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Caesarean Delivery and Postnatal Depression in a Tertiary Hospital in Southern Nigeria 尼日利亚南部一家三级医院的剖腹产和产后抑郁症
Pub Date : 2022-12-13 DOI: 10.9734/indj/2022/v18i2349
E. N. Solomon, N. Ijeoma
Background: Postnatal depression is one of the most devastating of the mental disorders affecting women six weeks postpartum, accounting for more than 20% of maternal deaths after childbirth. It is said that young children of mothers with postnatal depression have greater behavioural problems than those of non- depressed mothers. Mode of delivery with other risk factors has been implicated as a predictive factor and caesarean section in any form is said to be most implicated. This study intends to contribute to the raging arguments on the relationship between caesarean section and postnatal depression. Objective: To examine the relationship between caesarean sections and postnatal depression. Methods: Women visiting the postnatal clinic six weeks postpartum who consented to the study, where interviewed and screened for depression using the study designed questionnaire and the Edinburg postnatal depressive scale (EPDS). Data obtained were analysed using the statistical package for social sciences (SPSS) version 23.0, p values <0.05 were statistically significant. Results: Out of 405 women who participated in the study, 135 (33.3%) had an EPDS score of > 12 points. Among the risk factors isolated which included co-habiting, death of children, children challenges and partner violence, caesarean section showed a very strong association p=0.001, OR 1.68, 95% cl=1.10-2.58. Emergency caesarean section showed a stronger association p=0.001, OR 3.6, 95%cl=2.35-5.69. Conclusion: Emergency caesarean section has a strong significant impact on the development of postnatal depression.
背景:产后抑郁症是影响产后六周女性的最具破坏性的精神障碍之一,占产后产妇死亡人数的20%以上。据说,患有产后抑郁症的母亲的孩子比没有抑郁症的母亲有更大的行为问题。分娩方式和其他风险因素被认为是一个预测因素,任何形式的剖腹产都被认为是最受影响的。这项研究旨在为关于剖腹产与产后抑郁症之间关系的激烈争论做出贡献。目的:探讨剖宫产与产后抑郁症的关系。方法:产后6周到产后诊所就诊并同意该研究的女性,采用研究设计的问卷和Edinburg产后抑郁量表(EPDS)进行访谈和抑郁筛查。使用社会科学统计软件包(SPSS)23.0版对获得的数据进行分析,p值为12分。在包括同居、儿童死亡、儿童挑战和伴侣暴力在内的孤立风险因素中,剖腹产显示出非常强的相关性,p=0.001,OR 1.68,95%cl=1.10-2.58。紧急剖宫产显示出更强的相关性p=0.001,OR 3.6,95%cl=2.35-5.69。结论:紧急剖宫产对产后抑郁症的发展有很大的影响。
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引用次数: 0
Effectiveness of Psychosocial Intervention in the Management of Alcohol Dependence Syndrome with Poor Marital Adjustment: A Case Report 心理社会干预在婚姻适应不良的酒精依赖综合征治疗中的有效性:一例报告
Pub Date : 2022-11-01 DOI: 10.9734/indj/2022/v18i2348
Mayank Kumar, Riyal Das, A. Mukherjee, Atindra Paul, Banasri Chakraborty
Aim: Globally, it has been found that the mean lifetime prevalence of alcohol use is 80% and for alcohol use disorder (AUD) is 8.6%, and AUD has an adverse impact on an individual as well            as on the person’s family. In view of the same, we choose a case of alcohol dependence             syndrome (ADS) to investigate the effect of long-term alcohol use on family dynamics,                   marital adjustment, interpersonal relationship, and motivational level of the individual with ADS, as well as the effectiveness of pre- and post- brief psychosocial intervention in the treatment            outcome of the individual with ADS by involving his family and strengthening his interpersonal relationships. Presentation of the Case: The client had a history of alcohol use for 22 years. Gradually, his alcohol intake was increased from 100 ml/day to 2-5 litres/day in the last few years. Due to his worsening condition, he was admitted to hospital in 2016 and diagnosed with ADS. He remained abstinent for the next 5–6 months after discharge, but had poor treatment compliance. For the past 2.5 years (2016– 2019), the client again started drinking and the symptoms recurred. He was admitted there again on May 30, 2019. It was found that the prolonged alcohol use of the client had an adverse impact on his spouse’s wellbeing and also on his interpersonal relationships with his parents and siblings. Further, it was found that the client had a lower level of motivation, poor adaptive patterns, inadequate social support, and poor marital adjustment. Discussion: This study discovered a significant difference between pre- and post-psychosocial intervention in the management of ADS. After our intervention, the client has been doing well. His marital adjustment has increased with his improvement in quality of life, family dynamics, and adaptive patterns. Conclusion: It was found that psychosocial intervention with the person with alcohol dependence as well as his family is effective and plays a very crucial role in treatment and wellbeing.
