Comparison of demographic, clinical, spirometry, and radiological parameters between smoking and non-smoking COPD patients in rural Gujarat, India.

CONTEXT: A total of 20% of Chronic Obstructive Pulmonary Disease(COPD) patients are non-smokers due to preventable causes, such as biomass fuel exposure, post tuberculous sequelae, occupational exposure, air pollution, persistent chronic asthma, and genetic predisposition. AIMS: To compare smokers and non-smokers with COPD. SETTINGS AND DESIGN: An observational study was conducted at a tertiary care hospital on 60 patients diagnosed with COPD, (GOLD criteria), who were divided into smoker and non-smoker groups. SUBJECTS AND METHODS: Demographic data, clinical profile, smoking history, and radiological data were collected and compared. Exclusion criteria were individuals having active pulmonary tuberculosis and reversible air flow limitations. STATISTICAL ANALYSIS USED: Using STATA 14.2, quantitative and qualitative data were presented using descriptive statistics. RESULTS: A total of 100% of smokers were male, whereas 70% of non-smokers were female. Compared to non-smokers (16.67%), smokers (26.6%) presented with higher grade of dyspnea. A statistically significant difference was seen with more smokers diagnosed as severe (40%) and very severe (30%) COPD compared to non-smokers with mild (16.67%) and moderate (46.67%) COPD (P < 0.012), Post bronchodilator FEV1 among smokers (42.63) compared to non-smokers (56.63) (P < 0.01) and decrease in FEV1 as the grade of dyspnea increased (P < 0.002). Compared to 36.67% in non-smokers, 70% smokers showed emphysematous x-rays. CONCLUSIONS: In our study we found majority of non-smokers to be female, and smokers had a higher grade of dyspnea, more severe COPD, lower post bronchodilator FEV1, and more emphysematous changes on x-rays.

Frequency of emotional disturbances among hostelites and day scholars medical students.

OBJECTIVE: This study was aimed to determine and compare the frequency of the emotional disturbances, anxiety and depression among the medical students on Hospital Anxiety Depression scale (HAD) score among the hostelites and day scholars. METHODS: This cross sectional study was conducted at a private medical college in Faisalabad, Pakistan, from March 2019 to April 2019, comprising of 105 male and female students. Validated Hospital Anxiety depression scale (HAD-A and HAD-D) was used to collect data from 1st year and 2nd year MBBS students in order to evaluate anxiety and depression among them. Data was analyzed on SPSS 21. Pearson's Chi-square was applied to compare the percentages of anxious and depressed subjects among the studied group. Independent sample t-test was applied for comparison of mean HAD scores between hostelites and day scholars. P value ≤ 0.05 was taken as significant. RESULTS: There were 105 students in the study with a mean age of 19.4±0.68 years. Overall, 82.7% students had anxiety, and 52.1% suffered from depression. Average HAD -A and HAD- D scores were 11.2±3.41 and 7.2±3.37 respectively. Greater number of hostelites was suffering from emotional disturbances as compared to day scholars. HAD -A scores was significantly higher in hostelites than day scholars with P value 0.003*(11.85±3.42 Vs 10.92 ±2.56). HAD- D scores were also higher in hostilities but difference was insignificant. (7.57±3.42 Vs 6.85 ±1.58). CONCLUSIONS: Emotional disturbance including anxiety and depression are found to be highly prevalent among medical students of a private medical college in Faisalabad. Hostelites are more prone to anxiety and depression than day scholars.

The Impact of Autism Spectrum Disorder in Comparison with Other Neuro-Developmental Disorders in Children on the Family: Single Centre Experience.

BACKGROUND: Neurodevelopmental disorders (NDD), especially autism spectrum disorder (ASD), have a substantial impact on the family, with a consequent decrease in the quality of life. The current study was undertaken to understand if having ASD contributed to a higher impact on families compared to other NDD and to understand additional factors impacting families of children with either disorder in a low-middle income country (LMIC) setting. METHODS: Impact of ASD and other NDD along with sociodemographic factors was examined, by a retrospective analysis, among 540 children in a tertiary care center in South India. RESULTS: Both ASD and NDD had high, but comparable, impact on the family. Being a girl child, having seizures, and having sleep problems predicted a higher impact. CONCLUSIONS: In children with NDD, managing co-morbidities such as achieving better seizure control and addressing sleep-related problems may improve the impact of NDD on the family. Gender disparity in disability needs to be studied within the local cultural context.

Impact of chemical modification of sulfamidase on distribution to brain interstitial fluid and to CSF after an intravenous administration in awake, freely-moving rats.

