Search

Background: Severe mental illnesses have huge impact on health-related quality of life. They contribute to significant morbidity in terms of number of number of years of life lost in form DALYS (disability adjusted life years) and shorter life expectancy and early mortality. There is limited evidence on their burden in low- and middle-income countries like Pakistan. Objective: To determine the health-related quality of life in patients suffering from severe mental illness (schizophrenia, depression, and bipolar affective disorder) and demographic factors associated with poor health related quality of life in these patients. Methodology: This was descriptive cross sectional, using retrospective record view of data. Study was done under IMPACT (Improving Mental And Physical health Together) Program, which conducted a multi-morbidity survey conducted at institute of psychiatry, Benazir Bhutto hospital, Rawalpindi, using EQ 5d 5l (EURO QOL 5D5L) questionnaire having both subjective (EQVAS) and objective domains. Results: The study included 922 SMI patients, of whom 555 participants (60.2%) were males and 367(39.69%) were females. The participants suffered from major depressive disorder (422;45.8%), followed by bipolar affective disorder (392; 42.51%) and schizophrenia (108;11.7%). Most participants were in a younger age group with (80%) of population being below 50 years old and had education level below secondary education (57.4%). In the analysis of association between EQ-VAS (subjective quality of life scale) and demographic factors, a significant association was found for marital status(p<0.001), gender (p< 0.001) and education (p< 0.001). Women had lower EQ-VAS scores (M = 49.43±SD = 27.72) as compared to males (M = 58.81±SD = 27.1) and individuals with lower educational status also had lower mean scores. Additionally, participants who were single, divorced or widowed also had lower mean EQVAS scores. When health related quality of life was analyzed across SMI, it was lower in all SMI, but was significantly lower for depression in both subjective and objective domains of health related of quality-of-life instrument. Conclusion: Health related quality of life is an important outcome measure and regular assessment of both subjective and objective aspects should be incorporated in management plans of patients suffering from severe mental illnesses. [ABSTRACT FROM AUTHOR]

Environmental contaminants are becoming a growing issue due to their effects on the cryosphere and their impact on the ecosystem. Mountain glaciers are receding in the HKH region and are anticipated to diminish further as black carbon (BC) concentrations rise along with other pollutants in the air, increasing global warming. Air contaminants and BC concentrations were estimated (June 2017–May 2018). An inventory of different pollutants at three glaciers in Karakoram, Hindukush, and the Himalayas has been recorded with Aeroqual 500 and TSI DRX 8533, which are as follows: ozone (28.14 ± 3.58 µg/m3), carbon dioxide (208.58 ± 31.40 µg/m3), sulfur dioxide (1.73 ± 0.33 µg/m3), nitrogen dioxide (2.84 ± 0.37 µg/m3), PM2.5 (15.90 ± 3.32 µg/m3), PM10 (28.05 ± 2.88 µg/m3), total suspended particles (76.05 ± 10.19 µg/m3), BC in river water (88.74 ± 19.16 µg/m3), glaciers (17.66 ± 0.82 µg/m3), snow/rain (57.43 ± 19.66 ng/g), and air (2.80 ± 1.20 µg/m3). BC was estimated by using DRI Model 2015, Multi-Wavelength Thermal/Optical Carbon Analyzer, in conjunction with satellite-based white-sky albedo (WSA). The average BC concentrations in the Karakoram, Himalaya, and Hindukush were 2.35 ± 0.94, 4.38 ± 1.35, and 3.32 ± 1.09 (µg/m3), whereas WSA was 0.053 ± 0.024, 0.045 ± 0.015, and 0.045 ± 0.019 (µg/m3), respectively. Regression analysis revealed the inverse relationship between WSA and BC. The resulting curves provide a better understanding of the non-empirical link between BC and WSA. Increased BC will inherit ecological consequences for the region, ultimately resulting in biodiversity loss. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To analyse the calls received at a 24-hour helpline service at the Institute of Psychiatry during the first wave of the COVID-19 pandemic for the demographics of the service users, the reasons for calling, and the guidance provided. STUDY DESIGN: Descriptive retrospective clinical audit PLACE AND DURATION OF STUDY: The Institute of Psychiatry, Rawalpindi Medical University from June 2020 and February 2021. METHOD: The call records by psychiatry residents managing the helpline were analysed. Data regarding age, area of residence, and reasons for calling by the service users of the helpline, as well as the advice given by the resident on call were extracted. The findings were evaluated in terms of age, geographical distribution, reasons for seeking assistance, and the type of guidance provided. For data, compilation descriptive statistics were employed. RESULTS: Of the 102 calls analysed, most of the callers were between 30 to 39 years of age (33.3%), and hailed from Rawalpindi (78.4%), followed by Kashmir (5.9%), Chakwal (4.9%) and Murree (3.9%). The most frequently stated reasons for calling were to ask about availability of out-patient services (36.3%), to have medication revised (23.5%), and to enquire about the side effects of medication (11.8%). The responses to the callers were invitation to come to the hospital (44.1%), provision of relevant information about the particular questions asked (36.3%), adjustment of medications (11.8%), and prescribing medication with advice of physical follow-up (7.8%). CONCLUSION: There is a need to incorporate the use of technology in the delivery of psychiatric services to enhance accessibility and allow convenience. Future research should optimize interventions, assess long-term outcomes, and address challenges like privacy and access. [ABSTRACT FROM AUTHOR]