目的:在全球范围内,已经发现酒精使用的平均终生患病率为80%,酒精使用障碍(AUD)的平均终生患病率为8.6%,并且AUD对个人及其家庭都有不利影响。鉴于此,我们选择了一个酒精依赖综合征(ADS)的病例,探讨长期饮酒对ADS患者家庭动态、婚姻调整、人际关系和动机水平的影响,以及通过家庭参与和加强人际关系对ADS患者治疗结果的前后短暂社会心理干预的有效性。病例描述:患者有22年的酒精使用史。在过去几年中,他的酒精摄入量逐渐从每天100毫升增加到每天2-5升。因病情恶化,于2016年入院,诊断为ADS。出院后5-6个月保持戒断,但治疗依从性较差。2016 - 2019年2.5年,患者再次开始饮酒,症状复发。他于2019年5月30日再次入院。调查发现,当事人长期饮酒对其配偶的幸福以及他与父母和兄弟姐妹的人际关系产生不利影响。此外,我们还发现来访者的动机水平较低,适应模式较差,社会支持不足,婚姻适应能力较差。讨论:本研究发现,在ADS的管理中,心理社会干预前后存在显著差异。在我们的干预之后,客户的情况一直很好。他的婚姻调整随着他的生活质量、家庭动态和适应模式的改善而增加。结论:对酒精依赖者及其家庭进行心理社会干预是有效的,在治疗和健康中起着至关重要的作用。
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引用次数: 0
Comparison of Depressive Symptoms among Women with Gynecological Cancer and other Cancer Types Before and during the COVID-19 Pandemic COVID-19大流行前和期间妇科癌症和其他癌症类型女性抑郁症状的比较
Pub Date : 2022-10-15 DOI: 10.9734/indj/2022/v18i2347
Godwin S. Okoye, K. Ben-Umeh, V. Okoye, Shedrack Osuji, Rachel Vincent
Objective: Cancer patients are at a high risk of exhibiting depressive symptoms. However, what remains unknown is whether gynecological cancer (GC) worsens this risk. This study seeks to compare depressive symptoms amongst women diagnosed with GC and women diagnosed with other cancer types before COVID-19 pandemic and during the COVID-19  pandemic. It also seeks to compare both study periods to confirm if COVID-19 influenced depressive symptoms of women with GC. Methods: A retrospective cross-sectional study was conducted to find an association between depressive symptoms and gynecological cancers using other cancer type diagnosis in females as a reference. We utilized the sample adult file of NHIS (National Health Interview Survey) data from 2019 (Pre-Pandemic data) and data from 2020 (Pandemic data). We also utilized the PHQ-8 scale to quantify major depressive disorder. Each of the 8 items were scored from 0-3. All statistical analysis were performed using SAS v9.4 ((SAS Institute Inc, Cary, NC), and statistical significance  was set at α = 0.05. Results: A weighted population of women with GC vs other cancer types was obtained. Women with GC tend to have lesser Age, Educational status, Health status, Income. They also tend to be more obese and smokers. Women with GC tend to have had hysterectomy (68.03% vs 35.43%) and access to care during COVID-19 (71.63% vs 68.01%). Severe depressive symptoms were higher before pandemic and among women with GC OR 2.89 (95%CI 1.64 - 5.12). Moderate depressive symptoms were higher during the pandemic and among women with GC OR 2.19 (95%CI 1.35 – 3.57). Among women with GC, depressive symptoms were less likely in 2020 than 2019 with an OR 0.57 (95%CI 0.36 – 0.91) Conclusion: Based on the data available, women with gynecologic cancer are more prone to having depressive symptoms than women with other cancer types. Therefore, policies should be implemented to improve wellness of women with gynecologic cancer. Although, depressive symptoms wasn’t worsened by the COVID-19 pandemic.
