This seminar explains about the development, relations, ligaments, various attachments, vascular and nervous supply and various surgical approaches and its modifications to TMJ
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Detailed discussion on diagnosis and management of TMJ ankylosis. Surgical anatomy and applied aspects of TMJ is discussed. Reconstruction of ramus-condyle unit is also discussed. Compications of TMJ surgery are also discussed
The lower jaw frequently breaks due to accidents, assaults or sometimes due to underlying disease. Just as with other bones in the body, there are a various methods for repairing the mandible.
Abstract—Spiritual health is not given its due importance since long time. But nowadays modern medicine is seen in relation to spiritual health. and studies were conducted to find out its effect in various diseases. So this study was conducted on medical students of SMS Medical College, Jaipur (Rajasthan) India. aimed to assess the spiritual health and its association with psycho wellness. A cross-sectional study was conducted on 1st MBBS students present on the day of survey were given spiritual health assessment scale (SHAS) to assess the their spiritual health. Then these students were screened through Modified Mini Scale (MMS) to found out zone of psycho wellness i.e. red and orange zone of psycho-wellness. Association was inferred by Chi-square test and ANOVA with Post-hoc Tukey test. Out of 230 students attend on the day of survey, majority of students i.e.164(71.3%) were having good spiritual health. Likewise only 132 students (57.39%) were in green zone (no disease zone), while 36(15.65%) students were in orange (borderline) and 62 students (26.96%) were in red zone (Psychiatric disease zone) of psycho-wellness. On analysis it was found that Mean scores of spiritual SHAS of green zone was significantly high than mean SHAS scores of other zones. Majority of students were having poor spiritual health and this spiritual health was strongly associated with psycho-wellness of students. Poorer the spiritual health of students leads to poorer the psycho-wellness of students.
This seminar explains about the development, relations, ligaments, various attachments, vascular and nervous supply and various surgical approaches and its modifications to TMJ
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Detailed discussion on diagnosis and management of TMJ ankylosis. Surgical anatomy and applied aspects of TMJ is discussed. Reconstruction of ramus-condyle unit is also discussed. Compications of TMJ surgery are also discussed
The lower jaw frequently breaks due to accidents, assaults or sometimes due to underlying disease. Just as with other bones in the body, there are a various methods for repairing the mandible.
Abstract—Spiritual health is not given its due importance since long time. But nowadays modern medicine is seen in relation to spiritual health. and studies were conducted to find out its effect in various diseases. So this study was conducted on medical students of SMS Medical College, Jaipur (Rajasthan) India. aimed to assess the spiritual health and its association with psycho wellness. A cross-sectional study was conducted on 1st MBBS students present on the day of survey were given spiritual health assessment scale (SHAS) to assess the their spiritual health. Then these students were screened through Modified Mini Scale (MMS) to found out zone of psycho wellness i.e. red and orange zone of psycho-wellness. Association was inferred by Chi-square test and ANOVA with Post-hoc Tukey test. Out of 230 students attend on the day of survey, majority of students i.e.164(71.3%) were having good spiritual health. Likewise only 132 students (57.39%) were in green zone (no disease zone), while 36(15.65%) students were in orange (borderline) and 62 students (26.96%) were in red zone (Psychiatric disease zone) of psycho-wellness. On analysis it was found that Mean scores of spiritual SHAS of green zone was significantly high than mean SHAS scores of other zones. Majority of students were having poor spiritual health and this spiritual health was strongly associated with psycho-wellness of students. Poorer the spiritual health of students leads to poorer the psycho-wellness of students.
