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.

Postmenopausal bleeding is traditionally investigated with invasive procedures. Recent studies in white populations have suggested that these procedures can be avoided, as ultrasonographic endometrial thickness of < 5 mm is not associated with malignancy. We performed a prospective study in 75 Jamaican Afro-Caribbean women with postmenopausal bleeding to determine whether an endometrial thickness of < 5 mm excluded endometrial cancer. We also examined the aetiology of postmenopausal bleeding and looked for possible risk factors. Double-layer transvaginal ultrasonographic measurement of the endometrial thickness was followed by hysteroscopy, suction curettage and histopathological confirmation. Correlation between imaging and pathology was not reliable. Half the patients with endometrial cancer had an endometrial thickness of between 3 mm and 4 mm. Seventy per cent of the women with endometrial thickness of greater than 5 mm had benign pathology. Additionally, the following characteristics were found to be more strongly associated with women with endometrial cancer: age over 65 years and 5 or more years since menopause. However parity < 2 appeared not to have a significant effect.

Tuberculosis is the most frequent granulomatous disease involving larynx. In most cases it is secondary to pulmonary tuberculosis. Incidence of tuberculosis is now on a rise due to increase in incidence of immune deficiency states. Here we present a report of clinical characteristic of laryngeal tuberculosis based on our experience of 10 cases. A detailed retrospective analysis of 10 patients of laryngeal tuberculosis was done at our tertiary care laryngology centre. Majority of patients had change of voice and dry cough. All the patients had hyperemia and edema of vocal cords. 80% patients had involvement of the arytenoids and ary-epiglottic folds. Frank granulomatous growth was seen in 70% of patients. In all patients histopathological report was consistent with tubercular granuloma. Two patients had associated pulmonary tuberculosis. Eight patients did not reveal any feature suggestive of previous or co-existent pulmonary tuberculosis. All patients responded to chemotherapy with complete resolution. Primary laryngeal tuberculosis is not as rare as generally considered. This series provides an insight towards clinical feature, growth pattern and management of tuberculosis of larynx.

Despite attempts at improving therapeutic outcomes by creating tailored guidelines for repair of obstetric anal sphincter injuries, there is a serious barrier to success because 65% of senior clinicians were noncompliant.

Family history of early onset autosomal dominant type 2 diabetes appears to increase susceptibility to GDM in Jamaican women. Pregnant women of any age with family history of early onset autosomal type 2 diabetes should be screened for GDM.