the largest reduction (15.7%). Observed Text4Hope-related reductions in psychological distress during COVID-19 indicate that Text4Hope is an effective, convenient, and accessible means of implementing a population-level psychological intervention.

Impact of Silver Diamine Fluoride Therapy on Oral Health-related Quality of Life of Uncooperative Preschool Children: A Prospective Study.

Preschool children with early childhood caries (ECC) frequently exhibit extreme dental anxiety and fear, posing a considerable challenge to paediatric dentists for their treatment. The aim of this study was to evaluate the influence of silver diamine fluoride (SDF) treatment on the oral health-related quality of life (OHRQoL) of uncooperative preschool children using an Arabic version of the Early Childhood Oral Health Impact Scale (A-ECOHIS). A pre-validated A-ECOHIS was used to assess the sensitivity and responsiveness. Fiftyone children, uncooperative with conventional dental care, underwent SDF treatment; their mothers answered the A-ECOHIS before and 4 weeks after treatment. Based on the global transition rating (GTR), the mothers rated their child's oral health condition following SDF treatment. SDF effectively arrested caries after 4 weeks in all children. There was a statistically significant reduction in mean scores of the total A-ECOHIS, child impact scale and family impact scores at follow-up (Wilcoxon signedrank test; p ˂ 0.001). There were statistically significant changes in the mean GTR of children's oral health. A-ECOHIS was sensitive and responsive to SDF treatment. SDF statistically significantly improved the OHRQoL of uncooperative preschool children.

Comparative Efficacy of Cow Milk, KNO3, and Warm Saline Rinses in Treating Dentin Hypersensitivity Following Nonsurgical Periodontal Treatment: A Randomized Controlled Trial.

Aim: This study aimed to assess the desensitizing efficacy of commercially available cow milk compared to potassium nitrate (KNO3) mouthwash and warm saline rinses after nonsurgical periodontal treatment.Materials and Methods: A randomized controlled trial was conducted in the Department of Public Health Dentistry of a dental college from August 21, 2018 to September 10, 2018. A total of 75 patients who reported hypersensitivity after scaling and root planing (SRP) were recruited and randomly assigned into three groups: cow milk (I), KNO3 mouthwash (II), and warm saline rinses (III). Dentine hypersensitivity (DH) was assessed at six time points using the verbal rating scale (VRS) for thermal stimuli and visual analog scale (VAS) for air blast and thermal stimuli. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 21 (IBM Corp., Armonk, NY). Mean reduction in DH in each group was measured using non-parametric tests.Results: Patients in all the three groups were found to be comparable with respect to baseline characteristics. Mean reduction in VRS and VAS scores for DH in milk and KNO3 mouthwash was found to be significantly high as compared to warm saline rinses group.Conclusion: From the results, cow milk was found to be equivalent in efficacy as compared with KNO3 mouthwash but superior to warm saline rinses in treating DH post-SRP.

Impact of Jacobson’s Progressive Muscle Relaxation on Stress Levels of Exam Going MBBS Students of a Medical College in South Gujarat, India

Introduction: Academic examinations are a very stressful event for an Bachelor of Medicine and Bachelor of Surgery (MBBS) student. While many students learn to deal with it through the use of helpful or unhelpful coping skills, many still end up with considerable psychological morbidity in the form of anxiety and depression along with deterioration in overall health. Jacobson’s Progressive Muscle Relaxation (JPMR) causes deep muscle relaxation. Aim: To find out the prevalence of stress and exam anxiety in students of 1st year MBBS and to study the impact of JPMR. Materials and Methods: It was a quasi-experimental, pretest and post-test interventional study conducted amongst the first year MBBS students studying at the Government Medical College Surat, Gujarat, India, during March to May 2019. Two months before their internal exams, 114 1st year MBBS students were recruited for the study. They were given a pretest proforma which comprised of socio-demographic profile, Perceived Stress Scale (PSS), Test Anxiety Scale (TAS) and General Health Questionnaire (GHQ) 28. They were asked to attend JPMR sessions over the following month in batches of 30 each and asked to practise JPMR for one month leading up to their exams. Total 43 students attended these sessions while 71 did not. After one month, all 114 students were again given a post-test proforma comprising of the same scales. Paired t-test was applied to compare the pretest and post-test scores to see the impact of JPMR. Results: The mean age of participants was 19 years.The students who completed their schooling in Gujarati medium and those who reported to be staying at hostel experienced significantly more TAS scores at baseline evaluation as compared to their counterparts from English medium schools and those staying at home respectively. There was a statistically significant reduction in mean scores of PSS and TAS before and after practice of JPMR in the 43 students who attended and practiced JPMR (p-value=0.005 and p-value=0.002, respectively; p-value &lt;0.05 was considered to be significant). Conclusion: One month practice of JPMR was found to be effective in reduction of stress and exam anxiety.

