198 32nd World Congress of Internal Medicine (October 24-28, 2014) WCIM 2014
PS 0582 Psychiatry
Update Manajement Concurrent Infection Between Dengue Virus and Salmonella and an Appropriate Di- agnosis of Dengue Virus Infection in Some Cases Who Had and were Being Treated in Soerya Hospital Sepan- jang – Indonesia
Soegijanto Soegeng SOEGENG SOEGIJANTO1 Airlangga University, Indonesia1
Background: Since January 2014, Soerya Hospital has found many cases with positive result of IgM Salmonella along with NS1 or IgM and IgG Dengue. The clinical manifes- tations mostly were high fever, head pain, vomiting, malaise and plasma leakage. Some of the cases had also experienced convulsion and unconsciousness. Therefore, in order to get good management care of it the clinical phenomena should be studied carefully.
Methods: Observational study has been done since January-Maret 2014. Purposive sampling of 30 cases of concurrent Dengue and Salmonella infection compared to 30 cases of Dengue viral infection alone. The diagnostic procedure was established based on WHO 2011 criteria.
Results: By giving anti vomiting, anti pyretic, anti convulsion and anti biotic for Sal- monella infection and rehydration using Ringer Acetate or Ringer Acetate and Dex- trose 5% infution D5+1/2 NS or D5+1/4 NS during 4-5 days hospitalization. The result showed that all cases were well-recovered. There is no signifi cant different between concurrent Dengue with Salmonela infection compared to Dengue viral infection alone. Some cases showed to stay 1-2 days longer in hospital due to the delay of anti- biotic treatment for Salmonella infection.
Conclusions: All cases need to get early diagnostic and treatment accurately in order to get good result.
PS 0583 Psychiatry
Qualitative Evaluation of a Telephone-Based Cogni- tive-Behavioral Intervention on Postnatal Depression
Fei Wan NGAI1
The University of Hong Kong, Hong Kong S.A.R.1
Background: Postnatal depression is a signifi cant public health problem which can have detrimental effects on the well-being of the entire family. There is strong ev- idence supporting the effectiveness of cognitive behavioral therapy on postnatal depression. However, the benefi ts of delivering cognitive behavioral therapy via tele- phone for postpartum women have not been well evaluated. The purpose of this study was to explore Chinese women’s perceptions of a telephone-based cognitive-behavio- ral intervention at early postpartum.
Methods: This study used an exploratory qualitative design. A purposeful sample of 50 fi rst-time Chinese mothers who had participated in the telephone-based cognitive-be- havioral intervention was interviewed at 6-8 weeks postpartum. Data were analyzed using content analysis.
Results: The fi ndings revealed that Chinese women perceived the telephone-based cognitive-behavioral intervention to be helpful in improving their emotional control, increasing their confi dence in the maternal role, and increasing sense of support. Sug- gestion for improvement included extending the intervention into three months post- partum to reinforce the management of emotion and facilitate maternal role taking.
Conclusions: The present study provides qualitative support for the effectiveness of the telephone-based cognitive-behavioral intervention in facilitating maternal ad- aptation during the transition to early motherhood in Hong Kong. The results of this study give direction for the development of cultural relevant care to promote perinatal health.
PS 0584 Psychiatry
To What Extent Did Prevalence of Chronic Disease In- fl uence Prevalence of Emotional Disturbance in Indo- nesia?
Tenri Ashari WANAHARI1, Basofi Ashari MAPPAKAYA1, Rizqa Febriliany PUTRI1, Asmarani KUSUMAWATI2
Sebelas Maret University, Indonesia1, Gadjah Mada University, Indonesia2
Background: The objectives of this study were to asses the relationship and to estimate the effect of prevalence of chronic disease on prevalence of emotional disturbance in Indonesia, taking into account confounding infl uence of socioeconomic (SES) factor.
Methods: Data of prevalence of emotional disturbance, prevalence of seven chronic diseases, and human development index (HDI) on each provinces (N=33) in 2007 were collected from national database (Institute of Health and Bureau of Statistics of Indo- nesia). The relationship and the effect of prevalence of chronic disease on prevalence of emotional disturbance (incorporating HDI as controlled SES variable) were analyzed using Spearman’s correlation analysis and multivariate linear regression, respectively.
Results: Prevalence of emotional disturbance were strongly correlated (p<0.001) with prevalence of arthritis/other joint disorder (r=0.71), prevalence of heart disease (r=0.69), and prevalence of asthma (r=0.66). It was not correlated with prevalence of cancer, hypertension, diabetes, and stroke. After performing regression diagnostics, backward elimination regression, and consideration of multi-collinearity, 3 out of the 8 explanatory variables were selected into the statistical model, to predict prevalence of emotional disturbance. The model was highly signifi cant (F=24.15, p<0.001), explaining more than half of variability of prevalence of emotional disturbance (adj-R squared=0.69). The model explained scenarios which estimated each additional 1% of prevalence of arthri- tis/other joint disorder correspond to increase prevalence of emotional disturbance by 0.23%-0.53% (95% CI, p<0.001), and each additional 1% of prevalence of heart disease correspond to increase prevalence of emotional disturbance by 0.35%-0.98% (95% CI, p<0.001), given controlled SES factor.
Conclusions: The present ecological fi nding gives evidence to formulate hypothetical question for further research. It might not be over interpreted in causal inference, but equally it should not be ignored where evidence is lacking, especially in the developing country.
PS 0585 Psychiatry
Effect of Postoperative Ambulation on the Quality of Life in a Transtibial Amputee
Amit SARAF1
Swami Vivekanand Hospital, India1
Background: Quality of life of a transtibial (TT) amputee is not only determined by his functional rehabilitation but also social, economical and psychological rehabilitation.
A number of studies have analyzed the infl uence of lower limb amputation on these factors. This study analyses the effect of functional recovery on other parameters of quality of life in a TT amputee.Methods: The present study followed 160 patients of TT amputation. Their postoperative ambulatory status was calculated using Pinzur’s ambulatory level. Their quality of life was determined on the basis of answers to fi ve point questionnaire. These parameters were correlated to assess the influence of functional recovery on quality of life.
Results: All the amputees with Pinzur’s 0-1 level of ambulation suffered loss of income consequent to loss of job. All of them felt increased level of depression and anxiety after amputation. 50% of them felt socially neglected. Comparatively much less percentage of amputees with 5-6 level of ambulation suffered economic, social and psychological crisis.
Conclusions: Postoperative ambulation level directly affects the quality of life of a trans tibial amputee.
