Significant Lower Scores Research Articles

Long-term sequelae and quality of life after childhood-onset craniopharyngioma: Results of a Spanish multicenter study.

We aim to describe the characteristics of patients with childhood-onset craniopharyngioma and to analyze factors that impair quality of life (QoL) in this population. Multicenter national study including patients treated between 2008 and 2022, from 2 to 25years of age diagnosed with craniopharyngioma. QoL was assessed once during patient's follow-up by age-adapted versions of Pediatric Quality of Life Inventory (PedsQL) questionnaire. Sixty-six patients were included. Median age at diagnosis was 5years (interquartile range [IQR]: 3-8), while median follow-up was 7.4years (IQR: 2.8-9.7). Most craniopharyngioma were suprasellar (93.9%), and 59.7% had hypothalamic involvement (HI). All patients underwent surgery, 44.4% received radiotherapy, and 23.6% intracystic therapy. Most frequent long-term complications were visual deficit (72.7%) and endocrine impairment (94.5%). Patients exhibited hypothyroidism requiring hormone replacement (92.4%), hypocortisolism (80.3%), diabetes insipidus (86.4%), and/or growth hormone therapy (50%). When parents evaluated QoL, PedsQL median score was 53.8 points out of 100 (IQR: 41-71.6). Higher scores were noted when patients assessed their own QoL (median score 64.8 [IQR: 57.3-81.8]), observing statistically significant differences (p=.019). QoL was impaired by repeated surgeries (r=-.44; p=.014), HI (median score 51.5 [IQR: 39-63.8] vs. 76.4 [59-84.8]; p=.001), radiotherapy (median score 51.9 [IQR: 38.1-61.3] vs. 63.8 [IQR: 49-82.5]; p=.02) and longer follow-up (r=-.3; p=.01). In our study, most patients had significant comorbidities and low overall QoL scores, which was mainly affected by repeated surgery, radiation, and hypothalamic involvement. This reflects the need for further research and intensified studies of systemic therapy/alternate strategies to broaden the standard-of-care options, so that treatment-related sequalae can be avoided.

A histology and immunochemistry study comparing open versus close and open-method endoscopic saphenous vein harvesting.

The introduction of endoscopic saphenous vein harvesting (ESVH) has been reported to reduce wound pain and infection, compared with open saphenous vein harvesting (OSVH) techniques. There are still controversies regarding this technique. The aim of our study is to investigate the endothelial preservation of saphenous vein (SV) grafts harvested by different techniques. Further observations were made for harvesting and closure time, incision length and effect of pressure distension of the veins to the vein endothelium. Prospective observational study of sixty human saphenous vein grafts was performed to evaluate endothelial preservation by haematoxylin-eosin and Cluster of Differentiation 31 (CD 31) staining. Saphenous vein was harvested endoscopically either by closed CO2 (carbon dioxide) ESVH, open CO2 ESVH or OSVH harvesting technique. Demographic data and intra-operative data were collected. Two saphenous vein samples were collected from each patient to compare differences before and after distension of the veins. Both haematoxylin-eosin and immunohistochemistry slides were imaged by a high-resolution slide scanning system. Open CO2 ESVH group showed the highest number of endothelial detachments. Mean scoring of the immunohistochemistry method using the CD31 antibody was much lower in the open CO2 ESVH group (33.25% ± 28.71, P < 0.0003). This represents a more poorly preserved endothelial cells in the Open CO2 ESVH than the closed CO2 ESVH. Closure time and incision lengths were significantly shorter in both ESVH groups compared to the OSVH group. Significant low scores of immunohistochemistry for samples were seen in distended veins (39.0% ± 30.08, p = 0.004). The OSVH in random sample B, which represents the conduit that will be used, had a far better endothelium preservation and less endothelial detachment when compared to ESVH. We observed more endothelial detachment in the open CO2 ESVH group, due to lack of subcutaneous tissue separation, poor visualization and traction stress across the wall of the saphenous vein. The closed CO2 ESVH group had more endothelial cells preserved, but the OSVH group fared the best with the least number of endothelial cell detachment and a higher score of CD31 antibody. The online version contains supplementary material available at 10.1007/s12055-024-01752-3.

