ABSTRACT
Background: Irritable Bowel Syndrome [IBS] is a very common gastrointestinal dysfunction. Notwithstanding strong evidence of high prevalence of depression and anxiety in IBS there is very limited research on this topic in KSA
Materials and Methods: Cases of irritable bowel syndrome and controls with non-ulcerative dyspepsia were employed between March 2016 to May 2017 from the gastroenterology department in King Abdulaziz hospital, KSA. Presence of anxiety disorder and depression were evaluated by utilizing the Hamilton Anxiety rating scale and Hamilton Depression rating scale respectively. Occurrence rates of anxiety and depression were established and Odds Ratio [OR] was calculated to determine the association of depression and anxiety disorders with IBS
Results: In IBS cases, the prevalence of depression and anxiety disorder was 37.2% and 31.5% respectively. In patients with irritable bowel syndrome the OR for depression was 6.1 [95% CI 1.7-23.6, P=0.008] and the OR for anxiety disorder was 7.3 [95% CI 1.5-36.2, P=0.011]
Conclusion: The occurrence of depression and anxiety disorder in IBS is very high. As a result, screening of IBS patients for anxiety and depression would facilitate better interventions and consequently better outcomes and medical treatment
ABSTRACT
Background: the occurrences of diabetes mellitus and diabetic nephropathy have increased quickly in the past few decades and have become an economic burden to the healthcare system in KSA. Diabetic nephropathy is a major complication of diabetes mellitus and is a primary cause of end-stage renal disease [ESRD]. The occurrence of non-diabetic renal disease [NDRD] in diabetic patients has been increasingly recognized in recent years. It is generally believed that it is difficult to reverse diabetic nephropathy, whereas some cases of non-diabetic renal disease are readily treatable and remittable. However, diabetic nephropathy is known to co-exist with non-diabetic renal disease in a poorly defined population of patients with type 2 diabetes mellitus. This study estimated the pervasiveness of co-existing diabetic nephropathy and non-diabetic renal disease in Saudi patients
Methods: data were retrospectively analyzed from 122 patients with type 2 diabetes mellitus who had experienced a renal biopsy between February 2014 and June 2017 at King Abdulaziz Hospital, region[s], KSA. Male patients numbered 75 [61.5%] of the study population. The biopsies were performed as urinary abnormalities or renal functions were atypical of a diagnosis of diabetic nephropathy. Biopsy samples were examined using light, immunofluorescence [IF] and electron microscopy [EM]. Clinical parameters were recorded for each patient at the time of biopsy
Results: nineteen of 122 diabetic patients [8%] had co-existing diabetic nephropathy and non-diabetic renal disease. These patients showed clinical features and pathologic characteristics of diabetic nephropathy, containing a high prevalence of diabetic retinopathy [88.8%], a long duration of diabetes, increased thickness of the glomerular basement membrane [GBM] and mesangial expansion. Nonetheless, they similarly presented with clinical findings which were inconsistent with diabetic nephropathy, such as hematuria, rapidly progressive renal failure and marked proteinuria. Immunoglobulin A [IgA] nephropathy was apparent in 5 out of the 10 patients [50%], tubulointerstitial lesions were found in two patients [20%], membrano-proliferative glomerulonephritis [MPGN] in two patients [20%] and membranous nephropathy [MN] in one patients [10%]
Conclusion: retrospective analysis of biopsy data suggests that approximately 8% of Saudi patients with type 2 diabetes mellitus may have co-existing diabetic nephropathy and non-diabetic renal disease. The most common histological diagnosis in our small series was IgA nephropathy