The operation theater (OT) environment is the most complex and volatile workplace where two coequal physicians share responsibility of one patient. Difference in information, opinion, values, experience and interests between a surgeon and anesthesiologist may arise while working in high-pressure environments like OT, which may trigger conflict. Quality of patient care depends on effective teamwork for which multidisciplinary communication is an essential part. Troubled relationships leads to conflicts and conflicts leads to stressful work environment which hinders the safe discharge of patient care. Unresolved conflicts can harm the relationship but when handled in a positive way it provides an opportunity for growth and ultimately strengthening the bond between two people. By learning the skills to resolve conflict, we can keep our professional relationship healthy and strong which is an important component of good patient care.
We extend a recently proposed ternary free energy lattice Boltzmann model with high density contrast [1], by incorporating wetting boundaries at solid walls. The approaches are based on forcing and geometric schemes, with implementations optimised for ternary (and more generally higher order multicomponent) models. Advantages and disadvantages of each method are addressed by performing both static and dynamic tests, including the capillary filling dynamics of a liquid displacing the gas phase, and the self-propelled motion of a train of drops. Furthermore, we measure dynamic angles and show that the slip length critically depends on the equilibrium value of the contact angles, and whether it belongs to liquid-liquid or liquid-gas interfaces. These results validate the model capabilities of simulating complex ternary fluid dynamic problems near solid boundaries, for example drop impact solid substrates covered by a lubricant layer.
Background: Depression is most common psychiatric disorder in patients with epilepsy and it is the significant cause of morbidity. 1 Upto 50-60 percent of patients with epilepsy may develop psychiatric complications, particularly depression, anxiety, and psychotic disorders. 2 There is growing evidence of biological link between depression and epilepsy, and significant factors involved are the biological amines and gamma amino butyric acid (GABA) 3 along with other neurobiological and psychosocial factors. This study assess the symptoms and severity of psychiatric comorbidities in patients diagnosed with epilepsy. Methods and Findings: This study was conducted on patients attending psychiatric outpatient epilepsy clinic in psychiatry department, government medical college, Amritsar. A total of 40 patients were studied to find out the prevalence and severity of depression by using self applicable questionnaire, Beck depression inventory (BDI), 4 and MINI, in patients who are diagnosed with epilepsy by clinical interview and examination by senior psychiatrist consultant. In the results of our study 50% patients had psychiatric co-morbidities.40% had depressive disorder. Depression is found to be more among females in our study. 22.5 % were females and 17.5% were males. Among depressed patients, 22.5% had severe depression. Prevalence of moderate depression was 15% , and 2.5 % had borderline clinical depression, 5% had psychosis, and 5% had substance dependence. Conclusion: Diagnosing psychiatric co-morbidities can be difficult in patients with epilepsy. The treatment of both epilepsy and depression need for close collaboration. Patient taking antiepileptic medication may have symptoms of depression as a result of their treatment. Sadly, data from drug trials are often helpful. The antiepileptic medications most closely associated with acute depression on initiation of treatment are vigabatrin, phenobarbitone, and topiramate. Depression with topiramate may be due to abrupt cessation of seizures or drug toxicity. Patients starting tiagabine may develop symptoms of agitation, withdrawal, and mood disturbance suggestive of depression;. Thus good awareness and recognition of psychiatric conditions can help a long way in improving the quality of care of patients with epilepsy.
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