No abstract

Background: Mycophenolate mofetil (MMF) has been shown to be a well-tolerated drug which could maintain prolonged remission in patients with steroid dependent nephrotic syndrome (SDNS). MMF is known to have a steroid sparing effect. Objectives:To determine the effect of MMF in reducing relapses in Sri Lankan children with SDNS and to ascertain the incidence of side effects of MMF in this population. Method:Children between 1-18 years of age with SDNS who had been treated with MMF for 12 months or more at the paediatric nephrology unit, Teaching Hospital Peradeniya, were selected and reviewed retrospectively. Children who had previously received immunosuppressive therapy other than prednisolone, cyclophosphamide, cyclosporin A, tacrolimus and levamisole and those who were on MMF for indications other than idiopathic nephrotic syndrome were excluded. Children and parents were interviewed and their patient-held health records, including their 'nephrotic syndrome diary' were reviewed. Data were collected twice a week using pretested questionnaires, in the nephrotic syndrome clinic for a period of 8 weeks. Results were analysed using SPSS version 23. Results:Thirty five children who met the selection criteria were included. Of them 26 (74.3%) were male and 09 (25.7%) were female. The median age was 9.7 years. Mean number of relapses in the year before starting MMF and the year after starting MMF were 3.5 and 1.8 respectively. The reduction in the relapse rate after being on MMF was _________________________________________ The authors declare that there are no conflicts of interest Personal funding was used for the project. Open Access Article published under the Creative Commons Attribution CC-BY License significant (p=0.009). Child's age or gender did not impact the relapse rate (p>0.05). The most common side effect observed was cough (20%) and the least common ones were abdominal pain, dyspnoea and dizziness (3%). Conclusions:In this study MMF reduced relapse rates of children with SDNS, despite some minor side effects.

Depression is a common co-morbidity of cancer. Further, depression and cancer are significant public health issues. Depressive symptoms are found to cause deterioration of quality of life (QoL), leading to physical disabilities/impairments, poor drug adherence, prolonged hospitalization, shortened survival time and risk of suicides. This study identified the prevalence of depressive symptoms and explored correlates of depressive symptoms among patients with cancer in Sri Lanka. A descriptive crosssectional survey was conducted with a sample of 393 cancer patients undergoing treatment at a tertiary care hospital in Southern Sri Lanka. An interviewer-administered questionnaire and the Centre for Epidemiological Studies-Depression scale (CES-D) were used to collect information on prevalence and correlates of depressive symptoms. Basic descriptive statistics, independent t-test, and Pearson correlation coefficients were used in the statistical analysis. The mean age of the sample was 56 ±11.9 years and 59% were women. Elevated depressive symptoms were found in 8.4% of the patients (95% CI: 5.3%, 10.7%). Patients who reported having any form of impairments scored high on CES-D, compared to those with no physical impairments (p < 0.01). Patients with low income as well as those with low education had higher scores in CES-D scale. Depressive symptomatology appears to be a considerable health issue in this group. Correlates of depressive symptoms include poor income, low education level, and self-reported physical impairments; these correlates need to be considered in psychological interventions of patients with cancer.