India is gradually turning into graying nation. With increased life expectancy there is more number of citizens above 60-65 age range now. However the changes that come in later life – retirement, death of spouse, increased isolation – can lead to different psychological problems among which depression is quite common. At the same time, studies indicate that loneliness, self esteem are potent factors involved in such psychological problems. The present study was undertaken to find the relation of such factors on depression in elderly Kashmiris as well as their presence in different sections. The sample consisted of 100 old age retired persons taken from different districts of Kashmir. Geriatric Depression Scale, Rosenberg’s Self –Esteem Scale, and UCLA loneliness Scale were applied on the participants to collect the data. Spss 20 was used to analyse the data and results revealed significant positive as well as negative correlation among different variables. However no significant differences were found across gender and domicile of participants on any of the measure. Hence it is clear that there is relation of depression with lonliness and self-esteem, however the nature and the direction of effect is not fully established.
Introduction: Hydatid disease is a disease that has been known since antiquity and was described by Hippocrates with the particular term Liver filled with water followed by famous Arabian physician Al-rhazes who wrote on hydatid cyst of liver about 1000 years ago. Hydatid disease commonly known as Cystic Echinococcosis (CE) is a parasitic infestation caused by flatworm Echinococcus granulosus. Hydatid disease is characterized by cystic lesions occurring in different parts of body most commonly liver (65%), lungs (15%). Unusual sites of involvement include muscles (5%), bones (5%),kidney (3%), spleen (2%), diaphragm (1%), ovary (0.2%).The peritoneal cavity, thyroid, breast, gall bladder, omentum are rarely involved. Methods: Our study was a prospective observational study conducted in Postgraduate Department of General Surgery, Government Medical College, Srinagar, J&K for a period of 2 years. This study included 30 patients after fulfilment of inclusion and exclusion criteria. Ethical clearance was obtained from institutional Ethical Committee. Results: In this study 30 cases of hydatid disease were studied, the most common age group involved in this disease was 21-30 years. . Most of our patients were females 18 cases (60%) and males 12 cases (40%). Male: Female ratio of our study is 1:1.5. Majority of patients presented with abdominal pain 24 cases (80%) followed by vomiting in 5 cases (16.7%), palpable mass was found in 1 case (3.3%) and Jaundice in 1 case (3.3%). Laparoscopic hydatid cystectomy for hydatid liver was done in 10 cases (33.3%). Open hydatid cystectomy was done in 17 cases (56.7%). Conclusion: Hydatid disease can occur in any age group but is seen most commonly in middle age , females, patients belonging to low socioeconomic status and involved in farming. Low socioeconomic status, agricultural activities and association with dogs or cattle were risk factors for the disease. Absence of history of contact with cattle or dogs doesnt rule out the possibility of disease.
Background: Endoscopic retrograde cholangiopancreatography (ERCP) followed by laparoscopic cholecystectomy (LC) remains the cornerstone of treatment worldwide for coexisting CBD and gall bladder calculi. The interval between ERCP and LC is disputed. In our study, LC is performed at or more than 6 weeks after ERCP keeping in view by allowing the gall bladder to recover from the acute inflammatory changes if operated upon earlier.Methods: We conducted a prospective observational study in the postgraduate department of general surgery government medical college Srinagar J and K India over a period of 2 years. The 25 patients above age of 18 years and with cholecysto-choledocholithiasis who underwent ERCP and LC at or more than 6 weeks were included.Results: In our study the mean age was 45.3 years. Male: female ratio was 1:3.2. the distribution of patients as per Nassar grading scale 1 (4%) patient had grade I,12 (48%) patients had grade II, 5 (20%) patients had grade III and 7 (28%) patients had grade IV. In patients with grade I, the mean duration of surgery was 36.0 minutes, in grade II the duration of surgery ranged from 34-60 minutes with mean duration of surgery of 43.4 min (SD±8.9), in grade III duration of surgery ranged from 42-68 minutes with mean duration of surgery of 55.2 min (SD±10.06) and in grade IV duration of surgery ranged from 68-116 minutes with mean duration of surgery of 91.3 min (SD±17.66). We observed a definite relationship between the intraoperative Nassar grading scale and the post ERCP interval, 1 patient of grade I scale operated at 12 weeks post ERCP. 12 patients were between the post ERCP interval of 8-12 weeks (mean 10.1 weeks) and they had grade II. In grade III we had 5 patients with post ERCP interval of 7-11 weeks (mean 9.2 weeks). In grade IV we had 7 patients with post ERCP interval of 6-10 weeks (mean 7.9 weeks). p=0.008.Conclusions: Interval LC after ERCP is safe but challenging, longer the interval time between ERCP and LC lesser the chances of encountering intra-operative complications. We recommend LC more than 6 weeks after ERCP is safe.
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