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Introduction Gestational diabetes mellitus is defined by the American Diabetes Association as, 'Any degree of glucose intolerance with its onset or first recognition during pregnancy.' (1) If not diagnosed and [...], Objective To implement a community-based screening and awareness-raising project for gestational diabetes in Ahmedabad, India. Methods The project took place between April 2016 and August 2019 in Ahmedabad. Medical college faculty members and medical officers trained 3582 paramedical staff on screening for gestational diabetes. These paramedical staff tested all pregnant women 24-28 weeks gestation, who were attending village health and nutrition days--also called mamta days--in urban and rural health centres for routine antenatal care, for gestational diabetes. An oral glucose tolerance test was used and blood sugar [greater than or equal to] 7.8 mmol/L was the cut-off for gestational diabetes. Women with gestational diabetes were referred for counselling and treatment and all women were followed until 6 weeks after delivery. Findings Of53 522 pregnant women screened, 6786 (12.7%) had gestational diabetes and were referred for nutritional therapy or medication; 836 (12.3%) of these women started medication. There was no significant difference in the prevalence of stillbirths between women with gestational diabetes (0.8%; 54/6786) and women without (0.7%; 338/46 736; P-value: 0.51). Of the women on treatment, 38 had abnormal blood glucose after delivery and continued with the medication. Two women with gestational diabetes died; they had other associated co-morbidities--pre-eclampsia and anaemia. Conclusion We found a high prevalence of gestational diabetes, indicating the need for gestational diabetes screening and implementation of this project on a larger scale. Gestational diabetes screening at the community level is operationally feasible using the existing human resources and infrastructure of the reproductive health programmes. [phrase omitted] [phrase omitted] Objectif Mettre en reuvre un projet de sensibilisation et de depistage du diabete gestationnel au sein de la sphere communautaire a Ahmedabad, en Inde. Methodes Le projet s'est deroule entre avril 2016 et aout 2019 a Ahmedabad. Des medecins et membres de la faculte de medecine ont forme 3582 paramedicaux au depistage du diabete gestationnel. Ces paramedicaux ont teste toutes les femmes enceintes de 24 a 28 semaines ayant assiste a des journees locales consacrees a la sante et a la nutrition--egalement appelees journees mamta--dans les centres de sante urbains et ruraux dedies aux soins prenatals de routine, afin de detecter un eventuel diabete gestationnel. Ils ont utilise des tests oraux de tolerance au glucose et fixe la limite a [greater than or equal to] 7,8 mmol/L pour le taux de glycemie. Les femmes presentant un diabete gestationnel ont ensuite ete envoyees en consultation et recu un traitement; toutes ont ete suivies jusqu'a 6 semaines apres l'accouchement. Resultats Sur 53 522 femmes enceintes depistees, 6786 (12,7%) souffraient de diabete gestationnel et se sont vu proposer une therapie nutritionnelle ou des medicaments; 836 (12,3%) d'entre elles ont entame un traitement. Aucune difference notable n'a ete observee en matiere de prevalence des mortinaissances chez les femmes atteintes de diabete gestationnel (0,8%; 54/6786) par rapport aux autres (0,7%; 338/46 736; valeur-p: 0,51). Sur l'ensemble des femmes sous traitement, 38 presentaient un taux de glycemie anormal apres l'accouchement et ont continue a prendre des medicaments. Deux femmes souffrant de diabete gestationnel sont decedees; leur diabete etait associe a d'autres comorbidites--preeclampsie et anemie. Conclusion Nous avons constate une forte prevalence du diabete gestationnel, d'ou la necessite de depister et de deployer ce projet a plus grande echelle. Le depistage du diabete gestationnel au niveau communautaire est faisable sur le plan operationnel avec les infrastructures et ressources humaines existant dans le cadre des programmes de sante reproductive. [phrase omitted] Objetivo Poner en marcha un proyecto local de cribado y sensibilizacion sobre la diabetes gestacional en Ahmedabad, India. Metodos El proyecto tuvo lugar entre abril de 2016 y agosto de 2019 en Ahmedabad. Los miembros de la facultad de medicina y los funcionarios medicos formaron a 3582 miembros del personal paramedico en el cribado de la diabetes gestacional. Este personal paramedico realizo pruebas de diabetes gestacional