Effect of kangaroo mother care on serum bilirubin levels in term neonates undergoing phototherapy for neonatal jaundice: a cross-sectional study in South India

Background: Neonatal jaundice is a common condition affecting nearly 60% of full-term and 80% of preterm infants, characterized by elevated serum bilirubin levels. While most cases resolve without intervention, untreated hyperbilirubinemia can result in serious neurological complications such as kernicterus. Phototherapy is the standard treatment but may lead to adverse effects and prolonged hospitalization. Kangaroo mother care (KMC), involving skin-to-skin contact between infant and caregiver, has emerged as a supportive, cost-effective method that may enhance bilirubin clearance and improve recovery. Objective is to evaluate the effect of KMC on serum bilirubin levels in term neonates with jaundice undergoing phototherapy. Methods: A cross-sectional observational study was conducted over one year (July 2023 to August 2024) in the Department of Paediatrics at Sree Balaji Medical College and Hospital. A total of 120 term neonates (gestational age 37–42 weeks; birth weight >2500 g) with neonatal hyperbilirubinemia requiring phototherapy were included using purposive sampling. Exclusion criteria were preterm birth, low birth weight, early-onset jaundice, hemolytic disorders, and congenital anomalies. Participants were divided into two groups: phototherapy alone and phototherapy with KMC. Serial bilirubin levels were measured at baseline, 24, 48, and 72 hours, and at the end of treatment. Statistical analysis was performed using SPSS v27 with chi-square tests, correlation analysis, and Bland-Altman plots. Results: Infants receiving KMC alongside phototherapy showed significantly faster bilirubin reduction (p<0.05) compared to those receiving phototherapy alone. No significant association was found with infant gender or maternal age. However, higher gestational age and maternal education were positively correlated with improved outcomes. The KMC group demonstrated enhanced clinical recovery without adverse effects. Conclusions: KMC is an effective adjunct to phototherapy in managing neonatal jaundice. It accelerates bilirubin clearance, and may offer added benefits such as improved bonding and lower healthcare costs. KMC should be considered in routine neonatal care, especially in low-resource settings. Further research is needed to explore its long-term outcomes

Dysregulation of circadian rhythms has been reported to be particularly high in bipolar disorder, to evaluate whether this relationship is causal

Bipolar disorder is a mental illness characterized by dramatic alterations in mood and has several features which suggest a relationship to the biological clock. In bipolar disorders, there are extreme swings of mood, behavior, motivation and cognitive abilities in the same person. Also sleep and circadian rhythm disruptions are common observation in these patients, both during acute episodes as well as during disease-free periods. A plethora of evidence from various studies, including chronotype studies, studies of sleep-wake cycles, studies estimating neuroendocrine/biochemical markers, genetic studies, studies involving social zeitgebers and life events, pharmacological and therapeutic evidence all show a strong association of circadian disruption and bipolar disorder. There is a necessity of establishing a definite hypothesis in the pathways altered in bipolar disorder for development of novel and effective pharmacotherapy. Once the specific mechanistic pathways have been delineated, it will definitely aid in the discovery of novel treatment modalities.                               

An observational study on prevalence of skin diseases in psychiatric patients

Background: Skin diseases and psychiatric disorders are related to each other because of common ectodermal origin. The aim of this study was to study the prevalence and distribution of skin diseases in patients with primary psychiatric disorders. Methods: The 100 patients diagnosed with primary psychiatric disorders who gave consent were studied for dermatological diseases. Results: Of these 100 patients, 36 (36%) were diagnosed with schizophrenia, 24 (24%) with bipolar disorder, 14 (14%) with major depressive disorders, 14 (14%) with anxiety disorders and 12 (12%) with obsessive-compulsive disorder. Of these patients, 72 (72%) had dermatological disorders. Non-infectious dermatological disorders constituted 59.72% of the total skin diseases and infectious 40.28% of the total patients. Amongst non-infectious dermatoses, eczematous disorders were most prevalent (13.88%), while amongst infectious dermatoses, folliculitis and furunculosis were most commonly encountered (9.72% each). Conclusions: Infectious and non-infectious skin diseases were common in patients with primary psychiatric diseases