Crimson Publishers: The Impact of Chronic Diseases on Patients and Their Fami...CrimsonGastroenterology
The Impact of Chronic Diseases on Patients and Their Families: Case of Ulceratice Colitis and Crohn’s Disease by Maria Tsoukka in Gastroenterology Medicine & Research: Bowel Disease
Background: The purpose of the study is to identify the potential psychological effects of ulcerative colitis and Crohn’s disease on patients and their family environment.Aim: The objective aims of this current research are to identify the causal factors creating psychological problems among patients and their family members, exploring ways to eliminate them and create a general picture for their psychological condition in relation to the diseases at a Pancyprian level.Methods: The Greek translation of the Hospital Anxiety and Depression Scale (HADS) and the Greek translation of the Health Survey (SF-12) will be used for evaluating the psychological effects of ulcerative colitis and Crohn disease on patients and their families. In addition, the Greek translation of the inflammatory Bowel Disease Questionnaire will be used only on the patients. The questionnaires will be handed out to the patients and their attendants in Gastroenterology dispensaries all over Cyprus. Conclusion: In the context of improving health care quality, it was indicated that multifaceted interventions are more effective than simpler interventions and that the insistence on change requires a multi-layered approach. A major focus of health policy is the effective management of long term diseases both for reducing the burden on patients and professionals as well as of the health services also. Studying the Group of patients with IBD could be an important example of study as the patients themselves are chronic patients with 20 years being the peak age onset of the diseases and life expectancy of healthy individuals.
Cross-sectional study on prevalence of psychological comorbidity in patients ...komalicarol
This study investigates the prevalence of psychological comorbidity in patients with moderate to severe psoriasis vulgaris. Furthermore, the relation between the type of disorder and the degree of
psoriasis severity has been analysed. In 10 German study sites 137
female (61 = 44.5%) and male (76=55.5%) patients that had been
diagnosed with moderate or severe psoriasis by a qualified dermatologist were surveyed. The most frequent observed comorbidities
were moderate to severe depressive syndromes (23.4%), followed
by alcohol syndromes (5.8%) and panic disorders (4.6%). Analysis
of relations between the type and severity of disorder and the degree of psoriasis severity showed no significant correlations. The
present data confirm the psychosocial stress of patient with psoriasis regardless of the degree of severity
Psychometric assessment of the Life Satisfaction Questionnaire.docxamrit47
Psychometric assessment of the Life Satisfaction Questionnaire (LSQ) and a
comparison of a randomised sample of Swedish women and those su�ering from
breast cancer
Marianne Carlsson
1
, Elisabeth Hamrin
2
& Ragny Lindqvist
1
1Department of Public Health and Caring Sciences, Caring Sciences Unit, Uppsala University, Sweden; 2Department of
Medicine and Care, Division of Nursing Science, University of LinkoÈping, Sweden
Accepted in revised form 29 August 1998
Abstract. In a previous study, the Life Satisfaction
Questionnaire (LSQ) was developed especially for
women with breast cancer. The aim of the present
study was to assess the psychometric properties of the
LSQ in a randomized sample of Swedish women and
to compare the perceived quality of life with that of
women su�ering from breast cancer. Another aim was
to relate the result to educational background. A total
of 257 women aged 20±80, randomly selected from the
Swedish population register, answered the LSQ. The
result was compared with that from 362 women aged
27±78 su�ering from breast cancer. The construct
validity was calculated by a principal component
analysis, and the reliability by Cronbach a-coe�-
cients. It was concluded that the LSQ has acceptable
validity and reliability. The result also showed that the
women with breast cancer rated their perceived qual-
ity of life higher than women in general with respect to
the quality of personal relations and the quality of
daily activities, but lower for physical symptoms. In
the comparison with respect to educational back-
ground, women with university education rated their
quality of life higher than women with other types of
education. The testing of the LSQ will continue.
Key words: Breast cancer, Psychometric assessment, Quality of life
Introduction
The term `quality of life' refers to a person's perceived
quality of her/his physical, psychological, social and
existential functioning [1]. Several instruments have
been developed to measure quality of life in di�erent
groups of people. Some measure quality of life in
general, e.g. the NHP (Nottingham Health Pro®le)
[2], the SIP (Sickness Impact Pro®le) [3], the Swed-
Qual [4], the MOS SF-36 (Medical Outcome Studies
Short Form) [5, 6], and the QLI (Quality of Life In-
dex) by Ferrans and Powers [7]. Others are more
speci®c, for instance, for cancer patients, the QLI
(Quality of Life Index) by Spitzer et al. [8], the FLIC
(Functional Living Index Cancer) [9], the CIPS
(Cancer Inventory of Problem Scale) [10], the
CARES (Cancer Rehabilitation Evaluation System)
[11], the FACT (Functional Assessment of Cancer
Therapy) [12], and the EORTC QLQ-C30 (European
Organisation for Research and Treatment in Cancer,
Quality of Life Questionnaire) [13].
