IntroductionPsychological distress and suicide are known to be associated with exposure to traumatic life events. No literature is available on prevalence of suicidal ideation in the aftermath of terrorist attacks in Pakistan.ObjectivesTo study suicidal ideation and desire for death in trauma exposed population in Pakistan.AimsTo estimate the prevalence of suicidal ideation and desire for death one year after exposure to extreme trauma in a well-defined and accessible group in Pakistan.MethodsSubjects were examined 1 year after exposure to a bomb blast in Islamabad, Pakistan. A semi-structured interview schedule and Beck Scale for Suicidal Ideation were used to assess a group of female University students. Assessment record of 50 consecutive study participants were evaluated to estimate point prevalence of suicidal ideation and desire for death in the study population.ResultsAll subjects were enroled in full time university education at the time of assessment. 17 subjects (34%) presented with weak desire for death whilst 5 subjects (10%) presented with moderate to severe desire for death. 15 Subjects (30%) presented with active suicidal ideation at the time of assessment. However, ony 3 subjects (6%) presented with moderate to severe suicidal ideation. The subjects presenting with suicidal ideation described family ties, religious beliefs, fear of irreversible injury as protective factors against their suicidal thoughts. Only 2 subjects (4%) had engaged in some degree of planning towards committing suicide.ConclusionsThis study provides the first structured estimate of prevalence of suicidal ideation in trauma exposed population of Pakistan.
IntroductionSevere stress or exposure to life threatening trauma is known to affect social functioning and quality of life.ObjectivesTo study well-being and anger arousal as markers of social functioning and quality of life in a group of University students exposed to a suicide bomb attack on a University in Pakistan.AimsTo examine indicators of social functioning in order to higlight them as targets for therapeutic interventions.MethodsSubjects were assessed after one year of exposure to a life threatening incident on University campus. Subjects completed an assessment schedule incorporating World Health Organization's Well-Being Index and Novarco Anger Inventory (25 items).Results54 students completed the assessment. The mean age of the group was 24 years. All subjects had completed 14–16 years of education and were in full time education at the time of assessment. The Well Being Index Score range was 1–24 with 26 sujects scoring 13 or lower scores indicating poor quality of life. 29 subjects scored higer levels of anger arousal on 10 or more items of Novarco Anger Inventory indicating difficulties in social functioning. The overall group showed a statistically significant negative correlation between the Well-Being Index Scores and the number of Novarco Anger Inventory items scored in the two highest categories of anger arousal.ConclusionsThe results of the study highlight anger arousal and well-being as important markers of functioning in the aftermath of a stressful life event. The study confirms their usefulness as legitimate therapeutic targets for pharmacotherapy, psychotherapeutic, and social interventions.
The study showed that the introduction of Enstilar®, thanks to its incremental efficacy and shorter therapy cycle compared to other topical agents (4 weeks with Enstilar® compared to 8 weeks with Dovobet® Gel), generates savings for the Italian NHS equal to 4.926.537 € , 5.076.094 € and 6.465.717 € respectively in year 1, 2 and 3 over the total expenditure of 215.254.963 € , 224.089.975 € and 232.924.987 € related to the year 1, 2 and 3 in the first scenario. ConClusions: The present study indicates that the introduction of Enstilar® improves the adherence to the therapy thanks to its rapid onset of action and generates significant savings for the Italian NHS. Indeed, because of its incremental efficacy, Enstilar may reduce or delay the use -sometimes inappropriate -of systemic therapies.
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