Assessment of depression and diabetes distress in type 2 diabetes mellitus patients in a tertiary care hospital of South India

Background: Depression is one of the many complications seen among diabetics. Depression leads to lack of self-care by the diabetic and endangers the therapeutic compliance, accounting for a derangement in metabolic control which in turn causes further diabetic complications and may even result in hospitalization. This leads to an increase in depressive symptoms and thus the vicious cycle continues.Methods: It is a Descriptive, cross sectional study conducted in the Medicine outpatient department. Depression was assessed by Hamilton depression rating scale. Diabetic distress was assessed by diabetic distress scale.Results: Out of the 250 study participants, 142 (56.8%) were found to be suffering from depression and 6 (2.4%) were found to have diabetes distress. The magnitude of depression was similar in both male and female. Depression was high among illiterates, unemployed (70%), single, separated individuals and patients with complications of diabetes. There was no significant association between religion and low economic status with depression. Treatment modalities, complications of diabetes, sociodemographic factors like age, sex, occupation, education, marital status, religion and socio-economic status had no significant correlation with diabetic distress. But there was a statistically significant association between diabetic distress and co-morbid conditions. 95.8% with depression had no distress and this association was found to be statistically significant (0.038).Conclusions: The magnitude of depression and distress is much high among diabetics. Early detection, counselling and treatment are required for all diabetics, especially those who have additional risk factors for the development of depression

Preparation of Dhatryarishta by Dhatri Swarasa and Dhatri Kwatha

Dhatryarishta has been described for the first time in Charaka Samhita, in the context of Panduroga. The same reference is available in Chakradatta, Bhaishajya Ratnavali, and Sahastrayogam too. Generally Dhatri Swarasa [Amalaki (Emblica officinalis Gaertn.)] is used in the preparation of Dhatryarishta as per classical reference, but fresh Amalaki is not available in every season, so in the present study, Amalaki Kwatha (decoction) is used instead of Swarasa. A total of 13 batches of Dhatryarishta were prepared, out of which nine batches were prepared with Dhatri Swarasa and four batches with Dhatri Kwatha. For Dhatryarishta prepared by using Dhatri Swarasa, three methods were applied and in Dhatryarishta prepared by using Dhatri Kwatha two methods were applied. The study revealed that Dhatryarishta could only be prepared by using Amalaki Swarasa as quoted in the classics and not by using Amalaki Kwatha

30-Day morbidity and mortality of bariatric metabolic surgery in adolescence during the COVID-19 pandemic – The GENEVA study

Background: Metabolic and bariatric surgery (MBS) is an effective treatment for adolescents with severe obesity. Objectives: This study examined the safety of MBS in adolescents during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This was a global, multicentre and observational cohort study of MBS performed between May 01, 2020, and October 10,2020, in 68 centres from 24 countries. Data collection included in-hospital and 30-day COVID-19 and surgery-specific morbidity/mortality. Results: One hundred and seventy adolescent patients (mean age: 17.75 ± 1.30 years), mostly females (n = 122, 71.8%), underwent MBS during the study period. The mean pre-operative weight and body mass index were 122.16 ± 15.92 kg and 43.7 ± 7.11 kg/m2, respectively. Although majority of patients had pre-operative testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (n = 146; 85.9%), only 42.4% (n = 72) of the patients were asked to self-isolate pre-operatively. Two patients developed symptomatic SARS-CoV-2 infection post-operatively (1.2%). The overall complication rate was 5.3% (n = 9). There was no mortality in this cohort. Conclusions: MBS in adolescents with obesity is safe during the COVID-19 pandemic when performed within the context of local precautionary procedures (such as pre-operative testing). The 30-day morbidity rates were similar to those reported pre-pandemic. These data will help facilitate the safe re-introduction of MBS services for this group of patients