Gender differences in emotional regulation capacity among the general population

Background: Emotional regulation plays crucial part in overall psychological well-being of an individual as it impacts how he responds to stimuli. Evidences from past suggest that there are differences in emotional regulation strategies based on gender in patients suffering from different illnesses. However there is limited literature on emotional regulation strategies in general population. Material and methods: This was a cross sectional study conducted at a tertiary care centre on 60 subjects comprised of both genders, with no psychiatric or physical co-morbidity at present or in past. Emotional regulation among both genders was studied using Difficulties in Emotional Regulation Scale (DERS). Results: There was no significant difference in the socio-demographics of male and female participant groups. Among both gender, males had significantly higher difficulties in acceptance of emotions (P=0.035) and impulse dyscontrol (P=0.014) when compared to women. However, women had significantly lesser emotional clarity compared to men (P=0.003). Conclusion: These differences in emotional regulation strategies may be responsible for differences in clinical presentation and prevalence of various psychiatric illnesses among the gender group. Knowledge about emotional regulation strategies among both genders would help initiate gender specific interventions to avoid maladaptive behaviors and to prevent the onset or progression of illness.

To evaluate analgesic efficacy of dexamethasone as an adjuvant to ropivacaine in pectoral nerve block: A prospective randomized control study.

Background: Pectoral nerve (Pecs) block is an effective component of multimodal analgesic regimens for breast surgeries. In present study we compared analgesic effect of dexamethasone 8 mg as an adjuvant to 0.25% ropivacaine versus 0.25% ropivacaine alone in pectoral nerve block. Methods: The study was conducted in a randomized manner on 60 female patients of American Society of Anesthesiologists (ASA) Grade I and II, aged between 18 to 65 years, scheduled to undergo modified radical mastectomy under general anesthesia (GA). The patients were randomly allocated into 2 groups of 30 patients each. Group A received ultrasound (US)-guided Pecs block with 30 ml of 0.25% ropivacaine and 10 ml normal saline (total volume 40 ml) and Group B received with 30 ml of 0.25% ropivacaine and 8 mg dexamethasone in and 10 ml normal saline (total volume 40 ml). Post-operatively visual analogue score (VAS), duration of analgesia and total analgesic consumption was noted. Student t-test, Mann Whitney U test and Chi-square test were used for statistical analysis. Results: VAS were persistently low for first 4 hours in group B and for first 9 hours in group A (p value < 0.001 at some intervals). The mean duration of analgesia was prolonged in group B as compared to group A (612.33 ± 41.77 min in Group B and 307.70 ± 22.37min in group A) (p <0.001). Total analgesic consumption in first 24 hours post-operatively was also statistically lower in Group B (97.50± 34.96 mg) as compared to group A (177.50± 36.76) (p<0.001). No patient under study reported any adverse effects. Conclusion: Addition of 8 mg dexamethasone as adjuvant to 0.25% ropivacaine for pectoral nerve block increases the duration of analgesia and significantly reduces the amount of analgesic requirement in first 24 hours postoperatively without any significant adverse effects.

Colposcopy in postmenopausal women: a challenging procedure

Background: Introduction-carcinoma of cervix is the commonest cancer in Indian women. It constitutes 14%of the total population above age of 50 years. Atrophic changes in the genital tract causes problems in Pap smear as well as in the colposcopy.Methods: This is prospective observational study conducted in the department of obstetrics and gynecology of SGRDIMSR, Sri Amritsar, which comprised 30 cases of postmenopausal women referred for colposcopy. Inclusion criteria were complaints of post-menopausal bleeding, abnormal vaginal discharge, post coital bleeding, an abnormal PAP smear, an unhealthy-looking cervix. Women with history of any surgery on the cervix in the past three months or with obvious cervical cancer were excluded.Results: Patient with age group of 44-70 years were included, and maximum number of patients had complaint of post-menopausal bleeding (50%). 9 (30%) patients were positive for malignancy on histopathology, while with 9 (30%) false positive patients on colposcopy. Problems encountered while performing colposcopy includes cervix flushed with vagina, atrophy of introitus, bleeding from the cervix and relaxed vaginal walls. Use of various corrective measures were helpful to overcome the problems of colposcopy.Conclusions: It is an essential part of cervical screening programme, but it has some limitations and pitfalls which can lead to error in the diagnosis.