Comparative evaluation of efficacy of Physics Forceps versus conventional forceps in pediatric dental extractions: a prospective randomized study.

BackgroundThis study aimed to determine the efficacy of Physics Forceps in pediatric dental extractions.MethodsThis was a double-blind, randomized controlled trial with a parallel-arm design and identical allocation ratio (1:1). Children (n=104) were randomly divided into two groups for extraction of mandibular primary teeth (group I: Physics Forceps; group II: conventional forceps). The outcome variables assessed in the study were the time taken for extraction, pre- and postoperative anxiety (using RMS pictorial scale), incidence of fractured teeth, and postoperative pain on the first and third days (using the Wong-Baker faces pain scale).ResultsA significant reduction (P < 0.001) in intraoperative time, anxiety, and incidence of tooth fracture was confined to group I. The pain significantly reduced from the first to the third postoperative day in both groups, but the mean reduction in RMS scores in the physics forceps group was far better than that in the conventional forceps group.ConclusionPhysics Forceps aid in extraction of primary teeth with minimal trauma to supporting structures, as well as reducing anxiety in the pediatric population.

Efficacy of a Modified Audio-Tactile Performance Technique with Braille (ATPb) on the Oral Hygiene Status of Visually-Impaired Children.

We assessed the effectiveness of a modified audio-tactile performance (ATP) technique with braille (ATPb) on the oral health statuses of visually-impaired children. Ninety visually-impaired institutionalized children received oral hygiene instructions using audio (AM), ATP or ATPb techniques. Plaque scores were assessed at baseline and after reinforcement and non-reinforcement periods. In the totally visually-impaired, mean reductions in plaque scores in the ATPb, ATP and AM groups during the reinforcement period were 1.119 ± 0.260, 0.654 ± 0.239 and 0.237 ± 0.255, respectively (p <0.001), worsening to 0.107 ± 0.160, 0.083 ± 0.193 and -0.208 ± 0.267 during the non-reinforcement period (p <0.001), before culminating at 6 months at 1.227 ± 0.261, 0.737 ± 0.317 and 0.029 ± 0.108 (p <0.001). In partially visually-impaired children, reductions during the reinforcement period were 0.934 ± 0.279, 0.762 ± 0.270 and 0.118 ± 0.237, respectively, dropping to 0.176 ± 0.166, 0.083 ± 0.169 and -0.128 ± 0.114 without reinforcement and culminating at 1.109 ± 0.258, 0.845 ± 0.292 and -0.010 ± 0.226 (p <0.001). There were significant inter-group differences during the three periods (p <0.001), except in the ATP and ATPb groups during the non-reinforcement period for totally impaired (p = 0.157) and during reinforcement (p = 0.155) and non-reinforcement (p = 0.051) periods for partially impaired children. All three techniques were successful when reinforced periodically. However, only ATP and ATPb were successful during periods without reinforcement. The modified audio-tactile performance technique with braille (ATPb) was most effective, allowing visually-impaired children to retain oral hygiene information without intervention.

