Innovative Journal of Medical and Health Sciences

Nikhil Dhande, Meenakshi Khapre, Smrutiranjan Nayak, Abhay Mudey

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Background: Postnatal depression represents a considerable health problem affecting women and their families.  Recent studies, shows postnatal depression have a substantial impact on mother–baby interactions, longer-term emotional and cognitive development of the baby, especially when depression occurs in the first postnatal year of life. It is now considered a major health concern for women from diverse cultures.

Objectives: To find out prevalence of postnatal depression among mothers following delivery and to study factors responsible among participants.

Methods: Community based cross-sectional study conducted in Seloo village, which is field practice area of Jawaharlal Nehru medical college, Wardha. Mothers were interviewed using EPDS (Edinburgh Postnatal Depression Scale) and Multidimensional scale questionnaire with cut of score of 12 for EPDS

Results: 24% of mothers were found to be chronically depressed at 6 months after childbirth with mean age 24.34 years and 53% have monthly income less than 5000 rupees. Economic deprivation and poor marital relationships were important risk factors for the occurrence and chronicity of depression.

Conclusion: Analyses show that there is a strong interaction among many risk factors, such as economic deprivation, and the infant’s gender.

 

Keywords: Postnatal Depression, Edinburgh Postnatal Depression Scale, women’s health

archana rani, Anita Rani, Jyoti Chopra, Garima Sehgal, Punita Manik

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Knowledge of the variations of renal vascular anatomy has importance in exploration and treatment of renal trauma, renal transplantation, renal artery embolization, surgery for abdominal aortic aneurysm and conservative or radical renal surgery. The present case shows bilateral     duplication of renal artery in 60-year-old male cadaver during routine dissection of abdomen. On right side, the first renal artery was arising from abdominal aorta just below the origin of superior mesenteric artery. The artery was running laterally for a distance of 6 cm and reached the hilum of right kidney. The second renal artery was also taking origin from abdominal aorta 2 cm below the origin of superior mesenteric artery at the level of L1 vertebra, proceeding laterally and also entered the hilum of right kidney. On left side, the first renal artery was taking origin 1.5 cm below the origin of superior mesenteric artery from abdominal aorta while the second renal artery was arising from abdominal aorta at the level of L3 vertebra. Both the arteries were running laterally to enter the hilum of left kidney.

Nirmaladevi M

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Nonrotation of gut a subtype of Malrotation is an anomaly of intestinal rotation which is most often asymptomatic or incidental finding. Its incidence is 1 in 500 live births and has been described in 0.5 % autopsies. In intestinal nonrotation, the small bowel is located predominantly on the right side within the peritoneal cavity and the colon is located on the left side.During routine dissection for undergraduate teaching the nonrotation of midgut was found and studied in detail. Location of appendicitis pain, Midgut volvulus & small bowel obstruction with necrosis are common complications of nonrotation of midgut. Because of its rare presentation, embryological perspectives and its complications the case was presented.

 

Key words: Nonrotation, Malrotation, Midgut volvulus, appendicitis

Pooja Bhosle, Shubhada Aphale, Arunima PrasadShubhada Aphale, Arunima Prasad,

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A retrospective analysis of segmental epidural anaesthesia for upper and lower abdominal surgeries in 30 patients was undertaken. Epidural anaesthesia is a regional anesthetic technique that has a specific advantage in that selective segments can be blocked along with providing postoperative analgesia. We explored this advantage in selective cases. The patients were within the age group of 26-70 yrs with 67% females. Upper abdominal surgeries included open cholecystectomy, epigastric hernia repair, pyelolithotomy, upper ureterolithotomy, duodenal perforation. Lower abdominal surgeries like loop colostomies, umbilical and incisional hernia repairs with abdominoplasty were studied. Both routine (76.67%) and emergency (23.33%) cases were included into the study group. Patients with comorbidities like diabetes mellitus, chronic hypertension, respiratory disease, muscular dystrophy were part of the study group. The epidural catheter was placed at a level appropriate for the surgery to be undertaken and the segments required to be blocked. Local anaesthetic (lignocaine and bupivacaine) dose was as per the weight of the patient with appropriate age related reduction in geriatric patients. All patients were supplemented with oxygen. 23.33% of the patients required sedation. 23.33% developed hypotension which responded to IV fluids and vasopressors. 50% required post-operative epidural analgesia. In 23% of the patients in whom lower thoracic segments were blocked, none complained of any respiratory difficulty. To summarise, all our patients were operated under segmental epidural anaesthesia without any intraoperative complications. The regional technique was supplemented with light sedation. Thus, segmental epidural should be considered as a very good choice in patients with respiratory problems, muscular dystrophy or in the geriatric patients. The surgeries under segmental epidural anaesthesia have better outcome with surgeon’s & patient’s cooperation.

Dr Suman Saini

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Background: Shivering is a common occurrence in anesthesia practice. It is an involuntary,  rhythmic and intermittent muscle contraction beginning in the head & neck, extending to the extremities and culminating in generalized shaking. Objective: The present study was conducted with the aim of comparing response time and efficacy of pethidine and butorphanol for relief of postspinal shivering.We also compared the relapse of shivering and associated side effects. Methods: 60 patients of American Society of Anesthesiologist grade I and II, aged 18-60 yrs, belonging to either sex, scheduled for elective surgery under spinal anesthesia were included in the study. Patients were  randomly allocated to three groups of   twenty each to receive  either pethidine 25mg (Group A), butorphanol 1 mg (Group B) or normal saline 0.9% (Group C) in equal volume, on occurrence of shivering. Result: It was observed that the mean response time  was significantly less in Group B (1.59±0.79min) compared to  Group A (3.83±1.7min) and Group C (13.53±1.5min).  Success rate  of  butorphanol (Group B) was 95% compared to pethidine (Group A) 85% and saline (Group C) 15%.  Relapse of shivering was observed more in  patients  of Group A (11.7%) as compared to Group B (5.3%) while shivering reappeared in all the patients who responded to  saline treatment. Among the side effects, nausea was seen  only in   Group A (10%)   while sedation was found more with group B (20%) compared to Group A (10%) and Group C(0%).Conclusion: Butorphanol is better than pethidine for control of postspinal shivering with  more rapid response  and lesser recurrence rate but is more sedating.

 

Key words: Regional anesthesia, Perioperative shivering, Butorphanol, Pethidine.

subita patil

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Despite of population explosion in India majority of the students believed that family size should be completed by having two children; one of each sex. There is a need to create awareness among medical fraternity & the general population by health education.

Anil Shetty, Shraddha Shetty

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Background: Infant mortality rate and sex ratio are invaluable health and socioeconomic indicators. There have been considerable gains in both indices. However the gains are not uniform and consistent. Aims: To determine if the change in infant mortality rate has positively influenced the sex ratio and to study the regional variations of these parameters. Materials and Methods: Sex ratio and infant mortality rate data from the past 4 censuses from 1981 to 2011 on 24 states were collated and analyzed. Results: There is a significant regional variation among the states and ranges from a sex ratio of 1084 for Kerala and 868 for Delhi. The infant mortality rate ranges from 11 for Goa and Manipur and 59 for Madhya Pradesh. States which have a low IMR do not necessarily have a better balanced sex ratio. Conclusion: There is significant regional variation in these parameters and the gains of a falling IMR are not equitably distributed.