Prevalence of postpartum depression and associated risk factors in tertiary health care centre

Background: Postpartum depression (PPD) is defined as a depressive episode occurring during pregnancy or until 4-weeks post-childbirth. It is essential to diagnose postpartum depression since it can disrupt normal maternal and infant bonding and have a negative impact on both the short and long-term development of children. To determine the prevalence of postpartum depression and the associated risk factors in women delivering in a tertiary health care centre.Methods: A prospective observational study was conducted in a tertiary health care centre from January 2021 to June 2022 for a period of 18 months. Pregnant women were assessed using the Edinburgh postnatal depression scale (EPDS) at 2-3 days postpartum and at 6 weeks postpartum. The cut-off score for detecting major depression is a score greater than or equal to 13.Results: The study included 204 women, of which postpartum depression was present in 28 women. The prevalence of postpartum depression in this study group is 13.7%. Unplanned pregnancy, neonatal intensive care unit (NICU) admission of newborns, preterm delivery, lack of support from family, complications during pregnancy or birth, and delayed breastfeeding were significantly associated with postpartum depression.Conclusions: Psychological and emotional well-being should also be given priority in addition to the physical well-being of women. All women who are at high risk should be screened so that PPD can be detected earlier, and support should be extended in the form of counselling and treatment.

Congenital pulmonary airway malformation with atrial septal defect and pulmonary hypertension for lobectomy‑anesthetic considerations.

The association of congenital pulmonary airway malformation (CPAM) with congenital heart disease is rare. We present the case of a 6‑month‑old child with atrial septal defect and pulmonary hypertension (PH) who presented with severe respiratory distress and hypoxia. The patient underwent right lobectomy for CPAM. With timely management, real‑time monitoring, one lung ventilation, and adequate analgesia, we were able to extubate the child in the immediate postoperative period. We conclude that with meticulous planning and multidisciplinary team approach, such complex cases can be managed successfully.

Mid Arm Circumference: An Alternate Anthropometric Index of Obesity in Type 2 Diabetes and Metabolic Syndrome.

Aim: To evaluate alternate anthropometric index for obesity in type 2 diabetes and metabolic syndrome. Study Design: This is a cross sectional study. Place and Duration of the Study: Department of Medicine, Kasturba medical college-hospital, Mangalore, Manipal university, between January 2012 - July 2015. Methodology: We recruited 207 type 2 diabetic and 101 metabolic syndrome subjects with their age and sex matched controls. Anthropometric parameters like BMI, Waist circumference and mid arm circumference (MAC) were measured. Biochemical details were collected from case record. Results: The mean differences in anthropometric and biochemical parameters were compared between cases and controls by independent T test. MAC was correlated with clinical parameters in control subjects by Karl pearson’s correlation and multiple linear regression analysis. There was significant difference in MAC between metS and their control subjects (31.35±4.21 vs 28.04±2.86, P<.001). There was significant positive linear correlation of MAC with BMI (P<.001), WC (P<.05), post prandial blood sugar (P<.05) and HbA1c (P<.05) in controls. Further multivariate analysis after adjusting for conventional risk factors showed a significant association of MAC with BMI (β=0.611, P<.001). Conclusion: These findings show that MAC can be useful as an alternate index for obesity in South Indians.

Evaluation of Antioxidant potential of Costus igneus in ethanol induced peroxidative damage in albino rats.

Improved antioxidant status helps to minimize the oxidative damage and thus can delay the risk of developing many chronic age related, free radical induced damage in diseases like diabetes, cancer, neurodegenerative diseases. We tried to evaluate the antioxidant potential of Costus igneus (CI) leaves in ethanol induced peroxidative damage in albino rats. Wistar albino rats of either sex were divided into four groups. Group I was control group and received normal saline, Group II received ethanol, Group III received test drug CI at 300 mg/kg and Group IV received CI at dose of 600 mg/kg. Study duration was 30 days. Antioxidants estimated at the end of 30 days. The levels of reduced glutathione (GSH), superoxide dismutase (SOD), catalase (CAT) significantly reduced and (malondialdehyde) MDA levels raised in ethanol treated group compared to control group. The levels of reduced glutathione, SOD and catalase enzyme recovered completely in a dose dependent manner. Results demonstrate CI significantly reversed the reduction of GSH, SOD and CAT and reduced significantly the levels of MDA, a biomarker of lipid peroxidation in a dose dependent manner, suggesting its ability to enhance the antioxidant defense to prevent alcohol induced oxidative stress injury.

