Level of physical activity and its association with depression among chronic spinal cord injury patients at a paraplegic centre in Peshawar / Nivel de actividad física y su asociación con la depresión entre pacientes con lesión medular crónica en un centro para parapléjicos en Peshawar

Introduction: Spinal cord injury results in disability, limited participation in physical activities, and mental health problems which greatly affects the quality of life of the injured person. Engaging in physical activity is necessary for optimal recovery in individuals with spinal cord injury. Chronic spinal cord injury patients suffer from many secondary complications which become a challenge for the patient and the health care community to manage due to which recovery will be complex and difficult. The aim of this study is to find out the association of physical activity with depression among chronic spinal cord injury patients at Paraplegic Centre Peshawar.Material and methods: This study was a cross-sectional survey in which a consecutive sampling technique was used. Data was collected from n=109 spinal cord injury patients in which 85 (78.0%) were males and 24 (22.0%) were females. Physical activity was measured using the PARA-SCI scale and the CESD-R-10 questionnaire was used to assess depression.Results: The average minutes of participating in mild physical activity was 67.72 ± 17.98 minutes/week, moderate physical activity was 140.79 ± 33.47 minutes/week, heavy physical activity was 21.92 ± 9.18 minutes/week and total PA was 247.93 ± 55.76. P value= .004 for mild physical activity with depression, p value= .097 for moderate physical activity with depression, p value= .137 for heavy physical activity with depression and p value= .001 for total physical activity with depression.Conclusions: Mild and total physical activity was associated with depression. Moderate and heavy physical activity was not associated with depression. (AU)

Introducción: La lesión de la médula espinal produce discapacidad, participación limitada en actividades físicas y problemas de salud mental que afectan en gran medida la calidad de vida de la persona lesionada. La actividad física es necesaria para una recuperación óptima de las personas con lesión de la médula espinal. Los pacientes con lesiones crónicas de la médula espinal sufren muchas complicaciones secundarias que se convierten en un desafío para el paciente y la comunidad de atención médica debido a que la recuperación será compleja y difícil. El objetivo de este estudio es averiguar la asociación de la actividad física con la depresión entre los pacientes con lesiones crónicas de la médula espinal en el Centro Parapléjico de Peshawar.Material y métodos: Este estudio fue una encuesta transversal en la que se utilizó una técnica de muestreo consecutivo. Se recopilaron datos de n = 109 pacientes con lesión de la médula espinal, de los cuales 85 (78,0 %) eran hombres y 24 (22,0 %) eran mujeres. La actividad física se midió mediante la escala PARA-SCI y el cuestionario CESD-R-10 para evaluar la depresión.Resultados: El promedio de minutos de participación en actividad física leve fue 67,72 ± 17,98 minutos/semana, actividad física moderada 140,79 ± 33,47 minutos/semana, actividad física intensa 21,92 ± 9,18 minutos/semana y AF total 247,93 ± 55,76. Valor de p= .004 para actividad física leve con depresión, valor de p= .097 para actividad física moderada con depresión, valor de p= .137 para actividad física intensa con depresión y valor de p= .001 para actividad física total con depresión.Conclusiones: La actividad física leve y total se asoció con la depresión. La actividad física moderada e intensa no se asoció con la depresión. (AU)

Safety and efficacy of ureteroscopic pneumatic lithotripsy.

OBJECTIVE: To determine the safety and efficacy of ureteroscopic pneumatic lithotripsy (PL) for the clearance of ureteral calculi (UC). STUDY DESIGN: Experimental study. PLACE AND DURATION OF STUDY: Department of Urology, KRL Hospital, Islamabad, from March 2006 till December 2008. METHODOLOGY: Ureteroscopic PL was performed on 104 patients with ureteric calculus measuring > 6 mm; using Swiss Lithoclast through a 9.5 French semi-rigid ureteroscope. At the end of the procedure, a DJ stent was inserted. Complications were noted. Stone clearance was assessed through X-ray KUB. DJ stent was removed within 3 - 6 weeks after the procedure. RESULTS: Sixty-eight patients (65.4%) were males and 36 (34.6%) females. The average hospital stay was 2.6 + 2.8 days; 72 (69.6%) patients were discharged on the first post-procedure day. Complete stone clearance was achieved in 98 (94.2%) patients, at 3-6 weeks. Four patients (26.7% of upper ureteral stones) had stone retropulsion. The only major complication was perforation occurring in 2 (1.9%) distal ureters. One case was successfully managed by endoscopic DJ stent placement, the other required open repair. CONCLUSION: Ureteroscopic PL is effective in clearing majority of middle and distal UC. Patients with proximal stones may have stone retropulsion. Ureteric perforation is an uncommon complication.