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Poor Medication Adherence, Being Unemployed and Substance Use as Correlates of Suicidal Plan in Diabetes Mellitus Patients, 2020
Mogesie Necho,
Mekonnen Tsehay,
Asmare Belete
Issue:
Volume 8, Issue 3, September 2020
Pages:
40-45
Received:
29 April 2020
Accepted:
26 May 2020
Published:
10 August 2020
Abstract: BACKGROUND: Suicidal behaviors are parts of the course of diabetes due to multiple burdens diabetes imposes on patient’s life. However, these areas are not well researched. So we assessed suicidal plan and the associated risk factors among Diabetes Mellitus patients in this study. METHOD: Institution based cross-sectional study was conducted in May, 2017. A pre tested, structured and standardized questionnaire was used to collect data. Systematic sampling was used to recruit 421 participants. Binary logistic regression was employed to identify factors associated with outcomes. Odds ratio with 95%CI was computed and variables with a p-value of <0.05 in the final binary logistic regression model were declared as statistically significant predictors of suicidal plan. RESULTS: Four hundred twenty one patients included in our study with 96.3% response rate. Average age of the respondents was 38.0 (±13.9) years. The prevalence suicidal plan was 10.7%. Final regression model showed that being unemployed (AOR=3.59, 95% CI: 1.25, 10.89), poor medication adherence (AOR=2.43, 95% CI: 1.83, 8.15) and current use of substance (AOR=1.82, 95% CI (1.45, 4.24) were associated factors for suicidal plan. CONCLUSION: This study reached at a point that suicidal plan was high in diabetic patients. Being unemployed, poor medication adherence and current use of substance were associated factors for suicidal plan. Due consideration should be given for such public health issue in diabetes patients.
Abstract: BACKGROUND: Suicidal behaviors are parts of the course of diabetes due to multiple burdens diabetes imposes on patient’s life. However, these areas are not well researched. So we assessed suicidal plan and the associated risk factors among Diabetes Mellitus patients in this study. METHOD: Institution based cross-sectional study was conducted in May...
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Revisiting Clozapine in a Setting of COVID-19
Issue:
Volume 8, Issue 3, September 2020
Pages:
46-54
Received:
16 July 2020
Accepted:
28 July 2020
Published:
18 August 2020
Abstract: Clozapine is a highly potent atypical antipsychotic popularly used for treating refractory schizophrenia. Clozapine displays a complex mechanism of action. There are emerging views that its mode of action is immunomodulation rather than neuromodulation. It must be the immunomodulatory properties of clozapine that contributes to its superior efficacy and such a view help to validate the autoimmune ethology of a subset of schizophrenia. Agranulocytosis, one of the major side effects of clozapine is thought to be an autoimmune reaction. Because higher incidence of Flu related complications has been reported among clozapine users, there has been concern about the impact of COVID-19 among the patients on clozapine. As in the case of general population, infections with SARS-CoV-2 have been reported among clozapine users, but these are early days to make any firm conclusions about the higher risks of COVID-19 posing to clozapine treated patients. It is possible that clozapine may have therapeutic effects other than its antipsychotic effect and that needs further exploration.
Abstract: Clozapine is a highly potent atypical antipsychotic popularly used for treating refractory schizophrenia. Clozapine displays a complex mechanism of action. There are emerging views that its mode of action is immunomodulation rather than neuromodulation. It must be the immunomodulatory properties of clozapine that contributes to its superior efficac...