Effect of Phyllanthus niruri Linn. treatment on liver, kidney and testes in CCl4 induced hepatotoxic rats.

Phyllanthus niruri extract is extensively used in treating liver ailments. Effects of aqueous extract of P. niruri on liver, kidney and testes of CCl4 induced hepatotoxic rats were studied. High levels of malondialdehyde (MDA) were observed in the CCl4 test group with significant reduction of MDA levels in all groups on P. niruri extract administration. Highest levels of glutathione (GSH) were found in P. niruri group. Activities of alanine transaminase, aspartate transaminase and alkaline phosphatase enzymes were significantly reduced in the curative group (P. niruri treatment after CCl4 injection). Histopathology of liver showed lesser degree of inflammation in all P. niruri treated groups while the renal and seminiferous tubules showed eosinophilic protein casts with signs of tubular damage and degeneration. Testes also showed decreased amount of mature spermatozoa. The results suggest that P. niruri has anti-oxidant and hepato-protective activity with associated deleterious effects on kidney and testes.

Inhibition of selenium dependent glutathione peroxidase and superoxide dismutase in rats by diethyldithiocarbamate: effect of pre-administration of alpha-tocopherol.

Rats pre-administered with alpha-tocopherol (10 mgs/day) for 7 days afforded a significant protection at the tissue level against the lowering of superoxide dismutase and glutathione peroxidase, especially the selenium-dependent glutathione peroxidase. The protective action of alpha-tocopherol in the diethyldithiocarbamate treated rats may be attributed to its antioxidant/free radical scavenging action. It is concluded that selenium-dependent glutathione peroxidase and alpha-tocopherol act in a complementary fashion to block free radical formation.

Effect of dietary fish on antioxidant parameters of normal and cholesterol stressed rats.

Feeding fish (Sardinella longiceps) to normal rats increased lipid peroxidation and total and Se-dependent glutathione peroxidase (GSH-px) activity in erythrocytes and manganese dependent superoxide dismutase (Mn-SOD) activity in liver. Feeding fish to cholesterol stressed rats showed a significant increase in the activity of GSH-px and cholesterol feeding alone, resulted in a significant increase in the lipid peroxidation and liver Mn-SOD activity. The results suggest that the high polyunsaturated fatty acid content of S. longiceps, the fish abundantly available in the west coast of India, does not have any deleterious effect by way of free radical generation. The observed lipid peroxidation is not critical as is evident from the results of glutathione level and other scavenging enzymes.

Herpes simplex encephalitis: a diagnostic and therapeutic reapprisal.

Herpes Simplex Encephalitis (HSE) appears to be underdiagnosed in India, though viral encephalitides constitutes an important entity with significant morbidity. With an upsurge in AIDS, HSE may perhaps emerge as an important opportunistic infection in future. We discuss the clinical features and laboratory evaluation of nine cases of HSE seen in the last 12 years at our center. Diagnosis was established by brain biopsy in one, virological studies in six and at autopsy in three. Immunocytochemically viral antigens could be localized in 4 biopsied/autopsied brain tissue and in CSF cells on a cytospin preparation in one. This has facilitated rapid diagnosis in our cases. Virus isolation was successful in two. Three subjects were treated with acyclovir and all survived with variable morbidity. Four patients expired and none of them had received any specific antiviral drugs. Rapid diagnosis and early treatment with acyclovir has been highlighted.