ANXIETY, DEPRESSION, AND SELF-CARE MANAGEMENT AMONG PATIENTS WITH HYPOTHYROIDISM.

 Objective: The objective of the study was to assess anxiety, depression, and self-care management among patients with hypothyroidism.Methods: A qualitative descriptive study was done among 65 patients who was diagnosed with hypothyroidism, and the data were collected using structured questionnaire to know about self-care management of hypothyroidism and standardized tool (Hamilton rating scale) for assessing anxiety and depression.Results: The result showed that among 65 subjects, 30 (46.2%) had good self-care management, only 1 (1%) had excellent self-care management, 46.1% had severe anxiety, whereas 4.6% subjects had severe depression. There was a positive association between anxiety and depression with self-care management.Conclusion: Hypothyroidism is now becoming more prevalent in the Indian population. From the results of the study, it is obvious that patients with hypothyroidism are at increased risk of anxiety and depression. Self-care management decreases with an increase in anxiety and depression. Hence, proper management is necessary to reduce the deleterious effect of hypothyroidism on physical as well as mental health

Tumefactive demyelinating lesions: A Clinicopathological correlative study

Tumefactive demyelinating (TDL) lesions are focal zones of demyelination in the central nervous system and they often mimic the neuroimaging features of an intraxial neoplasm. In this report we describe the clinical, neuroimaging and neuropathological features of six cases of TDL. Only in two patients the neuroimaging features in MRI (magnetic resonance imaging) scans were suggestive of TDL while in the other four cases a diagnosis of glioma was suggested. In order to establish a confirmatory diagnosis neuronavigation/stereotactic biopsy was undertaken and the diagnosis of TDL was established in all six cases at histopathology. Two out of six patients did not respond to the conventional corticosteroid therapy and they were treated with plasma exchange. It is being concluded that neuronavigation biopsy, though provide only a small amount of tissue, and is extremely useful in making the diagnosis of TDL

Persistent post-stroke dysphagia treated with cricopharyngeal myotomy

Post-stroke dysphagia is a common problem after stroke. About 8-13% patients have persistent dysphagia and are unable to return to pre-stroke diet even after 6 months of stroke. Use of percutaneous endoscopic gastrostomy (PEG) may be required in these patients, which may be psychologically unacceptable and impair the quality of life. In those with cricopharyngeal dysfunction leading on to refractory post-stroke dysphagia, cricopharyngeal myotomy and injection of botulinum toxin are the treatment options. We present a case of vertebrobasilar stroke who had persistent dysphagia due to cricopharyngeal dysfunction with good recovery of swallowing function following cricopharyngeal myotomy 1.5 years after the stroke

The SARS‐CoV‐2/COVID‐19 pandemic and challenges in stroke care in India

Stroke care in India has evolved rapidly in the last decade with a focus on stroke awareness, prevention, rapid triage, treatment, and rehabilitation. But acute stroke care and poststroke rehabilitation in the country have limitations owing to the economic constraints and poor access to health care. The SARS-CoV-2/COVID-19 pandemic has made stroke care even more challenging. We outline the unfavorable circumstances in stroke care induced by the pandemic; propose mitigating measures; crisis management; and provide a comparative evaluation of stroke care between India and the United States during the pandemic. There is a need for public health systems in both developed and developing countries to improve awareness, implement proper strategies of triage, acute treatment, well-defined rehabilitation plans, telemedicine services, and virtual check-ins