目的:癌症患者表现出抑郁症状的风险很高。然而,妇科癌症(GC)是否会加重这种风险仍不得而知。本研究旨在比较在COVID-19大流行之前和期间被诊断为GC的女性和被诊断为其他癌症类型的女性的抑郁症状。它还试图比较两个研究时期,以确认COVID-19是否影响GC女性的抑郁症状。方法:采用回顾性横断面研究,以女性其他癌症类型诊断为参考,寻找抑郁症状与妇科癌症的关系。我们使用了2019年(大流行前数据)和2020年(大流行数据)的NHIS(全国健康访谈调查)样本成人文件数据。我们还使用PHQ-8量表来量化重度抑郁症。8个项目的得分从0-3分不等。所有统计分析均采用SAS v9.4 (SAS Institute Inc, Cary, NC)进行,统计学意义设为α = 0.05。结果:获得了胃癌妇女与其他癌症类型的加权人群。女性胃癌倾向于年龄、教育程度、健康状况和收入较低。他们也更倾向于肥胖和吸烟。GC女性倾向于在COVID-19期间进行子宫切除术(68.03%对35.43%)并获得护理(71.63%对68.01%)。严重抑郁症状在大流行前和GC女性中较高,OR为2.89 (95%CI 1.64 - 5.12)。在大流行期间和GC患者中,中度抑郁症状较高,OR为2.19 (95%CI 1.35 - 3.57)。在GC女性中,2020年出现抑郁症状的可能性低于2019年,OR为0.57 (95%CI 0.36 - 0.91)。结论:根据现有数据,妇科癌症女性比其他癌症类型的女性更容易出现抑郁症状。因此,应该实施政策来改善妇科癌症妇女的健康状况。尽管如此,抑郁症状并没有因为COVID-19大流行而恶化。
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引用次数: 0
Transcranial Magnetic Stimulation: New Sapience into How Brain Stimulation Palliates Symptoms of PTSD 经颅磁刺激:脑刺激如何缓解创伤后应激障碍症状的新发现
Pub Date : 2022-09-26 DOI: 10.9734/indj/2022/v18i2346
S. Khare
Posttraumatic stress disorder (PTSD) is a chronic, often debilitating psychological state disorder that may develop after a traumatic life event. Most patients get over the initial symptoms naturally, but those that experience persistent symptoms require standard treatment approaches such as 1: 1 psychotherapy, psychotropic medications, or both whichever have relevance. However, there are secondary hindrances such as drug safety and drug tolerability associated with these psychotropic medications, that interdict an appropriate course of treatment. The upshot of those events is that it creates a breach in our potential to properly manage PTSD in a significant number of patients, leaving them endangered to surfacing complications like employment-related incapacities, suicidal ideations, co-morbid medical disorders, and illicit drug abuse. Thus, there is a need for more worthwhile, tolerable, and long-standing approaches. Transcranial magnetic stimulation may be a safe and non-invasive treatment technique used to treat various psychiatric and neurological disorders. This neuromodulation technique involves stimulation of specific deep brain regions by the assembly of high and low-intensity magnetic fields thus filling the therapeutic void. This text mainly focuses on the results of controlled and pragmatic trials for efficacy, safety, and tolerability of patients affected by PTSD. The alternative treatment for PTSD currently is psychotherapy and antidepressant medications.Despite receiving these alternatives, there are about 50% of patients who continue to experience major symptoms..That is, the reason why TMS came out as another suitable option. Atleast 5 directories such as MEDLINE, CINAHL, Psych INFO, SCOPUS and EMBASE were probed to pinpoint pragmatic studies and randomized controlled trials that were designed for the treatment of PTSD with TMS. A total of 28 studies were found worthy for this review, out of which 5 are mentioned in this article. Although, so far it looks propitious in spite of the manifoldness as far as its outcomes and its clinical importance are concerned. Hence, still researches involving stimulation constraints are to be conducted in the near future.
