Quetiapine-induced hypokalemic periodic paralysis (QIHPP) is a rare condition. Herein, we present the case of a 31-year-old pregnant Malay woman diagnosed with bipolar II disorder and QIHPP. She presented to the casualty department with a 2-day history of bilateral lower limb weakness and numbness. Her renal function tests showed moderate hypokalemia (2.5 mmol/L), whereas other investigations were normal. Quetiapine was suspected to be the cause, prompting a psychiatric referral to manage her acute condition. Balancing the risks of untreated QIHPP against the potential relapse of bipolar symptoms from quetiapine discontinuation or dosage reduction poses a significant treatment challenge for pregnant women with QIHPP. Finally, we reduced the quetiapine dosage after careful consideration, leading to the normalization of potassium levels and symptom resolution. Therefore, clinicians should be aware of this side effect when initiating or continuing quetiapine treatment in women of childbearing age or pregnant women with psychiatric disorders. It is crucial to monitor serum electrolytes, especially potassium, following quetiapine administration and warn patients about its potential side effects.

Citations

• Novel CACNA1S Mutation c.3491 A>C in Hypokalemic Periodic Paralysis: First Report with Functional Validation
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Period poverty is a global community health dilemma that has long been overlooked. This condition is described as having insufficient access to menstrual products, education, and sanitation facilities. Briefly, period poverty means that millions of women are subjected to injustice and inequity due to menstruation. This review aimed to explore the definition, challenges, and effects of period poverty on the community, especially among women at their productive ages. In addition, suggestions to minimize the impact of period poverty are discussed. A search strategy was applied using the keywords “period poverty,” “period equity,” “period poverty,” and “menstrual hygiene” in Google Scholar, ScienceDirect, SpringerLink, MEDLINE, and PubMed electronic databases, journals, and articles on relevant topics. Trained researchers conducted a keyword search from January 2021 to June 2022. Based on the reviewed studies, it has been proven that many countries are still affected by the period stigma and taboo, inadequate exposure to menstrual health and its management, lack of education about menstruation, and shortage of access to menstrual products and facilities. The next step is to reduce and slowly eliminate the period poverty issue by conducting more research to increase clinical evidence and future references. This narrative review could inform policymakers of the magnitude of the burden related to this issue and guide them to develop effective strategies to minimize the impact of poverty, especially during the challenging years of the post-coronavirus disease 2019 era.

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Background
Diastasis rectus abdominis (DRA) involves the separation of the midline abdominal muscles and linea alba and affects more than half of postpartum women. This study aimed to assess the effect of a split tummy exercise program (STEP) on DRA closure in postpartum mothers.
Methods
A randomized controlled trial was conducted from 2008 to 2020 at the Obstetrics and Gynaecology Clinic of the Universiti Kebangsaan Malaysia Medical Centre. Primigravida mothers diagnosed with DRA were selected and randomly assigned to the intervention (n=21) or control (n=20) group. The intervention group underwent a home-based STEP consisting of three phases of nine abdominal exercises. DRA size was assessed at baseline and at 8 weeks postpartum using two-dimensional ultrasound.
Results
The mean age of the participants was 28 years (standard deviation, 3.6), with the majority of Malay ethnicity (87.8%) and working mothers (78%). After 8 weeks, the intervention group showed a significant reduction in DRA size of up to 27% (mean difference, 6.17 mm; 95% confidence interval, 3.7–8.7; P<0.001). No significant intergroup DRA changes were observed after 8 weeks of follow-up.
Conclusion
Early postpartum screening for DRA should be advocated to allow early STEP intervention to ensure favorable outcomes. STEP intervention is an effective postnatal training program for managing DRA.

