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Aim: Depression is highly affected comorbid condition with Chronic Obstructive Pulmonary Disease (COPD) patients remaining unrecognized and under-diagnosed. Co-morbid depression affects the prognosis of the disease leading to an increase in the mortality rate. Objective: The main objective of the study was to assess and evaluate the association of depression among COPD patients by using the Hamilton Depression Scale (HAM-D). Study Design, Place and Duration: A cross-sectional study conducted at Government headquarters hospital, Ooty, consisting of 82 COPD patients, who were assessed for depression. Results: Among 82 COPD patients, 17% (n=14) of the patients found without depression, 17% (n=14) of the patients suffered from mild depression, followed by 35.3% (n=29) of the patients from moderate depression, 25.6% (n=21) of the patients suffered from severe depression and 4.8% (n=4) patients diagnosed with very severe depression. Thus, the prevalence of depression in our study population was 82.9%. Depression was found to be significantly associated with age (p =0.000), alcoholism (p =0.012) and duration of disease (p= 0.000). A positive correlation was obtained between depression and age, duration of disease. Conclusion: The study revealed that the severity of depression is strongly associated with age, consumption of alcohol, and duration of COPD.

Chronic obstructive pulmonary disease is a progressive lung disease characterized by chronic obstruction of the lung airflow that interferes with normal bleeding and is not fully reversible. Chronic smoking is the most common risk factor for COPD causing severe cough, wheezing, labored breathing and reduced functionality. COPD not only exerts pulmonary symptoms but also has a spill over the extra pulmonary effects. Owing to the impact of the disease, it may lead to conditions like osteoporosis, cardiovascular complications as well as to psychological effects such as depression and anxiety. Such comorbidities are hidden and are not effectively treated. Depression, one of the most common hidden comorbidities is known to be present but never diagnosed. Various scales like HAM-D and Bode Index can be used to diagnose the extent of depression. Our review mainly focuses on the various studies conducted worldwide and comparing the results of the same. Based on the worldwide analysis, depression is known to affect a COPD patient at later stages and requires immediate diagnosis and appropriate treatment.

Cyanocobalamin is a presently coenzyme mainly involved in reactions leading to synthesis of Nucleic Acids and of that of methionine from homocysteine. On the other hand hematological neurological and epithelial clinical manifestations observed during Vitamin B12 deficiency may lead to Pernicious anemia. Pernicious anemia is a megaloblastic anemia which leads to abnormal erythrocyte nuclear maturation and leading to ultimate effect of loss of adequate stores of the Vitamin B12. Arthralgia induced after / following cobalamin administration is rarely. Despite of that various drugs are known to cause musculoskeletal adverse events such as arthralgia, myalgia and serum sickness. We present a Case of a 54 Year Old Male, with chief complaint of fever, pallor skin, shortness of breath and tiredness. On the fifth day, patient develops cyanocobalamin induced arthralgia and main treatment of the drug induced arthralgia is the discontinuation of the responsible drug. However patients can be managed with one active form of Vitamin B12 which is methyl cobalamin that has excellent beneficial therapeutic management for Joint Pain. In this case report a rare adverse event of Vitamin B12 Injection inducing arthralgia is reported.