English

BACKGROUND Allergic conjunctivitis is one of the commonly found clinical conditions in ophthalmology practice. Diagnostic features consist of itching, redness and swelling of conjunctiva. Cornea is rarely involved. The physiologic basis of allergy is mast cell degranulation releasing histamine and other pro-inflammatory mediators. Mast cells release histamine which is responsible for early acute phase of allergies and pro-inflammatory mediators like prostaglandins, leukotrienes etc. which are responsible for the late phase. Activation of H1 receptors on conjunctival neurons causes itching while that of H1 and H2 receptors on vascular endothelium is responsible for vasodilation (appearing as redness) and endothelial swelling. Itching and inflammation are caused by response of H4 receptors on immune and inflammatory cells. Olopatadine is an H1 receptor antagonist and mast cell mediator release inhibitor. It is available as 0.1 % formulation used twice daily, and 0.2 % and 0.7 % formulations, both used once daily. Alcaftadine has high affinity and specificity for H1 and H2 receptors, and moderate affinity for the H4 receptors. It is an inverse agonist of H1, H2 and H4 receptors and also acts as mast cell stabiliser. Thus, antihistaminic effect relieves the early phase and mast cell stabilisation relieves the late phase of ocular allergic response. Both have become the most important therapy for allergic conjunctivitis. METHODS This was a prospective, observer-masked, single centre clinical trial conducted at outpatient department of ophthalmology, S.N. Medical College, Agra, from February 2018 to July 2019. Subjects with allergic conjunctivitis (n = 136) were registered for a prospective study and followed up for two weeks. Subjects were randomised using computer generated random number tables into one of the two treatment groups: alcaftadine 0.25 % eye drop and olopatadine 0.2 % eye drop. In this study, efficacy of the drug was taken as mean reduction in severity score of the subjects evaluated at one week and two weeks follow up. RESULTS Patients treated with alcaftadine 0.25 % eye drop showed comparatively early alleviation of signs and symptoms in comparison to patients treated with olopatadine 0.2 % eye drop. Alcaftadine 0.25 % treated subjects experienced significantly higher mean reduction in severity score than olopatadine 0.2 % treated subjects at every follow up visit; after 1 week (p = 0.0205) and after 2 weeks (p = 0.0475). No adverse effects were reported with either drug. CONCLUSIONS Once daily alcaftadine 0.25 % eye drop showed higher efficacy than once daily olopatadine 0.2 % eye drop in relieving signs and symptoms of allergic conjunctivitis at both one week and two weeks follow up. Both treatment arms were found to be safe and effective. KEYWORDS Allergic conjunctivitis, Olopatadine, Alcaftadine

Effectiveness and safety of eberconazole 1% cream in Indian patients with Tinea corporis and Tinea cruris: a prospective real-world study

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; &lt;em&gt;Tinea corporis&lt;/em&gt; and &lt;em&gt;cruris&lt;/em&gt; are estimated to affect 22% to 55% of the Indian population. This real-world study was conducted to evaluate the effectiveness and safety of eberconazole 1% cream among Indian patients.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; In this prospective, single-arm, observational study, patients with &lt;em&gt;Tinea corporis&lt;/em&gt; and &lt;em&gt;cruris&lt;/em&gt; aged ≥18 years were prescribed eberconazole 1% cream (Ebernet®, Dr. Reddy’s Laboratory, India) for up to 3 weeks. The primary endpoint was proportion of patients with improvement in total signs and symptoms score with 2 weeks of treatment. The key secondary endpoint was mean percent reduction in individual signs and symptoms score (erythema, itching, scaling) from baseline to the end of the 1st, 2nd, and 3rd week. A post-hoc analysis was performed on a subgroup of patients (completer set [CS]) who reported application of eberconazole 1% cream for 3 weeks in the study. There were no adverse effects reported.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Of 120 enrolled patients;104 (86.7%) were included in the full analysis set (FAS) and 76 (63.3%) patients were included in the CS. After 2 weeks of treatment, total signs and symptoms score&amp;lt;2 was achieved by 25% of patients in the FAS and 28.9% in the CS. After 3 weeks of treatment, mean percent reduction in total sign and symptom score was 60.3% for erythema, 61.2% for itching, and 76.8% for scaling.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; The evidence from this real-world observational study and a post-hoc analysis suggests that eberconazole 1% cream is effective and safe treatment option in the management of &lt;em&gt;Tinea corporis&lt;/em&gt; and &lt;em&gt;cruris&lt;/em&gt; in Indian patients.&lt;/p&gt;

Changes in Stress, Anxiety, and Depression Levels of Subscribers to a Daily Supportive Text Message Program (Text4Hope) During the COVID-19 Pandemic: Cross-Sectional Survey Study.

