Depression and Anxiety among Patients undergoing Dialysis: An Observational Study

Introduction: Depression and anxiety are the most prevalentpsychological disorders among end-stage renal diseasepatients and are associated with various conditions that resultin poorer health outcomes, e.g. reduced quality of life andsurvival. Along with the psychological problems of patientsundergoing hemodialysis, sleep quality also plays a negativerole in patient health status. Frequent reports have documentedthat patients having complicated health and mental status maylead to poor health quality and may lead to mortality. Weaimed to investigate the prevalence of depression and anxietyamong patients undergoing renal dialysis therapy.Material and methods: A total of 95 patient’s data werecollected by using DASS questionnaire. DASS questionnairescores were evaluated, result was tabulated and interpreted.Scoring of questionnaire test is based on the a 0 – 3 scale whichindicates various range of depression, anxiety and stress scale.Results: Our study indicate that among 95 patients, manyof the patient having mild psychological problems includesdepression, anxiety and stress. Maximum range of 13.68%of patients have found out with anxiety and stress and nodepression state. But there were patients with no sign ofanxiety, stress and depression. Previous studies state thatpsychological variables include depression, stress, and,anxiety took part to get more health complications along withsleep disorders. But by providing right time health care andmental support, it is possible to get back patient health tonormal state. Our result concluded that none of the patient hasfound with complicated mental and health issues.Conclusion: Current study contributed that, among 95patient’s data analysis we have found out few number ofpatient with mild psychological abnormalities. But theseproblems did not reach to highly complicated state. So ourresearch study aimed to suggest nephrologists to aware ofthe quality of life in their patients and should consider thescreening of patients for various symptoms to improve thequality of life.

Sleeplessness in Patients with end-Stage Renal Disease Undergoing Dialysis Therapy in a Tertiary Care Center

Introduction: Maintenance dialysis patients experience a highburden of physical and emotional symptoms that directly affecttheir quality of life and health care utilization. Patient with endstage renal disease (ESRD), 80% of them have reported withcomplaints of subjective sleep abnormalities. Frequent reportshave documented in these patients such as sleep disturbancesmanifestation as insomnia, sleep apnea syndrome, restlessleg syndrome (RLS) periodic limb movement disorders, andexcessive day time sleepiness. Present study focused to findthe quality of sleep and sleep abnormalities in patients withESRD.Material and methods: Patient data were collected usingPittsburgh Sleep Quality Index(PSQI); The demographic andclinic questionnaire contained questions about age, gender,place of residence, dialysis frequency, HD (Haemodialysis)duration. Scoring of seven components answers is based ona 0 to 3 scale which reflects the various states of sleepingdisorders.Results: Study showed that during the earlier stage ofhemodialysis patients may have a high PSQI test score. In theperiod of 3- 12-month patients are facing poor sleep quality;indicating that in the earlier period of treatment patientsmay have taken more stress and conscious to adjust withhemodialysis as a routine treatment procedure for the rest ofthe life. This may instigate to have a high score in PSQI testscore.Conclusion: The current study indicates that RLS, poorquality sleep, and EDS are common in ESRD patients underhemodialysis. Additional studies involving the change ofhemodialysis shift may provide a better understanding ofthe correlation between time duration dialysis and sleepingdisturbances.

Serial Changes in Platelets and Outcomes in Dengue

Introduction: With marked growth of the population, rapidurbanization, inappropriate sanitisation and proliferatingtrend of mosquitoes, there is substantial increase in dengueinfections. The fatality rate due to dengue shock syndrome(DSS) can be brought down to as low as <0.2% with carefulmanagement. Understanding the factors which are responsiblefor progression of the disease to the severe stage and death isessential in determining the triage and management steps.Material and methods: All patients suspected to haveprobable dengue / probable dengue fever with warning signswere admitted in government hospital attached to KasturbaMedical College, Mangalore and were given an option ofenrolment in the study. After obtaining informed consent,all potentially eligible patients were screened for enrolment.All necessary blood samples needed to confirm dengue feverand other causes of fever were drawn on the first day. Plateletcounts were done every day till they reach stable levels or tilldischarge.Results: Out of 105 cases (Dengue Fever withoutcomplications), platelet counts (median values) were taken asa parameter. It was observed that the platelet counts are at alowest level on day 2 and day 3 and later on day 4 and day5 it improved. Friedman’s test value = 228.612 and p value<0.001 which was highly significant.Discussion: Thrombocytopenia is a distinctive feature ofdengue and it has been described that its intensity correlateswith the degree of viremia and with the magnitude of theimmune response. It has been suggested that a progressivedecrease in platelets may anticipate the severe form of dengue.