Mucopolysaccharidosis III A (MPS IIIA) is an autosomal recessive lysosomal storage disorder caused by deficiency of the enzyme sulfamidase. The disorder results in accumulation of heparan sulfate, lysosomal enlargement and cellular and organ dysfunction. Patients exhibit progressive neurodegeneration and behavioral problems and no treatment is currently available. Enzyme replacement therapy is explored as potential treatment strategy for MPS IIIA patients and to modify the disease, sulfamidase must reach the brain. The glycans of recombinant human sulfamidase (rhSulfamidase) can be chemically modified to generate CM-rhSulfamidase. The chemical modification reduced the affinity to the cation-independent mannose-6-phosphate receptor with the aim a prolonged higher concentration in circulation and thus at the blood brain barrier. The pharmacokinetic properties in serum and the distribution to brain and to cerebrospinal fluid (CSF) of chemically modified recombinant human sulfamidase (CM-rhSulfamidase) were studied and compared to those of rhSulfamidase, after a single intravenous (i.v.) 30 mg/kg dose in awake, freely-moving male Sprague Dawley rats. Distribution to brain was studied by microdialysis of the interstitial fluid in prefrontal cortex and by repeated intra-individual CSF sampling from the cisterna magna. Push-pull microdialysis facilitated sampling of brain interstitial fluid to determine large molecule concentrations in awake, freely-moving male Sprague Dawley rats. Together with repeated serum and CSF sampling, push-pull microdialysis facilitated determination of CM-rhSulfamidase and rhSulfamidase kinetics after i.v. administration by non-compartments analysis and by a population modelling approach. Chemical modification increased the area under the concentration versus time in serum, CSF and brain interstitial fluid at least 7-fold. The results and the outcome of a population modelling approach of the concentration versus time data indicated that both compounds pass the BBB with an equilibrium established fairly rapid after administration. We suggest that prolonged high serum concentrations facilitated high brain interstitial fluid concentrations, which could be favorable to reach various target cells in the brain.

Sociodemographic, Legal, and Clinical Profiles of Female Forensic Inpatients in Karnataka: A Retrospective Study.

BACKGROUND: Forensic patients are often admitted to psychiatric hospitals without any details of illness or treatment. They pose a unique challenge for clinical services in the context of diagnosis, management, and particularly legal issues. MATERIALS AND METHODS: We conducted a retrospective chart review using a structured data-extraction tool. A total of 23 female forensic inpatients were admitted under the Department of Psychiatry from January 2006 to June 2016. Data were analyzed by descriptive statistics. RESULTS: The mean age of the patients was 31.3 ± 7.9 years. In total, 82.6% of them were married, 87% were from a nuclear family, and 78.3% were from an urban background. Totally, 73.9% were referred from prison and 26.1% from the court. However, 73.9% were referred for the purpose of diagnosis and treatment and 21.7% for assessment of fitness to stand trial. Moreover, 47.8% had an alleged charge of murder (of killing close family members). A total of 30.4% had schizophrenia and other psychotic disorders, and 47.8% had a mood disorder. The mean duration of inpatient care was 6.2 ± 7.4 weeks, and 87% had shown considerable clinical improvement at the time of discharge. CONCLUSIONS: The majority of female forensic patients were young adults from nuclear families. They had mood disorders, schizophrenia, and other psychotic disorders. They were referred primarily for treatment purposes. Prospective studies are required for a better characterization of the relationship between crime and psychiatric disorders.

Psychophysiological stress response and memory in borderline personality disorder.

Background: Previously, we found that patients with borderline personality disorder (BPD) but not healthy controls (HC) showed improved memory retrieval after hydrocortisone administration. Objective: In this study, we examined whether increases in endogenous cortisol after psychosocial stress are associated with memory function in patients with BPD and in healthy individuals. Methods: We recruited 49 female patients with BPD and 49 female HC. All participants were exposed to a psychosocial stressor, the Trier Social Stress Test (TSST) and a control condition (Placebo (P-)TSST) in randomized order. Salivary cortisol, alpha amylase (sAA) and blood pressure were measured in response to stress. Subsequently, we examined free recall of a previously learned word list, autobiographical memory, and working memory. Results: We found a stress*time*group interaction effect for the cortisol response and for sAA to stress, which is mainly triggered by a slightly different increase in cortisol between groups from pre to post TSST. Furthermore, BPD patients showed a less pronounced increase in diastolic blood pressure compared to HC after stress. There was no effect of stress on memory performance in any tests, either in healthy controls or in patients with BPD. Conclusion: Our results suggest a slightly blunted response of the HPA axis and the sympathetic nervous system to stress in BPD compared to healthy women. In contrast to hydrocortisone administration, psychosocial stress did not improve memory retrieval in BPD patients. This might be explained by lower cortisol concentrations and parallel increases in norepinephrine and negative affect after stress.

