Background:Premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD) and depressive disorder are fairly common; symptoms do overlap, often under-identified and under-emphasized, particularly in rural India.Objective:The objective was to assess the occurrence of PMS and PMDD in a sample of students and staff of a nursing college and to find their correlation with depression.Materials and Methods:A prospective cohort study; Tertiary Care Hospital in Rural India (Wardha, Maharashtra); 118 female nursing students or staff aged between 18 and 40 years, who were likely to stay within the institution for the study period. The participants were rated on Penn daily symptom report prospectively for a period of 3-month. Those who scored positive were applied diagnostic and statistical manual of mental disorders, 4th edition, text revision (DSM-IV TR) criteria for PMDD; and were applied primary care evaluation of mental disorders depression screening followed by DSM-IV TR criteria for depression. Severity of depression was measured using Hamilton Depression Rating Scale.Results:Main outcome measures were frequency and severity of depression in individuals with PMS and PMDD and their clinical and sociodemographic correlation. The age range of the sample was 18-37 years. Some PMS symptoms were observed in 67%; diagnosis of PMDD in 10%; depressive symptoms in 28% of the sample. 46.4% of those with depressive symptoms had major depression. The diagnosis of major depression was significantly associated with the severity of PMS symptoms as well as the presence of PMDD.Conclusion:Premenstrual syndrome is present in a substantial proportion of young females. Concurrent depression is increased by the severity of PMS symptoms and the presence of PMDD. Gynecologist needs to screen such subjects for depression and refer to mental-health professional early, in routine clinical practice.

Introduction: Neonatal jaundice or icterus neonatorum is one of the common problem that is seen in newborns during first week of neonatal life. Clinical jaundice is found in about 80% of preterm and in about 60-70% of term neonates. The main objective of the study was to determine the correlation between cord serum albumin levels and development of significant hyper bilirubinemia in healthy term neonates. Methods: A prospective study was conducted on 316 healthy term neonates. Gender, mode of delivery and birth weight were taken into consideration. It was ascertained that there was no other risk factor for neonatal hyperbilirubinemia among these newborns. These neonates were divided into 3 groups, Group A (cord serum albumin levels < 2.8 gm/dl), Group B (cord serum albumin levels between 2.8 to 3.4 gm/dl) and Group C (cord serum albumin levels > 3.4 gm/dl). Result: Of the 316 babies included in the study, 102 babies were under Group A, 166 babies under Group B and 48 babies under Group C. 35 babies in Group A, 5 in Group B and none in Group C developed significant hyperbilirubinemia and required phototherapy. The sensitivity and specificity of cord serum albumin level < 2.8 g/dl to predict risk of development of significant neonatal hyperbilirubinemia in our study was 87.50% and 75.72% respectively. Conclusion: Cord serum albumin levels can help us to predict the possibility of significant hyperbilirubinemia among neonates. Hence this can help us to identify the at-risk neonates and utilize our limited resources efficiently among these newborns.

Objective: The goal of this research was to use optical coherence tomography to assess the prevalence of diabetic macular edoema and to determine the impact of systemic results and risk factors on the progression of DME. Material and Methods: This cross-sectional research was carried out at the Department of Ophthalmology, Chandka Medical College & Shaheed Mohtarma Benazir Bhutto Medical University Larkana. Patients were asked to fill out questionnaires about their health and lifestyle habits like smoking and alcohol consumption as well as their hemoglobin A1C and lipid profiles, as well as the duration of their diabetes, and the type of diabetes they had. There was an investigation into the link between systemic findings and DME Results: A total of 150 cases met the study's eligibility requirements. Males comprised 84 (56%) of the 150 participants, while females comprised 66 (44%). Sixty-five patients (43.33%) tested positive for DME, while 85 patients (56.66%) tested positive for DR. DME participants had HbA1c levels of 9.39 ± 1.67percent, whereas participants without DME had levels of 7.02 ± 3.23 percent and p=0.326; but no connection was found between the two measurements. There was a statistically significant difference between the mean serum creatine concentrations in cases with and without DME (p=0.011). For DME, a statistically significant difference (P-value = 0.001) was found between normal-albuminuric, microalbuminuric, and macroalbuminuric patients. Using the DME frequency in phakic and pseudophakic eyes as a guide, figure 2 below illustrates the results. Conclusions: Diabetic macular edema was seen in 43.33% of cases in the current study. An OCT-based study revealed that DME is common in Larkana Sindh. Regulating DME risk factors can help prevent or limit the development of DME, and treatment response may be improved. Keywords: Systemic risk factors, Diabetic macular edema, Optical coherence tomography,

Early detection and treatment of early onset schizophrenia (EOS) can lead to better outcome. Aripiprazole, a partial agonist of dopamine and a second generation antipsychotic, has been approved specifically for treatment of children with schizophrenia of aged 13-17 years. Though the use of this drug in adults may be associated with worsening of psychosis in occasional cases, no such data is available in adolescents. We report a case of EOS, who had worsening of psychosis with aripiprazole monotherapy. We discuss the possible mechanisms and clinical implications relevant in adolescents, and alert the clinicians to be vigilant in monitoring the patients on aripiprazole, especially after an increase in the dose of this medication.