Objectives To establish if the relatively low rate of involuntary psychiatric admission in a suburban area between 2007 and 2011 was maintained in 2014/2015, and explore key correlates of involuntary status. Methods We used existing hospital records and data sources to extract rates and selected potential correlates of voluntary and involuntary admission in south west Dublin (catchment area: 273 419 people) over 18 months in 2014/2015 and compared these with published national data from the census and Health Research Board. Results The rate of involuntary admission in the suburban area studied between 2007 and 2011 was 33.8 involuntary admissions per 100 000 population annually, which was lower than the national rate (48.6). By 2014/2015, the rate of involuntary admission in this area had risen to 46.8 involuntary admissions per 100 000 population annually, similar to the national rate (44.9). Nevertheless, the overall (voluntary and involuntary) admission rate in the suburban area (346.7 admissions per 100 000 population annually) was still lower the national rate (387.9), owing to a lower rate of voluntary admission in the suburban area (299.9) compared to Ireland as a whole (342.9). Multi-variable testing demonstrated that diagnosis was the strongest driver of involuntary admission in the suburban area: this area had 28.5 involuntary admissions per 100 000 population annually with schizophrenia or related disorders, compared to 18.9 nationally. Schizophrenia and related disorders accounted for 60.9% of involuntary admissions in the suburban area compared to 42.1% nationally. Conclusions Schizophrenia is the strongest driver of involuntary admission in the suburban area in this study.
This study was carried out in the Radiology Department, District Head Quarter Teaching Hospital (D.H. Qr) and Dera X-Rays / Ultrasound Clinic. Dera Ismail Khan, NWFP, by performing abdominal and pelvic ultrasonography of all the suspected patients and endo-vaginal of selected cases by comparing with other modalities used for the diagnosis of pregnancy especially the ectopic. Eighty-five percent cases of ectopic pregnancies were diagnosed by abdominal / pelvic ultrasonography, while this ratio was increased up to 95% by endo-vaginal ultrasonography in those cases where the abdominal sonography was not helpful for accurate diagnosis. The study concluded that increased availability of ultrasonography leads to improve quality in the detection of ectopic pregnancy. It is necessary to screen all the patients with first trimester cramping and bleeding by ultrasonography.
Cardiovascular disease (CVD), a broad-spectrum term comprising coronary artery disease, stroke, hypertension, and heart failure, presents as one of the most significant strains on global healthcare systems. Coronary artery disease, caused by atherosclerosis, has various modifiable risk factors such as dietary changes and exercise. Since these risk factors are found to be linked to oxidative stress and inflammations, the dietary supplementation with vitamins’ role in treating and preventing the diseases has been of much debate. With various vitamins having anti-inflammatory and antioxidative properties, studies have explored their correlation with cardiovascular health. Therefore, this narrative review explores and evaluates the benefits and risks of all vitamin supplementations in patients with CVD and provides future recommendations.
Autism spectrum disorder (ASD) refers to various neurodevelopmental disabilities generally seen in kids. Pakistan, being vulnerable to natural disasters, faced one of the most devastating floods in July 2022 due to which many individuals were displaced. This not only affected the mental health of growing children but also the developing fetus of migrant mothers. This report establishes the link between the aftereffects of migration due to floods on children particularly associated with ASD in Pakistan. Flood affected families are devoid of basic necessities and are under a lot of psychological stress. On the other hand, Extensive treatment for autism is complicated, expensive, and provided in proper settings only which is not easily accessible to migrants. Considering all these factors, there are chances that ASD will be more prevalent in future generations of these migrants. Our study calls on respective authorities to take timely action for this growing concern.
Objectives.Stroke or cerebrovascular accident is a global health problem.It is the second leading cause of morbidity and mortality worldwide.The relationship between dyslipidemia and acute ischemic stroke is intricate and varies according to the type of stroke and lipid levels.Given the inconsistent results of existing studies on the association of stroke with dyslipidemias, there is a need to further explore this relationship and to establish the role of lipid abnormalities in stroke incidence, severity, and prognosis.We aimed this study to know the lipid derangements in acute ischemic stroke patients who were already on lipid-lowering drugs for a substantial duration of time.Material and methods.This study was conducted as a descriptive, retrospective, observational study involving patients admitted in the Stroke Unit, with acute ischemic stroke included those who were using lipid-lowering drugs (most preferably statins) for more than a year with a continuous use for a period of atleast 3 months prior to the event of stroke.A total of 153 individuals met the inclusion criteria, and the sampling was done via non-probability consecutive methods.results.The mean age of the study population is 58.86 ± 14.02.The study population included 52.9% males (n = 81) and 47.1% females (n = 72), with a similar mean age (p = 0.855).The mean total cholesterol was 175.64 ± 51.41, with females had a slightly higher mean (p = 0.349).The mean total triglycerides were 134.01 ± 69.85, with a slightly higher value in males (p = 0.392).The mean LDL levels were found to be 118.41± 45.56, slightly higher in females (p = 0.308).The mean HDL levels were 36.76 ± 9.06 with equal values among the gender (p = 0.295).The mean VLDL was 26.78 ± 13.94 with slight variation among gender (p = 0.406).The mean non-HDL cholesterol was found to be 138.94± 48.02 and was slightly higher in females (p = 0.425).The most frequently deranged lipid marker in the study population was HDL, non-HDL, and LDL.conclusions.Despite the utilization of statins, frequent derangements of lipid markers are reported among acute stroke patients in our study with LDL/HDL ratio was the most prominently deranged lipid marker.
