Maternal postpartum depression impacts infants' joint attention differentially across cultures.

We assessed whether the negative association between maternal postpartum depression (PPD) and infants' development of joint attention (gaze following) generalizes from WEIRD (Western, Educated, Industrialized, Rich, and Democratic) to Majority World contexts. The study was conducted in Bhutan (N = 105, M = 278 days, 52% males) but also draws from publicly available Swedish data (N = 113, M = 302 days, 49% males). We demonstrate that Bhutanese and Swedish infants' development follows the same trajectory. However, Bhutanese infants' gaze following were not related to maternal PPD, which the Swedish infants' were. The results support the notion that there are protecting factors built into the interdependent family model. Despite all the benefits of being raised in a modern welfare state, it seems like Swedish infants, to an extent, are more vulnerable to maternal mental health than Bhutanese infants. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

High quality social environment buffers infants' cognitive development from poor maternal mental health: Evidence from a study in Bhutan.

Poor maternal mental health negatively impacts cognitive development from infancy to childhood, affecting both behavior and brain architecture. In a non-western context (Thimphu, Bhutan), we demonstrate that culturally-moderated factors such as family, community social support, and enrichment may buffer and scaffold the development of infant cognition when maternal mental health is poor. We used eye-tracking to measure early building blocks of cognition: attention regulation and social perception, in 9-month-old Bhutanese infants (N = 121). The cognitive development of Bhutanese infants in richer social environments was buffered from poor maternal mental health, while for infants in environments with lower rates of protective social environment factors, worse maternal mental health significantly predicted greater costs for infant attention, a fundamental building block cognition. International policies and interventions geared to improve maternal mental health and child health outcomes should incorporate each regions' unique family, cultural, and community support structures.

Development of DO*A and DO*B Allele Detections to Predict Transfusion-Induced Alloimmunization Risks in Thai Populations.

BACKGROUND: Two antithetical antigens, Doa and Dob of the Dombrock (DO) blood group system are implicated in acute to delayed hemolytic transfusion reactions among patients with anti-Doa or anti-Dob. Given the unavailability of specific antiserum, a polymerase chain reaction with sequence-specific primer (PCR-SSP) was developed to identify DO*A and DO*B alleles. This study aimed to determine DO*A and DO*B allele frequencies and to predict transfusion-induced alloimmunization risks in three Thai blood donor populations. METHODS: DNA samples obtained from 1,300, 300, and 400 blood donors from central, northern, and southern Thailand, respectively, were genotyped for the DO*A and DO*B allele detections using developed PCR-SSP. The results were confirmed by DNA sequencing. RESULTS: The validated genotyping results by PCR-SSP were in concordance with DNA sequencing. The DO*B/ DO*B was the most common genotype (77.0, 76.0, and 71.0%), followed by DO*A/DO*B (21.0, 22.7, and 25.2%) and DO*A/DO*A (2.0, 1.3, and 3.8%) among central, northern and southern Thais, respectively. The alleles found among central Thais showed significant differences from those found among southern Thais but not from those of northern Thais. The risk of anti-Doa production was higher than anti-Dob production among Thais. Concerning regional groups, the risk of Doa alloimmunization among southern Thais (0.2059) was higher than those among central (0.1771) and northern Thais (0.1824). CONCLUSIONS: This was the first study to distinguish DO*A and DO*B genotypes in Thai populations using in-house PCR-SSP. This would be useful to predict alloimmunization risks that might result from transfusion-induced reactions of undetermined red cell antigens among blood donors and in reagent red cells.

The successful implementation of the Enhanced Recovery After Surgery (ERAS) program among caesarean deliveries in Bhutan to reduce the postoperative length of hospital stay.

BACKGROUND: Enhanced Recovery After Surgery (ERAS) is a multidisciplinary perioperative care program to optimize and enhance postoperative recovery. It has a beneficial role in decreasing the length of hospital stay and improving the quality of care. This study aims to observe the successful implementation of ERAS in reducing the length of hospital stay (LOS) among caesarean deliveries. METHODS: A pre-and post-implementation study of ERAS protocol was conducted, among cohort of women who underwent caesarean deliveries from January to December 2020 in the Department of Obstetrics and Gynaecology, Mongar Regional Referral hospital. Data collected retrospectively and analyzed in SPSS (IBM SPSS trial version); and comparison of length of hospital stay between the two groups were tested by t-test. RESULTS: One hundred seventy-one patients were included in the study: 87 in the pre-ERAS and 84 in the post-ERAS cohort. Post implementation, LOS decreased by an average of 21.0 (CI 16.11-24.64; p-value < 0.001) hours in the postoperative period. A greater proportion of patients were discharged on day-2 (2.3% in pre-ERAS and 81% in ERAS; p-value < 0.001). CONCLUSION: Implementation of ERAS protocol can significantly decrease the postoperative length of hospital stay without increasing the complications and readmission rates.

Lithium-induced Symptomatic Hypercalcemia and Hyperparathyroidism in a Patient with Bipolar Affective Disorder: A Case Report and Review of Literature.

Lithium induced primary hyperparathyroidism is an uncommon endocrine side effect of long term lithium therapy. We studied the case of a 67-year-old female patient on long term lithium therapy for bipolar affective disorder, who developed resistant hypercalcaemia and parathyroid adenoma which required parathyroidectomy. Furthermore, the effect of chronic lithium therapy on parathyroid glands and serum calcium levels, its pathogenesis, and management were reviewed. Periodic monitoring of serum calcium levels in patients on long term lithium therapy should be practiced. Surgical removal of the affected parathyroid gland is an effective treatment modality in selected patients with resistant hypercalcaemia and parathyroid adenoma and/or hyperplasia. However, regular post-operative follow up is needed for early identification of recurrence in such patients.