Antecedentes: Previamente, encontramos que los pacientes con trastorno de personalidad límite (TPL), contrariamente a los controles sanos (CS), mostraron una mejor recuperación de memoria después de la administración de hidrocortisona.Objetivo: En este estudio, examinamos si los aumentos en el cortisol endógeno, después del estrés psicosocial están asociados con el funcionamiento de la memoria en pacientes con TPL y en individuos sanos.Métodos: Se reclutaron 49 pacientes de sexo femenino con TPL y 49 mujeres CS. Todas las participantes fueron expuestas a un estresante psicosocial, la Prueba de estrés social de Trier (TSST) y una condición de control (Placebo (P-) TSST) en orden aleatorio. El cortisol salival, la alfa amilasa (sAA) y la presión arterial se midieron en respuesta al estrés. Posteriormente, examinamos la recuperación libre de una lista de palabras previamente aprendida, la memoria autobiográfica y memoria de trabajo.Resultados: Encontramos un efecto de interacción grupal estrés*tiempo* para la respuesta de cortisol y para sAA al estrés, gatillada principalmente por un aumento ligeramente diferente en el cortisol entre los grupos desde el pre al post TSST. Además, las pacientes con TPL mostraron un aumento menos pronunciado en la presión arterial diastólica en comparación con las CS después del estrés. No hubo efecto del estrés en el rendimiento de la memoria en ninguna prueba, ni en controles sanos ni en pacientes con TLP.Conclusión: Nuestros resultados sugieren una respuesta ligeramente atenuada del eje Hipotálamo-Hipófisis-Adrenal y del sistema nervioso simpático al estrés en TPL en comparación con mujeres sanas. En contraste con la administración de hidrocortisona, el estrés psicosocial no mejoró la recuperación de la memoria en pacientes con TPL. Esto podría explicarse por menores concentraciones de cortisol y aumentos paralelos de norepinefrina y afecto negativo después del estrés.

Quality of life among patients with age-related severe macular degeneration assessed using the NEI-VFQ, HADS-A, HADS-D and SF-36 tests. A cross-sectional study

ABSTRACT BACKGROUND: Exudative age-related macular degeneration (e-AMD) may cause severe central vision loss. Patients with e-AMD can experience difficulties in daily basic activities and suffer from psychological problems. Our aim was to assess quality of life (QoL) and anxiety and depression status among patients with e-AMD. DESIGN AND SETTING: Cross-sectional study in a state university. METHODS: We included 200 e-AMD patients and 120 age and gender-matched controls. We assessed QoL using the National Eye Institute Visual Functioning Questionnaire-25 (NEI-VFQ-25) and the Short Form (SF)-36 test; and anxiety and depression status using the Hospital Anxiety Depression Scales A and D (HADS-A and HADS-D). RESULTS: The mean ages in the e-AMD and control groups were 68.40 ± 9.8 and 66.31 ± 8.98, respectively. Visual acuity among e-AMD patients was 0.37 ± 0.31 and 0.39 ± 0.32 in the right and left eyes, respectively. The e-AMD patients performed significantly worse than the controls in NEI-VFQ-25 (P < 0.05 for all items). The proportions of e-AMD patients scoring higher than the cutoffs in HADS-A and HADS-D were significantly higher than among the controls (41.5% versus 12.5% and 63.5% versus 27.5%; P < 0.001). The e-AMD patients had significantly lower mean scores than the controls for each of the SF-36 QoL items (P < 0.001). The NEI-VFQ-25 scores were significantly lower among patients with bilateral e-AMD than among those with unilateral disease (P < 0.05 for all). The HADS scores were positively correlated with duration of e-AMD and patient age, but negatively with vision levels (P < 0.05 for all items). CONCLUSION: The e-AMD patients had higher depression and anxiety scores and lower QoL scores.

Moderating Role of the Experience of having had a Female Boss in Relationship between Neosexism and Unfavorable Attitudes toward Female Leaders.

Modern sexist beliefs are currently emerging as one of the most important barriers to achieving gender equality in managerial positions in organizations. However, little research addresses the factors that can reduce or soften the negative effects that these beliefs have on unfavorable attitudes toward female leaders. In the present study, it is analyzed whether the experience of having a female leader moderates this relationship. Additionally, we sought to verify whether this moderation is found in both genders. A sample of 307 employees from various positions in Spanish companies participated in this study. We performed regression analyses in blocks. The results indicate that this moderating role emerges only among women. Nevertheless, the findings also indicate that coming into contact with female leaders can increase these attitudes when the level of neosexism is low. The results suggest that the organizational policies that are introduced with the aim of reducing unfavorable attitudes and discriminatory behaviors toward female leaders should take into account that the assignment of women to leadership positions may favor the achievement of this aim in, at least, female employees who highly adhere to neosexist beliefs. However, this could also lead to an increase of these attitudes in female employees who present a low adherence to them.

