Anitha G S

Abstract

Introduction: There is an increasing trend of making Diabetes one of the most common noncommunicable diseases globally. Gestational Diabetes Mellitus (GDM) is defined as “carbohydrate intolerance variable severity that is first diagnosed during present pregnancy, regardless of the need for insulin or persistence of the diabetic state after delivery”. Diabetes Mellitus is the most common disorder of pregnancy, although the prevalence is usually reported as 2 to 5% of pregnant women, it can be as high as 14% in high risk groups. Aims and Objective: To note the Foetal Outcome of pregnancy with impaired and abnormal glucose tolerance detected with DIPSI. Materials and Methods: Total of 200 patients was included in the study from Vanivilas hospital for 1 year. A detailed history from antenatal patients was taken to reveal all risk factors. The procedure of the study was explained and required consent for the study was taken. Examination of the patients was done and all relevant data was obtained. Fasting blood glucose was taken of all antenatal patients at their first visit. Pregnant women at 24-28 weeks were tested with 50g oral glucose load or 75g oral glucose load, at random. Patients were give 50g glucose irrespective of the meal and 1 hour venous blood sample was collected. Patients of 75 g of oral glucose were asked to come in fasting state, 75g of glucose was given, and following which 2 hour venous sample was collected. Blood glucose was tested by GOD-POD method. Diagnosis of GDM was made when the plasma glucose of >140mg/dL and impaired glucose tolerance diagnosis was made when plasma glucose was between 120-140mg/dl. Conclusion: High prevalence rate of GDM was obtained in our study, GDM has adverse maternal and fetal outcome. GDM when identification early and treatment initiated for mothers, maternal and fetal complications can be reduced. In conclusion, intensive care of GDM mothers can help primary prevention of obesity, impaired glucose tolerance and diabetes in the offspring. Keywords: Gestational diabetes mellitus, DIPSI, Blood glucose.

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Abstract

Introduction: Benign invasion of endometrial tissue into the myometrium of uterus is known as adenomyosis. It is found typically between the age of 35-50 years. Prevalence is 6- 39%. Modern imaging techniques, both ultrasound (TAS, TVS) and MRI have made possible, for the first time, a non-invasive identification of adenomyosis. Aims & Objectives: To analyse the spectrum of presentation of adenomyosis and to determine the accuracy of clinical examination and imaging modalities in the diagnosis. Materials and Methods: It is a retrospective study done at hospitals attached to Bangalore Medical College & Research Institute during august 2016-august 2017. The HPE reports and case records of all the hysterectomy specimens were reviewed. Data regarding age, parity, symptoms, obstetric history, examination, co morbidities, investigation findings, associated pathology and treatment modality were noted. They were tabulated and analysed. Results: Out of the 50 patients, 56% were in the age group of 41-50 years. The prevalence of adenomyosis in our study was only 10% in post-menopausal women when compared to the age group 41-50yrs (56%). Multiparous women had 94% incidence of adenomyosis. 26% of women had prior uterine surgeries. 22% of cases had history of infertility in this study. 56% had menstrual disturbances. Dysmenorrhea & Dyspareunia were the next common symptoms. Fibroid was the commonest associated pathology (38%). 34% had hyperplasia of endometrium whereas 66% had no pathology. Imaging picked up only 40% of cases contrary to 36% of clinical diagnosis and was raised to 66% with gross examination of specimen and 100% with HPE. Conclusion: Adenomyosis has a varied presentation. Ultrasound fails to diagnose all the cases. Clinical examination is a better modality. Associated pathology may mask the clinical features of adenomyosis, and diagnosis may be missed. Presently HPE is probably the gold standard for diagnosing adenomyosis. Keywords: Adenomyosis, Magnetic resonance imaging (MRI), Transvaginal scan (TVS), Menstrual disturbances, Hysterectomy.

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