A literature review by Carlsson and Hamrin [14]
showed that the diagnosis of breast cancer evokes
grief, anger and intense fear in women. But the ma-
jority do not experience long-term emotional distress.
Risk factors for psychological dist ...
1
3
Test Development Proposal: Step One
Jane Doe
The University of Arizona Global Campus
RES7402: Advanced Tests & Measurements (QAH114DS)
Dr. John Doe
April 5, 2021
Test Development Proposal: Step One
Bushnell et al. 2019, describes depression disorder as disorder that affects an individual's mood, usually making them has an unrelenting feeling of sadness and interest loss (p.908). The condition leads to a variety of physical and emotional problems. The patients, therefore, experience trouble doing day-to-day activities. Older adults and women are at a high risk of this condition. Understanding the complexities 0f depression, diagnosis, and treatment has never been more critical, whether developing a better understanding of depression to an individual’s personal life, a team, and an organization that directly impacts communities. A better understanding of depression is also fundamental in offering innovative leadership ideas on handling this condition. This is especially very important because data illustrates that there are a lot of deaths that are attributed to depression.
In this construct, various characteristics can be assessed, but I will be assessing the symptoms of this condition in this case. Various characteristics are present to people suffering from this condition. Some of the characteristics include feelings of sadness and interest loss, suicidal tendencies, disturbed or lack of sleep, isolation, inactivity, low self-esteem, guilt, disturbed eating patterns, and overwhelming feelings. Most of the available instruments assess almost these entire characteristics, so it is essential to address them.
Tests and Instruments
Geriatric Depression Scale
The most widely used screening tools for depression among the elderly is the Geriatric Depression Scale (GDS). It is significant because of its validity and reliability (Guerin et al., 2018). GDS is a screening test that helps in the identification of depression symptoms in the aged group. Patients answer questions in a yes/no format. The questions asked how a high connection with depressive symptoms such as enjoyment level interest and social interaction, among others. The patient needs to be evaluated further if they get a score of 5 or above. This tool's significant advantage is it is easy and quick, taking less than 7 minutes to complete. However, its challenge is that it has been observed that some people may extend the time further as they may want to expound further regarding their issues. The assessor, therefore, has a duty of redirecting the patient back to the question time and again. Similarly, some people are too much into a depression that they find it difficult to answer the question, while others do not wish to answer some personal questions.
PHQ9
One of the most valuable tests is depression screening, also known as PHQ9. This is a criteria-based diagnosis of depressive disorder that is very reliable and valid in measuring the symptoms of depression. The is nin ...
1
3
Test Development Proposal: Step One
Jane Doe
The University of Arizona Global Campus
RES7402: Advanced Tests & Measurements (QAH114DS)
Dr. John Doe
April 5, 2021
Test Development Proposal: Step One
Bushnell et al. 2019, describes depression disorder as disorder that affects an individual's mood, usually making them has an unrelenting feeling of sadness and interest loss (p.908). The condition leads to a variety of physical and emotional problems. The patients, therefore, experience trouble doing day-to-day activities. Older adults and women are at a high risk of this condition. Understanding the complexities 0f depression, diagnosis, and treatment has never been more critical, whether developing a better understanding of depression to an individual’s personal life, a team, and an organization that directly impacts communities. A better understanding of depression is also fundamental in offering innovative leadership ideas on handling this condition. This is especially very important because data illustrates that there are a lot of deaths that are attributed to depression.
In this construct, various characteristics can be assessed, but I will be assessing the symptoms of this condition in this case. Various characteristics are present to people suffering from this condition. Some of the characteristics include feelings of sadness and interest loss, suicidal tendencies, disturbed or lack of sleep, isolation, inactivity, low self-esteem, guilt, disturbed eating patterns, and overwhelming feelings. Most of the available instruments assess almost these entire characteristics, so it is essential to address them.
