Gestational diabetes and its adverse pregnancy outcomes

Background: Gestational diabetes mellitus is defined as any degree of glucose intolerance with the onset or first recognition during pregnancy with or without remission after the end of pregnancy. Objective: The aim of this study was to identify the gestational diabetes and its adverse pregnancy outcomes in pregnant women. Materials and methods: This was a hospital based prospective observational study conducted on pregnant women attending antenatal op, and they were screened for gestational diabetes according to DIPSI criteria and who were diagnosed to have GDM were followed till delivery and pregnancy outcome was observed . Results: In our study, 85 pregnant women were diagnosed to have gestational diabetes. Out of them two (2.4%) pregnant women were <20 years of age, and 50(58.8%) were in the age group of 20-30 years, and three (3.3%) were more than 40 years age. The mean age group was 26 years. Out of them 53 (62.5%) were multigravida and 32(37.5%) were primi gravida, 47(55.3%) pregnant women were delivered by LSCS, 32(37.6%) were delivered vaginally and 6(7.1%) were delivered by assisted forceps delivery. 70.9% babies were delivered with APGAR 8-10, and still births and IUD accounts for 11.6%.most common associated complication was pre eclampsia which accounts for 24.7%. Most common neonatal complication was hypoglycemia accounting for 9.4% that was 8 cases out of 85 deliveries. 10 babies were delivered with birth weight more than 4 kg which accounts for 11.7%. Conclusion: Gestational diabetes complicating pregnancy has adverse fetal and maternal outcome by means of higher rate of operational deliveries and increased incidence of still birth when compared to normal population. Early diagnosis and prompt treatment can minimise these complications.

Alteraciones electrolíticas asociadas a los métodos utilizados para la limpieza intestinal preoperatoria en niños / Electrolyte disturbances associated with the methods used for preoperative bowel cleansing in children / Distúrbios eletrolíticos associados aos métodos utilizados para a limpeza intestinal pré-operatória em crianças

ResumenIntroducción.El objetivo de esta investigación es describir las alteraciones electrolíticas asociadas a los métodos utilizados para la limpieza intestinal preoperatoria en niños e identificar el cuál es más seguro. Esto recae en la importancia de mantener el equilibrio correcto de los electrolitos ya que influyen significativamente sobre los resultados de la intervención quirúrgica y son un aspecto muy importante en la atención perioperatoria de los pacientes.Método. La presente investigación está comprendida entre los años 2009 al 2013 con una población de 172 internamientos de niños con cirugía colorectal programada. De tipo cuantitativo, no experimental-transversal y retrospectivo. Se consideró como variables dimensiones socio demográficas, como sexo, edad, peso, diagnóstico, tipo de cirugía, limpieza intestinal aplicada, alteraciones electrolíticas con respecto al sodio, potasio, cloro, calcio, y de ácido-base respectivamente, así como solución intravenosa utilizada.Para el análisis de los datos de utilizó el sistema SPSS.Resultado. Cinco fueron los métodos de limpieza intestinal utilizados en el tiempo de estudio los enemas e irrigaciones con suero fisiológico más neomicina al 0,25%, fosfosoda oral, suero fisiológico por SNG y polietilenglycol. El más usado fue el fosfosoda oral (n=46) con los niños de mayor a los 10 000grs. La estancia hospitalaria prequirúrgica destinada para la limpieza intestinal es de tres días. Lo que se traduce en una práctica bastante cara para el sistema de salud, la familia y el paciente a pesar de estar en discusión su utilidad.Conclusión. Es importante adecuar la limpieza intestinal a la iatrogenia de cada niño, considerar el peso, la dieta y sus patologías concomitantes al proceso quirúrgico, de esta forma y de acuerdo a los resultados obtenidos se puede determinar cuál es el método más seguro para prevenir alteraciones a las cuales los menores pueden ser más propensos.

AbstractIntroduction. The objective of this research is to describe electrolyte abnormalities associated with the methods used for preoperative bowel cleansing in children and identify what is safer. This lies in the importance of maintaining the correct balance of electrolytes and that significantly influence the results of surgery and are very important in perioperative patient care aspect.Method. This research is from the years 2009 to 2013 with a population of 172 admissions of children with colorectal surgery scheduled. Quantitative, non-cross experimental and retrospective. It was considered as variables socio demographic dimensions, such as gender, age, weight, diagnosis, type of surgery, intestinal cleansing applied, electrolyte disturbances with respect to sodium, potassium, chloride, calcium, and acid-base respectively, as well as intravenous solution used .For analysis data used SPSS software.Result. Five were intestinal cleaning methods used in the study time enemas and irrigations with saline plus neomycin 0.25%, oral phosphosoda, saline by SNG and polietilenglycol. The most used was the oral phosphosoda (n = 46) with children from more than 10 000grs. Preoperative hospital stay intended for bowel cleansing is three days. Which results in a quite expensive for the health system practice, the family and patient despite being question its usefulness.Conclusion. It is important to adapt the intestinal cleansing iatrogenic each child, consider the weight, diet and its attendant surgical process pathologies in this way and according to the results can determine the safest way to prevent alterations method which children may be more likely.