Pulmonary Brucellosis: a shrewd imposter

Brucellosis is a zoonotic bacterial infection with a broad clinical spectrum, often mimicking other infectious and non-infectious diseases. Due to its nonspecific presentation, delayed diagnosis is common, leading to potential complications. We report a case of young female presented with fever, associated with constitutional symptoms, cervical lymphadenopathy and lower respiratory tract infection features. Her Tuberculosis workup, tropical fever and other viral infection workup, lymphoma evaluation and vasculitis work up were negative. She had persistent symptoms and later Brucella serology sent as she came from area where Brucellosis is endemic. The report came as positive for Brucellosis. The patient managed in intensive care unit with respiratory support, antibiotic and other supportive care. Later she became symptomatically better and had radiological clearance

Narrative review on recent outbreaks of monkeypox: a global public health emergency

Several cases of monkeypox have been reported since July 2022 and was hence declared a global public health emergency (GPHE). Recent reports from WHO indicate a rise in mpox cases over 2 years, even when vaccination is considered a protective measure. In this review, we discussed the recent spread of cases worldwide from 1st January 2024 to 1st October 2024, providing updated evidence on clinical features of different strains, epidemiology, diagnosis, treatment, and preventive measures. Ever since the 2022 outbreak, monkeypox virus has been undergoing novel mutations, leading to different strains at an alarming rate. According to the Ministry of Health, India has reported a total of 30 cases to date with the most recent case reported in September 2024. Recent outbreaks from Clade Ib were reported among young males with a median age of 34 years and sexual contact being a common mode of transport. Mpox commences with prodromal flu-like symptoms and a maculopapular rash with centrifugal distribution followed by fever. Diagnosis is confirmed by PCR testing of the lesions. Prompt vaccination after exposure might reduce the risk of disease progression. However, antiviral treatments and symptomatic care should be considered for severe patient populations. This review gives an insight into the current mpox scenario by educating people on emerging global endemics and their preventive strategies. Unlike other neglected diseases, we now have treatment and prevention options for mpox, but access to treatment is limited in most parts of the world. Identification and spread of new cases can be tracked more efficiently with the help of improved surveillance methods

Malaria parasitaemia among the under-12 children in Akure, Ondo State, Nigeria

Background: Malaria is a preventable and curable but life-threatening disease that is transmitted to humans by female Anophelis mosquitoes. It is mostly found in tropical countries. The study sets out to determine the malaria parasitaemia among children under the age of 12 years in Akure, Ondo State. Methods: The study was a prospective, cross sectional and hospital-based where blood specimen were collected from children aged 1 day old to 12 years. Microscopy method was used to detect the malaria parasite and confirmed by nested PCR method. The data obtained were subjected to statistical analysis using Microsoft excel and the statistical package for the social sciences (SPSS) version 20.0 Results: Overall prevalence of malaria was 64.2%. The neonates had the highest prevalence of 96.8%. P. falciparum was the most predominant species (99.4%), prevalence of malaria decreases with increasing birth order but prevalence was significantly higher among children in the first birth order and lower socio-economic class. There was no significant difference between parasite intensity among gender, p=0.585. Majority of children (94.2%) were well nourished. Conclusions: The study showed that prevalence of malaria is high in children under 12 in Ondo State. The neonates were worse hit, though with least parasite intensity. We suggest intensified and concerted effort in malaria prevention and control in the state

Definitive role of surgery in management of acromegaly due to ectopic growth hormone secretion: review of literature

Acromegaly, characterized by excessive growth hormone (GH) secretion, typically arises from pituitary adenomas. Ectopic GH production from non-pituitary tumors, such as carcinoid tumors, is exceedingly rare, <1%. The majority of the growth hormone-releasing hormone (GHRH) - secreting tumors are bronchial carcinoids. Other GHRH-secreting tumors in decreasing order of occurrence are pancreatic adenomas, gastro-intestinal tumors, thymic tumors, and tumors associated with the MEN-I syndrome. We present a case of a 43-year-old female who presented with features consistent with acromegaly and was found to have an ectopic source of GH from a mediastinal tumor. Diagnostic evaluation included biochemical testing, imaging studies, and histopathological confirmation. Surgical intervention led to complete resolution of clinical symptoms and normalization of GH levels. This case highlights the diagnostic challenges posed by ectopic GH secretion and emphasizes the critical role of surgery in achieving favorable outcomes in such rare presentations of acromegaly

