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Biomedical subjects

S Pai

Publications and source records attributed to S Pai.

At least 73 records · Page 4Linked to original sources

Disaster severity and emotional disturbance: implications for primary mental health care in developing countries.

Two months following the 1987 earthquakes in Ecuador, 150 patients in the primary health care clinics of the area were screened for emotional problems; 40% of them were emotionally distressed. Risk factors included not being married, reporting poor physical or emotional health, and having ill-defined physical complaints. The findings from this research are discussed in relation to a disaster of much greater intensity, whose victims were studied by the authors, utilizing the same instrument and research design. The comparison between these 2 groups of disaster victims revealed that: 1) the prevalence of emotional distress was smaller among the Ecuador victims, but the frequency of symptoms among the distressed was similar for both groups; 2) the symptom profiles were remarkably similar; and 3) the most frequent symptoms and the strongest predictors of emotional distress were very similar. These findings support a focused training of health care workers on selected emotional problems that are regularly present among victims of different disasters.

Adolescent↗

[Primary mental health care for the victims of the disaster in Armero, Colombia].

Seven to eight months after the disastrous volcanic mudslide that destroyed the town of Armero, Colombia, 200 victims were screened up by means of the Self-Reporting Questionnaire (SRQ) for emotional disorders identification. In order to assess disorders' specific nature, a 104-victim subsample was interviewed by psychiatrists. The most frequent diagnosis ranged among (a) Post-traumatic stress syndrome, (b) Depressión, and (c) Generalized anxiety disorder. Our findings help us to point out that (1) In a developing country a higher prevalence of well-defined emotional disorders among victims of any first-magnitude disaster is to be detected at such a level it can safely be said a real epidemic is to be tackled with, (2) Basically, the identified symptomatology confines itself to anxiety-depression disorders, (3) SRQ is indeed an apt instrument for disasters victims screening, and (4) Mental health specialized resources proved to be insufficient for an adequate coverage of the needs of the affected communities to be performed. As far as mental health is concerned, if the necessary services are to be offered so that all aspects involved are taken care of, it is imperative that victims be attended to by primary care workers. So far, mental health primary care area is still lacking a systematical research within a disaster situation framework. We understand that our paper may serve as an initial orientation for this care strategy being duly implemented and furthered up.

Adolescent↗

Elevation of serum aluminum in humans on a two-day sucralfate regimen.

Serum aluminum concentrations were determined in ten healthy subjects treated with phenytoin 500 mg and with sucralfate and phenytoin in a crossover fashion. Each subject received four 1,000-mg sucralfate tablets between 8 AM and 10 PM one day before the study, and this was repeated during the study day. A total of eight doses of sucralfate was administered over the two-day period. Serum samples were drawn at 0, 2, 4, 8, 12, 24, 32, and 48 hours after administration. The areas under the serum aluminum concentration-time curves before and after sucralfate (mean +/- SD) were 496.0 +/- 80.9 and 770.9 +/- 146.6 hr-ng/mL, respectively. This increase is statistically significant (P less than .01), indicating that serum aluminum levels are elevated even after two days of treatment with sucralfate. The results from this study are not in agreement with the only other report on this subject.

Adult↗

Concurrent medical and psychiatric disorders among schizophrenic and neurotic outpatients.

The records of two groups of patients (358 schizophrenics and 69 neurotics), attending the community mental health center of the Johns Hopkins Hospital, were reviewed to assess the extent and severity of reported medical problems. Results indicate that 38% of the schizophrenics and 53% of the neurotics report medical problems, but schizophrenics present with serious medical problems more often than do the neurotics. The authors draw attention to the need for properly assessing the severity of these medical problems and for adequately coordinating psychiatric and medical care. Strategies to overcome these difficulties are suggested.

Adult↗

Evidence in humans for a postsynaptic interaction between noradrenaline and angiotensin II with regard to systolic but not diastolic blood pressure.

Much animal evidence exists to suggest that there is an interaction between noradrenaline (NA) and angiotensin II (AII). We have now sought evidence for a postsynaptic AII/NA interaction. Ten normotensive volunteers were infused with dextrose/saline, All/saline, dextrose/NA or AII/NA in a randomized single-blind fashion. The respective increases in systolic blood pressure (SBP) were -4 +/- 6, -2 +/- 9, 4 +/- 6 and 14 +/- 16 mmHg at comparative time intervals while the corresponding increases in diastolic blood pressure (DBP) were 2 +/- 4, 6 +/- 7, 9 +/- 6 and 14 +/- 8 mmHg. ANOVA confirmed that AII and NA had a synergistic interaction (P less than 0.05) in elevating SBP while there was merely an additive effect in elevating DBP. Plasma NA and AII levels were unchanged by the coincidental presence of AII and NA, respectively, which excludes a generalized pharmacokinetic interaction between AII and NA. This study provides evidence for a postsynaptic AII/NA interaction with regard to SBP but not DBP although the precise location of this interaction remains uncertain. Therefore, in considering the pathogenesis of SBP abnormalities, concomitant measurements of both NA and AII may be important.