CT-guided paravertebral injection of doxorubicin for treatment of postherpetic neuralgia: a database-based retrospective stratified study.

This study explored the impact of different doeses of doxorubicin in CT-guided transvertebral foraminal injections for postherpetic neuralgia (PHN) treatment and the impact of 0.5% doxorubicin treatment on patients with different disease courses and lesion locations. This retrospective study included 291 patients with PHN who received CT-guided doxorubicin injection at West China Hospital between April 2014 and February 2020. A total of 228 patients received 0.5% doxorubicin treatment and 63 received 0.33% doxorubicin. Both groups showed significantly improvement in visual analogue scale (VAS) and Brief Pain Inventory (BPI) scores. The 0.5% doxorubicin group demonstrated significant lower VAS scores at 6 and 12 months after surgery (all p < 0.001) and a significant lower score on the BPI at 6 and 12 months than the 0.33% doxorubicin group (all p < 0.05). Stratified analysis of 0.5% doxorubicin demonstrated a significant reduction in VAS score at 1 week, 3 months, 6 months, and 12 months after treatment compared to baseline (all p < 0.05) and significant improvements in BPI score after treatment compared to baseline (p < 0.05). The VAS score of the chest group was significant higher than facial, neck and upper limbs and abdomen groupsin groups 1 week after surgery (all p < 0.05). Various aspects of quality of life, including daily life, enjoyment of life, sleep, relationships, work, walking ability, and emotions, significantly decreased after surgery (p < 0.05). Especially in sleep duration, there was an increase in patients reporting intermediate sleep (4-7 h) and a proportion achieving a normal sleep duration of ≥7 h. And no significant differences of BPI were observed among different affected locations. The incidence of adverse events in the 0.5% doxorubicin group and 0.33% doxorubicin group was 8.78 and 6.34%, respectively. CT-guided doxorubicin injection therapy has the potential to alleviate pain and enhance the quality of life in patients with PHN. Notably, the use of a 0.5% doxorubicin concentration yields more pronounced pain relief compared to a 0.33% concentration. While longer durations of PHN and specific affected sites may influence the response to treatment, the overall improvements in quality of life remain consistent.

Pelvic floor physical therapy in the treatment of chronic anal fissure (PAF trial): quality of life outcome.

Chronic anal fissure is one of the most common anorectal diseases and is associated with reduced quality of life. The aim of this study was to investigate the effects of pelvic floor physical therapy on quality of life in patients with chronic anal fissure using the Short-Form 36 Health Survey (RAND-36). Adult patients, with chronic anal fissure and concomitant pelvic floor dysfunction, such as dyssynergia and increased pelvic floor muscle tone, were recruited at the Proctos Clinic in the Netherlands, between December 2018 and July 2021 and randomly assigned to an intervention group, receiving 8weeks of pelvic floor physical therapy or assigned to a control group receiving postponed pelvic floor physical therapy (PAF trial). Quality of life and pain ratings were outcomes of the study and were measured at 8- and 20-week follow-up. One hundred patients (50 women and 50 men, median age 44.6years [range 19-68years]), completed the RAND-36 questionnaire and visual analog (VAS) pain scale score at admission. A significant improvement was found at 20-week follow-up in all domains of the RAND-36; physical functioning, pain, health change (p < 0.001); physical role, vitality, general health, social functioning, emotional role, mental health (p < 0.05). VAS pain was significantly reduced at 8weeks (mean estimated difference 1.98; 95% CI 1.55-2.42, p < 0.001) and remained significant at 20-week follow-up (p < 0.001). The difference between the groups as regards change in the mean pain intensity scores at 8weeks was 2.48 (95% CI -3.20 to -1.75; p < 0.001). Compared to the reference values of the general Dutch population, the patients in our study with a chronic anal fissure and pelvic floor dysfunction reported an impaired quality of life in 8 of 9 domains of the RAND-36. After treatment, significant lower scores were found in 2 out of 9 domains. The results of this study provide evidence that treatment by pelvic floor physical therapy improves quality of life and reduces pain, making it an important tool in management of chronic anal fissure and concomitant pelvic floor dysfunction.

