RESUMO
Background: Nicotine dependence and depression have been associated in many studies. The current study aims to determine the association of nicotine dependence and depression, the association of severity of nicotine dependence with depression and the severity of depression in nicotine dependent patients suffering from depression. Methodology: It was an observational, cross sectional, and comparative study. 150 consecutive patients attending medical OPD diagnosed as having nicotine dependence by Diagnostic Statistical Manual (DSM)- 5 were screened by Fagerstrom test, Modified Fagerstrom scale and diagnostic criteria of Major Depressive Disorder using DSM-5. Hamilton Depression (HAM-D) rating scale was applied to patients suffering from depression to know the severity. Statistical analysis was done using z test, Chi square test, Fischer’s exact test and Odds’ ratio. Results: Patients with nicotine dependence were found to have statistically significant higher rate of depression than persons without nicotine dependence. (17.8 % vs 8.6%). It was found more in married patients (52%) and in patients from lower socio-economic class (75%). 72.7% of patients used smokeless forms. Conclusion: Though highly prevalent, tobacco use disorder is often ignored due to absence of behavioral symptoms. Not only there is increase prevalence of depression in nicotine dependent patients, having depression can lead to increased chances of nicotine dependence. Hence addressing nicotine use is essential for better prognosis of both disorders
RESUMO
Background: Diallelic [insertion/deletion (I/D)] polymorphism in the angiotensin-converting enzyme (ACE) gene has been reported inconsistently as being associated with risk of diabetic nephropathy (DN). Objective: To examine the three ACE poly-morphic variants in intron 16 for a possible role in modulating DN in T1DM patients from Kutch region, Gujarat. Design and setting: I/D polymorphism in intron 16 of the ACE gene was examined in a case-control group (280 participants with T1DM, case participants n=138; control participants n=142) for association with nephropathy. All recruited individuals were carefully phenotyped and genotyping was performed using polymerase chain reaction and gel electrophoresis methods. Suitable descriptive statistics was used for different variables. Results: No departure from Hardy-Weinberg equilibrium was observed in cases or controls. Genetic polymorphism at the ACE locus in intron 16 were significantly associated with nephropathy when analyzed either by genotype or allele frequencies and D/D variant were significantly (p=0.0002) associated with nephropathy at the 5% level. In multivariate analysis, D/D variant had an independent and strongest influence on the micro-albumin excretion (p=0.002, OR=2.11, 95% CI=1.26– 4.48). However, it did not independently change the odds of having macroalbuminuria versus microalbuminuria. Conclusion: Genotype-associated differences in ACE in intron 16, have functional consequences in genetic susceptibility to diabetic nephropathy in a population with T1DM, and thus represent a potential DN genetic susceptibility locus worthy of replication.