Effect of Prenatal Dietary Pattern on Maternal Anemia and Low Birth Weight in Rural Areas of Kanpur

Background: In India, the dietary pattern of women from low socioeconomic status are almost same during pre-pregnant, pregnant and lactating periods. Additional foods are required to improve weight gain in pregnancy and birth weight of infants. Aim & Objective: To identify the impact of prenatal dietary pattern on maternal anemia and low birth weight in rural areas of Kanpur Nagar. Methods: This study was a cross sectional study conducted amongst mothers who recently delivered (RDW) in rural blocks of District Kanpur Nagar. Data was collected by interviewing study subjects using a semi-structured interview schedule after applying multistage random sampling technique. Results: Out of 102 women studied, 39.2% women had consumed >90 IFA tablets, 49.1% of mothers had practiced MMF and 47.1% of women practiced MDD during their prenatal period and 40.1% babies of current pregnancy were born as LBW. IFA consumption during pregnancy was significantly associated with maternal anemia. MMF during pregnancy was significantly associated with LBW. Conclusions: In our study it was found that IFA consumption, MMF and MDD during antenatal is a key preventive measure to reduce anemia status in pregnant females and birth weight of baby during prenatal period.

El papel de los esquemas cognitivos y la adversidad infantil en la probabilidad de desarrollar un trastorno depresivo mayor / The role of cognitive schemas and childhood adversity in the likelihood of developing Major Depressive Disorder

Abstract Introduction/objective: Major Depressive Disorder (MDD) is a multifactorial mental health disorder. Stressful events and childhood abuse have been included in different models to explain its etiology. However, little evidence is available on how attributional style and early maladaptive schemas are related to MDD. Method: A retrospective case-control study using a three-stage hierarchical logistic model was conducted to explore the relationship between MDD and psychosocial variables such as childhood adversity, stressful life events, attributional style, and cognitive schemas in a sample of 171 individuals with a current depressive episode and 171 healthy controls. Results: Depression could be predicted by childhood adversity, an attributional style characterized by interpreting stressful events as negative and uncontrollable and the cognitive schemas in impaired autonomy/performance domains and impaired limits. Conclusions: Our results highlight the relevance of identifying cognitive factors, beyond clinical symptoms that could be useful to better understand MDD. These findings may result in better preventive programs and create awareness of the role of cognitive domains in MDD.

Resumen Introducción/objetivo: el trastorno depresivo mayor (TDM) es un trastorno de salud mental de origen multifactorial. Los eventos estresantes y el maltrato infantil se han incluido en diferentes modelos para explicar su etiología. Sin embargo, hay poca evidencia disponible sobre cómo el estilo atribucional y los dominios de esquemas maladaptativos tempranos se relacionan con el TDM. Método: Se realizó un estudio retrospectivo de casos y controles utilizando un modelo logístico jerárquico de tres etapas para explorar la relación entre el TDM y variables psicosociales como la adversidad infantil, los eventos estresantes, el estilo atribucional y los esquemas cognitivos en una muestra de 171 individuos con un episodio depresivo actual y 171 controles sanos. Resultados: La depresión podría predecirse por la adversidad infantil, un estilo atribucional caracterizado por interpretar los eventos estresantes como negativos e incontrolables y los esquemas cognitivos en los dominios de autonomía/desempeño y límites deteriorados. Conclusiones: Nuestros resultados resaltan la relevancia de identificar factores cognitivos, más allá de los síntomas clínicos, que podrían ser útiles para alcanzar una mejor comprensión del trastorno. Estos hallazgos favorecen el diseño de programas de prevención que enfaticen en el rol de los esquemas cognitivos.

Total serum cholesterol level in patients with major depressive disorder: Simple yet undermined

Human brain cholesterol acts as structural components of cellular membrane, synapse and dendrite formation.Researchers have found a possible association between low serum cholesterol levels and mood disorders though the literature from India in this regard is limited. To estimate serum levels of total cholesterol in patients with major depressive disorder. 75 patients of MDD were compared with equal number of age and sex matched controls. 5 ml of fasting sample of blood was obtained in a plain vacutainer to analyse total cholesterol level by Cholesterol oxidase-peroxidase method. Statistical analysis: The obtained results were tabulated and analyzed by multiple logistic regression analysis, independent t-test, Chi-square test and area under the curve. The mean level of cholesterol in cases (158.85±61.22 mg/dL) which was significantly lower compared to the controls (182.71±40.98 mg/dL) with P <0.01. The symptoms of MDD negatively correlated with lower serum cholesterol level with odds ratio of 0.99. There was statistically significant lower level of cholesterol in the MDD group below 140 mg/dL compared to the control group with P <0.001. As the measurement of total serum cholesterol is simple and cost effective, it can be used as an important biochemical marker for MDD.

