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Burden and Quality of Life Among Primary Caregiver of Alcohol Dependence Syndrome
Bharat Kumar Goit,
Bishnu Acharya,
Jai Bahadur Khattri,
Rakhi Sharma
Issue:
Volume 9, Issue 1, March 2021
Pages:
1-6
Received:
18 December 2020
Accepted:
25 December 2020
Published:
12 January 2021
Abstract: Background: Alcohol Dependence syndrome is one of the common psychiatric illnesses in the society. It not only affects the individual but also has major impact on the family members especially the primary caregiver. There are minimum studies regarding impact of the alcohol dependence patients on the primary caregiver in Nepal. The objective of this study was to study the burden and quality of life among primary caregiver of alcohol dependence syndrome. Material and Methods: This is a cross-sectional study conducted among the primary caregiver of alcohol dependent patient. This study is conducted in the in-patient and out-patient unit of Psychiatric Department of National Medical College and Teaching Hospital, Birgunj, Nepal. The total sample size was 123 taken by non-probability homogenous purposive sampling method. The diagnosis of alcohol dependence syndrome was made using International Classification of Disease-10 (ICD-10) criteria. The socio-demographic profile of alcohol dependence patients and their primary caregivers were assessed using semi-structured proforma. The burden and quality of life of the primary caregiver of the alcohol dependent patient were determined using Family Burden Interview Schedule (FBIS) and World Health Organization Quality of Life- BREF version. The data were entered and analyzed using SPSS 21. Result: In this study, it was found that caregiver of Alcohol Dependence Syndrome patient faced moderate to severe burden according to the different domains of Family Burden Interview Schedule. In quality of life assessment, the mean score on perception of quality of life was 2.78 (±0.66) and the mean score on overall perception of health was 3.57 (±0.64). Similarly, the mean score on physical health was 23.40 (±3.04), the mean score on psychological health was 18.91 (±2.36), the mean score on social relationships was 10.63 (±1.39), the mean score on the environment was 25.58 (±2.80) which indicates the poorer quality of life in the caregiver of alcohol dependent patient. Conclusion: The study concluded that burden level on the primary caregiver of alcohol dependent patient was moderate to severe. The quality of life of the caregiver of alcohol dependent patient had poorer quality of life.
Abstract: Background: Alcohol Dependence syndrome is one of the common psychiatric illnesses in the society. It not only affects the individual but also has major impact on the family members especially the primary caregiver. There are minimum studies regarding impact of the alcohol dependence patients on the primary caregiver in Nepal. The objective of this...
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A Critical Look at the Concept of Addiction in DSM-5 and ICD-11
Issue:
Volume 9, Issue 1, March 2021
Pages:
7-14
Received:
8 December 2020
Accepted:
16 December 2020
Published:
15 January 2021
Abstract: The article begins by providing an overview of the conceptual roots of addiction as a disorder as described in DSM-5 and ICD-11. The underlying organ-pathological perspective is then criticized and an alternative social-science perspective is presented: The “dependence syndrome” defines addiction independently of the cultural, socio-demographic and situational context. States of inebriation are reduced to the effects of substances described in pharmacological terms. Diagnoses are based on only a few abstract criteria. The biography of the person affected is not taken into account; neither are the severity of the disorder (e.g. quantity and frequency of consumption or activity), sociodemographic characteristics or defense structure. The core concept of “impaired control” is a metaphor: The individual’s hierarchically structured ability to control her addictive behavior is not clarified. Neurobiological models contain overgeneralizations and speculative connections between brain processes and addictive behavior. One aspect which remains unconsidered is that addiction is primarily social. Addiction is rooted in a continuing lack of social integration and requires a wide range of inebriation-specific incentives. Addictive behavior can be seen as a purposeful coping mechanism for excessive burdens. In order to overcome an addiction, the sufferer’s autonomy needs to be strengthened in order to ensure the regeneration of physical health, individual competences and interpersonal relationships. This requires the cooperation of the relevant professional groups.
Abstract: The article begins by providing an overview of the conceptual roots of addiction as a disorder as described in DSM-5 and ICD-11. The underlying organ-pathological perspective is then criticized and an alternative social-science perspective is presented: The “dependence syndrome” defines addiction independently of the cultural, socio-demographic and...
