Objective: The aim of this study was to assess the fetomaternal outcome in patients with gestational diabetes mellitus.Methodology: This study was conducted in the department of obstetrics and gynecology GMC Srinagar. Patients with period of gestation more than 28 weeks with Gestational Diabetes Mellitus were included in study group and 100 non diabetic patients with similar period of gestation were taken as controls. Risk factors and fetomaternal outcome was compared in the two groups.Results: Gestational diabetes was seen commonly in patients with >30 years of age, increased parity, Positive family history and past poor obstetric history. Antepartum complications were seen more frequently in GDM group. Caesarean section rate was also high (74%) in diabetic group. Neonatal complications were seen more frequently in diabetic group. A significant percent (42.8%) patients developed overt diabetes over a one year follow up period. Conclusion: There was significant fetomaternal morbidity in patients with gestational diabetes mellitus. Hence early detection and treatment would reduce the fetomaternal mortality and morbidity.

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Background: The prevalence of pulmonary embolism (PE) in patients of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) varies over a wide range. Early detection and treatment of PE in AECOPD is a key to improve patient outcome. The purpose of the study was to investigate the prevalence and predictors of PE in patients of AECOPD in a high burden region of North India. Materials and Methods: This prospective study included patients of AECOPD with no obvious cause of exacerbation on initial evaluation. Apart from routine workup, the participants underwent assessment of D-dimer, compression ultrasound and venous Doppler ultrasound of the lower limbs and pelvic veins, and a multidetector computed tomography pulmonary angiography. Results: A total of 100 patients of AECOPD with unknown etiology were included. PE as a possible cause of AE-COPD was observed in 14% of patients. Among the participants with PE, 63% ( n = 9) had a concomitant presence of lower extremity deep venous thrombosis. Hemoptysis and chest pain were significantly higher in patients of AECOPD with PE ([35.7% vs. 7%, P = 0.002] and [92.9% vs. 38.4%, P = 0.001]). Likelihood of PE was significantly higher in patients who presented with tachycardia, tachypnea, respiratory alkalosis (PaCO2 <45 mmHg and pH >7.45), and hypotension. No difference was observed between the two groups in terms of in-hospital mortality, age, sex distribution, and risk factors for embolism except for the previous history of venous thromboembolism (35.7% vs. 12.8% P = 0.03). Conclusion: PE was probably responsible for AECOPD in 14% of patients with no obvious cause on initial assessment. Patients who present with chest pain, hemoptysis, tachypnea, tachycardia, and respiratory alkalosis should be particularly screened for PE.

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Use of contrast agents like gadolinium in MR imaging studies has considerably increased. Although safe in patients with normal kidney function, administration of these agents in people with renal dysfunction can result in many clinical problems that the nephrologists should be familiar with. This brief review discusses these iatrogenic problems that can be induced by contrast agents like gadolinium. JMS 2012;15(2):166-69