BackgroundIn addition to the obvious physical medical impact of COVID-19, the disease poses evident threats to people’s mental health, psychological safety, and well-being. Provision of support for these challenges is complicated by the high number of people requiring support and the need to maintain physical distancing. Text4Hope, a daily supportive SMS text messaging program, was launched in Canada to mitigate the negative mental health impacts of the pandemic among Canadians.ObjectiveThis paper describes the changes in the stress, anxiety, and depression levels of subscribers to the Text4Hope program after 6 weeks of exposure to daily supportive SMS text messages.MethodsWe used self-administered, empirically supported web-based questionnaires to assess the demographic and clinical characteristics of Text4Hope subscribers. Perceived stress, anxiety, and depression were measured with the 10-Item Perceived Stress Scale (PSS-10), the Generalized Anxiety Disorder–7 (GAD-7) scale, and the Patient Health Questionnaire–9 (PHQ-9) scale at baseline and sixth week time points. Moderate or high perceived stress, likely generalized anxiety disorder, and likely major depressive disorder were assessed using cutoff scores of ≥14 for the PSS-10, ≥10 for the GAD-7, and ≥10 for the PHQ-9, respectively. At 6 weeks into the program, 766 participants had completed the questionnaires at both time points.ResultsAt the 6-week time point, there were statistically significant reductions in mean scores on the PSS-10 and GAD-7 scales but not on the PHQ-9 scale. Effect sizes were small overall. There were statistically significant reductions in the prevalence rates of moderate or high stress and likely generalized anxiety disorder but not likely major depressive disorder for the group that completed both the baseline and 6-week assessments. The largest reductions in mean scores and prevalence rates were for anxiety (18.7% and 13.5%, respectively).ConclusionsText4Hope is a convenient, cost-effective, and accessible means of implementing a population-level psychological intervention. This service demonstrated significant reductions in anxiety and stress levels during the COVID-19 pandemic and could be used as a population-level mental health intervention during natural disasters and other emergencies.International Registered Report Identifier (IRRID)RR2-10.2196/19292

Application of vortioxetine in outpatients with endogenous depression

The study aimed to evaluate the clinical action, safety, and tolerability of vortioxetine in outpatients with depressive conditions. Material and methods . An open comparative study of patients with various nosological forms of endogenous depressive conditions (depressive episodes, recurrent depressive disorder, and bipolar affective disorder) was conducted. The course of therapy with vortioxetine in a daily dose of 10–20 mg lasted 42 days. Methods of clinical and psychometric evaluation of the results were used as well as correlation analysis using Spearman’s coefficient. The severity and degree of reduction in depressive and anxiety symptoms were recorded using the Hamilton Depression Scale (HAM-D), the Hamilton Anxiety Scale (HAM-A), and the Clinical Global Impression–Disease Severity Scale (CGI-S). To assess the severity of adverse side effects, the side effects rating scale (UKU) was used. Results . Vortioxetine has been found to be an effective antidepressant. At the end of therapy, a reduction in the mean total score on the HAM-D scale by more than 50% was registered in 92.2% of patients. Furthermore, 76.3% of patients had a therapeutic effect with a reduction in the mean total scores of the HAM-D scale by more than 80%. The reduction in mean scores on the HAM-A scale by day 28 reached 87.25%. According to the CGI-S scale values, 68.4% of patients completed the course of therapy with complete remission. Significant direct correlations were found between the daily drug dose and disease duration and the initial depressive symptom severity. A correlation between the anxiety level and vortioxetine dose was observed in all stages of therapy. The depression level on days 7 and 21 correlated with the dose size, starting from week 3. The adverse event severity detected in most cases ranged from mild to moderate. Conclusion . Thymoanaleptic and anxiolytic activities provide vortioxetine with efficacy in various nosological forms of endogenous depression. For conditions with a longer duration and severity of the disease, a higher dosage of vortioxetine (20 mg/day) is required. During therapy, vortioxetine has demonstrated a favorable safety and tolerability profile; therefore, it can be used in an outpatient basis.