Parent-report health-related quality of life in school-aged children with cerebral palsy: Across-sectional study.

Quality of life is both a goal and an outcome in Cerebral Palsy (CP) rehabilitation. Children with CP may show impaired health-related quality of life (HRQoL) compared to their typical peers. Parents' perceptions of HRQoL of their children could help rehabilitation professionals to identify areas for intervention aiming to improve health and wellbeing. This study aims to compare the proxy HRQoL of Portuguese school-aged children with CP and the general population, and to analyze child and family correlation. Differences were examined using European normative data for children from 8 to 18 years. Correlation and regression analysis examined the association between child and family variables in the CP group with statistically significant low scores. Sixty-eight parents of children and adolescents with CP (12.5 ± 2.91 years) answered the KIDSCREEN-52 parent version. We identified clinically significantly lower HRQoL in four out of ten HRQoL domains (Physical well-being, Autonomy, Moods & Emotions, and Bullying) than the norm peers. Correlations were found between the number of siblings and Autonomy (r = .315), meaning that having more siblings was associated with greater autonomy, and between mobility and Moods & Emotions (r = -.261), where children with impaired mobility shown low scores as perceived by their parents. Age, sex, mobility and cognitive impairment explained 32% of Physical well-being scores (p < .001). Mobility and cognitive impairment explained 16% of Bullying scores (p = .001). Although the family and child variables identified in this study are non-modifiable, they can help in the identification and early intervention aimed at improving HRQoL. Rehabilitation professionals should assess parent perceptions, extending the HRQoL assessment to children who can report and other informants, aiming at fostering wellbeing in children and adolescents with CP.

Personality assessment with Temperament and Character Inventory in Parkinson's disease

IntroductionThere is a growing interest in personality evaluation in Parkinson's disease (PD), following observations of specific temperaments in PD patients. Therefore, our objective was to evaluate personality dimensions from the Temperament and Character Inventory (TCI) in a cohort of fluctuating PD patients considered for deep brain stimulation. MethodsFluctuating PD patients from the PREDISTIM cohort were included. Description of TCI dimensions and comparison with a French normative cohort were performed. Pearson correlations between TCI dimensions and motor, behavioral and cognitive variables were investigated. Structural and internal consistency analysis of the TCI were further assessed. ResultsThe 570 PD patients presented significant higher scores in Harm Avoidance, Reward Dependence, Persistence, Self-Directedness and Cooperativeness and significant lower scores in Self-Transcendence compared to the French normative cohort; only Novelty Seeking scores were not different. Harm Avoidance and Self-directedness scores were correlated with PDQ-39 total, HAMD, HAMA scores, and anxiolytic/antidepressant treatment. Novelty Seeking scores were correlated with impulsivity. Pearson correlations between TCI dimensions, principal component analysis of TCI sub-dimensions and Cronbach's alpha coefficients showed adequate psychometric proprieties. ConclusionThe TCI seems to be an adequate tool to evaluate personality dimensions in PD with good structural and internal consistencies. These fluctuating PD patients also have specific personality dimensions compared to normative French population. Moreover, Harm Avoidance and Self-Directedness scores are associated with anxio-depressive state or quality of life and, and Novelty Seeking scores with impulsivity.

Patient Satisfaction regarding Conventional One-Piece Versus Two-Piece Magnet-Retained Obturator for Patients with Complete Edentulism: A Preliminary Crossover Clinical Trial

