The Relationship of Dry Eye Disease With Depression in Saudi Arabia: A Cross-Sectional Study

Objective

Estimate the prevalence of depression among individuals with a dry eye disease (DED) in Saudi Arabia using two questionnaires: Patient Health Questionnaire (PHQ-9) and Dry Eye Questionnaire (DEQ-5), and explore potential factors implicated in the development of depression among the DED population.

Methods

This is a descriptive cross-sectional study of 476 patients with DED which was conducted using a PHQ-9 questionnaire to screen for depression and a DEQ-5 questionnaire to diagnose DED. The questionnaires were merged and distributed using Google Forms through various social media platforms targeting the Saudi population. After data collection, it was revised, coded and fed to statistical software IBM SPSS version 22 (SPSS, Inc. Chicago, IL).

Results

Depression was diagnosed among 200 participants (42%) of the cases with dry eyes. From which 5.7% had mild depression, 13.9% had moderate depression, 12.6% had moderately severe depression, and 9.9% had severe depression. A female predominance was noticed; 44.7% of the females with dry eyes had depression compared to 32.4% of males with recorded statistical significance (P=0.023). Depression was detected among 55% of those who are less than 20 years old in comparison to 27% of those who are 30 years or older (P=0.001). Laser-assisted in-situ keratomileusis (LASIK), prolonged electronic device usage and contact lens wear are reported as risk factors associated with an increase in dry eye symptoms. However, there is no statistically significant relationship between contact lens wear and depression among dry eye disease patients.

Conclusion

Suffering from DED is a possible risk factor for developing depression as DED is associated with depression of higher degrees of severity. Depression among DED patients is found to be significantly more prevalent among females and the young adult population rather than older adults.

Depression Among Keratoconus Patients in Saudi Arabia

Background

Depression is a highly prevalent disorder globally and locally in Saudi Arabia. Individuals with chronic conditions are more liable to develop depression. Keratoconus is a chronic progressive corneal disorder that markedly affects the vision and quality of life, making its sufferers liable to developing depression.

Methods

This is a descriptive cross-sectional study that was conducted using 9-item Patient Health Questionnaire (PHQ-9) to screen for depression among adults aged between 18 and 60 years old only. The participants in this study are patients who have been previously diagnosed with keratoconus by their ophthalmologists. The structured questionnaire was distributed using Google Forms through various social media platforms. After extracting the data, it was revised, coded and then analyzed using the Statistical Packages for Social Sciences (SPSS), version 21 (IBM Corp., Armonk, NY).

Results

A total of 330 keratoconus patients living in Saudi Arabia were recruited in this study. The modal age group was 31-40 years old (44.5%), and the male to female ratio was 3:2. The most frequently reported concurrent eye diseases of the patients were astigmatism (48.5%) and myopia (36.7%). The prevalence of depression among patients with keratoconus was 40.6% (n = 134). The use of corrective contact lens (includes both: hybrid and rigid lens) in both eyes contributed to a significantly higher depression rate among its wearers compared to users in one eye and non-users (p<0.001).

Conclusion

Depression is highly prevalent among keratoconus patients. This is especially true among corrective contact lens wearers of both eyes. Keratoconus is associated with depression regardless of disease severity and socio-demographic characteristics.

Structural, electronic and magnetic properties of the ordered binary FePt, MnPt, and CrPt3 alloys

We perform ab initio simulations to investigate the structural, electronic and magnetic properties of the ordered binary FePt, MnPt, and CrPt3 alloys. In particular, equilibrium structural lattice parameters, electronic properties such as density of states (DOS), partial density of states (PDOS) and electronic band structure of each binary alloys are investigated and interpreted. Moreover, the magneto-crystalline anisotropy energies (MAE) are calculated. We found MAE values of FePt, MnPt and CrPt3 ordered alloys to be 2.66, 0.46 and 0.42 meV/f.u., respectively, corresponding to magneto-crystalline anisotropy constant K of 7.6 × 107, 1.3 × 107 and 1.1 × 107 erg/cm3, respectively. The large MAE and K values reveal that FePt, MnPt and CrPt3 binary alloys are eligible to be key components in magneto-optical and opto-electronic devices. In addition, we estimated the Curie temperatures of the three ordered alloys from exchange energy. We found the TC of L10-FePt, L10-MnPt and L12 CrPt3 to be 955 K, 989 K and 762 K, respectively. The high Curie temperatures obtained enable the ordered alloys to serve as write assist in Heat-Assisted Magnetic Recording (HAMR). We believe that our findings would pave the way to fabricate bulk and thin films based on the ordered binary FePt, MnPt, and CrPt3 ordered alloys that have attractive electronic and magnetic properties.

