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Background: Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy and associated with adverse outcomes of pregnancy for mother and baby. GDM exposes fetus to hyperglycemia and it leads to macrosomia, birth trauma, shoulder dystocia, neonatal hypoglycemia, hyperbilirubinemia, hypocalcemia, polycythemia, and respiratory distress syndrome. Aim and Objectives: The objective of this study is to analyze maternal and neonatal outcomes of pregnancy in women with GDM. Materials and Methods: This study was carried out prospectively in the department of obstetrics and gynecology, tertiary care hospital, Gujarat, over a period of December 2020–December 2021. Total 104 patients were diagnosed with GDM and included in this study. Exclusion criteria include pregnant women with pre-existing diabetes, pregnancy with more than one fetus, other chronic disease, still birth, on medication that might affect glucose metabolism (steroids, anti-psychotic medications, etc.), not willing to participate. A detailed history of all patients was taken. Results: Out of 990 patients, 104 (10.5%) pregnant women were found to have GDM. Adverse maternal outcomes were polyhydramnios (38.4%), antepartum haemorrhage (1.9%), postpartum hemorrhage (4.8%), sepsis (1.9%), wound infection (1.9%), and urinary tract infection (10.6%). Most common neonatal complication was hypoglycemia (29.8%), prematurity (16.3%), and macrosomia (10.5%). Conclusion: The increasing prevalence of risk factors related to GDM; it is likely that GDM in pregnant women will give adverse outcomes. The antenatal screening for GDM is key for early diagnosis and treatment during antennal visit and that will improve maternal and fetal outcome. Management of GDM can prevent development of future diabetes mellitus in women.
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Background: Continuous positive airway pressure (CPAP) is the treatment of obstructive sleep apnea (OSA). The CPAP pressure is generally estimated by manual titration or an auto-CPAP device. An alternative method involves the use of the predictive equation. There is limited study available for the Indian population. Objectives: To compare CPAP pressure obtained by mathematical formulas with auto-CPAP titration and formulation, a preliminary predictive equation from derived data to be validated with titrated CPAP. Methods and materials: A retrospective observational study was performed in 130 patients in Department of Pulmonary Medicine of our institute from April 2019 to July 2021. Detailed history, anthropometric parameters, whole-night level-II polysomnography (PSG), and CPAP titration were performed. Stepwise linear regression was applied to establish predictive equation. This equation results were compared with available other equations and autotitrated readings. Results: The mean (SD) of age, BMI, neck girth, Epworth score, lowest SPO2 (%), and AHI was 56.72 (11.31), 33.87 (6.43), 39.7 (4.46), 17.75 (3.18), 84.65 (8.44), and 48.75 (21.09), respectively, with male杅emale ratio of 3:2. Mild, moderate, and severe OSA were 7 (5.4%), 18 (13.8%), and 105 (80.8%), respectively. Continuous positive airway pressure obtained from equations was in the range of 7.40�.95 cm H2O. Obtained readings by equations showed a comparable correlation with CPAP-titrated results (p <0.001). Conclusion: The optimum titration pressure correlates with pressure derived from the predictive equation that is predicted average therapeutic CPAP pressure = 3.98 + 0.065 (ODI) + (AHI) + 0.018 (nadir SPO2) - 0.013 (NC).
RESUMO
Background: Diffuse parenchymal lung disease affects interstitium. Pulmonary Function Test is utilized for diagnosis, severity assessment, and treatment response. Spirometry and diffusing capacity of carbon monoxide (DLco) are commonly used in routine. Aim and Objectives: The aim of the study was to study demography and radiology of interstitial lung diseases (ILDs) and to assess severity and progression of ILDs. Materials and Methods: A prospective and observational study was carried out of age group >12 years at tertiary care center from October 2019 to September 2021. Participants having clinical suspicious of ILD were advised for high-decision computed tomography. Among those having ILDs were evaluated for spirometry at first visit and at 6 month. The treatment was given according to the standard guidelines protocol in between. Results: Total 100 participants (58 male and 42 female) involved in the study. Mean (standard deviation [SD]) of age and body mass index was 49.1 (13.6) and 23.84 (4.51), respectively. Smokers, ex-smoker, and non-smoker were 32%, 10%, and 58%, respectively. Exertional dyspnea (93%) and dry cough (45%) were the most common symptoms to be encountered. Spirometry parameters such as forced expiratory volume at 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC, DLco, and gender, age, and physiology index depicted 50.25 (13.56), 54.06 (13.53), 95.50 (18.35), 42.52 (11.23), and 3.30 (1.45), respectively. Significant decline in lung function was observed at 6 months (P < 0.001). Septal thickening (71%) and traction bronchiectasis (43%) were commonly observed radiological patterns. Conclusion: The spirometry data of ILD patients have predominant restrictive pattern (moderate severity) with high incidence of IPF (Idiopathic pulmonary fibrosis). The majority ILDs are progressive in nature; lung function declined in course of time and equally distributed irrespective the smoking status.