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An Unusual Case of Progressive Multifocal Leukoencephalopathy in an Immunocompetent Patient Masquerading as a Stroke
Nisahan Balasingam,
Zhi Yang Siow,
Athula Kosgallana,
Tom Robertson
Issue:
Volume 9, Issue 1, March 2021
Pages:
15-18
Received:
17 February 2021
Accepted:
4 March 2021
Published:
22 March 2021
Abstract: Background: Progressive multifocal leukoencephalopathy is a fatal demyelinating condition due to reactivation of latent JC virus in cerebral white matter. Its prevalence is 1in 200,000 and extremely rare in immunocompetent individuals. It can mimic subacute stroke, brain tumours and other demyelinating conditions which have different outcomes. PML typically occurs in an immunocompromised patient, where the archetype JC virus gains pathogenic potential and initiate oligodendroglial inflammation. Currently, the immune reconstitution is considered as the treatment of choice; however, paradoxical worsening with IRIS PML is a significant challenge. There is limited evidence available on how to manage PML in immune competent patients. Direct antiviral agents have no convincing evidence to-date. There is anecdotal evidence that IL-2, filgrastim, and vaccination may be helpful. Case presentation: A 74-year-old man presented with right-sided weakness and dysphasia. He was initially managed as having subacute stroke based on imaging and clinical findings. He subsequently deteriorated, triggering to revisit of the original diagnosis and repeat imaging. He underwent extensive workup, including lumbar puncture and JC viral testing. He was commenced on Mirtazapine to prevent JC viral spread; however, he later passed away. A subsequent post-mortem brain biopsy confirmed the progressive leukoencephalopathy. Conclusion: Even though extremely rare, progressive multifocal leukoencephalopathy should be considered in the differential diagnosis of progressive neurological conditions. It is essential to rule out other treatable conditions as progressive multifocal leukoencephalopathy has a fatal outcome invariably.
Abstract: Background: Progressive multifocal leukoencephalopathy is a fatal demyelinating condition due to reactivation of latent JC virus in cerebral white matter. Its prevalence is 1in 200,000 and extremely rare in immunocompetent individuals. It can mimic subacute stroke, brain tumours and other demyelinating conditions which have different outcomes. PML ...
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Psychology in Pregnancy: Cases of 50 Primigravidae Followed up in Prenatal Consultation at the South Abobo General Hospital (Abidjan)
Konan Koffi Paulin,
Ahounou Etobo Innocent,
Traore Brahim Samuel,
Toure Petiori Laurence,
Mbra Amenan Gisele,
Yeo-Tenena Yessonguilana Jean-Marie
Issue:
Volume 9, Issue 1, March 2021
Pages:
19-24
Received:
23 February 2021
Accepted:
5 March 2021
Published:
26 March 2021
Abstract: Pregnancy is a time of fragility and maturation, and always involves important psychological adjustments. The primigravidae, who are women carrying their first pregnancy, are not left out of these problems. As a study in Togo has shown, psychological disorders were more frequent in young pregnant women and in primigravidae. In view of this reality, which is observed in all women during their first pregnancy, we felt the need to undertake a study whose general objective was to describe the psychological experience of primigravidae followed in prenatal consultation at the Abobo-Sud General Hospital. This was a cross-sectional prospective study with a descriptive aim. It involved a sample of 50 consenting primigravidae selected according to the technique of accidental or convenience sampling. The results showed that 44% of the primigravidae were under 20 years old and 54% of them did not live in a couple. When the pregnancy was announced, the main reactions observed were: discouragement / sadness (66%), joy (60%) and crying (44%). In 40% of the cases, the pregnancy was unwanted and was negatively perceived by 54% of the primigravidae. The reasons for this negative perception were: parental anger (32%), not being ready to become a mother (28%) and financial difficulties (26%). The desire for an abortion was expressed by 40% of those who did not wish to have a child. Regarding the act of childbirth, 84% of primigravidae were afraid, because of their inexperience and the pain they would experience. The difficulties they encountered were sleep disturbances (80%) and financial difficulties (72%). Although the results of this study already take into account the physical parameters, the results of this study plead in favour of including psychological aspects in the follow-up of primigravidae during prenatal consultations. Hence the importance of training midwives in the care of primigravidae.
Abstract: Pregnancy is a time of fragility and maturation, and always involves important psychological adjustments. The primigravidae, who are women carrying their first pregnancy, are not left out of these problems. As a study in Togo has shown, psychological disorders were more frequent in young pregnant women and in primigravidae. In view of this reality,...
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