RESUMEN
Chronic diseases and pain exacerbate depressive symptom in Syria. Limited research on hospital-induced depressive symptom among Syrian patients with chronic diseases warrants further study. A cross-sectional study in four Damascus hospitals revealed high rates of pain and depressive symptom. This study aims to investigate the prevalence and severity of chronic pain and hospital-induced depressive symptom in Syrian patients, as well as the relationship between pain, depressive symptom, and medication behavior. This study analyzes the impact of pain, hospitalization, and medication on patients with chronic diseases. The four Damascus hospitals included 453 patients from various departments. Data were collected through structured interviews and internationally recognized scales such as the PSEQ, HADS, and MMAS. These findings offer insights into pain management and psychological well-being, with implications for patient care and support strategies. The study involved 453 patients with chronic diseases, with gender distribution showing 46.6% females and 53.4% males. The age range was from 7 to 87 years, with an average of 46.87 years. Chi-square tests revealed a significant connection between gender and HADS-A scores, where 48.3% of females had abnormalities (χ2 (1, N = 453) = 7.125, p = 0.028). Marital status was significantly associated with anxiety and depressive symptom levels, particularly among widowed and divorced patients. Employment status, education, and comorbidity were linked to abnormal HADS-A scores, while education level showed a positive correlation with HADS-D scores. ANOVA tests showed significant differences in MMAS scores across income groups (F (3, 449) = 3.167, p = 0.024), with a notable difference between low-income and lower-middle-income groups (mean difference = 0.389, p = 0.031. Chronic pain and HID are prevalent among Syrian patients with chronic diseases and influenced by socio-demographic factors. Personalized interventions are needed to address psychological symptoms and medication behavior.
Asunto(s)
Depresión , Hospitalización , Humanos , Masculino , Femenino , Persona de Mediana Edad , Siria/epidemiología , Adulto , Depresión/epidemiología , Anciano , Estudios Transversales , Adolescente , Enfermedad Crónica , Adulto Joven , Anciano de 80 o más Años , Dolor Crónico/tratamiento farmacológico , Dolor Crónico/epidemiología , Dolor Crónico/psicología , Niño , PrevalenciaRESUMEN
INTRODUCTION AND IMPORTANCE: Uterine arteriovenous malformation (UAVM) can be present at birth or acquired later, often after trauma like cesarean delivery. It can cause severe vaginal bleeding but may have no symptoms. What makes our case special, other than being a rare condition, is the surgical technique used. CASE PRESENTATION: A 24-year-old woman came in with abdominal pain at 38 weeks pregnant. She had a cesarean delivery 13 months before. She had an uncomplicated repeat cesarean but bled heavily after from uterine atony. A 5 × 7 cm asymptomatic uterine AVM was found incidentally in the right uterine horn. After the transfusion, B-Lynch sutures were used to treat the atony and AVM. The patient recovered well after the sutures. Follow-up ultrasound showed the AVM got much smaller and no more bleeding. CLINICAL DISCUSSION: While conventional approaches advocate hysterectomy or uterine artery embolization (UAE), our case, situated in a low-income setting, necessitated innovative strategies. With embolization unavailable, and surgery carrying inherent risks, the B-lynch Procedure emerged as a pragmatic choice. CONCLUSION: Uterine AVM with no symptoms can happen after cesarean delivery. In low-resource settings, modified compression sutures can effectively treat heavy bleeding after delivery and shrink AVM size, avoiding hysterectomy.