Tests and Instruments
Geriatric Depression Scale
The most widely used screening tools for depression among the elderly is the Geriatric Depression Scale (GDS). It is significant because of its validity and reliability (Guerin et al., 2018). GDS is a screening test that helps in the identification of depression symptoms in the aged group. Patients answer questions in a yes/no format. The questions asked how a high connection with depressive symptoms such as enjoyment level interest and social interaction, among others. The patient needs to be evaluated further if they get a score of 5 or above. This tool's significant advantage is it is easy and quick, taking less than 7 minutes to complete. However, its challenge is that it has been observed that some people may extend the time further as they may want to expound further regarding their issues. The assessor, therefore, has a duty of redirecting the patient back to the question time and again. Similarly, some people are too much into a depression that they find it difficult to answer the question, while others do not wish to answer some personal questions.
PHQ9
One of the most valuable tests is depression screening, also known as PHQ9. This is a criteria-based diagnosis of depressive disorder that is very reliable and valid in measuring the symptoms of depression. The is nin ...
Depresi dan bunuh diri sebagai masalah kesehatan mental yang lazim untuk pasien hemodialisis. Tujuan: Para penulis meneliti faktor-faktor demografi dan psikologis yang terkait dengan depresi pada pasien hemodialisis dan dijelaskan hubungan antara depresi, kecemasan, kelelahan, kualitas kesehatan yang berhubungan hidup yang buruk, dan meningkatkan risiko bunuh diri.
PREVALENCE OF DEPRESSION AND ITS ASSOCIATED FACTORS IN ADULTS WITH DIABETES M...pijans
The prevalence of Diabetes Mellitus has been rising steadily owing to several factors such as sedentary
lifestyle, obesity and an aging population. The prevalence of diabetes is predicted to double globally from
171 million in 2000 to 366 million in 2030 with a maximum increase in India with up to 79.4 million
individuals in India. Depression occurs frequently with diabetes but there are not many studies in India to
estimate its prevalence and associated factors. This study was done with the aim of estimating the
prevalence of depression among diabetes patients using the validated Patient Health Questionnaire-9 and
also its associated factors.
Abstract—Asthma is a chronic inflammatory disease of the airways that affects people of all ages. It may manifest as severe attacks, which can require urgent health care. It causes limitations in daily activities, loss of school and work days, lung function impairment, reduced quality of life, and an adverse socioeconomic burden. There is no cure of asthma, once it is diagnosed it can be managed by a good treatment plan, so that patient can live a better quality of life with the disease. This present study was planned to compare the effect of traditional treatment alone and in combination with Root Heal Therapy on asthma cases. A Quincy experiment was conducted on 60 patients of Asthma, who were taking treatment from a physician working in Jaipuriya Hospital, Jaipur. Out of these 60 asthama patients who were receiving traditional treatment, 30 patients were given this RHT along with traditional treatment. Baseline status of asthma and Asthma Quality of life Questionnaire (AQLQ) was assessed. These cases were followed for 18 months, again they were assessed as per AQLQ. Changes in status of asthma in both the group over this period were compared with Chi-square test and Unpaired 't' test. It was found that significantly more cases were benefited with this RHT in the form of number of spells of asthma, duration of illness due to asthma, mean days of activity loss and proportion of cases needed hospitalization during last one year. Pulmonary Function test were also better in experimental group than control group. Although mean number of eosinofills decrease was also found higher in experimental group but it was not found significant. It is concluded that Quality of life of these asthma cases were significantly improved on physical, emotional, social and occupational domains of life in cases with RHT than the cases only on traditional treatment.
A cross sectional and comparative study of attitudes in undergraduate medical...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
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We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Journal Club Presentation in maxillofacial surgery.pptx
1. Presented by- Dr. Abhijeet Kamble
2nd Year PG
Dept of Maxillofacial and Oral Surgery
Government Dental College, Shimla
2. 1. About the Journal
2. Abstract
3. Introduction
4. Material and Methods
5. Results
6. Discussion
7. Review of Literature
8. References
3. Prospective evaluation of psychological burden
in patients with oral cancer
K. Kumar a, S. Kumar a,f , D. Mehrotra a,∗, S.C. Tiwari b, V. Kumar c, S. Khandpur d, R.C. Dwivedi e
4. • British Journal Of Oral and Maxillofacial Surgery
• Peer reviewed journal
• Open access PubMed Indexed Journal
• Impact factor – 3.192
• Published by – Elsevier Inc.