创伤后应激障碍(PTSD)是一种慢性的、经常使人衰弱的心理状态障碍,可能在创伤生活事件后发展。大多数患者会自然克服最初的症状,但那些经历持续症状的患者需要标准的治疗方法,如1:1心理治疗、精神药物或两者兼有。然而,与这些精神药物相关的药物安全性和药物耐受性等次要障碍阻碍了适当的疗程。这些事件的结果是,它破坏了我们在大量患者中正确管理创伤后应激障碍的潜力,使他们面临出现并发症的危险,如与工作相关的丧失能力、自杀意念、共病医疗障碍和非法药物滥用。因此,有必要采取更有价值、可容忍和长期的办法。经颅磁刺激可能是一种安全、无创的治疗技术,用于治疗各种精神和神经疾病。这种神经调控技术包括通过高强度和低强度磁场的组合来刺激特定的脑深部区域,从而填补治疗空白。本文主要关注创伤后应激障碍患者的疗效、安全性和耐受性的对照和实用试验结果。目前PTSD的替代治疗方法是心理治疗和抗抑郁药物。尽管接受了这些替代方案,但仍有约50%的患者继续出现重大症状。。也就是说,TMS之所以成为另一个合适的选择。对MEDLINE、CINAHL、Psych INFO、SCOPUS和EMBASE等至少5个目录进行了探索,以确定应用TMS治疗创伤后应激障碍的实用研究和随机对照试验。共有28项研究值得进行本综述,其中5项在本文中提到。尽管就其结果和临床重要性而言,它看起来是有利的,尽管它有很多优点。因此,在不久的将来仍将进行涉及刺激约束的研究。
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引用次数: 0
Impacts of Telehealth on Access-to-Care for Mental Health Patients 远程医疗对心理健康患者获得护理的影响
Pub Date : 2022-09-19 DOI: 10.9734/indj/2022/v18i2345
Jennings Hernandez
The age of technology and smart devices has paved the way for a current and encouraging method to address mental healthcare that benefits from global connectivity: telehealth. According to the American Telemedicine Association, telehealth or telemedicine is defined as the usage of medical information from one site to another through electronic communication with the goal of improving a client’s overall health through emails, cellular phones, two-way videos, and conference calls.  With the current Covid-19 pandemic, hospitals (especially those with mental health units or free-standing psychiatry facilities) are seldomly able to keep up with the influx of mental health patients without being turned away or having to wait for an extended period of time. Through telemedicine, those barriers have been lifted providing more efficient and enhanced access to care for everyone, especially those seeking mental health services. This review paper attempts to establish that despite the observations that telehealth has a positive impact on improved access to mental healthcare, it has not flourished to the extent it could have prior to the COVID-19 pandemic. We also try to provide long-term telehealth solutions, some of which are already being implemented in the current pandemic to improve the quality of mental healthcare access to a larger majority of Americans and those in other countries as well.  With people being advised to stay-at-home coupled with the fear of cross-contamination in public places, people are resorting to telehealth for psychiatric visits and follow-ups. Before this pandemic, however, certain laws and rules have been a barrier to more telehealth options becoming available or feasible to the public. Telehealth is changing the conventional standard of psychiatric medicine by enhancing access to care, reducing re-admission rates, and enhancing the quality of life. Those that have tested positive for the COVID-19 virus and are quarantined at home can still meet with their mental healthcare provider periodically to discuss progress and prognosis. Research has shown that telemedicine has neutralized the impacts of delayed care, hospital admissions, and complications from psychiatric conditions globally. Telehealth has proven to provide steady benefits to patients, psychiatrists, and mental health providers through round-the-clock access remotely.
