Omkar Parshad

Prevalence of pre- and postpartum depression in Jamaican women

BackgroundMaternal depression during pregnancy has been studied less than depression in postpartum period. The aims of this study were to find out the prevalence of prepartum and postpartum depression and the risk factors associated in a cohort of Afro-Jamaican pregnant women in Jamaica.MethodsThe Zung self-rating depression scale instrument was administered to 73 healthy pregnant women at 28 weeks gestation and at 6 weeks postpartum for quantitative measurement of depression. Blood samples were collected at 8, 28, 35 weeks gestation and at day 1 and 6 weeks postpartum to study the thyroid status.ResultsStudy demonstrated depression prevalence rates of 56% and 34% during prepartum and postpartum period, respectively. 94% women suffering depression in both periods were single. There were significant variations in both FT3 and TT4 concentrations which increased from week 8 to week 28 prepartum (p < 0.05) and then declined at the 35th week (p < 0.05 compared with week 28) and 1 day post delivery study (p < 0.05 compared with week 35). The mean values for TSH increased significantly from week 8 through week 35. The mean values at 1 day postpartum and 6 week postpartum were not significantly different from the 35 week values. For FT3, TT4 and TSH there were no significant between group differences in concentrations. The major determinants of postpartum depression were moderate and severe prepartum depression and change in TT4 hormone concentrations.ConclusionHigh prevalence of depression was found during pre- and postpartum periods. Single mothers, prepartum depression and changes in TT4 were factors found to be significantly associated with postpartum depression.

Neem (Azadirachta indica) treatment decreases spontaneous motor activity in rats: implications for its central sedative action

The administration of a crude steroidal extract of neem (Azadirachta indica A. Juss) leaf significantly decreased the total spontaneous motor activity (SMA) scores in rats receiving either 100 mg/kg body weight (i.p.) twice per week for 6 weeks (p <0.01) or a single dose (p <0.05), indicating that neem may have a sedative effect on rats. Single dose (acute) treatment also significantly decreased (p <0.01) the amplitude of the peak twitch force of the gastrocnemius muscle in vivo, but the neem extract exerted no significant effect on amplitude or conduction velocity of the compound action potential of the toad sciatic nerve preparation in vitro. It is therefore concluded that the depression of the SMA may be due to an effect of neem on the central nervous system and/or muscle strength, but not on peripheral nerve conduction.

Plasma arginine vasopressin response to water load during labor

To find out whether plasma vasopressin (PAVP) response to a water load during pregnancy is inappropriately high, as had been speculated, we measured PAVP by radioimmunoassay in 30 women at the time of delivery. Ten women had received infusion of aqueous glucose solution during labor for hydration (GW group); another ten received infusion of glucose solution as a vehicle for oxytocin (OT group), and ten women did not receive any intrapartum intravenous fluid therapy (controls). Serum sodium and osmolality were also determined in all the subjects. PAVP levels were significantly lower in GW (0.70 ± 0.4 pg/ml) and OT groups (0.7 ± 0.6 pg/ml) (P < 0.05). Significant negative correlation was seen between the amount of glucose solution infused and levels of PAVP (r = −0.66; P < 0.01), while a significant positive correlation was seen between PAVP and serum sodium (r = 0.61; P < 0.01). These findings suggest that during labor, the physiological relationship between serum osmolality and PAVP is intact, and that infusion of a water load in the form of aqueous glucose solution is attended by an expected lowering of PAVP. We infer that inappropriate ADH response is not the cause of water retention and hyponatremia often seen in women receiving aqueous glucose solution during labor.