ResumoIntrodução. O objetivo desta pesquisa é descrever alterações eletrolíticas associadas com os métodos utilizados para a limpeza intestinal pré-operatória em crianças e identificar o que é mais seguro. Este encontra-se na importância de manter o equilíbrio correto de eletrólitos e que influenciam significativamente os resultados da cirurgia e são muito importantes no aspecto assistência ao paciente no período perioperatório.Método. Esta pesquisa é a partir dos anos de 2009 a 2013, com uma população de 172 internações de crianças com cirurgia colorretal programados. Quantitativa, non-cross experimental e retrospectivo. Considerou-se como variáveis ​​sócio dimensões demográficas, como sexo, idade, peso, diagnóstico, tipo de cirurgia, limpeza intestinal aplicada, distúrbios eletrolíticos com relação ao sódio, potássio, cloro, cálcio e ácido-base, respectivamente, bem como solução intravenosa utilizado. Para dados de análise utilizado software SPSS.Resultado. Cinco eram métodos de limpeza intestinal utilizados nos enemas de tempo de estudo e irrigações com solução salina mais neomicina 0,25%, phosphosoda oral, soro fisiológico por SNG e polietilenglycol. O mais utilizado foi o phosphosoda oral (n = 46) com crianças de mais de 10 000grs. Internação pré-operatória destina-se a limpeza do intestino é de três dias. O que resulta em um muito caro para a prática do sistema de saúde, a família eo paciente, apesar de ser causa a sua utilidade.Conclusão. É importante adaptar o intestinal limpeza iatrogênica cada criança, considere o peso, dieta e seus assistentes cirúrgicos patologias processo desta forma e de acordo com os resultados pode determinar a maneira mais segura para evitar método alterações que as crianças podem ser mais provável.

Preoperative malignant looking retrobulbar, infratemporal and middle cranial fossa tuberculoma in a young child - a case report.

Tuberculosis involving skull base and brain is relatively common in developing countries. Preoperative neuro-radiological features of such lesions mimic neoplastic lesions of brain & skull base and postoperative histopathological study brings the ultimate diagnosis. Here we present a case of large tubercular lesion involving retrobulbar, infratemporal and middle cranial fossa that preoperatively thought to be a malignant lesion in a young child and was managed surgically with anti-tubercular drugs having a happy termination. Even radiologically malignant looking mass lesion in brain and skull base can be proved as tuberculosis that can bring happiness to the patient and also to the treating neurosurgeons.

Significance of Preoperatively Determined CA 19-Serum Levels in Patients with Gastric Cancer

Gastric cancer is a common, frequently lethal affliction and remains a serious and unsolved problem in general surgery. And gastric cancer is still the most common cancer in Korea, and it is the number one cause of cancer death in Korea. The prediction of prognosis is as important as treatment in gastric cancer. CA 19-9 is defined by a monoclonal antibody developed by Koprowski et al., and elevated levels of CA 19-9 have been found in the sera of patients with various malignancies, especially in patients with pancreatic cancer. To evaluate the prognostic role of CA 19-9 in gastric cancer, we studied preoperative CA 19-9 serum values in 1356 patients with gastric cancer who underwent operations in the Cancer Institute Hospital, between 1988 and 1993. CA 19-9 RIA test kits (Centocor, Malvern, Pa., U.S.A.) were used, and the cut-off value was 37.0 u/ml. The Chi-square test was used to evaluate the statistical significance of differences between seropositivities and clinicopathological parameters, and the Kaplan-Meier method was used to calculate survival rate. 1159 patients (85.5%) were negative for CA 19-9 (CA 19-9 less than 37.0 u/ml), and 197 patients (14.5%) were positive for CA 19-9 (CA 19-9 greater than 37.0 u/ml). In comparison with clinicopathological parameters, seropositivity was correlated with tumor size, gross types, depth of invasion and lymph node metastasis. Peritoneal and hepatic metastases, and stage correlated with seropositivities. The five-year survival rate was significantly higher in patients negative for CA19-9 than in patients positive for CA 19-9; 80.6% versus 57.2%. This study suggests that preoperative CA 19-9 serum levels were useful for predicting the prognosis in patients with gastric cancer.