Association of Hyperparathyroidism with Depression and Anxiety Among Chronic Hemodialysis Patients in the Al Baha Region, Kingdom of Saudi Arabia.

Introduction Anxiety and depression are prevalent psychological issues among hemodialysis patients, adversely affecting their well-being and treatment response. The study aims to identify the relationship between these mental health concerns and hyperparathyroidism in chronic hemodialysis patients from the Al Baha Region, Kingdom of Saudi Arabia. Methods This retrospective study included 143 chronic hemodialysis patients aged 18-85 years. Monthly laboratory records for parathyroid hormone (PTH) levels and the Hospital Anxiety and Depression Scale (HADS) for mental health assessment were utilized. Demographic information and the primary causes of end-stage renal disease were obtained through patient interviews. Statistical analyses, including chi-square tests, odds ratio, and significance tests, were performed to assess associations. Results Elevated PTH levels were associated with increased anxiety and depression in hemodialysis patients. Patients with PTH levels >400 pg/ml exhibited higher rates of abnormal HADS scores for anxiety and depression than those with PTH levels <400 pg/ml. Gender differences were evident, with women showing a higher predisposition to anxiety disorders and men having depression. Additionally, patients with PTH levels <150 pg/ml had a significantly higher proportion of the "normal" depression score than those with PTH levels >800 pg/ml. Conclusion The study underscores the association between hyperparathyroidism and adverse mental health outcomes in chronic hemodialysis patients. Maintaining optimal PTH levels plays a crucial role in mitigating anxiety and depression. Gender differences in mental health outcomes highlight the need for tailored interventions. Routine mental health assessments, utilizing tools such as the HADS, are important in the comprehensive care of hemodialysis patients.

Postmastectomy pain syndrome after preoperative stellate ganglion block: a randomized controlled trial.

BACKGROUND: This study investigated the effect of preoperative ultrasound (US) guided stellate ganglion block (SGB) with bupivacaine on the frequency of post mastectomy pain syndrome (PMPS). METHODS: Eighty patients scheduled for mastectomy with axillary dissection for breast cancer were included in this randomized controlled trial. Patients were randomized into two equal groups: Group A received US guided SGB one hour before surgery using five mL of 0.5% bupivacaine and multimodal systemic analgesia, Group B (control) received multimodal systemic analgesia only. Patients were followed up for six months. PMPS was assessed using the grading system for neuropathic pain (GSNP). Postoperative opioid consumption in the first 24 hours and numeric rating scale (NRS) were documented. Patient daily activity and functional capacity were evaluated using the Eastern Cooperative Oncology Group (ECOG) score. RESULTS: PMPS proportion was significantly lower in group A than group B (30% vs. 62.5%, P=0.004; 52% decrease [95% CI: 18.4%-71.8%]). Postoperative opioid consumption and NRS were significantly lower in group A as compared to group B. ECOG score was significantly higher in Group A than Group B. CONCLUSIONS: Following mastectomy with axillary dissection, preoperative US guided SGB is associated with less PMPS proportion, postoperative pain and opioid consumption and better patient daily activity and functional capacity.

Ginger and vitamin C as protective agents against oxidative stress and liver injury induced by methyl parathion

Methyl parathion is one of the highly toxic organophosphorus (OP) compounds. It induces hepatotoxicity, which might be related to generation of reactive oxygen species. This study was carried out to investigate the protective roles of vitamins C and ginger against hepatotoxicity induced by methyl parathion in male albino rats.Sixty male albino rats were randomly divided into 6 groups (ten rats each). Group I was considered as controls. Animals of groups II, III and IV were given methyl parathion (2 mg/kg), ginger (200 mg/kg) and vitamin C (100 mg/kg) respectively. Groups V and VI were given ginger (200 mg/kg) and vitamin C (100 mg/kg) respectively 2 hours before methyl parathion administration. All animals were treated orally, once daily, for four weeks. Blood and liver samples were obtained for biochemical, immunohistochemistry and histopathological examinations.Administration of either ginger or vitamin C along with methyl parathion significantly reduced the alanine aminotransferase (ALT) and malondialdehyde (MDA) levels in rats compared to those only treated with methyl parathion. Treatment with either ginger or vitamin C in combination with methyl parathion resulted in increased level of reduced glutathione compared to the methyl parathion treated group. However, oral ginger significantly increased glutathione-S-transferase levels compared to the control group, and this may outbalance the protective value of ginger over vitamin C to guard against liver injury and oxidative stress. The immunohistochemical and histopathological examinations showed that ginger or vitamin C combination with methyl parathion resulted in less hepatocytes degeneration and milder portal tract infiltration compared to the methyl parathion group.In conclusion, pre-treatment with either ginger or vitamin C appears to alleviate methyl parathion-inducted hepatotoxicity. However, their protective role is still limited and needs further investigation

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