Objectives: The primary objective was to investigate the prevalence of persisting diabetes and high cholesterol in postpartum women with prior Gestational Diabetes Mellitus (GDM). Research design and methods:All women with a diagnosis of GDM who delivered from April 2010 to 30 June 2012, at Joondalup Health Campus were included in the study. On the postnatal ward, women were given an appointment to attend a diabetes follow up clinic at 6-12 weeks postpartum. They were provided with a pathology request for a glucose tolerance test, fasting cholesterol, triglycerides, LDL-C and HDL and cardiac risk ratio.Results: Of 4956 women with no prior known history of diabetes who delivered at the hospital over the audit period, 168 (3.4%) were diagnosed with GDM, of whom 136 attended for postpartum review (85%) at 6-12 weeks. Persisting glucose intolerance and type 2 diabetes were diagnosed in 16% and 6% of the patients. Fasting cholesterol, low-density lipoprotein C and triglyceride levels in excess of Australian recommended standards were identified in 54%, 50% and 13% respectively.Conclusions: 6% and 54% of women had persisting glucose and cholesterol abnormalities at 6-12 weeks postpartum. Specific follow up to address cardiovascular risk factors is recommended.

This study evaluates the outcome of urgent neurologic referrals. This was a retrospective review of all referrals to the Floating Hospital for Children in 1 month. The total number of patients referred to our center was 223. Amongst those, 108 were new patients and 195 were follow-up visits; 30 patients were deemed urgent, yet 6 of them did not present to their visit. Urgent and routinely scheduled patients were compared based on the need for further evaluation or medication initiation following their visit. The frequency of visit outcomes was statistically similar between urgently and nonurgently referred patients. We did observe though, that diagnostic testing and medication were initiated more frequently for the patients urgently referred for seizure compared with those routinely scheduled patients for seizure evaluation. For this reason, we suggest that pediatric neurologists preferentially should hold clinic space open for urgent referrals for patients with new-onset seizure.

Fathers in the setting of teenage pregnancy may have a negative attitude towards breastfeeding. Breastfeeding education for fathers is desirable to ensure they are aware of the short-term and long-term health benefits for infant and mother.

A 41-year-old male patient presented with isolated right lower limb swelling. An ultrasound scan showed right external iliac and femoral vein deep vein thrombosis due to extrinsic compression by an aneurysm of the right common iliac artery. Investigations including imaging and a tissue biopsy of right and left femoral arteries confirmed a rare clinical presentation of fibromuscular dysplasia involving iliac, coeliac, renal and pulmonary vessels. The common iliac artery aneurysm was successfully treated with endovascular repair. Six months later, he developed coronary artery involvement with spontaneous dissection of left anterior descending artery diagnosed on coronary angiogram which was managed conservatively. At 6-year follow-up, he remains clinically asymptomatic and continues with regular surveillance imaging. Iliac arterial fibromuscular dysplasia is uncommon and clinical presentation with a complication such as a deep vein thrombosis is atypical.