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The Libertine Carmen, a Female Don Juan
Issue:
Volume 8, Issue 3, September 2020
Pages:
55-59
Received:
10 July 2020
Accepted:
4 August 2020
Published:
27 August 2020
Abstract: For the psychoanalyst André Green, there is a link between the creations of a writer and his life. The creators can be totally unconscious or partially conscious of the material arising from the depth of their unconscious. My goal is to show that creations like dreams are a royal path to reveal unconscious. I will try to show it with Mérimée‘s short story and then with the Bizet’s opera. Mérimée’s Carmen was inspired during a travel in Spain by a news item from the Countess of Montijo and a gypsy met in a cabaret near Valencia. Mérimée is a bachelor, a libertine. He falls in love with a beautiful, brown-haired, sensual, married woman, Valentine Delessert. After a passion-love of four years she breaks for another lover. The short story was written five years later, a mourning work. His Carmen is a gypsy who steels and lies, a non-moral prostitute, a narcissistic pervert. The Carmen of Bizet and his librettists is a mythic character created for the Comic opera in Paris, a seductress and a manipulator. Don José’s passion will lead him to a love crime. Bizet in his twenties has been a seducer, rejected by Celeste Mogador. Celestine Galli-Marié will sing his Carmen. She seduces him and rejects him just before the first performance of Carmen. Bizet died a few weeks later, a drama on stage and in life. A writer or a composer don’t choose the subject of a novel or an opera by chance. The success of the opera Carmen is related to the capacity of the creators to give life and emotion to their characters. Carmen’s destiny expresses Mérimée and Bizet’s death wishes and those of men seduced and abandoned by such a woman.
Abstract: For the psychoanalyst André Green, there is a link between the creations of a writer and his life. The creators can be totally unconscious or partially conscious of the material arising from the depth of their unconscious. My goal is to show that creations like dreams are a royal path to reveal unconscious. I will try to show it with Mérimée‘s shor...
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Factors Associated with Relapse of Schizophrenia in Bangladesh
Md Kamrul Hassan,
Md Inamul Islam,
Abul Hossain Muhammad Kazi Mostofa Kamal,
Md Julfikkar Alam
Issue:
Volume 8, Issue 3, September 2020
Pages:
60-64
Received:
21 August 2020
Accepted:
1 September 2020
Published:
10 September 2020
Abstract: Context: In the face of increasing number of relapse cases of schizophrenia, sufficient work is not available in Bangladesh. Aims: To find out the common factors of relapse of schizophrenia in Bangladesh and to find out the relationship of relapse of schizophrenia with sociodemographic characteristics. Settings and Design: Cross-sectional descriptive study; Department of Psychiatry, Combined Military Hospital, Dhaka, National Institute of Mental Health (NIMH), Dhaka and Psychiatry department of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. Materials and Methods: Data from 50 relapse patients receiving treatment of schizophrenia were collected, from April 2018 to September 2018. Statistical Analysis Used: The data were processed and analyzed with the help of computer program SPSS (Statistical Package for Social Sciences) win version 16. Results: The mean age was 31.16 (±10.59) years ranging from 14 to 55 years. Majority of the respondents 70% (n=35) were under 35 years. 62% (n=31) of the respondents were male and 38% (n=19) were female. 96% (n=48) of the respondents were Muslims. 52% (n=26) of the respondents were married and 46% (n=23) were unmarried. 46% (n=23) were from rural background and 54% (n=27) of the respondents were from urban background. 40% (n=20) of the respondents were from lower class, 52% (n=26) were from middle class, and only 8% (n=4) were from higher class. 56% (n=28) of the respondents had perceived stressful life events and 44% (n=22) of the respondents had no such history. 52% (n=26) of the patients had experienced high expressed emotion and 48% (n=24) had low expressed emotion. Among the 50 relapsed schizophrenia patients, only 26% (n=13) had full compliance, 30% (n=15) had full noncompliance and rest had partial compliance. There was no significant relationship between educational status and medication compliance in the current study. The study revealed significant association with lower social class and presumptive stressful life events. Conclusions: This study highlighted the perceptions of schizophrenic patients and their caregivers about factors that influence relapse. It indicated that stressful life events, high expressed emotion, and non-compliance to medication had a role in relapse. This study provides information about socio-demographic and other related factors which can offer important guideline for future study. Adherence to antipsychotic medication, reducing high expressed emotion and stressful life events protect patients from relapse.
Abstract: Context: In the face of increasing number of relapse cases of schizophrenia, sufficient work is not available in Bangladesh. Aims: To find out the common factors of relapse of schizophrenia in Bangladesh and to find out the relationship of relapse of schizophrenia with sociodemographic characteristics. Settings and Design: Cross-sectional descripti...
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