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  Laís Campos de Oliveira, Laura Isabel Martins de Almeida, Maria Clara Fagundes Lucio, Jorge Furtado de Campos Júnior, Raphael Gonçalves de Oliveira
  Medicine.2025; 104(23): e42723.     CrossRef
• The Italian national consensus conference on the diagnosis and treatment of Rectus Abdominis diastasis in Post-gravidic Women
  Umberto Bracale, Cesare Stabilini, Giuseppe Cavallaro, Francesca Pecchini, Gerardo Sarno, Ferdinando Agresta, Michele Carlucci, Simona Rocchetti, Alberto Sartori, Alberto Di Leo, Jacopo Andreuccetti, Giusto Pignata, Ernesto Tartaglia, Carlo Sagnelli, Dieg
  Hernia.2025;[Epub]     CrossRef
• An evidence-based comparison of rehabilitation strategies for diastasis recti abdominis in postpartum women: a systematic review and network meta-analysis
  Nahid Bigdeli, Ali Yalfani, Amin Doosti-Irani, Ali Qodrati
  Scientific Reports.2025;[Epub]     CrossRef
• Precision medicine exploration of postpartum rectus abdominis muscle separation: from basic research to clinical practice
  MengMeng Huang, Zhihong Huang, Hanzhang Huang
  BMC Surgery.2025;[Epub]     CrossRef
• EFFECTIVENESS OF POSTPARTUM EXERCISES ON REDUCING INTERRECTI DISTANCE: A QUASI EXPERIMENTAL STUDY AMONG POSTPARTUM MOTHERS
  Salma Nabilah Fauziyyah, Faizah Betty Rahayuningsih
  International Journal of Nursing and Midwifery Science (IJNMS).2025; 9(3): 373.     CrossRef
• Recomendaciones médicas desde atención primaria sobre ejercicio físico en el posparto
  L.M. Gallo-Galán, M.A. Gallo-Vallejo, J.L. Gallo-Vallejo
  Medicina de Familia. SEMERGEN.2024; 50(3): 102148.     CrossRef
• Intra‐ and Interimage Reliability of Inter‐Rectus Distance Measurements Determined via Ultrasound Imaging by the Same or Different Testers in Women in the Early Postpartum Period
  Qing Jiang, Ya Gao, Shuyu Xia, Yuefan Gu, Jun Gu, Jianfeng Guo, Guannan Feng, Qifeng Deng, Xuedong Deng
  Journal of Ultrasound in Medicine.2024; 43(6): 1037.     CrossRef
• FISIOTERAPIA NA DIÁSTASE DOS MÚSCULOS RETOS ABDOMINAIS NO PÓS-PARTO: REVISÃO INTEGRATIVA
  Ana Clara Moreira de Jesus, Andresa Santos Souza, Gabrielle Barreto Menezes, Jisielle Oliveira dos Santos, Luiz André Santos Silva, Elisama de Campos Guimarães, Isabela da Silva Vasconcelos Rodrigues, Grace Kelly Melo de Almeida
  Revista Contemporânea.2024; 4(7): e5102.     CrossRef
• Comparison of Health Parameters in Postpartum Diastasis Recti: A Randomized Control Trial of SEMG Biofeedback-Assisted Core Strengthening Exercises with Kinesiotaping vs. Non-Assisted Exercises
  Ujala Afzal, Quratulain Saeed, Muhammad Nabeel Anwar, Sanna Pervaiz, Manahil Shahid, Rimsha Javed, Muhammad Umair Ali, Seung Won Lee
  Healthcare.2024; 12(16): 1567.     CrossRef
• Effect of hypopressive and conventional abdominal exercises on postpartum diastasis recti: A randomized controlled trial
  Mercedes Soto-González, Iria Da Cuña-Carrera, Eva María Lantarón-Caeiro, Augusto Gil Pascoal, Shabnam ShahAli
  PLOS ONE.2024; 19(12): e0314274.     CrossRef

“Rusty pipe syndrome” is a condition that needs to be considered in a primiparous woman who presents with bilateral bloody nipple discharge in the early postpartum period. Its prevalence is low and can occur due to physiological condition that arises primarily in primiparous women with increased alveolar and ductal vascularization associated with the onset of lactation. Here, we report a case of a 29-year-old primigravida who presented with bilateral painless bloody nipple discharge after delivery. Her breast examination showed no signs of infection or structural changes, and breast ultrasound did not reveal any significant observations except for a bilateral simple breast cyst. Six days after the onset of lactation, the bloody nipple discharge ceased and lactation continued on demand.