Evaluation of hormonal and metabolic factors related to depression in reproductive age women / Evaluación de factores hormonales y metabólicos relacionados con la depresión en mujeres en edad fértil

Abstract Introduction Major depressive disorder (MDD) is a prevalent disease affecting women more than men worldwide. Various factors are involved in the genesis of depression, including hormones such as testosterone and certain metabolic factors Objective To evaluate hormone levels and metabolic variables in women with major depression and healthy controls. Method A cross-sectional, comparative analytical study was conducted in 40 participants, 23 patients with an MDD diagnosis and 17 controls, all of women in reproductive age between the ages of 18 and 45. Sociodemographic variables, hormonal profile, and metabolic variables were assessed and the 17-item Hamilton Depression Scale was used to evaluate depressive symptoms. Results No statistically significant differences were observed between the groups in the hormonal and metabolic variables explored. Nevertheless, it was observed that the lower the testosterone levels and the higher the serum glucose levels, the more intense depressive symptoms were. Discussion and conclusion Testosterone is associated with a lower depressive symptoms score on the Hamilton Depression scale, suggesting a potential antidepressant effect, whereas high glucose levels are associated with a higher score on this scale. We believe that the measurement of hormonal and metabolic variables in women can contribute to a better understanding of the pathophysiology of depression.

Resumen Introducción El trastorno depresivo mayor (TDM) es una enfermedad prevalente a nivel mundial, que afecta más a mujeres que a hombres. En la génesis de la depresión se consideran diversos factores, entre ellos algunas hormonas como la testosterona y ciertos factores metabólicos Objetivo Evaluar los niveles de hormonas y variables metabólicas en mujeres con depresión mayor y controles sanas. Método Se realizó un estudio transversal, comparativo y analítico en 40 participantes, 23 pacientes con diagnóstico de TDM y 17 controles, todas ellas mujeres de 18 a 45 años en periodo reproductivo. Se evaluaron variables sociodemográficas, perfil hormonal y variables metabólicas, y se aplicó la Escala de Depresión de Hamilton de 17 reactivos para evaluar los síntomas depresivos. Resultados No se observaron diferencias estadísticamente significativas entre los grupos en las variables hormonales y metabólicas exploradas. Sin embargo, se observó que, cuanto menores eran los niveles de testosterona y mayores los de glucosa sérica, los síntomas depresivos eran de mayor intensidad. Discusión y conclusión La testosterona se asocia con un menor puntaje de síntomas depresivos en la Escala Hamilton, lo que sugiriere un potencial efecto antidepresivo, mientras que los niveles altos de glucosa se asocian con un mayor puntaje en dicha escala. Consideramos que la medición de variables hormonales y metabólicas en la mujer puede contribuir a mejorar el conocimiento de la fisiopatología de la depresión.

Review of brain mechanism of abnormal semantic processing in major depression disorder / 上海交通大学学报（医学版）

Major depression disorder (MDD) is a serious mental illness with high disability rate and high recurrence rate, accompanied by cognitive impairment including language processing. This article reviews neurophysiological evidences of abnormal semantic processing in MDD patients in recent years. Electrophysiological data indicates that abnormal semantic processing in the patients begins in the early stages of perceptual processing and persists in subsequent cognitive processing stages with hemispheric lateralization. Brain imaging studies show that the patients have abnormal activation levels in the medial prefrontal cortex and inferior frontal gyrus. The current research paradigms cannot separate semantic processing from other cognitive processes, and more research is needed.

Advanced research of kynurenine pathway mechanism in suicide of major depressive disorder / 上海交通大学学报（医学版）

Major depressive disorder (MDD) is one of the world’s major chronic and disabling mental diseases. By 2030, MDD is expected to be the top of all the disease burden in the world, with high prevalence, high recurrence rate, high disability rate, and high suicide rate. Suicide is the most serious consequence of MDD. Current studies showed that inflammatory levels in the central nervous system and peripheral blood of patients with MDD were higher, and increased more significantly in depressive patients with suicidal ideation or behavior. Related researches showed that increased levels of inflammatory cytokines were associated with dysregulation of kynurenine metabolic pathway, leading to imbalances in neurometabolites, such as an excess of the neurotoxic product quinolinic acid and a decrease in the protective neuropeptide picolinic acid. This paper reviews kynurenine metabolic pathway, expecting to identify the biomarkers of MDD patients with suicide.

