Association of depression with dental caries and periodontal disease at a tertiary care hospital.

OBJECTIVE: To determine the association of depression with dental caries and periodontal disease. METHODS: The cross-sectional descriptive study was conducted at the Nishtar Institute of Dentistry, Multan, Pakistan, from May 7, 2018 to January 7, 2019, and comprised samples from subjects with dental caries and periodontal disease. Hospital Anxiety and Depression Scale was applied to screen the participants for the presence or absence of depression. Data was analysed using SPSS 21. RESULTS: Of the 296 participants, 125(42.2%) were males and 171(57.7%) were females. The overall mean age was 38.74±12.87 years. Depression was found in 195(65.8%) patients. Significant association of depression in patients of dental caries and periodontal disease was found with female gender, age <50 years, illiteracy, marital status, pre-existing hypertension, coronary artery disease, illicit substance addiction and psychotropic medication use (p<0.05). CONCLUSION: There was high frequency of depression among patients of dental caries and periodontal disease.

Red blood cell distribution width as a prognostic factor in patients undergoing transcatheter aortic valve implantation.

BACKGROUND: Red blood cell distribution width (RDW), which is routinely reported in complete blood counts, is a measure of the variability in size of circulating erythrocytes. RDW is an independent predictor of prognosis in patients with cardiovascular diseases. We evaluated the short- and long-term prognostic value of RDW in a large cohort of transcatheter aortic valve implantation (TAVI) patients. METHODS: The impact of RDW on outcome was determined prospectively in 1029 consecutive patients with severe aortic stenosis (AS) undergoing transfemoral TAVI. The cohort was divided into 2 groups according to RDW above and below 15.5%. Collected data included patient characteristics, medical background, left ventricle ejection fraction (LVEF), frailty score, Society of Thoracic Surgeons (STS) score, periprocedural laboratory results, and long-term (up to 7.5 years) clinical outcomes. RESULTS: The mean age (±SD) was 83.1±6.3 years, mean STS score was 4.2±3.1% and mean estimated LVEF was 55.7±8.4%. Mean pre-TAVI RDW levels were 15.3±3.2%. Patients with RDW≤15.5% (n=683) and RDW>15.5% (n=346) had a 1-year mortality rate of 6% and 17%, respectively (p=0.001) and a 5-year mortality rate of 20% and 38%, respectively (p<0.001). Baseline RDW>15.5% was independently associated with all-cause mortality (hazard ratio 1.83, 95% confidence interval 1.44-2.32, p<0.001). CONCLUSIONS: Elevated RDW is a strong independent marker and predictor of short- and long-term mortality following TAVI, that might present a relevant future supplement to current preprocedural risk scores. Additional research is needed to clarify the mechanisms responsible for this finding.