Purpose: This study aimed at evaluating patients' satisfaction with conventional one-piece obturators versus two-piece magnet-retained obturators in completely edentulous patient maxillectomy cases. Materials and Methods: Ten completely edentulous participants with hemimaxillectomy (8 males and 2 females) were selected in a crossover study. Participants received a conventional obturator one-piece and two-piece obturators connected by magnet attachment in alternate periods (sequences A‐B and B‐A), and outcomes were assessed after 1 week, 3 months, and 6 months Evaluation was made using Obturator Functioning Scale (OFS) and Oral Health Impact Profile for edentulous people (OHIP-EDENT). One way ANOVA test and multivariate analysis of variance with a general linear model with repeated measures was used to test the impact of the group, time, and order on each of the studied scores (α=.05). Results: Magnet design showed a statistically significant lower score (P &lt;.050) than the conventional design regarding the overall satisfaction score of OFS along all follow-up periods. Concerning OHIP-EDENT, the magnet design showed a statistically significant lower score (P &lt;.050) than the conventional design regarding total functional limitations, total physical pain, and total social disability along all follow-up periods while for total psychological discomfort, total physical disability, and total handicap, no statistically significant difference was observed between both groups (P &gt;.050). Conclusion: Two-pieces magnet-retained obturator could provide better satisfaction and better restoration of orofacial function than the conventional one to manage completely edentulous patients. Clinical Trial Registration Number: NCT05066828

Urogenital dysfunction and quality of life in women after stroke: Pilot study

Introduction: Research shows that urinary and sexual dysfunction is very common neurological sequelae of stroke with a markedly significant impact on body self-image and quality of life. Still, there is a lack of recent research to address this problem in female stroke survivors. The study aimed to examine the existence and level of urinary and sexual dysfunction, quality of life, and self-reported body image in a group of women after stroke and compare findings with those found in a group of women with other chronic non-neurological diseases. Methods: This study’s sample consisted of 30 females; two groups composed of 15. The stroke group consisted of subjects after stroke and the non-neurological group with different chronic non-neurological, mainly muscle-skeletal conditions. This study’s specific interest data were collected from respondents through pelvic floor distress inventory (PFDI-20), the pelvic floor impact questionnaire (PFIQ-7), female sexual function index (FSFI), and an eight-item body image scale (BIS). The SPSS v.26 program was used for statistical processing. Results: Results show a statistically higher scores in stroke group (M = 219.65 ± 34.573) on PFDI-20 than in non-neurological group (M = 118.54 ± 27.734). Furthermore, statistically significant higher scores were found in stroke group in PFIQ-7 (Mdn = 233.33) and BIS (Mdn = 16.00) than in non- neurological group (Mdn = 28.57) – PFIQ-7; (Mdn = 11.00) – BIS. Also, statistically significant lower scores were found in stroke group (Mdn=10.40) on FSFI index than in non-neurological group (Mdn=24.60). Conclusions: Women after stroke show significantly more urinary and sexual dysfunction, lower quality of life, and poorer body self-image than the non-neurological group of chronic non-neurological conditions. There is a clear need for research on this issue in women after stroke.

Computer-controlled Intraligamentary local anaesthesia in extraction of mandibular primary molars: randomised controlled clinical trial

BackgroundLocal anesthesia (LA) poses a threat in children more than the treatment process itself, so pediatric dentists are always demanding less painful techniques. Computer-controlled Intraligamentary anaesthesia (CC-ILA) is designed to reduce injection pain and side effects of conventional techniques. The present study aims to assess the pain experience using Computer-controlled Intraligamentary anaesthesia (CC-ILA) during injection and its effectiveness in controlling pain during extraction of mandibular primary molars in pediatric patients.MethodsThis randomized controlled clinical trial includes 50 healthy cooperative children, aged 5–7 years with mandibular primary molars indicated for extraction. They were randomly allocated to two groups according to LA technique: test group received CC-ILA and control group received Inferior alveolar nerve block (IANB). Pain was measured during injection and extraction: physiologically using Heart rate (HR), subjectively using Face-Pain-Scale (FPS), and objectively using Sound-Eye-Motor scale (SEM). Patients were recalled after 24-h to record lip-biting events. Data was collected and statistically analysed.ResultsA total of 50 children (29 females and 21 males) with mean age 6.10 ± 0.76 participated in the study. There were significantly lower scores in the heart rate in the CC-ILA group during injection (p = 0.04), but no significant difference was recorded between the two groups during extraction (p = 0.17). The SEM and FPS showed significant lower scores in the CC-ILA group during injection (p < 0.0001, p < 0.0001) and extraction (p < 0.0001, p = 0.01) respectively. No children in CC-ILA group reported lip-biting after 24-h compared to 32% in IANB (p < 0.0001).ConclusionCC-ILA provides significantly less painful injections than conventional techniques and has proved to be as effective as IANB during extraction of mandibular primary molars. An important advantage of this technique was the complete absence of any lip/cheek biting events.Trial registration The study was prospectively registered in ClinicalTrials.gov with the identifier: NCT04739735 on 26th of January 2021, https://clinicaltrials.gov/ct2/show/NCT04739735.