Is there seasonality in hospitalizations for major depressive disorder in Canada?

Abstract Background Canada, a temperate country with four defined seasons incurs an annual productivity loss of over $30 billion on major depressive disorder (MDD); however it remains unknown whether inpatient hospitalization for MDD exhibits seasonal variations. Objective Our study objective was to determine if there are seasonal variations in hospitalization rates for MDD in Canada. Methods We used time series analysis to determine monthly rates of hospitalizations for MDD from 2006 - 2013, on data from population level health-administrative databases in Ontario, Canada. We also stratified analysis by gender and three age groups: 18 to 39, 40 to 65 and those over 65. We compared demographic and comorbidity profiles of patients admitted in April, August and December to elucidate if patient characteristics differed by season of admission. Results We identified a total of 130,336 admissions for MDD for 95,439 unique patients. Baseline characteristics of the patients were similar across seasons. We did not detect significant seasonality of hospitalizations for MDD across any of the gender or age subgroups. Discussion Our results question the popularly held belief that hospitalizations for MDD vary with seasons. These findings highlight the need for uniform hospital resource allocation for MDD throughout the year in Canada.

Potential Relationship between Season of Birth and Clinical Characteristics in Major Depressive Disorder in Koreans: Results from the CRESCEND Study

We aimed to examine the potential relationship between season of birth (SOB) and clinical characteristics in Korean patients with unipolar non-psychotic major depressive disorder (MDD). Using data from the Clinical Research Center for Depression (CRESCEND) study in South Korea, 891 MDD patients were divided into two groups, those born in spring/summer (n=457) and those born in autumn/winter (n=434). Measurement tools comprising the Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Brief Psychiatric Rating Scale, Scale for Suicidal Ideation, Clinical Global Impression of severity, Social and Occupation Functional Assessment Scale, WHO Quality of Life assessment instrument-abbreviated version, Alcohol Use Disorder Identification Test, and Temperament and Character Inventory were used to evaluate depression, anxiety, overall symptoms, suicidal ideation, global severity, social function, quality of life, drinking, and temperament and character, respectively. Using independent t-tests for continuous variables and χ2 tests for discrete variables, the clinical characteristics of the two groups were compared. MDD patients born in spring/summer were on average younger at onset of first depressive episode (t=2.084, p=0.038), had greater loss of concentration (χ2=4.589, p=0.032), and were more self-directed (t=2.256, p=0.025) than those born in autumn/winter. Clinically, there was a trend for the MDD patients born in spring/summer to display the contradictory characteristics of more severe clinical course and less illness burden; this may have been partly due to a paradoxical effect of the 5-HT system.

Clinical Significance of the Number of Depressive Symptoms in Major Depressive Disorder: Results from the CRESCEND Study

Our study aimed to establish the relationship between the number of depressive symptoms and the clinical characteristics of major depressive disorder (MDD). This would enable us to predict the clinical significance of the number of depressive symptoms in MDD patients. Using data from the Clinical Research Center for Depression (CRESCEND) study in Korea, 853 patients with DSM-IV MDD were recruited. The baseline and clinical characteristics of groups with different numbers of depressive symptoms were compared using the χ2 test for discrete variables and covariance (ANCOVA) for continuous variables. In addition, the scores of these groups on the measurement tools were compared by ANCOVA after adjusting the potential effects of confounding variables. After adjusting the effects of monthly income and history of depression, a larger number of depressive symptoms indicated higher overall severity of depression (F [4, 756] = 21.458, P < 0.001) and higher levels of depressive symptoms (F [4, 767] = 19.145, P < 0.001), anxiety symptoms (F [4, 765] = 12.890, P < 0.001) and suicidal ideation (F [4, 653] = 6.970, P < 0.001). It also indicated lower levels of social function (F [4, 760] = 13.343, P < 0.001), and quality of life (F [4, 656] = 11.975, P < 0.001). However, there were no significant differences in alcohol consumption (F [4, 656] = 11.975, P < 0.001). The number of depressive symptoms can be used as an index of greater illness burden in clinical psychiatry.

