Evaluation of psychological status in patients with asthma and COPD.

Chronic obstructive pulmonary disease (COPD) and asthma are major public health problems, which seems to have close association with psychiatric disorders. The present study was conducted to compare the psychological status between asthmatic and COPD patients and clarify the relationship with severity of pulmonary obstruction. This cross-sectional study was planned to compare the psychological status in 67 stable obstructive lung patients (17 asthma, 24 asthmatic bronchitis and 26 COPD) referred to respiratory clinic of Ghaem hospital and 33 healthy controls, in Mashhad city, north east of Iran. Severity of pulmonary obstruction was determined based on GOLD criteria. "Beck Depression Inventory", "Hamilton Anxiety Rating Scale" and "SCL-90-R" questionnaires were used to determine the psychological status. Prevalence of general psychopathology in asthma, COPD, asthmatic bronchitis and control groups were 64.7%, 42.3%, 33.3% and 36.4% respectively. Psychological status was directly related to severity of pulmonary obstruction (p=0.048), Prevalence of depression in asthmatic, COPD and asthmatic bronchitis groups were 66.7%, 54.2% and 44.4% respectively. Depression score was related to severity of pulmonary obstruction (p=0.000).Prevalence of anxiety in asthma, COPD and asthmatic bronchitis were 46.7%, 45.8% and 40.7% respectively. Anxiety score was related to marital status and satisfaction with income Asthmatic and COPD patients are at equal risk of developing psychiatric disorders and both require psychological evaluations in respiratory clinics. Therapists must pay more attention to patients with severe pulmonary disease.

Evaluation of polymerase chain reaction for diagnosis of "tuberculous pleurisy".

BACKGROUND: Differential diagnosis between tuberculous pleurisy (TBP) and non- tuberculosis pleural effusion represents a critically important clinical problem. In recent years, several noninvasive methods have been found for diagnosis of tuberculous pleurisy. This study aimed to evaluate the value of detection of the genome of Mycobacterium tuberculosis (MTB) by polymerase chain reaction (PCR) method for the diagnosis of tuberculous pleurisy and compare the results with those of conventional methods. MATERIALS AND METHODS: In this cross-sectional study, we studied 62 patients (42 men and 20 women) with pleural effusion in Ghaem Hospital, affiliated to Mashhad University of Medical Sciences from January 2006 to June 2007. RESULTS: A total of 20 patients had tuberculous pleurisy (45.4%), 15 patients had malignant pleural effusion (34%), 3 patients had pleural effusion with various "non-tuberculosis non-malignant" etiologies (6.8%) and 6 patients had transudative pleural effusion (13.6). The sensitivity, specificity, positive predictive value and negative predictive value of PCR in tuberculous pleurisy were 85%, 100%, 100% and 88.8%, respectively. CONCLUSION: The value of PCR test and pleural biopsy was similar in the diagnosis of TBP. However, PCR detected MTB in pleural effusion when conventional pleural biopsy failed to do so.