A case report of retroperitoneal dedifferentiated chondrosarcoma with femoral nerve involvement

Chondrosarcomas, a type of malignant bone tumour, are relatively rare and originate from cartilage producing cells. Dedifferentiated chondrosarcoma (DDCS), which makes up about 10% of all chondrosarcomas, is a rare and extremely aggressive subtype with high risk of metastasis. Here we report a case of 60-year-old lady with left lower abdomen lump of 10x10cm since 5months with normal gait, normal sensory, motor, spine and hip examination which shows no bony involvement in X-rays. On CECT and MRI there was large heterogenous enhancing soft tissue density mass lesion of size 11.7×10.9 cm with multiple coarse calcifications, without bone involvement. On Ultrasound guided core needle biopsy, it was found to be low grade chondrosarcoma. Patient was planned for wide local excision of tumor with adequate margins. Intraoperatively femoral nerve was seen passing inside the tumor which was resected and nerve repair done with sural nerve graft. In Post operative period patient had difficulty in extending left leg so knee gaiter was advised for support. After 6months follow up patient was seen healthy and walking without knee gaiter. Dedifferentiated chondrosarcoma (DDCS), which makes up about 10% of all chondrosarcomas, is a rare and extremely aggressive subtype. It is associated with high rates of metastasis and poor survival. Surgery is generally the standard of care for patients and adequate margins are recommended. Role of chemoradiotherapy is controversial. Surgery is the treatment of choice in dedifferentiated chondrosarcoma in patients with local disease with no metastasis

Effect of preoperative anxiety on recovery time in general anesthesia

Background: Preoperative anxiety, common in patients undergoing surgery under general anesthesia, can negatively affect recovery by increasing stress responses and postoperative complications. This study investigates the impact of preoperative anxiety on recovery times and evaluates the effectiveness of non-pharmacological interventions, like relaxation techniques and patient education, in reducing anxiety and improving surgical outcomes. The aim was to assess the impact of preoperative anxiety on recovery time and evaluate anxiety management strategies in surgical patients. Methods: This prospective observational study was conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from June 2022 to May 2023, with 142 patients aged 20-60 years undergoing elective surgery under general anesthesia. Data collection included demographics, preoperative anxiety using the state-trait anxiety inventory (STAI), physiological stress indicators, and recovery times. Patients with psychiatric conditions or on anxiety medications were excluded. Statistical analysis was performed using statistical package for the social sciences (SPSS) (version 27.0.1) to assess anxiety and recovery outcomes. Results: The largest group of patients was aged 40-49 (29.58%) with more males (54.93%). Moderate preoperative anxiety was most common (38.73%). Surgery typically lasted 2-3 hours (38.73%), and most patients recovered within 3-4 hours (36.62%). Mild anxiety patients had faster recovery times, while severe anxiety prolonged recovery. Pain was the most frequent postoperative complication (38.73%), followed by nausea/vomiting (31.69%) and drowsiness (21.13%). Conclusions: Preoperative anxiety prolongs recovery time. Effective management through pharmacological and non-pharmacological methods enhances postoperative recovery and outcomes

Instruments for conducting comprehensive interviews with victims and informants of sexual harassment in the university environment

Background: Having qualitative research instruments to study sexual harassment at university is essential to understand the experiences and perceptions of victims, improving the quality of research and interventions to prevent and address this problem. Objective was to validate, by experts, in-depth interview instruments for victims of sexual harassment and key informants in the university environment. Methods: In-depth interview instruments for victims and key informants of sexual harassment allow to investigate qualitative data on sexual harassment at the university, such as: perceptions, the context in which it occurs, experiences of sexual harassment, perceived needs, physical, psychological, social and academic effects, as well as the perception of individual and institutional actions against sexual harassment. Results: In-depth interview instruments for victims and key informants of sexual harassment allow to investigate qualitative data on sexual harassment at the university, such as: perceptions, the context in which it occurs, experiences of sexual harassment, perceived needs, physical, psychological, social and academic effects, as well as the perception of individual and institutional actions against sexual harassment. Conclusions: In-depth interviews with victims of university sexual harassment and key informants allow to obtain relevant data from the students' perspective, pertinent information to identify the complexity of university sexual harassment and to commit the university to the implementation of effective prevention, intervention and comprehensive reparation policies