ABSTRACT
Dry eye syndrome is a common multifactorial disorder of the tear film and ocular surface. In rare cases, it may be caused by systemic diseases. Corneal melting is a complication of dry eye syndrome and is a potentially blinding condition. Here we report a case of a 67-year-old patient who attended her general practitioner for a year complaining of persistent dry eyes. Ophthalmological assessment showed severe dry eye syndrome with cornea melting in left eye. Blood test revealed anaemia and thrombocytopenia with circulating blasts. Bone marrow biopsy showed 15% myeloblasts with monosomy 7, compatible with acute myeloid leukaemia. Patient was started on intensive chemotherapy regime and was a candidate for allogenic bone marrow transplant. To our knowledge, this is the first case report demonstrating dry eye syndrome with sterile corneal melting as the possible presenting complaints of acute myeloid leukaemia. This case will serve as a useful reminder to general practitioners and accident and emergency doctors about the current guidelines regarding referral of persistently symptomatic patients with dry eye syndrome for further investigation in secondary care.
ABSTRACT
The objective of this study was to investigate the prevalence of depression and anxiety among patients with chronic hepatitis C and how depression and anxiety correlate with respective health-related quality of life (HRQoL) domains, sociodemographic factors, and clinico-epidemiological characteristics. This prospective study involved 150 patients with chronic hepatitis C awaiting interferon treatment for hepatitis C and 150 healthy subjects. All individuals enrolled in the study completed the Short Form 36 (SF-36) questionnaire and Hospital Anxiety Depression Scale. The symptoms showed greater severity/score among patients with chronic hepatitis C for both depression (t=3.37; p<0.01) and anxiety (t=2.35; p<0.05). Regression analysis was used for estimating the relationship between depression and the set of predictors (domains of the SF-36 questionnaire). Three HRQoL domains (Physical Functioning, Vitality, and Mental Health) were found to have the strongest predictive contribution to the occurrence of depression. A series of Kruskal-Wallis and Mann-Whitney tests showed a significant difference in depression level between marital status categories (χ2(2)=7.86, p<0.05). Divorced participants had significantly higher scores compared to married participants (Z=-2.40, p<0.05) and single participants (Z=-2.75, p<0.01). Unemployment was associated with a higher degree of depression and anxiety. There was no association identified between duration of the disease, route of hepatitis C virus transmission, existence of cirrhosis, and depression or anxiety. The findings of this study can assist in developing a standard protocol for the management of chronic hepatitis C that will include psychological assessment and support.