Objectives. To determine the frequency of depression in patients with idiopathic parkinsonism presenting to a tertiary care Hospital in Karachi. Material and methods. This case study was conducted at the neurology department Jinnah Postgraduate Medical Centre, Karachi (JPMC). The duration of the study was six months from 22nd January 2019 to 2nd June 2019. A total of 114 patients of parkinsonism (idiopathic Parkinson’s disease) were included in this study. Patients were assured of confidentiality. They were given questionnaire with Beck depression inventory while waiting in the neurology outpatient clinic. Questionnaire was taken back after 25 minutes. Patient score more than 9 was diagnosed as depression. The identified depressed patient was offered treatment. Results. Frequency of depression in patients with idiopathic Parkinson’s disease was observed in 48.25% (55/114) cases. Conclusions. It is concluded that our study indicates the burden of depression in Parkinson disease (PD) patients. However, even with stable or mild deficit in motor function, the wide prevalence of depression indicates that it should be suspected and treated. Over the past several years, systematic studies of depression and its treatment have contributed significantly to this most challenging psychiatric problem in PD. Hence, there is a need of policy for screening and prompt treatment of such patients so they could lead to enhance quality of life.
Introduction The rising incidence of heart failure (HF) among the U.S. population has become a major concern for healthcare providers. This study aims to assess mortality trends related to HF across different age groups, racial demographics, and geographic locations from 1999 to 2020. Material and methods This descriptive analysis uses death certificate data from the CDC WONDER database to track mortality trends among HF patients from 1999 to 2020. Log-linear regression models were used to delineate trends. The study used deidentified public data, complying with ethical standards. Results Over 21 years, 1,426,657 HF-related deaths were recorded in individuals aged 15 and older, with a slight overall increase in mortality (AAPC = 0.11). Mississippi recorded the highest age-adjusted mortality rates (AAMRs) at 58.0 per 100,000. The Midwest showed the highest regional mortality rates, while the oldest individuals (≥ 85) exhibited the highest crude mortality rate (CMR) of 663.9. Males consistently demonstrated higher AAMRs than females, despite females accounting for 57.6% of the deaths. Black ancestry individuals experienced the highest mortality rates, with rising trends, particularly in non-metropolitan areas. After 2012, significant increases in mortality were noted, especially in individuals over 85, with stable rates in younger demographics. Conclusions Males and Black ancestry individuals are disproportionately affected, demonstrating the need for targeted interventions.
Background Electroconvulsive therapy (ECT) is a widely used treatment for severe psychiatric disorders such as schizophrenia, depression, and mania. The procedure involves applying brief electrical stimulation to induce a seizure, and anesthesia is used to ensure sedation and muscle relaxation. Finding the right anesthetic agent with minimal side effects, especially on seizure duration, is crucial for optimal outcomes because seizure duration is an important factor in the effectiveness of ECT, but the anesthetic agents used can affect it. Objective This systematic review and meta-analysis aimed to pool the results of all relevant studies comparing the two induction agents, etomidate and propofol, for motor and electroencephalogram (EEG) seizure duration outcomes. Methods A comprehensive literature search was conducted in the PubMed, Medline, and Cochrane Library databases to identify the relevant articles. The primary outcome measures were motor and EEG seizure durations. Statistical power was ensured by performing heterogeneity, publication bias, sensitivity analysis, and subgroup analysis. Standard mean difference and 95% confidence intervals were calculated for continuous outcomes, and a random-effects model was used. Results A total of 16 studies were included in this meta-analysis, comprising 7 randomized control trials (RCTs), 7 crossover trials, and 2 cohorts. The overall motor seizure duration was statistically significantly longer with etomidate than with propofol. The overall result for EEG seizure duration was also longer with the use of etomidate over propofol and was statistically significant. In addition, subgrouping was performed based on the study design for both outcomes, which showed insignificant results in the cohort's subgroup for both outcomes, while the RCTs and crossover subgroups supported the overall results. Heterogeneity was assessed through subgrouping and sensitivity analysis. Conclusion Our meta-analysis found that etomidate is superior to propofol in terms of motor and EEG seizure duration in ECT, implying potentially better efficacy. Hence, etomidate should be considered the preferred induction agent in ECT, but larger studies are needed to further validate our findings.
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