Effectiveness of intravenous ketamine in mood disorder patients with a history of neurostimulation

Patients unsuccessfully treated by neurostimulation may represent a highly intractable subgroup of depression. While the efficacy of intravenous (IV) ketamine has been established in patients with treatment-resistant depression (TRD), there is an interest to evaluate its effectiveness in a subpopulation with a history of neurostimulation. This retrospective, posthoc analysis compared the effects of four infusions of IV ketamine in 135 (x̄ = 44 ± 15.4 years of age) neurostimulation-naïve patients to 103 (x̄ = 47 ± 13.9 years of age) patients with a history of neurostimulation. The primary outcome evaluated changes in depression severity, measured by the Quick Inventory for Depression Symptomatology-Self Report 16-Item (QIDS-SR16). Secondary outcomes evaluated suicidal ideation (SI), anxiety severity, measured by the Generalized Anxiety Disorder 7-Item (GAD-7), and consummatory anhedonia, measured by the Snaith-Hamilton Pleasure Scale (SHAPS). Following four infusions, both cohorts reported a significant reduction in QIDS-SR16 Total Score (F (4, 648) = 73.4, P < .001), SI (F (4, 642) = 28.6, P < .001), GAD-7 (F (2, 265) = 53.8, P < .001), and SHAPS (F (2, 302) = 45.9, P < .001). No between-group differences emerged. Overall, the neurostimulation-naïve group had a mean reduction in QIDS-SR16 Total Score of 6.4 (standard deviation [SD] = 5.3), whereas the history of neurostimulation patients reported a 4.3 (SD = 5.3) point reduction. IV ketamine was effective in reducing symptoms of depression, SI, anxiety, and anhedonia in both cohorts in this large, well-characterized community-based sample of adults with TRD.

Short Term Effectiveness of Intraatricular Injection of Methylprednisolone Acetate in Subacromial Impingement Syndrome in a tertiary care hospital.

Objective: To determine mean decrease in VAS pain score of intraarticular injection of methyl prednisolone acetate in patients of subacromial impingement syndrome. Methods: Its Descriptive Case Series/ Quasi experimental study. Study was conducted in department of Orthopedics Unit- I, Jinnah hospital Lahore. Study completed in Six months i.e. from June 2014 to December 2014.After taking an informed consent, 70 newly diagnosed cases of Subacromial impingement syndrome by history and examination (described by the patient as pain in subacromial space when the humerus was elevated or internally rotated and tested by having the patient place his hand on the unaffected shoulder and gradually forward flexing the shoulder (positive impingement sign)which have not received any kind of treatment were included. Results: Effectiveness of intraarticular injection of methyl prednisolone acetate was measured on visual analogue scale (VAS) from 0 to 10 by VAS score after 6 weeks. 70 patients with mean age of 36.2 ± 10.6 years were included. 61 patients (75.7%) were male, 10 patients (14.3%) had gout and 20% were diabetic. Mean pretreatment VAS score was 5.03 ± 1.58 while mean post-treatment VAS score was 3.86 ± 0.839. Mean reduction was 1.17 ± 1.57 ranged from 2 to 6. There was non-significant association of age and diabetes with mean reduction in VAS score while female gender and gout were significantly and negatively associated with treatment outcome. It is concluded that mean reduction in VAS score after 6 weeks of treatment of subacromial impingement syndrome after intra articular methylprednisolone injection is 1.17 ± 1.57 and acceptable. Conclusion: It is concluded that intraatricular injection of methyl prednisolone injection is efficacious and effective for treatment of Subacromial impingement syndrome in Pakistani population. Keyword: subacromial impingement syndrome, intra articular methylprednisolone injection, visual analogue scale, effectiveness.

Work-based risk factors and quality of life in health care workers providing maternal and newborn care during the Sierra Leone Ebola epidemic: findings using the WHOQOL-BREF and HSE Management Standards Tool

IntroductionBefore the 2014, Ebola epidemic in Sierra Leone, healthcare workers (HCWs) faced many challenges. Workload and personal risk of HCWs increased but their experiences of these have not been well...