Citations

• Case series – Rusty pipe syndrome of the breast
  Jnaneshwari Jayaram, Smitha Sreesha, Suajaya V. Rao, P. Chandini Bhandary
  Muller Journal of Medical Sciences and Research.2025; 16(2): 140.     CrossRef
• Nursing care for women with rusty-pipe syndrome: About a case
  Lidia Sanz Durán
  Enfermería Clínica (English Edition).2023; 33(6): 438.     CrossRef
• Atención enfermera a la mujer con síndrome de tuberías oxidadas o rusty-pipe syndrome: a propósito de un caso
  Lidia Sanz Durán
  Enfermería Clínica.2023; 33(6): 438.     CrossRef
• Grossly Bloody Colostrum—The Need for Staff Education and Maternal Support
  Katarzyna Wszołek, Stanisław Przewoźny, Adrianna Nowek, Angelika Odor, Paulina Małyszka (Hoffmann), Marcin Przybylski, Jakub Żurawski, Małgorzata Pięt, Maciej Wilczak
  Journal of Clinical Medicine.2023; 12(23): 7326.     CrossRef
• Early recognition of rusty pipe syndrome to avoid disruption of breast feeding
  Jia Ming Low, Zubair Amin, Yvonne Peng Mei Ng
  Archives of Disease in Childhood - Fetal and Neonatal Edition.2022; 107(3): 241.     CrossRef
• Review of Rusty Pipe Syndrome with a Case Report
  Tolga Kalayci, Murat Kartal
  Indian Journal of Surgery.2022; 84(S3): 832.     CrossRef
• Rusty pipe syndrome: a case report and review of the literature
  Huanna Tang, Wenting Zhu, Jianpeng Chen, Dan Zhang
  BMC Pregnancy and Childbirth.2022;[Epub]     CrossRef

Citations

• Investigating the Relationship between Oral Health and Severe Mental Illness: Analysis of NHANES 1999–2016
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• Analysis of the utilization rate of claimed dental implants and related factors.
  Hyang-Ah Park, Ah-ran Pae, Yong-Dae Kwon, Seoung-Jin Hong, Kun-Chul Lee, Jae-In Ryu
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• Association between Smoking and Periodontal Disease in South Korean Adults
  Ka-Yun Sim, Yun Seo Jang, Ye Seul Jang, Nataliya Nerobkova, Eun-Cheol Park
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Background
: It is evident that obesity and other associated chronic diseases are increasing. Since 1998, periodic health examination has been taken in the first grade of high school in accordance with the law nationally and will be expanded to other grades. We evaluated the health status of this population and thought the problems and pitfalls of this program.

Methods : We took 983 students of the first grade of 3 high schools in Seongnam city from April to June 2002. We used the questionnaire and test results as the first line methods of evaluation. Phone counselling was used as the follow-up method. Chi-square test was the main analytic method.

Results : Impaired visual acuity and absence of hepatitis B viral antibody were shown in over 40% of this population. Obesity, anemia, hyperlipidemia, hypertension were followed as the next most popular problems. Though 7.9% of 983 students were to be examined again, only 53.8% of them were re-examined. 52.7% of the student who took re-examination was proved normal. 47% of the test students thought that they were not healthy. Over half of students had the problems of exercise and eating behavior.

Conclusion : We concluded that many students had the behavioral problems causing the chronic diseases. Medical prevention and education program is needed and medical faculties must participate in these programs. In periodic health examination various follow-up programs and screening-questionnaires on psychologic problems must be invented and applied for students.

Background
: Dietary intervention is important in the prevention and treatment of chronic degenerative diseases, such as diabetes mellitus, hyperlipidemia, obesity, fatty liver, cerebrovascular accident, hypertension. To contribute to the improvement of periodic health examination, we investigated the current status of nutritional screening.

Methods : We gathered information about nutritional screening and education by review of questionnaires and telephone interview with physicians and dieticians in 20 university hospitals.

Results : Nutritional screening and education was not being done in 11 out of 20 hospitals. It was done only to those who were need of in 3 hospitals. In one hospital, brief nutritional screening was carried out to all and nutritional education only to those who were in need of it. In the rest of the hospitals, nutritional screening and education was done to all.

Conclusion : Nutritional screening and education was sufficient for primary and secondary preven-tion in olny a few hospitals. Joint development of nutritional screening tools and educational materials is needed.