ABSTRACT
Depression is one of the common problems of patients with chronic obstructive pulmonary disease [COPD]. Depending on the severity of lung disease in patients and the kind of study, the prevalence of depression has been reported to lie between 10%-80%. Depression may not be diagnosed in routine examinations, so the patients may not receive appropriate treatment. Due to the lack of similar studies in Iran, the main purpose of this study was to determine the prevalence of depression in COPD patients in Qom. In this cross-sectional study, 207 known cases of COPD were evaluated for depression and its severity by using standardized tests of Beck depression screening. Other variables in the study such age, sex, educational level, marital status and smoking rates were taken into account. SPSS version 15 and Chi square test were utilized for data analysis [p<0/05]. Data analysis showed that 83.3% of patients suffer edfrom varying degrees of depression, of whom 12.9% had severe or very severe depression. Moreover, a significant relationship was found between depression and education level. Depression is one of the common problems in COPD patients reducing their quality of life. It can be treated by physicians which can lead to improved quality of life for these patients
ABSTRACT
Parapneumonic effusion is a common accompaniment of bacterial pneumonia and mostly is resolved with medical management. We studied the etiology and possible underlying causes of complicated parapneumonic effusion and timing of pulmonary decortication. A descriptive study on 34 patients with postpneumonic empyema which required decortication carried out. Post surgical and post traumatic empyema were excluded. Patients' age ranged from 20 to 75 with a mean of 46 years. The most common clinical findings were fever [90%], pleural dull pain [80%], productive cough [73%] and dyspnea [70%]. PPD test was negative in all patients. In 78%, white cell count was normal; in remainder it was more than 10.000. Bacteriological findings were negative and acid fast bacilli were not detected. All patients underwent posterolateral thoracotomy and decortication and completely expansible lung was achieved. Tissue diagnosis after decorticating showed tuberculosis in 8 [24%] patients and necrotic tissue in remainder. Average medical management time and postoperative hospital stay were 38 +/- 2 and 6.7 +/- 2 days, respectively. Morbidity rates were acceptable and there was one late mortality. No recurrence was happened. In parapneumonic effusions not responding to standard treatment, tuberculosis must be considered, especially in addicted persons, positive family history and ESR > 100. In complicated parapneumonic effusion, early thoracotomy and full decortication is recommend because it is diagnostic, allows control of infection, releases the pulmonary entrapment, early discharge from hospital, need not further antibiotic administration and is cost benefit