CURRENT ISSUE

ABSTRACT: Abstract
Background: Postpartum depression (PPD is a prevalent and disabling condition with significant consequences for maternal and infant well-being. Women who conceive through assisted reproductive technologies (ART) may experience distinct psychological vulnerabilities in the postpartum period due to prolonged infertility, treatment-related stress, and prior pregnancy loss. Digital health interventions (DHIs) have emerged as promising tools for addressing perinatal mental health needs; however, their relevance and effectiveness for women following assisted reproduction remain insufficiently synthesized.
Objective: This narrative review aims to critically examine the current evidence on digital health interventions for postpartum depression in the context of assisted reproduction, with a focus on conceptual relevance, methodological strengths and limitations, and implications for clinical practice and future research.
Methods: A structured narrative synthesis was conducted using transparent search procedures across major bibliographic databases, including PubMed, PsycINFO, Scopus, and Web of Science. Peer-reviewed empirical studies, reviews, and key conceptual papers addressing digital mental health interventions for postpartum depression were included, with particular attention to the representation and reporting of ART-conceived populations.
Results: Existing digital interventions—such as mobile health applications, web-based psychotherapy, telepsychology, and emerging AI-supported tools—demonstrate feasibility and acceptability in general postpartum populations. However, ART-specific evidence remains limited, with most studies embedding women who conceive through assisted reproduction within broader perinatal samples and rarely tailoring intervention content to infertility-related psychological experiences. Methodological heterogeneity, small sample sizes, short follow-up periods, and limited subgroup analyses constrain the strength of population-specific conclusions.
Conclusions: Digital health interventions hold considerable promise for addressing postpartum depression following assisted reproduction, but current evidence is largely indirect. Conceptually, DHIs align well with the psychological needs of ART populations; empirically, however, rigorous validation is lacking. Future research should prioritize ART-specific trials, longitudinal designs, participatory co-design approaches, and integration with clinical care pathways to develop effective, personalized, and equitable digital mental health solutions for this high-risk population.

ABSTRACT: Galactosemia is a rare metabolic disease, and late diagnosis can lead to severe liver injury. We present a clinical case of galactosemia type I that manifested during the late neonatal period with vomiting, cholestatic liver injury, coagulopathy with hemorrhagic syndrome, and poor weight gain. Differential diagnoses included necrotizing enterocolitis and intestinal obstruction. The residual activity of the GALT enzyme corresponded to the biochemical variant but did not match the severity of the clinical presentation. On a lactose-free formula, the child's condition improved. Genetic testing identified two pathogenic heterozygous mutations in exons 3 and 6 of the GALT gene. Subsequent observation revealed delayed motor development by the end of the first year of life.

ABSTRACT: Fournier’s gangrene (FG) is a rapidly progressive necrotizing soft tissue infection associated with high mortality, particularly in patients with diabetes mellitus. Early recognition and immediate surgical source control are critical determinants of survival.
We report the case of a 62-year-old male with long-standing type 2 diabetes mellitus who presented with rapidly progressive perineal necrosis complicated by systemic inflammatory response and severe metabolic derangement, including hyperlactatemia (7.3 mmol/L) and metabolic acidosis.
Emergency radical surgical debridement was performed within hours of admission, followed by intensive multidisciplinary management. Despite high predicted mortality risk based on clinical and laboratory parameters, the patient demonstrated favorable clinical recovery with wound healing by secondary intention.
This case highlights the potential limitation of traditional scoring systems and emphasizes the prognostic role of hyperlactatemia as an early indicator of tissue hypoperfusion requiring immediate surgical intervention.

ABSTRACT: Background: The rising prevalence of childhood obesity and sedentary lifestyles has blurred the traditional distinction between type 1 and type 2 diabetes. Double diabetes represents the coexistence of autoimmune β-cell destruction and insulin resistance, posing diagnostic and therapeutic challenges, particularly in adolescents.
Case presentation: We report the case of a 17-year-old obese female with a three-year history of type 1 diabetes who developed marked insulin resistance and metabolic syndrome features. Despite high insulin requirements (1.6 U/kg/day), glycemic control remained poor (HbA1c 12.8%). Clinical examination revealed obesity (BMI 32.4 kg/m²) and acanthosis nigricans. Laboratory evaluation showed preserved C-peptide secretion, dyslipidemia, elevated leptin and homocysteine levels, and positivity for anti-GAD65 and islet cell antibodies, supporting the diagnosis of double diabetes.
Management and Outcomes: A combined therapeutic strategy including optimization of basal-bolus insulin therapy, adjunctive metformin, structured nutritional intervention, and regular physical activity was implemented. Six months later, and at the stage of her transition, HbA1c decreased to 7.8%, body weight was reduced by 8 kg, daily insulin requirements decreased by 35%, and lipid parameters improved significantly.
Conclusion: This case highlights the importance of early recognition of double diabetes in youth and demonstrates that integrated metabolic and autoimmune-targeted management can significantly improve glycemic control and cardiometabolic risk.