技术和智能设备的时代为一种当前且令人鼓舞的方法铺平了道路,这种方法可以解决受益于全球连接的心理健康问题:远程医疗。根据美国远程医疗协会的说法,远程医疗或远程医疗被定义为通过电子通信将医疗信息从一个站点使用到另一个站点,目的是通过电子邮件、手机、双向视频和电话会议改善客户的整体健康。在当前新冠肺炎大流行的情况下,医院(尤其是那些拥有精神卫生单位或独立精神病设施的医院)很少能够跟上精神卫生患者的涌入,而不会被拒之门外或等待很长一段时间。通过远程医疗,这些障碍已经消除,为每个人,特别是寻求心理健康服务的人,提供了更有效和更方便的护理机会。这篇综述论文试图证明,尽管观察到远程医疗对改善获得精神卫生保健的机会有积极影响,但它并没有像新冠肺炎大流行之前那样蓬勃发展。我们还试图提供长期的远程医疗解决方案,其中一些方案已经在当前的疫情中实施,以提高大多数美国人和其他国家的人获得心理健康服务的质量。由于人们被建议呆在家里,再加上担心公共场所的交叉污染,人们正求助于远程医疗进行精神病检查和随访。然而,在这场疫情之前,某些法律和规则一直是公众获得或可行更多远程医疗选择的障碍。远程医疗正在通过增加获得护理的机会、降低再次入院率和提高生活质量来改变传统的精神医学标准。那些新冠肺炎病毒检测呈阳性并在家隔离的人仍然可以定期与他们的精神卫生保健提供者会面,讨论进展和预后。研究表明,远程医疗在全球范围内消除了延迟护理、入院和精神疾病并发症的影响。远程医疗已被证明通过全天候远程访问为患者、精神科医生和心理健康提供者提供稳定的好处。
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引用次数: 0
The Mental Health Syndrome Known as Alice in Wonderland - A Case Report 被称为爱丽丝梦游仙境的心理健康综合症-一个病例报告
Pub Date : 2022-09-17 DOI: 10.9734/indj/2022/v18i1344
Jennings Hernandez
The Alice in Wonderland Syndrome (AIWS) is a rare neurological and psychiatric condition, represented as the appearance of disorienting perceptual disorder with occasional episodes of bizarre visual illusions and spatial distortions. It was first introduced by John Todd in 1955, based on the literary chronicles of the strange encounters described by Lewis Carroll in Alice in Wonderland books. A 30-year-old healthy male presented to the doctor’s office with left-sided headaches lasting 24 hours and preceded by an aura. During these auras, the patient was experiencing erratic behaviors consistent with the phenomena experienced by Alice, the main character in the world-famous story. He reported objects being larger and further away than they really were and his hands appearing smaller than they really were. Symptoms lasted up to 45 minutes. All clinical and diagnostic workups and evaluations were unremarkable, and the patient was treated for migraines with auras using Valproic Acid. During his follow-up at 3 months intervals, the patient continued with symptoms, and his medication dosage was increased. In his next follow-up three months later, he described having no more symptoms. AIWS has been found to be related to migraines with preceding auras.  It is both common in pediatrics as well as in adults. I present an AIWS case co-existent with aura migraines.
爱丽丝梦游仙境综合症(AIWS)是一种罕见的神经和精神疾病,表现为迷失方向的知觉障碍,偶尔出现奇怪的视觉错觉和空间扭曲。它最初是由约翰·托德在1955年提出的,基于刘易斯·卡罗尔在《爱丽丝梦游仙境》中所描述的奇怪相遇的文学编年史。一位30岁的健康男性因左侧头痛持续24小时而就诊,并伴有先兆。在这些光环中,患者经历了与世界著名故事中的主角爱丽丝所经历的现象一致的不稳定行为。他报告说,物体比实际更大、更远,他的手看起来比实际更小。症状持续了45分钟。所有临床和诊断检查和评估均无显著差异,患者使用丙戊酸治疗偏头痛先兆。在每隔3个月的随访期间,患者持续出现症状,并增加了用药剂量。在三个月后的随访中,他描述没有更多的症状。已发现AIWS与先兆偏头痛有关。这在儿科和成人中都很常见。我报告一例伴有先兆偏头痛的AIWS病例。
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引用次数: 0
Trends in Psychological Distress and Burnout Syndrome among Healthcare Workers due to COVID-19 新冠肺炎引起医护人员心理困扰和精疲力竭综合征的趋势
Pub Date : 2022-09-16 DOI: 10.9734/indj/2022/v18i1343
Jennings Hernandez
The coronavirus COVID-19 pandemic has caused significant physical and mental tension among frontline workers globally. Poor working conditions, lack of protective personal equipment (PPE), short-staffed departments, medication shortage, depleted hospital beds, and ventilators have had a direct correlation with occupational burnout syndrome (BOS) and psychological distress among frontline healthcare workers (HCW) and their physical and mental well-being. The limitless hours on shift, the abundant number of daily cases, and the upturn of fatalities have contributed to the stressors among HCWs during this pandemic. In this paper, we will