ABSTRACT
Background: Diabetes mellitus is the most common metabolic disorder complicating pregnancy. The incidence of pre-gestational (type 1 and type 2) and gestational diabetes mellitus is on the rise in India. Authors aimed to study the clinical profile and outcome of the infant of diabetic mothers.Methods: The study was conducted in the Sick Newborn Care Unit attached to Stanley Medical College in Chennai over a period of 6 months. All infants born to diabetic mothers during the study period were included in the study.Results: Among the total of 6236 babies delivered in total during the study period, 566 (9.07%) were born to diabetic mothers. 16.25% were pre-gestational diabetic mothers and 83.75% were GDM Mothers. The incidence of prematurity was 15.2% and LGA was 7.9%. The majority were AGA (495 out of 566). Symptomatic Hypoglycemia was observed in 16 babies and asymptomatic hypoglycemia in 35 babies with total occurrence of hypoglycemia in 9% of babies. Hyper-bilirubinemia is the most common problem encountered in 29% of babies, congenital heart disease and renal problems were the most common congenital anomalies noted in IDM 44 out of 566 babies (7.8%).Conclusions: There is lack of awareness regarding dog bite and its management among the rural populatEarly detection and optimal management of diabetic status during the antenatal period along with anticipation, early recognition and management of postnatal complications will reduce the mortality of infants of diabetic mothersion.
ABSTRACT
Purpose: Optic nerve invasion is an important cause of mortality in retinoblastoma. We aimed correlate preoperative imaging and surgical histopathology findings in enucleated eyes with retinoblastoma to determine the efficacy of preoperative imaging in predicting optic nerve invasion in retinoblastoma. Methods: A retrospective review of records of all patients undergoing primary enucleation for retinoblastoma at a tertiary eyecare system between March 2013 and December 2017 with all patients having undergone preoperative imaging, either CT scan or MRI. Data was analyzed statistically to determine the correlation between preoperative CT scan/MRI and histopathology. Results: Totally, 97 eyes of 97 patients were included in the study who underwent primary enucleation for unilateral retinoblastoma. The average age at presentation was 27.8 months with the chief complaint being leukocoria in all the cases. 14 patients (14.43%) had evidence of optic nerve involvement in preoperative imaging. 30 patients had optic nerve invasion on histopathology (laminar and retrolaminar). Spearman's rank correlation test revealed a significant correlation between MRI findings and HP and an insignficant correlation between CT findings and HP. The CT scan had a sensitivity of 20%, specificity of 88.89%, 50% positive predictive value and 66.67% negative predictive value. MRI had a sensitivity of 40%, specificity of 93.55%, positive predictive value of 66.67% and a negative predictive value of 82.86%. Conclusion: MRI showed significant moderate correlation with surgical histopathology for predicting optic nerve invasion in retinoblastoma whereas CT shows insignificant correlation with HPE. Therefore, we recommend MRI for predicting optic nerve invasion in cases of retinoblastoma.