Prevalence and spectrum of iron deficiency in heart failure patients in south Rajasthan.

OBJECTIVE: To estimate the prevalence and pattern of iron deficiency (ID) in heart failure (HF) patients with or without anemia. METHODS: This is a single-center observational study, conducted at a tertiary care hospital of south Rajasthan. Patients admitted to hospital with clinical diagnosis of HF based on validated clinical criteria were included in the study. ID was diagnosed based on complete Iron profile, including serum iron, serum ferritin, total iron binding capacity, and transferrin saturation (TSAT). Anemia was defined as hemoglobin (Hb) <13g/dl for males and <12g/dl for females, based on World Health Organization definition. Absolute ID was taken as serum ferritin<100µg/L and functional ID was defined as normal serum ferritin (100-300µg/L) with low TSAT (<20%). RESULTS: A total of 150 patients of HF (68% males and 32% females) were studied. Most of the patients were of high-functional NYHA class (mean NYHA 2.89±0.95). ID was present in 76% patients with 48.7% patients having absolute and 27.3% patients having functional ID. Females were having significantly higher prevalence of ID than males (91.6% vs 68.6%; p=0.002). Nearly one-fourth of the patients were having ID but without anemia, signifying importance of workup of ID other than Hb. CONCLUSION: Our study highlights the yet underestimated and neglected burden of ID in HF patients in India. This study suggests further large-scale studies to better characterize this easily treatable condition and considering routine testing in future Indian guidelines.

Association of depression and its relation with complications in newly diagnosed type 2 diabetes.

INTRODUCTION: The prevalence of major depressive disorders is higher among persons with diabetes compared to the general population. These associations may be related to the increased risk of depressive symptoms in individuals with diabetes, increased risk of type 2 diabetes (T2DM) in individuals with depressive symptoms, or both. OBJECTIVES: To study the association of depression with diabetes and its complications in newly diagnosed type 2 diabetes in eastern UP. MATERIAL AND METHODS: Sixty cases and an equal number of age- and sex-matched controls were assessed for depression, diabetes complications, and a demography profile. RESULTS: Depression was found in 26 (43.34%) cases, while it was present in only eight (13.33%) controls (P = 0.002). Depression correlated with the level of hyperglycemia at presentation, as measured by fasting and postprandial blood glucose (FBG and PPBG) values. The presence of diabetic nephropathy was significantly associated with depression, while the prevalence of other complications of diabetes (retinopathy and dyslipidemia), although higher among those with depression, was not statistically significant. The level of HbA1c was 8.56 ± 1.66 in the depressed versus 8.04 ± 1.88 in the non-depressed diabetics (P = 0.26). CONCLUSIONS: The association of depression with diabetes and its complications in newly diagnosed type 2 diabetics was highlighted in our subpopulation and emphasized the need for integrated health services. The prevalence of depression was higher among them compared to controls. The chances of becoming depressed increased as the diabetes complications worsened.