Quality Of life of children on renal replacement therapy

This is a descriptive cross-sectional hospital-based study conducted during the period from October to December 2009 at Noora Children Center for Dialysis and Renal Transplant at Soba University Hospital, and Dr. Salma Nephrology Center for Dialysis and Transplant, Khartoum, Sudan. The objectives were to study the health-Related Quality of Life (HRQol) in children on Renal Replacement Therapy (RRT) and to correlate the effect of RRT in improving the Quality of Life (QoL). The study included 77 children with End Stage Renal Disease (ESRD) and their families. The majority of children 45 (58.4%) were at the age group 13 – 16 years. 38 (49.4%) were on Hemodialysis (HD), 20 (26%) were on Peritoneal Dialysis (PD) and 19 (24.6%) had renal transplantation. Male to female ratio was 1.3:1. Results: ESRD had negative effect on children’s physical, psychological and social domains of QoL. Children on HD and PD had significant lower scores in all domains of QoL compared to transplanted children.

Quality of life of cardiac outpatients with and without psychiatric disorders: a cross-sectional study

BackgroundThe study aims to measure the quality of life (QOL) for cardiac outpatients with psychiatric disorders (CPP) in comparison to cardiac outpatients without psychiatric disorders (CPOP). A semi-structured interview was performed for consecutive cardiac outpatients. Psychiatric diagnoses were confirmed using the mini-international neuropsychiatric interview (MINI). The QOL was measured by the World Health Organization quality of life (WHOQOL-BREF).ResultsOut of the 343 enrolled patients, 93 (27.1%) patients were found to have psychiatric disorders. The WHO-BREF score of QOL was 4.25 ± 0.85. The CPP were found to have statistically significant lower scores in QOL than CPOP in all the WHOQOL-BREF domains. Particularly, the domain of psychological health showed the highest difference between the two groups (76.9 vs. 87.8, P < 0.001), whereas the environment domain showed the lowest difference between them (80.2 vs. 87.9, P < 0.001). Within each QOL domain, patients with congestive heart failure and psychiatric disorders showed the lowest QOL in both the physical domain (51.4 vs. 71.3, P < 0.02) and the social domain (64.7 vs. 81.9, P < 0.05), while patients with vulvular heart disease and psychiatric disorders showed the lowest QOL in the psychological domain (74.6 vs. 85.7, P < 0.001) and patients with arrhythmias and psychiatric disorders in the environment domain (80 vs. 86.2, P < 0.02).ConclusionsThe QOL of CPP were found to have poorer QOL than CPOP. The magnitude of difference in QOL was the highest in the psychological health domain and the lowest in the environment domain.

Health-Related Quality of Life Among Patients With Sickle Cell Disease in an Adult Hematology Clinic in a Tertiary Hospital in Lagos, Nigeria.