examine the occupational burnout syndrome and the psychological distress among HCWs working frontline during the pandemic. Also, the paper will explore whether there is a correlation between occupational burnout syndrome, mental and psychological distress, and COVID-19. The goal of this research is to acquire and establish if there had been an increase in anxiety and other mental health concerns as well as burnout levels for workers impacted by COVID-19. Categories explored will entail anxiety levels, mental and physical strains of working long hours, working under subpar conditions with limited PPE and patient rooms, and fear of exposure to the virus. Throughout the pandemic, many cases of tragic suicidal deaths have emerged. Consequently, attention to the well-being of healthcare professionals (HCPs) across the world has become imperative to adequately support and monitor. The Diagnostic and Statistical Manual of Mental Disorders, (DSM-5) and the Maslach Burnout Inventory – Medical Personnel (MBI-MP) are tools used by psychiatrists to diagnose and treat mental health such as burnout syndrome and psychological distress levels which also encompasses post-traumatic stress disorder (PTSD) and mass traumatic events (MTE). Studies have shown a high prevalence of PTSD symptoms, anxiety, fear, depression, and frustration in emergency professionals involved in the COVID-19 pandemic. Through various studies, we will demonstrate how the pandemic has affected frontline workers' mental and psychological well-being as well as how inadequate working conditions and long working hours lead to occupational burnout syndrome. Results will show how healthcare workers are feeling unaccomplished, second-guessing their clinical decisions, defeated, and mentally and physically drained. It is expected that subpar working conditions will continue to deteriorate the physical and mental well-being of HCWs on the frontline as the number of COVID-19 cases continue globally even after three years since its inception.
冠状病毒新冠肺炎大流行在全球一线工作人员中造成了严重的身心紧张。恶劣的工作条件、缺乏个人防护设备、部门人手不足、药物短缺、病床和呼吸机耗尽,与一线医护人员的职业倦怠综合征(BOS)和心理困扰及其身心健康直接相关。无限制的轮班时间、大量的每日病例以及死亡人数的上升,都是这场疫情期间HCW面临压力的原因之一。在本文中,我们将调查疫情期间在一线工作的HCW的职业倦怠综合征和心理困扰。此外,本文还将探讨职业倦怠综合征、精神和心理困扰与新冠肺炎之间是否存在相关性。这项研究的目标是了解和确定受新冠肺炎影响的员工的焦虑和其他心理健康问题以及倦怠水平是否增加。探索的类别包括焦虑程度、长时间工作的精神和身体压力、在个人防护装备和病房有限的恶劣条件下工作,以及对接触病毒的恐惧。在整个疫情期间,出现了许多悲惨的自杀死亡案例。因此,关注世界各地医疗保健专业人员(HCP)的福祉已成为充分支持和监测的当务之急。精神障碍诊断和统计手册(DSM-5)和Maslach倦怠量表-医务人员(MBI-MP)是精神病学家用来诊断和治疗精神健康的工具,如倦怠综合征和心理困扰水平,其中还包括创伤后应激障碍(PTSD)和大规模创伤事件(MTE)。研究表明,在参与新冠肺炎大流行的急救专业人员中,创伤后应激障碍症状、焦虑、恐惧、抑郁和沮丧的发病率很高。通过各种研究,我们将展示疫情如何影响一线员工的心理健康,以及工作条件不足和工作时间过长如何导致职业倦怠综合症。结果将显示医护人员是如何感到未完成、事后猜测他们的临床决定、失败以及身心疲惫的。随着新冠肺炎病例数在全球范围内持续增加,即使在其成立三年后,低于标准的工作条件也将继续恶化一线医务人员的身心健康。
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引用次数: 0
Anencephaly and Its Associated Congenital Anomalies: A Case Report of a Delivery in a Rural Hospital, in Eastern Uganda 无脑畸形及其相关先天性畸形:乌干达东部一家农村医院分娩的病例报告
Pub Date : 2022-09-09 DOI: 10.9734/indj/2022/v18i130215
Ismail Opolot, Christopher Knox Waako, J. Wandabwa, Joyce Namwase, Jennipher Mariam Konso
