ABSTRACT
Background. Bronchial asthma is a serious global health problem. Depression, the most common mood disorder, is often found to be higher among people with chronic health conditions like bronchial asthma. Methods. Patients with newly diagnosed to have bronchial asthma (n=100) who fulfilled the study criteria were evaluated for depression with Beck Depression Inventory (BDI) score. Severity and level of bronchial asthma control were determined as per Global Initiative for Asthma (GINA) guidelines. Subjective asthma severity was assessed by Perceived Control of Asthma Questionnaire. Follow-up evaluation was done after three months of asthma management with the same study tools. Results. In our study population, 65% asthma patients showed depression on first visit (95% Confidence interval [CI] 55.65-74.35). Correlation coefficient between subjective asthma severity and severity of depression was –0.945 (p<0.001) while correlation coefficient between objective asthma severity and depression severity was 0.066 (p=0.515). In follow-up visit after asthma management 63% patients still had depression (95% CI 53.54-72.46). Correlation coefficient between objective asthma control and depression severity was 0.1 (p=0.320). Correlation coefficient between subjective asthma severity and severity of depression was –0.979 (p<0.001). Conclusions. Our observational study suggests that depression is highly prevalent in asthma patients. There is a high inverse correlation between depression and patient’s perception of asthma control. However, no significant correlation could be observed between objective measures of asthma severity and depression.
ABSTRACT
Background. Pleural effusions of diverse aetiologies are encountered in patients with chronic kidney disease (CKD). The objectives of the present study were to examine the frequency of occurrence, causes, clinical features and management strategies of pleural effusion in patients with CKD including renal transplant recipients. Methods. A prospective cross-sectional observational analysis of pleural effusion in adult patients with CKD (stages 3 to 5) attending the Departments of Nephrology and Respiratory Medicine of a tertiary care institution in Eastern India was performed over a period of one year (February 2010 to January 2011). Results. Pleural effusion was found in 29 out of 430 patients with CKD (6.7%) and in two out of 34 post-renal transplant recipients (5.9%) evaluated during the study period. The mean age was 37.35±1.8 (mean±SEM [standard error of mean]) with a male to female ratio of 2:1. Exudates and transudates were found in equal frequencies. Heart failure was the single most common cause (41.9%, 13 of 31). Tuberculosis (TB) (n=8, 25.8%) and uraemic effusions (n=6, 19.4%) were responsible for the majority of exudates. Unilateral effusion with a normal heart size had a positive predictive value of 83.3% for nonheart failure aetiology. Conclusions. Symptomatic pleural effusion was present in a small proportion of 6.7%; (n=29) patients with CKD including post-renal transplant recipients. Heart failure, TB and uraemic effusions accounted for most of the cases. Differentiating TB from uraemic effusion requires a combined clinico-pathological approach and this differentiation is absolutely necessary for proper management.