Hypoglycemia in Neonates More than 1500 Gram Weight with No Secondary Cause – Its Effects and Outcome

Aim: 1) To study the outcome of hypoglycemia in neonates weighing >1500gram both symptomatic and asymptomatic having exclusively hypoglycemia with no any other medical condition known to cause brain damage , till 9 months of corrected gestational age(CGA).2) To study the clinical profile of hypoglycemia in neonates weighing >1500gram. Methods: 35 neonates weighing >1500gram with hypoglycemia (<40 mg/dl), both symptomatic and asymptomatic without any other medical condition known to cause brain damage were enrolled in the study. Hypoglycemia was confirmed with venous sample laboratory value. Both neonatal and maternal history was taken in detail, clinical examination, anthropometry was done. Follow up was done at 3, 6, 9 months of CGA for assessing neurodevelopmental outcome (motor developmental quotient i.e. MoDQ and mental developmental quotient i.e. MeDQ using DASII6 i.e. development assessment scale for Indian infants) and we did anthropometry and clinical examination, ultrasonography at discharge, electroencephalogram (EEG) done in patients with seizure, Magnetic Resonance Imaging (MRI) at 3 months, Brainstem evoked response audiometry (BERA) at 6 months, vision assessment at 9 months of CGA. Appropriate statistical analysis was done to calculate results. Results: Out of 35 enrolled cases follow up was possible in 30 cases. In our study, the prevalence of abnormal neurodevelopmental outcome according to DASII6 was 53.33% (n=16) cases with abnormal MoDQ (<70%) and 56.66% (n=17) cases with abnormal MeDQ (<70%) at 3, 6, 9 months of CGA respectively. There was statistically significant difference in the mean values of MoDQ (p value 0.014, 0.011, 0.02) and mean MeDQ (p value 0.019, 0.008, 0.02) on follow up at 3, 6, 9 months of corrected gestational age respectively between symptomatic and asymptomatic hypoglycemic cases. 8 (57.14%) symptomatic cases and 6 (37.5%) asymptomatic cases had microcephaly on follow up and the difference was not statistically significant. MRI was abnormal in 10 (71.4%) symptomatic cases and 6 (37.5%) asymptomatic cases and the difference was not statistically significant. Ultrasonography was done in all cases at discharge and it was found abnormal in 2(5.7%) cases. BERA, vision assessment and EEG was normal in all cases. Conclusion: Both symptomatic and asymptomatic hypoglycemia leads to abnormal neurodevelopmental outcome but it is more poor in symptomatic neonates as compared to asymptomatic hypoglycemia.

Evaluation Of Thrombocytopenia In The Pediatric Patients By Platelet Indices: A Study In A Tertiary Care Hospital.

Background: Evaluation of thrombocytopenia involves a meticulous approach in which complete clinical history, clinical examination, complete hemogram and bone marrow aspiration if indicated, are included. The various platelet indices produced by the automated analysers such as, Mean platelet volume (MPV), Platelet distribution width (PDW), Plateletcrit (PCT) and Large cell ratio (LCR) can be used to distinguish the underlying etiology of thrombocytopenia. Methods: Total of seventy three thrombocytopenic patients <14 years with proper clinic-hematological work up were included in the study. The results were compared by manual examination of the peripheral blood smear. Results: Patients were grouped based on the mechanism- Peripheral destruction 54 (73.9%), Hypoproduction 10 (13.6%), Hypersplenism 9 (12.3%). There was a linear correlation between the platelet count and all the platelet derived indices (MPV, PDW, PCT, LCR) in the patients with peripheral destruction of platelets.The p-value of all the derivatives was statistically significant (level of significance less than 0.05). In patients with hypoproduction and hypersplenism,there was positive correlation between the platelet count and MPV, PDW, PCT & LCR. None of the pvalues were statistically significant. Conclusions: Platelet indices especially MPV and PDW can be used as important initial and supportive tool to differentiate between the hyperdestructive versus hypoprodution and hypersplenism cases.