BackgroundSickle cell disease (SCD) is a genetic disease of public health concern. Improved quality healthcare has increased the life expectancy of these patients; however, they also face an increased frequency of vaso-occlusive crises and other SCD complications. These complications affect their quality of life, an area of care, which healthcare providers often overlook. We sought to determine the health-related quality of life among patients living with sickle cell disease in Lagos, Nigeria. Materials and methodsWe conducted a cross-sectional study of 198 patients with sickle cell disease who attended the adult sickle cell clinic at a tertiary hospital in Lagos, Nigeria, during the period from October 1, 2018, to February 28, 2019. A self-administered questionnaire was used to obtain the clinical and socio-demographic characteristics of the patients and the 35-item Short-Form Health Survey (SF-36) questionnaire was used to determine their health-related quality of life (HRQoL). Determinants of HRQoL were established using bivariate and multivariate regression analysis. ResultsThe mean age of the 198 patients who participated in the study was 28.4±9.1 years, mean steady-state hemoglobin was 8.2 ± 1.3 g/dl, and 85 (42.9%) patients had a monthly income of 150 USD or less. In the previous year, 65 (32.1 %) and 33 (16.6%) patients, respectively, suffered one to two episodes (s) of acute bone pain crises and acute chest syndrome, and 43 (24.7%) had blood transfusion. Using the scoring system for SF-36 provided by RAND Health, role limitation due to physical health had the lowest median score of 50 (interquartile range {IQR}: 0-100). On bivariate analysis, bone pain crisis was associated with statistically significant low scores across all the 8 HRQoL domains of the SF36 questionnaire. Other variables, including having received blood transfusion, recent hospitalization, acute chest syndrome, lower level of income, and younger age, were also associated with significantly low scores. On regression analysis, bone pain crisis, level of income, and acute chest syndrome were found to be independent determinants of quality of life in the patients.ConclusionSickle cell disease has a negative impact on the health-related quality of life of those affected. The presence of bone pain crisis is an important predictor of health-related quality of life in sickle cell disease patients. To improve patient outcomes, healthcare providers should take a holistic approach in evaluating and managing this disease, taking into cognizance how the complications and the financial burden of this disease impact the quality of life of affected patients.

COVID-19 Pandemic: Psychological Stress and Coping Strategies among Doctors

Objective: To determine the prevalence of psychological distress among medical doctors during the covid-19 pandemic and identify the coping mechanisms being employed by them. Study Design: Descriptive cross-sectional study. Place and Duration of Study: Department of Community Medicine, HITEC Institute of Medical Sciences, Taxila from 1st February 2020 to 31st July 2020 Methodology: Three hundred and ninety eight doctors (non-specialists, interns, junior consultants and senior consultants) from emergency services, medicine and allied and surgery and allied departments. Results: There were 224 (56.3%) females, 174 (43.7%) were males. Mean age was 35.2±8.6. Majority of participants were from medicine department (n=266,66.8%). Health professionals who worked at frontline during Covid pandemic were 186 (46.7%). One hundred and ninety four (48.7%) participants had no psychological distress, 62 (15.6%) had mild, 30 (7.5%) had moderate and 112 (28.1%) had severe psychological distress. BREIF-COPE questionnaire was found to have high reliability (Cronbach alpha=0.82). High mean scores were observed for Problem focused (4.7±1.4) and Emotional focused coping (4.7±1.1). Relatively low mean score was found for dysfunctional coping (3.3±1.0). A statistically significant low positive correlation ofIES-R scores was observed with Problem focused coping (r=.47, p=.001) and with emotional focused coping (r=.42, p=.001). However, moderately positive correlation was observed between IES-R scores and dysfunctional coping (r=.64, p=.001). Conclusion: Psychological distress was significantly higher among Covid-19 frontline health workers, particularly among postgraduate trainees working in Medicine and Emergency departments.

Development of a 3D Printed Lung Model Made of Synthetic Materials for Simulation.

Considering the complexity of lung structures and the difficulty of thoracoscopic surgery, simulation-based training is of paramount importance for junior surgeons. Here, we aim to design a high-fidelity lung model through utilizing the three-dimensional (3D) printing technology combined with synthetic materials to mimic the real human lung. The 3D printed lung model was manufactured based on the computed tomography images of a randomly selected male patient. Synthetic materials were used for the construction of lung parenchyma, blood vessels, and bronchi. Then, the model was assessed in terms of its visual, tactile, and operational features by participants (the senior surgeons, junior surgeons, and medical students), who were asked to complete the specially designed survey-questionnaires. A 3D printed model of the right lung made of synthetic materials was successfully fabricated. Thirty subjects participated in our study (10 senior surgeons, 10 junior surgeons, and 10 medical students). The average visual evaluation scores for senior surgeons, junior surgeons, and medical students were 3.97 ± 0.61, 4.56 ± 0.58, 4.76 ± 0.49, respectively. The average tactile evaluation scores were 3.40 ± 0.50, 4.13 ± 0.68, 4.00 ± 0.64, respectively. The average operation evaluation scores were 3.33 ± 0.83, 3.93 ± 0.66, 4.03 ± 0.66, respectively. Significant lower scores were obtained in the group of the senior surgeons compared with the other two groups. A high level of fidelity was exhibited in our 3D printed lung model and it could be applied as a promising simulator for the surgical training in the future.