Effect of polydextrose-containing beverage on bowel habits and gastrointestinal symptoms of constipated subjects: a pilot study

Introduction: Indonesians have a low intake of dietary fibre, a key component for an increased incidence in constipation. Available data have documented the benefits of polydextrose (PDX) in healthy subjects. However, data on constipated subjects are lacking. This study aimed to investigate the effect of consuming a PDX (prebiotic) beverage on bowel habits and gastrointestinal symptoms of constipated subjects over seven days. Methods: This was a randomised, non-blinded, nonplacebo-controlled parallel design study involving 24 subjects, divided equally into two groups. Group A (active control group) consisted of 12 subjects, consuming one serving size of 6g PDX beverage. While Group B (intervention group) consisted of 12 subjects, consuming two servings of the same product, containing 12g PDX beverage. Changes in bowel habits (constipation score, stool frequency and stool consistency) and gastrointestinal symptoms (abdominal pain, bloating and flatulence) were monitored. Results: Within seven days, Group B showed 4.9% more reduction in overall constipation mean score than that of Group A. Positive improvement in gastrointestinal symptoms were reported: i.e. abdominal pain (∆M = -0.08±0.43), bloating (∆M = -0.29±0.37) and flatulence (∆M = -0.17±0.47). Majority of subjects had desirable stool frequency (87.5%, &gt;3 defecations/week) and stool consistency (58.3%, type 4). These improvements were due to the fact that PDX provides physiological effects consistent with prebiotic fibre, which alters the gut microbiota composition during the fermentation cycle in the large intestine. Conclusion: Findings of this study suggested that daily PDX beverage consumption effectively improved bowel habits, with fewer constipated subjects reporting of gastrointestinal symptoms.

Sankofa pediatric HIV disclosure intervention did not worsen depression scores in children living with HIV and their caregivers in Ghana

BackgroundThe ‘Sankofa’ pediatric HIV disclosure study (2013–2017) was an intervention that aimed to address the low prevalence of disclosure of HIV status in Ghana.MethodsWe conducted a cross-sectional study at the intervention site in Kumasi, Ghana, in 2019, (2 years after study closure) and administered the 21-item Beck Depression Inventory (BDI) and the 10-item Child Depression Inventory (CDI) to caregiver-child dyads who received the intervention.ResultsWe enrolled 65% (N = 157) of the original dyads in the present study. Between Sankofa enrollment baseline and the present study, both children and caregivers had significant (p < 0.0001) mean reductions in CDI scores and BDI scores, respectively. CDI scores of the children were significantly correlated with BDI scores of the caregivers (r = 0.019, p = 0.019). No statistically significant associations between disclosure status and either CDI score or BDI score were found.ConclusionsOur findings did not support caregivers’ fears that disclosure leads to depression.Trial registrationClinicalTrials.gov Identifier: NCT01701635 (date of registration Oct 5, 2012).

Xiangshao granules can relieve emotional symptoms in menopausal women: a randomized controlled trial

Objective This study aimed to investigate the safety and efficacy of Xiangshao granules for treating emotional disorders in perimenopausal and postmenopausal women. Methods The current investigation was a double-blind, randomized, placebo-controlled, multicenter trial that included 300 perimenopausal and postmenopausal Chinese women aged 40–60 years. Participants received either a placebo (n = 150) or Xiangshao granules (n = 150) for 8 weeks. Outcome measures included Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Rating Scale (HAMA) scores, which were assessed at baseline, 4 weeks, and 8 weeks. The primary efficacy variables were changes in HAMD and HAMA scores after 8 weeks. Results After 8 weeks, the mean HAMD scores decreased from 15.0 to 7.9 in the Xiangshao group and from 16.3 to 10.0 in the placebo group, and the respective mean reductions in HAMA scores were from 16.0 to 8.5 and from 17.1 to 10.9. Clinical improvements in symptoms of both depression and anxiety after 8 weeks differed significantly in the two groups (p < 0.05). The cure rate was significantly higher in the Xiangshao group. There were no significant differences in the rates of adverse events in the two groups. Conclusions Xiangshao granules can relieve symptoms of depression and anxiety significantly and safely.