Parámetros bioeléctricos in vitro e in vivo, estimados con los analizadores Bodystat®1500-MDD y BioScan®98 / Bioelectrical parameters in vitro and in vivo estimated with analyzers Bodystat®1500-MDD and BioScan®98

Se efectuó un estudio comparativo de 2 analizadores comerciales de bioimpedancia eléctrica corporal (Bodystat® 1500-MDD y BioScan®98) en el Servicio de Oncopediatría del Hospital Infantil Sur de Santiago de Cuba, desde septiembre hasta octubre del 2009, para lo cual se realizó una simulación in vitro con los calibradores de cada equipo y un estudio in vivo de 32 adultos aparentemente sanos y 32 niños con diferentes afecciones. La resistencia eléctrica y la reactancia capacitiva se estimaron con ambos analizadores; además, se calcularon el módulo de impedancia y el ángulo de fase. La prueba t-student de 2 medias para muestras apareadas y el método de Bland-Altman fueron los criterios estadísticos usados. No existieron diferencias significativas entre ambos analizadores al introducir los factores de corrección para la resistencia eléctrica y la reactancia capacitiva; por tanto, es posible usarlos indistintamente para caracterizar bioeléctricamente a los individuos aparentemente sanos y pacientes con diferentes enfermedades.

A controlled trial with 2 body electrical impedance commercial analyzers was carried out (Bodystat® 1500-MDD and BioScan®98) at the Pediatric Oncology Department of the Southern Children Hospital in Santiago de Cuba, from September to October 2009, for which an in vitro simulation with gauges of each device and an in vivo study in 32 apparently healthy adults and 32 children with different conditions were conducted. Electrical resistance and capacitive reactance were estimated with both analyzers, and impedance module and phase angle were also calculated. The two-means Student's t test for paired samples and the Bland-Altman method were used as statistical criteria. There were not significant differences between the two analyzers by introducing correction factors for electrical resistance and capacitive reactance; therefore, it is possible to use either to characterize bioelectrically apparently healthy individuals and patients with different conditions.

Relation between locus of control and parental rearing patterns of adolescent with major depressive disorder / 中华行为医学与脑科学杂志

Objective To explore the locus of control and the relationship with parenting patterns of ado-lescents with first-onset major depressive disorder (MDD). Methods Patients with first-onset MDD (n= 98) and controls (n=98) were investigated by Sphere of Control Questionaire and EMBU, the results were compared and analyzed correlatively. Results The scores of the individual strength scale ( 37.47±13.66) and the relations with people scale ( 38.65±13.19 ) of patients were significantly lower(P<0.05 ) than the controls [(45.39± 12.84) and (45.90±11.20 ) each], while the scores of social-political management (39.01±10.28) were not significantly lower (P>0.05)than the controls' (39.12±9.50). The scores of patients' paternal excessive inter-ference factor(2.66±0.49) , maternal excessive protection/interference (2.79±0.55 ) and rejection/denial fac-tor(2.55±0.39) of EMBU were significantly higher(P<0.05)than controls' [(2.17±0.58),(2.17±0.49) and( 1.75±0.51 ) each]. The scores of patients' paternal affection/understanding factor were significantly posi-tively correlative with patients' scores of relations with people (r=0.27, P<0.05), maternal affection/under-standing factor was significantly positively correlative with patients' scores of individual strength (r=0.21, P <0.05) and relations with people(r=0.23, P<0.05 ) , while maternal excessive interference/excessive protection and individual strength (r=-0.24, P<0.05 ) and relations with people (r=-0.22, P<0.05), maternal rejec-tion/denial and individual strength (r=-0.26, P<0.05) were significantly negatively correlative. Conclusion Adolescents with MDD have abnormal locus of control,which might be correlative with their parenting patterns.

Once daily dosing of aminoglycoside in children / 소아과

Aminoglycosides are frequently used antibiotics in children. The multiple daily dosing (MDD) in infants and children is twice or three times daily depending on age. Recent studies in adults have shown that once daily dosing (ODD) maximizes the bactericidal activity and might minimize the toxicity of antibiotics. So, I reviewed many studies about efficacy, toxicity and cost effectiveness of ODD of aminoglycosides in children. Most studies suggest that ODD compared with MDD of aminoglycosides is theoretically more efficacious and has no higher toxicity in infants and children. But, the total number of patients included in the studies is not large. Multi-center, controlled prospective studies are required in larger numbers of infants and children to determine the efficacy and safety of the ODD regimen in children before ODD of aminoglycosides can be recommended for routine use.