The prevalence of anxiety and its association with the quality of life and illness severity among bipolar affective disorder patients in a developing country

The objective of the study was to determine the prevalence of anxiety symptoms and describe the association with illness severity, quality of life (QOL) and current medications among patients with BPAD who are currently in remission. A descriptive cross-sectional study conducted among outpatient clinic patients at the University Professorial Unit of University of Ruhuna, Sri Lanka. The study population consisted of patients diagnosed with BPAD and who are currently in remission. Anxiety symptoms among BPAD patients were assessed using the DASS-21 anxiety subscale and QOL was assessed using WHOQoL-BREF. Medications and severity of illness related information were gathered from both the patent and from their medical records. The study population consisted of 145 patients. The prevalence of anxiety among patients with BPAD who are currently in remission was 48.3 % (95 %CI 40.0–56.6). Multiple logistic regression revealed that being anxious was independently associated with currently not being married (aOR 2.92) and currently not being employed (aOR 2.1). Presence of anxiety significantly reduced the QOL in all the domains. Having anxiety was significantly associated with having one or more relapses within the past three years (aOR 4.1), one or more hospital admissions within the past three years (aOR 6.1), needing more psychoactive medications to maintain a euthymic state (aOR 7.7), and one or more suicidal attempts in the past (aOR 6.5). Anxiety was highly prevalent among patients with BPAD. Those with anxiety experienced significantly lower QOL and were found to be having significantly high adverse outcomes from the disease.</p

A rare case of concomitant acute occlusion of left main coronary artery and right coronary artery with characteristic electrocardiographic pattern

Acute Left Main Coronary Artery (LMCA) occlusion is a rare clinical presentation which often manifests as a cardiogenic shock with worse prognosis. However the clinical outcome depends on the age of the patient, co-morbidities and the patency and dominancy of Right coronary artery. Since it supplies a large myocardial territory of left ventricle, it shows a characteristic Electrocardiographic (ECG) pattern which helps to an early diagnosis. Presence of ST elevation in aVR with ST depression of more than six leads is highly characteristic for LMCA occlusion. Here we are reporting an extremely rare case of acute concomitant occlusion of LMCA and Right coronary artery manifesting as a cardiogenic shock with ST elevation in aVR, ii, iii leads with ST depression in all other leads. Patient showed excellent clinical outcome and reversal of characteristic ECG pattern following Percutaneous Coronary Intervention (PCI) to the culprit vessels.&nbsp;</p