Study on awareness, perceptions, experiences in decision process of hysterectomy in women presenting to Goa Medical College

Background: Hysterectomy (removal of uterus) has many indications like fibroids, dysfunctional uterine bleeding, uterine prolapse and chronic pelvic pain. The purpose of this study is to know the level of awareness of women about hysterectomy, to study their experiences, to assess their involvement in decision making process and to develop a suitable protocol, counselling and education material to ensure women’s involvement.Methods: This is a cross sectional study using validated semi-structured interview questionnaire over 6 months (1st December, 2018 to 31st May, 2019) in Goa Medical College. Data was entered in epidata manager and analysed using SPSS 22 version. Categorical variables were expressed in percentages and proportions and quantitative variables in mean±SD. Significance was checked using Chi square test and association between dependent and independent variables was assessed by using bivariate analysis. P value <0.05 was taken as significant.Results: A total of 149 women were recruited into the study who were admitted for hysterectomy. The mean age of women was 49.3 years. The awareness with respect to various aspects of hysterectomy was good in 23.4% subjects and poor in 76.6% subjects. The awareness was significantly related to level of education (p=0.002), urban location (p=0.016) and socioeconomic status (p=0.028). Education was significant factor in decision-making process (p< 0.05). It was observed that good experience had positive correlation to their perception about hysterectomy.Conclusions: It was concluded that awareness about hysterectomy was significantly related to education, urban location and socio-economic status of women. Pre-operative education would help to reduce the post-operative symptoms for a women undergoing hysterectomy

COMPREHENSIVE REVIEW ON NANOCRYSTAL TECHNOLOGY IN PHARMACEUTICAL FORMULATIONS

Many techniques have been developed to overcome the bioavailability problem of poorly soluble drugs. The nanonization is one of the techniques in that micronized particle is converted in nanoparticle. Several processes are applied for nanocrystal production including precipitation, milling, high pressure homogenization and combination method. The nanocrystal formulation administered via various routes like oral, intravenous, intramuscular, pulmonary, ocular and dermal but due to safety, patient compliance and ease of administration oral drug delivery is preferred. There are two basic ways to prepare drug nanocrystals like “bottom-up” and “top-down” technologies. The present literature provides an overview of the achievement in improving bioavailability of poorly soluble drug by using different methods

Screening for Psychological Distress among Outpatient Attendees at a Rural Health Center in Goa, India, Using World Health Organization Self-Reporting Questionnaire-20 Scale: A Cross-sectional Study

Introduction: Psychological distress has been defined as a state of emotional suffering with predominant symptoms of depression and anxiety. Given the state of poor awareness of psychological morbidities in general population, the associated stigma as well as the lack of training among primary health-care professionals in identifying psychological morbidities has led to poor detection rates. We therefore conducted this study to estimate the psychological distress among outpatient department attendees at a rural health center in Goa, using the World Health Organization Self-Reporting Questionnaire (WHO-SRQ)-20 screening questionnaire and to identify some associated factors. Methodology: A hospital-based cross-sectional study was conducted in a rural area. Systematic sampling technique was used to include 300 study participants aged 18 years and above. Psychological distress was measured using the 20-point WHO-SRQ. Those identified as having psychological distress were reconfirmed by the Hamilton Depression Rating Scale (HAM-D) under supervision by a trained psychiatrist. Data were later entered into Google Sheets and analyzed using IBM-SPSS 24. Results: Around 7.7% of the participants had psychological distress. Female sex, marital status, education level, type of family, and alcohol use were significantly associated with psychological distress. Confirmation of diagnosis by the HAM-D indicated 21 of the 23 participants identified by WHO-SRQ had definitive psychological distress. Conclusion: WHO-SRQ is a simple screening tool which can be routinely used to effectively screen for psychiatric morbidities at primary care level

Outcomes in Newly Diagnosed Atrial Fibrillation and History of Acute Coronary Syndromes: Insights from GARFIELD-AF

BACKGROUND: Many patients with atrial fibrillation have concomitant coronary artery disease with or without acute coronary syndromes and are in need of additional antithrombotic therapy. There are few data on the long-term clinical outcome of atrial fibrillation patients with a history of acute coronary syndrome. This is a 2-year study of atrial fibrillation patients with or without a history of acute coronary syndromes