• Volume – 61
• Issue – 2
• Year of publication - 198
5. • Purpose : The purpose of this study therefore was to evaluate depression, anxiety, and stress
in patients with oral cancer using the short version of the Depression Anxiety and Stress Scale
(DASS-21),12 and to compare DASS-21 with HADS (Hospital Anxiety and Depression Scale).
• Method : A total of 111 patients were enrolled and 75 of them completed the questionnaires
at diagnosis, one month after treatment, and three months after discharge. Scores were high
for stress at diagnosis, and for depression at the other time points, but were low for anxiety
at all three.
• Results : The results of Friedman’s ANOVA showed that mean ranks for depression and stress
were significant (p < 0.05). Scores for depression and stress rose significantly between
diagnosis and three months after operation, but those for anxiety (which had increased
between diagnosis and operation p > 0.05), were stable three months postoperatively. .
• Conclusion :The DASS-21 was a useful method of evaluating stress. Correlation of the results
from the two questionnaires showed a strongly positive association. We therefore recommend
psychological intervention to improve overall outcome.
6. Oral cancer is the sixth most common cancer worldwide and the second most common in
Southeast Asia. In India, an increase in the use of tobacco has considerably increased its
incidence.Treatment depends on the stage of the disease, but diagnosis is often late, and this
affects both recovery and survival.When first diagnosed, patients experience several physical,
mental, emotional, and social difficulties, and the effects of the treatment on daily activities
such as chewing, swallowing, and speech, can cause depression, anxiety, and stress, which
must be treated to enable patients to cope.
Many studies have reported the difficulties patients face7 and several have focused on anxiety
and depression,but to our knowledge few have looked at potential anxiety or stress. Patients
who are stressed typically find it difficult to relax, and are irritable, tense, and agitated.
Various analytical studies have reported a correlation among stress, depression, and anxiety,
but few if any data about all three concurrently.
7. We studied patients who were treated at the Department of Oral and Maxillofacial Surgery
and Oncology at the North India Medical University between 2013 and 2016. Those with
histopathologically confirmed oral squamous cell carcinoma (SCC), who were 18 years and
above, and able to read and write in English or Hindi, were included. Those who had a history
of mental illness, or had psychological treatment for a mental illness, were excluded. Of the
111 patients who were enrolled, 17 did not attend, 11 refused, and eight had died, so 75
were included They each completed the DASS-21 and HADS at three different time points
during their treatment: at the time of diagnosis (after histopathological confirmation and
before treatment), one month after operation, and three months after discharge. Data were
assessed by only one rater, a psychologist (KK), to reduce problems with inter-rater reliability
8. Questionnaires
DASS-21 (Depression, Anxiety, and Stress Scale) To evaluate depression,
anxiety, and stress, we used the DASS-21, a shorter version of the DASS-42, in
both the Hindi and English languages.12 Each of the three domains includes
seven items, which are scored from 0 (does not apply to me at all) to 3
(applies to me very much, or most of the time). Scores for each domain are
added to give the total.
9. At the time of diagnosis, age affected the incidence of
depression but not that of anxiety and stress (Table 2).
Table 3 shows that when diagnosed, the depression
scores of those aged between 30 and 60 differed
significantly from those who were over 60.
10. Studies on depression and anxiety among patients with oral cancer, tend not to evaluate
stress together with depression and anxiety. Initially, psychological burden was measured only
in terms of anxiety and depression, and “stress”, which focused on difficulty in relaxing,
impatience, tension, agitation and irritability, was added later. Selye defined it as “the non-
specific response of the body to any demand for change” and described it as being “the rate
of wear and tear on the body.
Anxiety was almost stable, but stress increased. Studies have indicated a close affinity
between the two,15 and some of the symptoms of stress such as chronic arousal, tension,
fatigue, worry, nervousness, discouragement, shortness of temper, fidgetiness, interrupted
sleep, avoidance, and irritability, overlap with those of anxiety. These findings could be a
reason for the difference between our results and those of previous studies
11. To combat the disease, patients’ psychological needs must be addressed together with their
physical needs, not only during, but also after, treatment. To identify those who need
support, the DASS-21 is particularly useful because it also assesses stress.