Introduction: Anencephaly also called cranioschisis is part of neural tube defects spectrum which occur when the neural tube fails to close normally during the 3rd and 4th weeks of development leading to fetal loss, still birth or neonatal death. Literature show that causation of anencephaly is multifactorial involving interaction of genetics and the environment though not well characterized. In this case report, we present the features of anencephaly and its different clinical associated malformations. Methods: A case report study design was employed to explore the prenatal and antenatal events that resulted into an anencephaly delivery. The intra-natal and immediate postnatal fetal observations and outcome were documented. We also documented the care given to the mother throughout ANC, time of delivery and postnatally until discharge. Results: 29-year G2P1+0 at 29W2D, presented with 2 days’ sudden progressive per vaginal bleeding and clear non-foul discharge on 2nd day of admission with no history of abdominal pain, fever or trauma. Two days later she was delivered by Caesarean section to a grossly neural malformed preterm baby boy with APGAR score 6 at 1 minute and 4 at 5 minutes. Birth weight and length were 1.5 kg and 48.6cm respectively. The baby life indicators deteriorated progressively and finally died at 36 minutes after time of delivery. Conclusion: Although interaction between genomic and environmental factors that play a key role in the causation of anencephaly can not clearly be evaluated, there is an understanding of pre-natal and antenatal factors that predispose to this case such as lack of Folate and or interference with its bioavailability, use of teratogenic drugs taken during pregnancy and antenatal maternal conditions. We therefore recommend routine supply of folate to girls and women intending or risk to conceive 3 months before pregnancy through first trimester and health education about use of native drugs and any other conventional medicines during pregnancy.
简介:无脑畸形也称为颅裂,是神经管缺陷谱系的一部分,当神经管在发育的第3和第4周不能正常关闭时发生,导致胎儿丢失,死产或新生儿死亡。文献表明,无脑畸形的病因是多因素的,涉及遗传和环境的相互作用,但没有很好地表征。在本病例报告中,我们介绍了无脑畸形的特点及其不同的临床相关畸形。方法:采用病例报告研究设计,探讨导致无脑畸形分娩的产前和产前事件。记录了出生时和出生后的胎儿观察和结果。我们还记录了在整个ANC期间对母亲的护理,分娩时间和产后直到出院。结果:29岁G2P1+0, 29W2D,表现为2天突发性进行性阴道出血,入院第2天无明显无污物分泌物,无腹痛、发热、外伤史。两天后,她通过剖腹产生下了一个严重神经畸形的早产儿,1分钟时APGAR评分为6分,5分钟时APGAR评分为4分。出生体重1.5 kg,体长48.6cm。婴儿生命指标逐渐恶化,最终于分娩后36分钟死亡。结论:虽然基因组和环境因素之间的相互作用在导致无脑畸形的原因中起关键作用还不能明确评估,但有一个了解产前和产前因素,如缺乏叶酸和或干扰其生物利用度,妊娠期间使用致畸药物和产前产妇条件。因此,我们建议在怀孕前3个月至妊娠头3个月期间,向有意或有怀孕风险的女孩和妇女定期提供叶酸,并就怀孕期间使用天然药物和任何其他传统药物进行健康教育。
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引用次数: 0
Risk Factors Associated with Substance Abuse among Adolescents 与青少年药物滥用有关的危险因素
Pub Date : 2022-09-07 DOI: 10.9734/indj/2022/v18i130214
H. I. Chisom, Ohaeri Beatrice, O. O. Iyanuoluwa, Babarimisa, Oluwatoyin
Substance abuse is a global public health problem with physical, social, psychological, economic, and health implications. Adolescent age is an important transitional period and comes with a high level of vulnerability, curiosity, experimentation, and making choices that may be detrimental to them in the long run. The problem of substance abuse has become very popular among adolescents, several researchers from different parts of the world have reported a high prevalence rate of substance abuse among teenagers and its resultant health and social problems. This study identified four different levels of factors that influence substance abuse among teenagers which includes family-related problems, and individual, psychological and social factors. Different preventive measures have also been identified, highlighting roles that should be played by family, the community, schools, as well as the government. These measures will have a great impact on curbing the menace of substance abuse among young people in societies, they will be able to avoid risky behaviors, function effectively, and achieve their dreams.