Effect of haemoglobin deficiency on cognitive functions in elderly of Bangalore city

Adequate nutrition is fundamental to healthy ageing. Among older adults with anaemia, approximately one-third have evidence of iron, folate, and/or vitamin B deficiency. Lower haemoglobin levels are common in older adults and frequently are measured in clinical practice.1. To assess haemoglobin levels in elderly. 2. To assess cognitive functions in different levels of haemoglobin. This study involved 80 healthy elderly subjects with consideration of inclusion and exclusion criteria. Written informed consent was taken. For each subject, blood sample of 4ml was collected for Haemoglobin assessment. Anthropometric measurements were taken. 24-hour dietary recall, General history questionnaire and Spreen &amp; Stauss Neuropsychology battery of tests were administered.Results were compiled and statistically analyzed. The results show that Elderly with haemoglobin deficiency had statistically significant low scores in all parameters (P &amp;#60; 0.05), especially with executive function &amp; processing speed.It can be concluded that haemoglobin levels were associated with worse global cognitive function and greater decline in psychomotor speed and executive function.

Impact of three-dimensional chemoradiation on pelvic bone mineral density, low back pain, and disability in cervical cancer: a prospective study

ObjectiveTo prospectively analyze the effect of three-dimensional chemoradiation on the bone mineral density of pelvic bones and its association with low back pain and disability in patients with locally advanced...

THE PREFERED LEARNING STYLES OF NURSING STUDENTS AT THAI NGUYEN UNIVERSITY OF MEDICINE AND PHARMACY

Background: Each individual may prefer one or several learning styles. This study aims to explore preferred learning styles of nursing students. Materials and Methods: In this cross-sectional research, 156 participants, who were the second-year nursing students at Thai Nguyen University of Medicine and Pharmacy, were surveyed by self-administered questionnaires. The assessment of learning styles was developed with the reference to the VARK questionnaire developed by Flemming. Students’ learning styles were categorized as Visual, Aural, Read/Write, and Kinesthetic style. Results: It was found that 32.7% of the students did not demonstrate clear preferences to any learning styles. While nearly one-half (28.2%) of respondents prefer one learning style, the percentage of students who were simultaneously interested in two, three, and four learning styles are 17.9%, 12.2%, and 9%, respectively. Notably, the results found no significant difference in students’ preferences to three learning styles, which were Aural, Read/Write, and Kinesthetic. However, there was significant lower score of preference of Visual style in comparison to all other three styles. Conclusions: The preferred learning styles are varied among nursing students. The faculty should not solely pay attention to any single learning style. They should design their teaching to meet students’ various styles, especially the Aural, Read/Write, and Kinesthetic preferences

Patient’s Knowledge and Satisfaction Regarding Nursing services and Physical Infrastructure of a Tertiary Care Hospital Situated in Rural area of Northern India (Haryana)

Background: Nowadays health care quality is a universal concern. The health sector is changing rapidlydue to the escalating requirements and desires of patients. The most appropriate method to measure a client’sexperiences about available hospital services is a patient satisfaction survey. Present study aimed to assesspatient’s knowledge and satisfaction regarding nursing services and physical infrastructure. Methods: 330patients were selected by purposive sampling technique attending various indoor departments of the selectedhospital. Self-structured checklist and three-point rating scale each containing a total 90 sets of items usedto assess knowledge and satisfaction. The reliability coefficient for the knowledge tool was 0.87 by KR 20and satisfaction was found 0.85 by Cronbach’s Alpha. Result: Study results showed that more than half(59.7 %) patients had very good level of knowledge regarding availability of services. 72.4% & 69.7% ofpatients were satisfied with Nursing services and physical infrastructure facilities respectively. Item wisedistribution of level of satisfaction among patients regarding nursing services reveals that “nurses hearyou carefully(64.5%)”, “explain patient’s condition to the family (64.5%),” and “Adequate space in ward(75.5%)” was found ranked 1st with the highest satisfaction, whereas “provide psychological counseling”,“Toilet facility and cleanliness(32.1%)” was found ranked lowest. A significant low positive correlation foundbetween mean knowledge and satisfaction scores regarding nursing services and physical infrastructure asevident by computed ‘r’ value (0.38)Conclusion: Using these necessary responses from the patients, various shortcomings can be pointed outand notify to hospital administration for improvement of the nursing care services & physical infrastructure.

