Assessment of subjective sleep quality in iron deficiency anaemia

Objectives: We aimed to assess the effect of anemia on subjective sleep quality in patients with iron deficiency anemia (IDA).Methods: One hundred and four patients diagnosed with IDA and 80 healthy individuals, who are gender and age matched, were included in the study. All participants were requested to fill 3 forms: a socio-demographic form (age, gender, marital status, income level and educational status), hospital anxiety and depression (HAD) scale and pittsburgh sleep quality index (PSQI).Results: According to the HAD scale, the average anxiety score was found 9.24±4.37 in patients and 7.58± 4.07 in controls. And, the average depression score was 7.53±4.10 in patients and 6.41±2.74 in controls. The total sleep quality score was 6.71±3.02 in patients and 4.11±1.64 in controls. There was a statistically significant difference in terms of anxiety, depression and sleep quality scores. Linear regression analysis showed no association between anxiety and depression with poor sleeping.Conclusion: IDA affects sleep quality irrespective of psychological symptoms such as depression and anxiety.Keywords: Iron deficiency anemia, sleep quality, anxiet

Delta-Function Potential with a Complex Coupling

We explore the Hamiltonian operator H=-d^2/dx^2 + z \delta(x) where x is real, \delta(x) is the Dirac delta function, and z is an arbitrary complex coupling constant. For a purely imaginary z, H has a (real) spectral singularity at E=-z^2/4. For \Re(z)<0, H has an eigenvalue at E=-z^2/4. For the case that \Re(z)>0, H has a real, positive, continuous spectrum that is free from spectral singularities. For this latter case, we construct an associated biorthonormal system and use it to perform a perturbative calculation of a positive-definite inner product that renders H self-adjoint. This allows us to address the intriguing question of the nonlocal aspects of the equivalent Hermitian Hamiltonian for the system. In particular, we compute the energy expectation values for various Gaussian wave packets to show that the non-Hermiticity effect diminishes rapidly outside an effective interaction region.Comment: Published version, 14 pages, 2 figure

Irrational prescribing of over-the-counter (OTC) medicines in general practice: testing the feasibility of an educational intervention among physicians in five European countries

Background: Irrational prescribing of over-the-counter (OTC) medicines in general practice is common in Southern Europe. Recent findings from a research project funded by the European Commission (FP7), the “OTC SOCIOMED”, conducted in seven European countries, indicate that physicians in countries in the Mediterranean Europe region prescribe medicines to a higher degree in comparison to physicians in other participating European countries. In light of these findings, a feasibility study has been designed to explore the acceptance of a pilot educational intervention targeting physicians in general practice in various settings in the Mediterranean Europe region. Methods: This feasibility study utilized an educational intervention was designed using the Theory of Planned Behaviour (TPB). It took place in geographically-defined primary care areas in Cyprus, France, Greece, Malta, and Turkey. General Practitioners (GPs) were recruited in each country and randomly assigned into two study groups in each of the participating countries. The intervention included a one-day intensive training programme, a poster presentation, and regular visits of trained professionals to the workplaces of participants. Reminder messages and email messages were, also, sent to participants over a 4-week period. A pre- and post-test evaluation study design with quantitative and qualitative data was employed. The primary outcome of this feasibility pilot intervention was to reduce GPs’ intention to provide medicines following the educational intervention, and its secondary outcomes included a reduction of prescribed medicines following the intervention, as well as an assessment of its practicality and acceptance by the participating GPs. Results: Median intention scores in the intervention groups were reduced, following the educational intervention, in comparison to the control group. Descriptive analysis of related questions indicated a high overall acceptance and perceived practicality of the intervention programme by GPs, with median scores above 5 on a 7-point Likert scale. Conclusions: Evidence from this intervention will estimate the parameters required to design a larger study aimed at assessing the effectiveness of such educational interventions. In addition, it could also help inform health policy makers and decision makers regarding the management of behavioural changes in the prescribing patterns of physicians in Mediterranean Europe, particularly in Southern European countries

Frequency of symptoms, determinants of severe symptoms, validity of and cut-off score for Menopause Rating Scale (MRS) as a screening tool: A cross-sectional survey among midlife Nepalese women

<p>Abstract</p> <p>Background</p> <p>Majority of Nepalese women live in remote rural areas, where health services are not easily accessible. We determined the validity of Menopause Rating Scale (MRS) as a screening tool for identification of women with severe menopausal symptoms and cut-off MRS score for referral.</p> <p>Methods</p> <p>A cross-sectional survey was carried out between February and August, 2008. Trained health workers administered MRS and a questionnaire to 729 women (40 to 65 years) attending health screening camps in Kaski district of Western Development Region of Nepal. Information about demographics, menopausal status, and use of hormone replacement therapy (HRT), chronic disease, self-perceived general health and reproductive history was also collected. Menopausal status was classified according to the Staging of Reproductive Ageing Workshop (STRAW). We calculated rates of menopausal symptoms, sensitivity, and specificity and likelihood ratios of MRS scores for referral to a gynaecologist. We also carried out multivariate analyses to identify the predictors for referral to a gynaecologist for severe symptoms.</p> <p>Results</p> <p>A total 729 women were interviewed. Mean age at menopause was 49.9 years (SD 5.6). Most frequently reported symptoms were, sleeping problems (574, 78.7%), physical and mental exhaustion (73.5%), hot flushes (508, 69.7%), joint and muscular discomfort (500, 68.6%) and dryness of vagina (449, 61.6%). Postmenopausal women (247, 33.9%) and perimenopausal (215, 29.5%) women together experienced significantly higher prevalence of all symptoms than the premenopausal (267, 36.6%) women. MRS score of ≥16 had highest ratio for (sensitivity + specificity)/2. Women who reported urogenital symptoms [OR 5.29, 95% CI 2.59, 10.78], and self perceived general health as poor [OR 1.29, 95% CI 1.11, 1.53] were more likely to be referred to a gynaecologist for severe menopausal symptoms. While women reporting somatic [OR 0.72, 95% CI 0.63, 0.82] and psychological [OR 0.86, 95% CI 0.74, 0.99] symptoms were less likely to be referred.</p> <p>Conclusion</p> <p>MRS may be used as a screening tool at a cut-off score of ≥16 with least misclassification rate. However, its utility may be limited by woman's general health status and occurrence of urogenital symptoms.</p

Enzyme production from food wastes using a biorefinery concept

According to Food and Agricultural Organization (FAO), one-third of food produced globally for human consumption (nearly 1.3 billion tonnes) is lost along the food supply chain. In many countries food waste is currently landfilled or incinerated together with other combustible municipal wastes for possible recovery of energy. However, these two options are facing more and more economic and environmental stresses. Due to its organic- and nutrient-rich nature, theoretically food waste can be converted to valuable products (e.g. bio-products such as methane, hydrogen, ethanol, enzymes, organic acids, chemicals and fuels) through various fermentation processes. Such conversion of food waste is potentially more profitable than its conversion to animal feed or transportation fuel. Food waste valorisation has therefore gained interest, with value added bio-products such as methane, hydrogen, ethanol, enzymes, organic acids, chemicals, and fuels. Therefore, the aim of this review is to provide information on the food waste situation with emphasis on Asia–Pacific countries and the state of the art food waste processing technologies to produce enzymes

Four cases of sarcoma botryoides

[No abstract available