Prevalence and risk factors of postpartum depression in sub-Himalayan region.

Background: Postpartum depression (PPD) is a common problem faced by women after childbirth. The adverse effects of PPD upon the maternal-infant relationship and child development reinforce the need for early identification and effective treatment models. This study intends to add to the existing knowledge about the prevalence of PPD and its associated risk factors in the hilly region in Himachal Pradesh. Methods: A hospital-based cross-sectional study was conducted on 426 women presenting for a postpartum visit at 6 weeks postpartum. Sociodemographic characteristics were recorded on a pretested questionnaire. Women were screened for postpartum depression using a validated EPDS (Edinburgh postnatal depression scale) prestructured questionnaire with 10 questions. Women were divided into two groups based on screening results. Results: The overall prevalence of PPD in the study was 17.4%. Out of sociodemographic factors, age (0.010) and family structure (0.008) were found to be significant. Nuclear family women were more prone to PPD. Domestic abuse (<0.001) is also a leading factor for PPD. By comparing obstetric and gender issues, it was found that the total number of previous living children (p-value <0.001), gender of previous living children (<0.001), and gender of newborns (<0.001) are the major determining factors of PPD. Another factor that was significantly related to PPD was an unwanted pregnancy. Conclusions: We have found a high prevalence of PPD in our region that does not have screening protocols for the screening of such patients. We, therefore, propose routine screening for postpartum depression at 6 weeks postpartum.

Randomized Controlled Trial Comparing Ferrous Sulfate and Iron Sucrose in Iron Deficiency Anemia in Pregnancy.

INTRODUCTION:  Anemia among pregnant women is one of the major health concerns for healthcare workers. The management becomes a concern in the pregnancy where the question arises of which is better the intravenous iron sucrose or the oral ferrous sulfate tablets. To answer this, a randomized control trial comparing both the treatment options in a tertiary care government hospital was set up in the hilly terrains of India. This study discusses the effectiveness and practical aspect of using both, which seems to be the better out of both, and why. METHODS:  The study was conducted as a parallel-group, open-label randomized controlled trial (RCT) in the Department of Obstetrics and Gynecology of a tertiary care government hospital in India, with approximately 4,000 delivery loads annually. Ethical clearance was obtained from the institute's ethics committee (IEC), and the trial was registered with the Clinical Trial Registry of India (REF/2022/06/055013). Two hundred sixty-eight pregnant women between 18 and 45 years of age with moderate iron deficiency anemia (IDA) (hemoglobin (Hb) 7-9g/dl, microcytic-hypochromic, and serum ferritin <30ng/ml) were included in the study. Patients were randomly divided into two groups: group 1 with 134 patients to receive intravenous iron sucrose and group 2 with 134 patients to receive oral ferrous sulfate tablets. RESULTS: The intravenous iron sucrose is superior in terms of tolerability and correction of iron deficiency anemia during pregnancy. CONCLUSION: It yields a quicker rise in Hb and serum ferritin with no major side effects. In the difficult terrain of Himachal Pradesh, this makes IV iron sucrose a better option for anemic pregnant women who do not have easy access to health facilities resulting in a large number of them reaching hospitals with moderate to severe anemia at a later gestation.

Rare Transverse Vaginal Septum in an Adolescent Girl.

An uncommon malformation of the female genital system is the transverse septum which is often known as the vaginal septum. A problem with the union and channelling of the Mullerian conductors and urogenital sinus is the primary common cause of progressive pathogenesis. This anatomical blockage can block the vagina, which can lead to a hematocolpos that is connected with periodic pelvic discomfort in teenage females immediately after menarche. A thorough clinical gynaecological evaluation, particularly an abdominal or transrectal ultrasound scan, and in even more complicated situations, magnetic resonance imaging is used to determine the presence of a vaginal septum. The surgical intervention must be performed as soon as feasible. We report the management of a case of a 16-year-old girl presented with primary amenorrhea associated with severe pain in the lower abdomen for 2-3 days, which was cyclic in nature and spasmodic in character. She revealed a hematocolpos during the examination, aggravating a full transverse vaginal septum. Removing the hematocolpos and examining the cervix were the steps in the therapy.