Personality disorders (PDs) are common among psychiatric outpatients and are associated with increased morbidity and worse treatment outcomes. Epidemiological research conducted among this population in Asian countries is limited, reflecting a significant gap in the current literature. One barrier to this research is the lack of appropriate screening tools. The current research assessed the feasibility of using the SAPAS (Standardized Assessment of Personality-Abbreviated Scale) screening tool to identify individuals at high risk of PD in an Indian psychiatric outpatient population and provides an initial estimate of PD prevalence by using a validated diagnostic interview, the ICD-10 International Personality Disorder Examination. The findings suggest that whilst use of the SAPAS was feasible, acceptable to patients and led to clinically useful findings, when using the recommended cut-off score of 4, the SAPAS largely overdiagnoses the risk for PD in psychiatric outpatients in India (positive predictive value = 26.3%). The estimated prevalence of personality disorder in the sample was 11.1%, based on administering the International Personality Disorder Examination diagnostic interview to high-risk patients scoring 4 and above on the SAPAS, which is higher than previous estimates for this population and still likely to be an underestimation. Future studies should translate the measure into Bengali and evaluate its sensitivity and specificity at different cut-off points in order to optimize its use in Indian populations. Copyright © 2017 John Wiley & Sons, Ltd.
Purpose: This study was conducted to examine microbiological profile with their antibiotic sensitivity in cases of bacterial keratitis in north and central India to ensure appropriate use of antibiotics. Methods: The microbiology laboratory records of 228 patients with culture-proven bacterial keratitis from 1 st January to 31 st December 2019 were analyzed. Cultured bacterial isolates were subjected to antimicrobial susceptibility testing to antibiotics commonly used in the treatment of corneal ulcer. Chi-squared or Fisher’s exact test were applied to check the significance of difference between the susceptibility levels of antibiotics. Results: The prevalence of Staphylococcus aureus and Pseudomonas aeruginosa –induced keratitis was higher in northern India, whereas that by Streptococcus pneumoniae was more prevalent in central India. In central India, 100% of S. pneumoniae isolates were found to be sensitive to ceftriaxone compared to 79% in northern India ( P = 0.017). In comparison to 67% of isolates from north India, 15% of S. aureus isolates from central India were found to be sensitive to ofloxacin ( P = 0.009). Similarly, 23% of isolates from central India were found sensitive to amikacin compared to 65% of isolates from north India ( P = 0.012). P. aeruginosa isolates from central India were found to be sensitive to ceftazidime in 63% of cases compared to 21% of isolates from north India ( P = 0.034). Conclusion: Prevalence of bacteria and their susceptibility to antibiotics are not uniform across geography. Vancomycin remained the most effective drug in all gram-positive coccal infections. S . aureus susceptibility to amikacin was significantly greater in north India. P . aeruginosa showed less susceptibility as compared to previous reports.
Background Personality disorders (PD) lead to frequent emergency department (ED) visits. Existing studies have evaluated high-risk ED populations in Western settings. PD screening tools, such as the Standardized Assessment of Personality – Abbreviated Scale (SAPAS), have thus far only been validated in Western populations. Aims This study aimed to establish the screened prevalence of PD, and to evaluate the performance of the SAPAS as a screening tool within an ED setting in India. Methods The study took place in the ED of a private multi-speciality hospital in Kolkata, India. All attendees were approached during two days per week over three months, except those who were medically unfit to participate. The SAPAS and the International Personality Disorder Examination (IPDE) were translated into Bengali and then used as screening tools for PD and as the reference standard for PD diagnosis. Results Out of 120 ED attendees approached, 97 participated (48 men and 49 women), of whom 24% met the criteria for a diagnosis of PD. A cut-off score of 4 on the SAPAS provided the best trade-off between sensitivity and specificity for detecting PD. Conclusion The prevalence of PD was similar to Western samples, and the SAPAS showed promise for use in a non-Western setting.
Background: Premature ovarian insufficiency (POI) is the preferred term for the condition that was previously referred to as premature menopause or premature ovarian failure. The condition differs from menopause in that there are varying and residual ovarian functions. This study aimed to analyze the clinical characteristics of infertile women with premature ovarian insufficiency. Material & Methods: This prospective study was conducted at the OPD of Impulse Fertility Center, Impulse Hospital, Dhaka, Bangladesh. The study was conducted for a period from January 2022 to December 2022. A total of 23 patients who received outdoor treatment during the study period were purposively selected as sample size. A purposive sampling technique was followed in this study. After approval by the Ethics committee of the Hospital, informed consent from the respondents was obtained after explaining the purpose of the study to them. To be included in the study, respondents should have met the classical definition of infertility defined by the WHO as the inability of a sexually active non-contraceptive using woman to have a live birth after 12 or more months of regular sexual intercourse without a malefactor. Women who had male-factor infertility were excluded. In this study live birth was used as a measure of proven fertility (Because couples desire children, not simply pregnancies, infertility affects couples regardless of whether the etiology lies in conception or the progression of the pregnancy). All the necessary laboratory investigations were done. A questionnaire was developed and data were collected by interviewing the patients and some data were collected from the laboratory results. Data were processed and analyzed by SPSS 19 version. Results: All patients had normal puberty, and menarche occurred at ages 11–15, followed by a regular menstrual cycle. Women who presented with oligomenorrhea were younger than patients with infertility. The mean period of oligomenorrhea before diagnosis was 0.9 years in the oligomenorrhea group and 1.8 years in the infertility group. The mean age when the infrequent periods started was 28 years in the group with oligomenorrhea and 29 years in the group with infertility, and their anthropometric characteristics were not different. In most patients, the FSH levels on day 3 of their menstrual cycle were less than 25 mU/ml. FSH levels >25 mU/ml were confirmed in two patients with oligomenorrhea and five patients in the infertility group. AMH levels were low than 1.0 ng/ml (considered to be in poor ovarian reserve ranges: from 0.13 to 1.0 ng/ml in patients with oligomenorrhea and from 0.13 to 0.9 ng/ml in the infertility group. Transvaginal ultrasound-determined AFC on menstrual cycle days 4–8 was accessed in all patients. We consider AFC < 6 small follicles (diameters 3–9 mm) as a low ovarian reserve indicator. The lowest AFC (one small follicle) was noted in one infertile patient with oligomenorrhea. Conclusion: This study concluded that the subjects usually present with menstrual irregularity (oligomenorrhea) or infertility, and after proper evaluation, their poor ovarian reserve can be confirmed and an occult form of POI established. women who presented with only oligomenorrhea were younger than infertile patients; therefore, menstrual irregularity may be the earliest clinical symptom of occult POI.
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