The mediating role of shame in the relationship between childhood bullying victimization and adult psychosocial adjustment.

Background: Psychological distress following experiencing bullying victimization in childhood has been well documented. Less is known about the impact of bullying victimization on psychosocial adjustment problems in young adulthood and about potential pathways, such as shame. Moreover, bullying victimization is often studied in isolation from other forms of victimization. Objective: This study investigated (1) whether childhood experiences of bullying victimization and violence were associated with psychosocial adjustment (distress, impaired functioning, social support barriers) in young adulthood; (2) the unique effect of bullying victimization on psychosocial adjustment; and (3) whether shame mediated the relationship between bullying victimization and these outcomes in young adulthood. Method: The sample included 681 respondents (aged 19-37 years) from a follow-up study (2017) conducted via phone interviews derived from a community telephone survey collected in 2013. Results: The regression analyses showed that both bullying victimization and severe violence were significantly and independently associated with psychological distress, impaired functioning, and increased barriers to social support in young adulthood. Moreover, causal mediation analyses indicated that when childhood physical violence, sexual abuse, and sociodemographic factors were controlled, shame mediated 70% of the association between bullying victimization and psychological distress, 55% of the association between bullying victimization and impaired functioning, and 40% of the association between bullying victimization and social support barriers. Conclusions: Our findings support the growing literature acknowledging bullying victimization as a trauma with severe and long-lasting consequences and indicate that shame may be an important pathway to continue to explore. The unique effect of bullying victimization, over and above the effect of violence, supports the call to integrate the two research fields.

Planteamiento: La angustia psicológica después de haber experimentado victimización por acoso en la infancia ha sido bien documentada. Se sabe menos sobre el impacto de la victimización por acoso en los problemas de ajuste psicosocial en la adultez joven y sobre vías potenciales, como la vergüenza. Además, la victimización por acoso a menudo se estudia aisladamente de otras formas de victimización. Objetivo: Este estudio investigó (1) si las experiencias infantiles de victimización por acoso y violencia estaban asociadas con el ajuste psicosocial (angustia, funcionamiento, barreras al apoyo social) en la edad adulta; (2) el efecto único de la victimización por intimidación en el ajuste psicosocial; y (3) si la vergüenza mediaba en la relación entre la victimización por acoso y estos resultados en la adultez temprana. Método: La muestra incluyó 681 encuestados (con edades entre 19 y 37 años) de un estudio de seguimiento (2017) realizado a través de entrevistas telefónicas derivadas de una encuesta telefónica comunitaria recopilada en 2013. Resultados: Los análisis de regresión mostraron que tanto la victimización por acoso como la violencia grave se asociaban de manera significativa e independiente con la angustia psicológica, el deterioro del funcionamiento y el aumento de las barreras al apoyo social en la edad adulta. Además, los análisis de mediación causal indicaron que cuando se controlaba la violencia física infantil, el abuso sexual y los factores sociodemográficos, la vergüenza mediaba en un 70% de la asociación entre la victimización por acoso y la angustia psicológica, en un 55% de la asociación entre la victimización por acoso y el deterioro del funcionamiento y en el 40% de la asociación entre la victimización por acoso y las barreras al apoyo social. Conclusiones: Nuestros hallazgos apoyan la creciente literatura que reconoce la victimización por acoso como un trauma con consecuencias severas y duraderas, e indican que la vergüenza puede ser un camino importante para continuar explorando. El efecto singular de la victimización por acoso, más allá del efecto de la violencia, respalda la llamada a integrar los dos campos de investigación.

Skin temperature changes during a footbath in patients who had had a stroke with consequent sensory impairment.

AIM: The objectives of this study were to examine skin temperature changes on the unaffected and affected sides as well as changes in perceived temperature and comfort during a footbath in patients who had had a stroke with consequent sensory impairment. METHODS: The study used a quasi-experimental design in which the results of intervention for patients who had had a stroke and healthy adults were compared. The subjects were 20 patients who had had a stroke with consequent sensory impairment and 20 healthy adults. RESULTS: Before the footbath, the skin temperature of the dorsum of the foot on the affected side of the patient who had had a stroke was lower than that of the foot on the unaffected side. Five minutes after the start of the footbath, however, the relationship reversed, with the skin temperature on the affected side increasing in parallel with the water temperature. After the footbath, the dorsum skin temperature on the affected side was again lower than that on the unaffected side. In healthy adults, a difference was found in dorsum skin temperature between the left and right feet. In contrast with patients who had had a stroke, no reversal of the sides was found with the lower and higher temperature. CONCLUSION: Unlike in the healthy adults, the skin temperature of the patients who had had a stroke with consequent sensory impairment was susceptible to changes in the external environment. However, no significant changes in the physiological indices were seen, while perceived temperature and comfort remained at high levels after the footbath.