Severity and risk factors of depression in Alzheimer's disease

To determine the frequency, severity and risk factors of depression in Alzheimer's disease. Descriptive study. The Department of Psychiatry, Sir Ganga Ram Hospital, Lahore, from August 2007 to December 2008. Consecutive patients of Alzheimer's disease reporting to the department during the study period were included and those with extreme cognitive impairment were excluded. The cognitive status was judged by using the Mini-Mental State Examination [MMSE]. The Hamilton rating scale for depression [Ham-D] was used as a symptom checklist to diagnose major depression according to the DSM-IV criteria. Chi-square test was used to check the significance of association. There were 73 patients comprising of 34 males and 42 females. The mean age was 67.74 +/- 6.71 years; 66% were married, 14% were single and 20% were widowed; 47% had family history of depression and medical co-morbidity was observed in 48%. Based on MMSE, 31.5% had mild Alzheimer, 55.3% had moderate and 13.1% had severe Alzheimer. Judging from Hamilton rating scale, 25% patients were free from depression, 19.7% had mild depression, 27.6% had moderate depression and 27.6% were suffering from severe depression. The frequency of depression was significantly higher [p= 0.0013] among females [90%] as compared to males [55.9%]. There is a high frequency of depression among patients of Alzheimer's disease particularly among female patients. This finding is consistent with the reports from other countries

Frequency and risk factor of abdominal wound dehiscence

To find out the frequency of abdominal wound dehiscence [AWD] in a tertiary care hospital and the assessment of associated risk factors. Design: a cross sectional analytical study. Place and Duration of Study: This study was carried out at Nishter Hospital Multan between May 1998 to May 2000. Subjects and This study was carried out on 406 patients who underwent laparotomy for intra peritoneal procedure and complied with inclusion criteria. Demographic features were recorded and any complications documented. Out of a total of 406 patients, 32 showed wound dehiscence giving an over all frequency of 7.8%. The male to female ratio was 2.8:1. The frequency was greater in males than in females. Majority patients suffered from an underlying malignancy. Malignant intestinal obstruction was the leading cause of wound dehiscence. Forty three patients had hypo-albuminemia[serum albumin <35 gm/l] and 09 of them had AWD. Emergency surgery showed a higher frequency of AWD[12.5%], as compared to elective surgery [18/143 and 14/263 respectively]. Wound infection was a major contributor to AWD as out of 406, 76 patients developed infection and then 21 manifested AWD. older age was also associated with greater frequency. The overall mortality of AWD in this study was 28.1%. AWD still continues to be major post operative complication, with a high morbidity and mortality. The significant risk factors in this study were age more than 55 years, male gender, underlying malignancy, wound infection, jaundice, use of steroids, emergency surgery, uraemia and technique of closure