Association of depression with dental caries and periodontal disease at a tertiary care hospital.

OBJECTIVE: To determine the association of depression with dental caries and periodontal disease. METHODS: The cross-sectional descriptive study was conducted at the Nishtar Institute of Dentistry, Multan, Pakistan, from May 7, 2018 to January 7, 2019, and comprised samples from subjects with dental caries and periodontal disease. Hospital Anxiety and Depression Scale was applied to screen the participants for the presence or absence of depression. Data was analysed using SPSS 21. RESULTS: Of the 296 participants, 125(42.2%) were males and 171(57.7%) were females. The overall mean age was 38.74±12.87 years. Depression was found in 195(65.8%) patients. Significant association of depression in patients of dental caries and periodontal disease was found with female gender, age <50 years, illiteracy, marital status, pre-existing hypertension, coronary artery disease, illicit substance addiction and psychotropic medication use (p<0.05). CONCLUSION: There was high frequency of depression among patients of dental caries and periodontal disease.

A study of bone turnover markers in gestational diabetes mellitus.

INTRODUCTION: Gestational diabetes is defined as carbohydrate intolerance resulting in hyperglycemia of variable severity with the first recognition during pregnancy. Established risk factors for gestational diabetes mellitus (GDM) are maternal age, obesity, family history of diabetes, etc. Vitamin D, parathyroid hormone (PTH), and various other hormones are known for their function in maintaining calcium and phosphorous homeostatic. Furthermore, Vitamin D, PTH serum ionized calcium, and alkaline phosphatase (ALP) have been reported to be altered with glucose homeostasis. The present study compares the bone markers in pregnant women with and without gestational diabetes. MATERIALS AND METHODS: This cross-sectional study was conducted at outpatient antenatal check-up clinic and outpatient diabetic clinics at J. N. Medical College and Hospital, Aligarh. One hundred pregnant females, of which fifty with GDM and fifty without GDM, were included in the study from January 2014 to November 2015. Detailed history, physical examination, and anthropometric measurement were done. Bone turnover markers in the form of Vitamin D, parathyroid hormone, serum ionized calcium, and serum ALP were measured in pregnant women who had gestational diabetes which was compared with normal pregnant women. RESULTS: In our study, the mean age of participate of GDM group was 28.2 ± 3 years, while the mean age group in non-GDM group was 25.44 ± 2.78 years. Ionized calcium in GDM was found to be 4.606 ± 0.354 mEq/L, while in non-GDM, it was 4.548 ± 0.384 mEq/L, P = 0.430. Vitamin D came out to be 21.80 ± 9.48 ng/ml, while it was 32.346 ± 8.37 ng/ml in non-GDM group. Serum PTH in GDM group was 71.436 ± 36.189 pg/ml and 37.168 ± 8.128 pg/ml in nondiabetic gestational group. Serum ALP in GDM group was 9.1 ± 4.56 KA U/dl and 6.98 ± 2.2 KA U/dl in nondiabetic gestational group, P - 0.0038. In GDM group, there was a significant negative linear correlation between PTH and 25-hydroxyvitamin D with research correlation coefficient r = -0.9073, P = 0; there was a significant positive linear correlation coefficient between PTH and ALP with Persian correlation coefficient r = 0.6597, P = 0; there was no statistically significant correlation between PTH and ionized calcium r = 0.1416, P = 0.3267. CONCLUSION: All GDM subjects should ideally be screened for serum calcium, vitamin D, PTH, ALP. If found impaired should immediately be corrected in order to prevent its adverse effects on maternal and fetal outcome. Vitamin D supplementation should ideally be initiated in all GDM females even if the above parameters are not investigated in Indian setup.

Short-course postpartum (6-h) magnesium sulfate therapy in severe preeclampsia.

OBJECTIVE: To assess the efficacy of short-course postpartum (6-h) magnesium sulfate therapy versus 24-h conventional magnesium sulfate therapy in severe preeclampsia. METHODS: Cases of severe preeclampsia were randomly allocated to group A (n = 76) and group B (n = 43). Group A and group B received magnesium sulfate loading dose (4 g) followed by infusion for 6 and 24 h postpartum (1 gm/h), respectively. Cases in both the groups were monitored closely after the initiation of therapy. t test and Chi-square test were used for data analysis. RESULTS: No occurrence of convulsions was noted in both group A and group B. The mean amount of magnesium sulfate used in the study group was 15.1 ± 5.4 g as against 42.3 ± 7.3 g in controls. The duration of Foley catheterization and monitoring was significantly less in group A (mean 11.3 ± 5.1 and 11.1 ± 4.9 h, respectively) as compared to group B (mean 38.3 ± 7.3 and 38.4 ± 7.2 h, respectively). The mean duration of hospital stay was 2.7 ± 0.7 days in cases delivered vaginally and 7.5 ± 1.6 days in those who underwent cesarean section in group A, while it was 4.04 ± 1.47 and 11.11 ± 3.14 days, respectively, in group B. CONCLUSION: Short-course, i.e., 6-h, postpartum magnesium sulfate therapy is as effective as conventional 24-h postpartum magnesium sulfate therapy in preventing convulsions in severe preeclampsia.

Maternal outcomes after 12hours and 24hours of magnesium sulfate therapy for eclampsia.

OBJECTIVE: To assess the effectiveness of a reduced duration (12hours) of magnesium sulfate (MgSO4) administration for eclampsia. METHODS: In a prospective randomized study, women with eclampsia (prepartum, intrapartum, or postpartum) attending Jawaharlal Nehru Medical College, Aligarh, India, between January 2012 and September 2013 were enrolled. The inclusion criteria were blood pressure of at least 140/90mm Hg after 20weeks, proteinuria (dipstick value≥+1), and seizures not attributed to other causes. Participants were assigned to control and study groups according to the time of enrollment (6-month blocks). All patients received a MgSO4 loading dose (4g, intravenously), followed by maintenance doses (1g/hour) for 12hours (study group) and 24hours (control group). The primary outcome was recurrent convulsions after completion of MgSO4 therapy. Patients with treatment failure were excluded from analyses. RESULTS: Analyses included 132 patients in the study group and 72 patients in the control group. No convulsions recurred in either group after the completion of treatment. CONCLUSION: For women with eclampsia, 12hours of magnesium sulfate could effectively prevent recurrent convulsions.