Acute Pancreatitis in Advanced Chronic Kidney Disease and Kidney Transplant Recipients: Results of a US Nationwide Analysis

Objective

To study the prevalence, etiology, and outcome of acute pancreatitis (AP) in kidney transplant and stage 5 chronic kidney disease (CKD) populations in comparison to a non-CKD cohort.

Patients and Methods

Using the Nationwide Inpatient Sample database, we identified patients with acute pancreatitis as the primary discharge diagnosis, after which propensity scores were used to create 2 cohorts of patients: 1 with CKD (n=13,425) and 1 without CKD (n=13,425). The CKD group was subsequently subdivided into dialysis-independent stage 5 CKD (n=690), dialysis-dependent stage 5 CKD (n=11,415), and kidney transplant recipients (n=1320). Patients younger than 18 years old, those who received a kidney transplant during the incident admission, and pancreas transplant recipients were excluded.

Results

The adjusted odds ratios (ORs) of AP were comparable between the no CKD, stage 5 CKD, and kidney transplant populations. Adjusted inpatient mortality was highest in patients with dialysis-dependent stage 5 CKD (OR, 2.72; 95% CI, 2.2-3.3; P<.01), followed by kidney transplant recipients (OR, 2.29; 95% CI, 1.12-4.51; P=.02), compared to the non-CKD group. Patients with stage 5 CKD experienced higher rates of shock and intensive care unit admission and had more prolonged and costly hospitalizations than the non-CKD group (P<.01 for all). Hypercalcemia was the most common cause of AP in both dialysis-dependent and dialysis-independent patients with stage 5 CKD, while viral and drug-induced pancreatitis were more prevalent in the transplant recipients.

Conclusion

Despite comparable adjusted prevalence of AP among the stage 5 CKD, transplant, and non-CKD populations, mortality, morbidity, and resource utilization were higher in the patients with stage 5 CKD and transplant recipients. Hypercalcemia is the most common cause of AP in the stage 5 CKD population irrespective of dialysis requirement.

High-risk echocardiographic features predict mortality in pulmonary arterial hypertension

AIMS

Echocardiography is the most common imaging modality for assessment of the right ventricle in patients with pulmonary arterial hypertension (PAH). Echocardiographic parameters were identified as independent risk factors for mortality in the Registry to Evaluate Early and Long-term PAH Disease Management (REVEAL) and other PAH cohorts. We sought to identify readily obtained echocardiographic features associated with PAH survival.

METHODS AND RESULTS

Retrospective analysis of 175 patients with Group 1 was performed. Baseline clinical and laboratory assessment including REVEAL risk criteria were obtained and standard 2-Dimensional and Doppler echocardiography performed at baseline was reviewed. Univariate and multivariate analyses of echocardiographic parameters were performed. Estimated right atrial pressure> 15 mmHg (HR 2.39, P = .02), tricuspid regurgitation ≥ moderate (HR 2.16, P = .04), and presence of pericardial effusion (HR 1.8, P = .05) were identified as independent, high-risk echocardiographic features in PAH. A validation cohort of 677 patients was identified and Kaplan-Meier survival analysis was performed in both cohorts. High-risk echocardiographic features stratified survival curves of both cohorts (P < .01 for all). The presence of 3 high-risk echocardiographic features greatly increased risk of 1-year (RR 4.86) and 3-year (RR 3.35) mortality (P < .05 for both).

CONCLUSION

Estimated right atrial pressure> 15, tricuspid regurgitation ≥ moderate, and presence of pericardial effusion are high-risk echocardiographic features in PAH. When seen in combination, these features greatly increase risk of mortality in PAH and may lead to more timely enhanced therapy for patients identified as having an increased risk for death.