药物滥用是一个全球性的公共卫生问题,对身体、社会、心理、经济和健康都有影响。青少年年龄是一个重要的过渡期,伴随着高度的脆弱性、好奇心、实验性,以及做出从长远来看可能对他们不利的选择。药物滥用问题在青少年中非常普遍,来自世界各地的几位研究人员报告称,青少年中药物滥用的流行率很高,并由此产生健康和社会问题。这项研究确定了影响青少年药物滥用的四个不同水平的因素,包括家庭相关问题,以及个人、心理和社会因素。还确定了不同的预防措施,强调了家庭、社区、学校和政府应发挥的作用。这些措施将对遏制社会中年轻人滥用药物的威胁产生重大影响,他们将能够避免危险行为,有效发挥作用,实现梦想。
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引用次数: 0
Effects of Ethanolic Root Extract of Clitoria ternatea against Experimentally Induced Convulsions and Anxiety in Rodents 阴蒂乙醇根提取物对实验性鼠惊厥和焦虑的影响
Pub Date : 2022-08-24 DOI: 10.9734/indj/2022/v18i130212
N. Reddy V, M. Raju, M. Niharika, B. Pratyusha
In animal models for screening for anticonvulsant activity, it has been scientifically established that medicinal herbs used in traditional medicine for the treatment of epilepsy possess promising anticonvulsant properties and can be a source of newer anticonvulsants. This study's objective was to evaluate the ethanolic root extract of Clitoria ternatea Linn for its preliminary phytochemical components, anticonvulsant, and anxiolytic effects. Anticonvulsant activity was evaluated against Maximum electroshock (MES) induced convulsion and pentylenetetrazole (PTZ)-induced convulsion model in rats. Using phenytoin (25 mg/kg) as a standard drug, the efficacy of the extract at oral dose levels of 200 and 400 mg/kg were evaluated in an experimental rat model. The marble bury test was used to assess the mice for anxiolytic activity, and lorazepam served as the standard drug at a dose of 0.05 mg/kg. Phytochemical screening revealed that C. ternatea extract contain carbohydrates, flavonoids, alkaloids, proteins, triterpenoids, phenols and steroids. The ethanolic extract significantly decreased the duration of tonic flexion and tonic extension in MES induced model (p<0.05). The ethanolic extract significantly increased the latency of convulsion and decreased the duration of convulsion in PTZ induced model (p<0.05). The ethanolic root extract were found to be significantly decrease the number of marbles buried in the treated groups as compared to control group, indicating anxiolytic activity. According to specific investigations, terpenes and steroids exhibited anticonvulsant effects in some experimental seizure models, including MES and PTZ. Alkaloids and triterpenes, which are phytoconstituents in ethanolic extract of Clitoria ternatea (EECT), might be the basis of its anxiolytic actions. Based on the findings of the study, Clitoria ternatea's ethanolic root extract has anticonvulsant and anxiolytic effects on animals.
在筛选抗惊厥药物活性的动物模型中,已经科学地证实,传统医学中用于治疗癫痫的草药具有很好的抗惊厥药物特性,并且可以作为新型抗惊厥药物的来源。本研究的目的是评估阴蒂的乙醇根提取物的初步植物化学成分,抗惊厥和抗焦虑作用。对大鼠最大电休克(MES)诱发惊厥和戊四唑(PTZ)诱发惊厥模型进行抗惊厥活性评价。以苯妥英(25 mg/kg)为标准药物,在实验大鼠模型上评价200和400 mg/kg剂量下提取物的疗效。采用大理石掩埋法测定小鼠的抗焦虑活性,以0.05 mg/kg剂量的劳拉西泮为标准药。植物化学筛选结果显示,三萜提取物含有碳水化合物、类黄酮、生物碱、蛋白质、三萜、酚类和类固醇。乙醇提取物显著降低MES模型强直屈伸持续时间(p<0.05)。乙醇提取物显著增加PTZ模型的惊厥潜伏期,显著缩短惊厥持续时间(p<0.05)。与对照组相比,乙醇根提取物显著减少了治疗组的弹珠数量,显示出抗焦虑活性。根据具体的研究,萜烯和类固醇在一些实验性癫痫发作模型中表现出抗惊厥作用,包括MES和PTZ。阴蒂乙醇提取物中的生物碱和三萜可能是其抗焦虑作用的基础。本研究结果表明,阴蒂乙醇根提取物具有抗惊厥和抗焦虑作用。
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引用次数: 0
期刊
International neuropsychiatric disease journal
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