Depression, anxiety, and quality of life in patients undergoing hemodialysis and renal transplantation

Background End-stage renal disease (ESRD) is a severe and debilitating disease. Insignificant data exist on depression, anxiety, quality of life (QoL), and life satisfaction in patients on hemodialysis (HD) in comparison with patients with renal transplantation (RT).Aim The aim of this study was to compare the presence and severity of depression and accompanying anxiety symptoms between HD patients and RT recipients and to correlate both depression and anxiety with the QoL and life satisfaction affection in both groups of patients.Patients and methods A comparative cross-sectional study was conducted on 64 patients with ESRD who were recruited consecutively from the nephrology outpatient clinic of Kasr Al Ainy, Cairo University Hospitals, over a period of 1 year. Patients were applied the Physical, Cognitive, Affective, Social, Economic and Ego Questionnaire to assess QoL, Beck Depression Inventory to assess depression, Middlesex Hospital Questionnaire to assess anxiety, and Life Satisfaction Scale for life satisfaction.Results The study results showed that depression, anxiety, and somatization in the HD group showed significant higher scores than the RT group. Patients on HD were significantly less satisfied with their life and showed lower scores on the physical domain, whereas patients with RT had significant lower scores on the economic domain of QoL. Life satisfaction and most domains of QoL were negatively correlated with depression, anxiety, and somatization in the HD group.Conclusion Depression accompanied with a variety of anxiety symptoms constituted determinants of poor QoL in the setting of ESRD and consequently, less life satisfaction. HD patients showed higher levels of depression, anxiety, and somatization along with poorer QoL and less life satisfaction than patients with RT.

Foot care knowledge, attitudes and practices among patients with diabetic foot and amputation in St. Kitts and Nevis.

About one-third of admissions to the surgical unit annually are diabetes foot infections in need of amputation In St. Kitts and Nevis. However, the risk factors related to diabetes foot and amputation remain unknown. This study investigated factors associated with diabetic foot and amputation (DFA). Retrospective case control study design, and purposive and quota sampling method was used to recruit the participants. Patients with and without DFA were interviewed at two main hospitals, several primary health centres, and a private doctor's office during July and August 2018. Self-development questionnaires were applied to assess patients' demographic, physical and behaviour, foot care knowledge, attitudes, and practices related to DFA. Chi-square, t-test, and multiple logistic regressions were used to analyse the data. A total of 210 patients were evaluated, 89 had DFA, while 121 did not, with a mean age of 61.10 (SD = 11.85). Participants' responses indicated good knowledge, favourable attitudes, and adequate practices related to foot care. The two items of the questionnaire, ways to maintain blood flow in the lower extremities and wash their feet daily, had significant lower score in DFA group. In multiple logistic regression, knowledge, attitudes, and practices related to foot care were not a significant predictor of DFA. Being male was a predictor of DFA than female (OR = 3.53; 95% CI = 1.65-7.57; P < .01). Participants who were currently unemployed were less likely to have DFA than those who were employed (OR = 0.38; 95% Cl = 0.17-0.86; P < .05). Comparing patients with the longest experience of diabetes mellitus (31 years or more) with those who had diabetes for the shortest period of time (between 1 and 10 years) was less likely to have DFA (OR = 0.38; 95% CI = 0.15-0.97; P = <.05). The combination of these independent variables could explain 29% of the variance in DFA. Based on these findings, strategies to prevent diabetic foot and amputation should focus on male and outdoor heavy worker, and longer duration of diabetes patients which are identified in this study.