Assessment of depression and its correlates among college students in Rishikesh Uttarakhand

Background: Depression is a major contributor to the overall global burden of disease and is the leading cause of disability worldwide. Objective: To assess the levels of depression and its correlate among college students in Rishikesh, Uttarakhand. Methodology: Community based cross sectional study was conducted from February 2018 to April 2018 among 126 students of a Government PG College Rishikesh belonging to age 18 -26 years. A pre-validated semi- structured pretested Physical Health Questionnaire (PHQ-9) was applied for this purpose. Results: Mean age of the participants was 22.84±1.5 years. Overall prevalence of depression among study population was 74.60% among them 4% were severely depressed. 58% of females and 40% males had suicidal ideations. Majority of participants were stressed with the undue peer pressure followed by career pressure. Physical activity for atleast 30 minutes a day for 5 days in a week was found to be significantly (p<0.02, odds ratio 0.20 (0.06-0.7 at 95%CI) beneficial for depression. Conclusion: Depression is prevalent among college going population. Peer pressure, academic stress, career pressure, financial stress in home, undue parental expectations on students are associated with depression among college going students.

A Pre-Operatively Diagnosed Abdominal Cocoon.

Abdominal Cocoon or idiopathic encapsulating peritonitis is a rare cause of intestinal obstruction. It more commonly occurs in young adolescent girls and the diagnosis is usually made at laparotomy. Recent case reports suggest that it is not uncommon in males and pre-operative diagnosis is possible by radiological investigations. We present a case of abdominal cocoon in an adult male, pre-operatively diagnosed by ultrasound and computerized tomography.

Inverse Marcus Gunn phenomenon.

Inverse Marcus-Gunn phenomenon is very rare. It is usually acquired. We report a young male patient presenting with congenital ptosis and inverse Marcus-Gunn phenomenon.

Emergency transcatheter balloon recanalization of acutely thrombosed modified Blalock-Taussig shunts.

BACKGROUND: Modified Blalock-Taussig shunts are used to palliate a variety of cyanotic heart diseases associated with reduced pulmonary blood flow. Acute shunt thrombosis in patients with shunt-dependent pulmonary blood flow can result in life-threatening hypoxia. We describe our experience of emergency transcatheter recanalization in 5 severely hypoxic children with acute shunt occlusion. METHODS AND RESULTS: Five patients with ages ranging between 5 and 24 months (median 11 months) and weight ranging from 4 to 8 kg (median 5 kg) presented with severe hypoxia, acidosis and hypotension following acute occlusion of modified Blalock-Taussig shunts placed 11 days to 12 months ago. As severe hypoxia (saturation range 3 5%-5 0%), acidosis and a state of shock in all the patients increased the risk for a redo surgical procedure, they were taken up for emergency transcatheter recanalization within 2-6 hours of hospitalization. This was done by positioning a Judkin's right coronary catheter at the mouth of the thrombosed shunt, crossing the shunt with a guidewire and serial dilatations with coronary and/or peripheral angioplasty balloons to the size of the graft. This technique was immediately successful in 4 of the 5 patients, thereby avoiding a repeat palliative operation. In 2 patients with residual stenosis, stents were used to restore luminal patency. One patient with acute stent thrombosis was managed successfully with local delivery of thrombolysis for 36 hours, which resulted in good luminal patency. At follow-up after 6 and 12 months, the shunts in both the stented patients are patent, with an oxygen saturation of 78% and 80%, respectively. In 2 other patients who had undergone plain balloon angioplasty, the shunts remained patent for 11 days (died of bronchopneumonia and septicemia) and 3 months, respectively. The procedure was unsuccessful in one very sick patient in whom the shunt had a tortuous course. CONCLUSIONS: Transcatheter recanalization of an acutely thrombosed Blalock-Taussig shunt is feasible. It can offer satisfactory short-term palliation in selected patients. Stents may play a role in patients with residual narrowing after dilatation. The procedure can be expeditiously accomplished in an emergency situation in a severely hypoxic child and may be a realistic alternative to surgery or thrombolysis.

Evaluation of laboratory tests for diagnosis of chlamydial infections in conjunctival specimens.

We evaluated the chlamydial direct diagnostic tests and McCoy cell culture methods for detection of Chlamydia trachomatis in 234 conjunctival scrapings from 127 patients. Direct (rapid) diagnostic methods of Giemsa stain cytology, fluorescent antibody test (FAT) and immunoperoxidase (IPO) stain and McCoy cell culture isolation method using IPO staining and FAT for detection of C. trachomatis antigen were carried out. McCoy cell culture isolation using FAT antigen detection method was considered as the gold standard. The specificity of all the direct diagnostic tests were above 90 per cent but sensitivity of Giemsa cytology, FAT and IPO stain were 36, 54 and 53 per cent respectively showing that as direct diagnostic tests Giemsa stain cytology was inefficient and FAT and IPO were useful. Specificity and sensitivity of McCoy cell culture using IPO stain for detection C. trachomatis antigen were above 90 per cent and it is suggested that this test can be used as a routine diagnostic method.