Analysis of Variance↗

Screening for the psychological consequences of a major disaster in a developing country: Armero, Colombia.

Seven months following the volcanic eruption that destroyed the small town of Armero, 200 victims were screened for emotional problems with the Self-Reporting Questionnaire, a simple and reliable instrument. Fifty-five percent of the victims were found to be emotionally distressed. Variables associated with the presence of emotional distress included living alone, having lost previous job, feeling not being helped, not knowing date for leaving temporary shelter, being dissatisfied with living arrangements, complaining of non-specific physical symptoms or epigastric pain, and presenting several physical problems. The high prevalence of emotional distress supports the need to deliver mental care to disaster victims in developing countries through the primary level of care. Our findings provide guidelines for early detection of individuals at risk for developing emotional problems.

Adolescent↗

Logistic analysis of risk factors in acute retinopathy of prematurity.

In a prospective study of 328 high-risk neonates, we used computer-assisted logistic regression of 47 potential risk factors to study acute retinopathy of prematurity. Only four factors were significant in the logistic regression equation: ventilator hours, xanthine administration, birthweight, and maternal bleeding. Xanthine administration was identified as a new independent and significant (P less than .0001) predictor of acute retinopathy of prematurity.

Female↗

Home care for chronic mental illness in Bangalore: an experiment in the prevention of repeated hospitalization.

The article describes the outcome of a comparative study of home care, by a trained nurse, versus hospital out-patient supervision in the management of chronic psychiatric patients in Bangalore, India. Twenty-five patients, with a mean duration of illness of nine years, were started on the home care programme while a matched control group of 25 similar patients continued the regular out-patient contact offered by the hospital. Comparative assessments were carried out on the groups at the time of intake and again after two years. The results indicate that hospital admission was less often needed among the home care group.

Adult↗

Physiologic changes associated with endotracheal intubation in preterm infants.

Physiologic changes associated with endotracheal intubation were examined in 10 preterm infants. Laryngoscopy was associated with apnea and minor abnormalities in cardiac rhythm in 2 infants. Three infants had nasal airflow recordings which demonstrated obstructed breaths during laryngoscopy. Systolic blood pressure (BP) increased 47% when the trachea was intubated, whereas heart rate and transcutaneous oxygen tension (PtcO2) decreased. Because endotracheal intubation is a physiologically stressful procedure, personnel who intubate preterm infants must be skilled and experienced to minimize the duration of laryngoscopy and the number of intubation attempts.

Blood Pressure↗

Neonatal bladder injury occurring after umbilical artery catheterization by cutdown.

Umbilical artery catheterization is a widely used technique for monitoring sick neonates. When it is performed by cutdown, the proximity of peritoneum, urachus, and bladder makes these structures vulnerable to injury. Three neonates experienced bladder perforation that resulted from umbilical artery catheterization by cutdown. The diagnosis was aided by measuring electrolyte levels in the umbilical fluid and was confirmed by cystography. Conservative treatment was successful in one neonate, but two required operative repair of the bladder laceration.

Catheterization↗

Evaluation of home care treatment for schizophrenic patients.

Twenty-seven patients diagnosed as schizophrenics suffering their first episode of illness and who had not received any prior medical treatment for the present illness, have been treated in their own homes. The treatment was carried out by a visiting nurse, trained in follow-up assessment and counselling. The outcome of this group was compared with a similar group of 27 patients who underwent initial mental hospital admission and subsequent outpatient follow-up. Both groups were followed up for 6 months. The results reveal that the home treatment through a visiting nurse gives a better clinical outcome, better social functioning of the patient and greatly reduces the burden on the patients' families. This treatment modality is also more economical.

Adolescent↗

Follow-up study of schizophrenic patients initially treated with home care.

A follow-up enquiry was carried out after two years on 54 patients who had earlier participated in a controlled experiment on home-care through a community nurse in Bangalore. Thirty seven of these patients could be contacted, of whom 21 had undergone the experimental care (home care) and 16 were from the control group, which had been treated by hospital admission. It was found that the experimental subjects had maintained a significantly better clinical status than the controls, and had been readmitted less often.

Follow-Up Studies↗