a todas las mujeres embarazadas de entre 24 y 28 semanas de gestacion que asistian a las jornadas de salud y nutricion de las aldeas, tambien llamadas jornadas mamta, en los centros sanitarios urbanos y rurales para la atencion prenatal de rutina. Se utilizo una prueba de tolerancia oral a la glucosa y se establecio un limite de glucemia [greater than or equal to]7,8 mmol/l para detectar la diabetes gestacional. Las mujeres con diabetes gestacional fueron remitidas para recibir asesoramiento y tratamiento y se realizo un seguimiento de todas ellas hasta 6 semanas despues del parto. Resultados De 53 522 mujeres embarazadas sometidas a cribado, 6786 (12,7 %) tenian diabetes gestacional y fueron remitidas para recibir un tratamiento nutricional o medicamentos; 836 (12,3 0/o) de estas mujeres iniciaron la medicacion. No hubo diferencias significativas en la prevalencia de mortinatos entre las mujeres con diabetes gestacional (0,8 %; 54/6786) y las mujeres que no la padecian (0,7 %; 338/46 736; valor de p: 0,51). De las mujeres en tratamiento, 38 tuvieron una glucemia anormal despues del parto y continuaron con los medicamentos. Dos mujeres con diabetes gestacional murieron; tenian otras comorbilidades asociadas: preeclampsia y anemia. Conclusion Se detecto una alta prevalencia de diabetes gestacional, lo que indica la necesidad de realizar el cribado de la diabetes gestacional y de aplicar este proyecto a mayor escala. El cribado de la diabetes gestacional a nivel local es factible desde el punto de vista operativo utilizando los recursos humanos y la infraestructura existentes en los programas de salud reproductiva.

Background and objectives: Mucormycosis is a complication in post-coronavirus disease 2019 (COVID-19) patients in India. This study was done to evaluate the prognostic value of clinical, histopathologic findings, microbiological features, and biochemical parameters such as D-dimer, lactate dehydrogenase, and serum ferritin in post- COVID-19-patients with rhino-orbital mucormycosis. Methods: This retrospective observational study was carried out on biopsies taken from 50 post-COVID-19 patients suspected of mucormycosis. The biopsy specimens were processed and stained with hematoxylin and eosin, periodic acid– schiff, and Wright-Giemsa. In addition, 10–20% potassium hydroxide wet mount and culture on sabouraud dextrose agar were performed to detect Mucor. The biochemical parameters were measured using ARCHITECT ci8200 chemistry analyzer. Results: Overall, 30 cases (60%) were positive for fungal elements, and growth of Mucor spp. was found in 28 cases (56%). In histopathology, 70% of cases (n=35) showed broad, aseptate, ribbon-like hyphae with wide-angled branching diagnostic of mucormycosis. There seemed to be a site-wise overlap between the nasal/maxillary sinus and rhinoorbital/rhino-cerebral variety. There was no difference between the patients in terms of gender. The most common risk factor was diabetes mellitus (observed in 80% of cases). In patients with invasive mucormycosis, inflammatory biomarkers such as serum ferritin, serum lactate dehydrogenase, C-reactive protein, and Ddimer were greater than the normal range, whereas procalcitonin was within the reference range. Conclusion: It can be concluded that raised metabolic markers, direct 10% KOH examination and histological features including angioinvasion as well as rhino-orbital and cerebral extension might assist doctors in diagnosis, progression, and survival rate. [ABSTRACT FROM AUTHOR]

Background: Data on eye diseases among non-schooling children is very rare. Considering the fact those 19 million visually impaired children, 12 million children are due to refractive errors while 1.4 million are irreversibly blind for the rest of their lives. Early detection and treatment of ocular morbidity among children is important. Objective: To estimate the prevalence of ocular morbidity among urban-slums, non-schooling children of age 0-15 years. Methods: A cross sectional community based study was carried out in five slum areas of urban health training center, Asarwa, adopted by Dept. of Community Medicine to cover non-schooling children of below 15 years of age, from November 2010 to December 2010. Information was collected on a pretested semi structured proforma. An ophthalmologist from Regional Institute of Ophthalmology (RIO) did visual acuity and detailed ophthalmic examination. Data was analyzed with appropriate statistical tests like simple proportions and chi-square (x2) test. Result: Total 391 (14.2%) children in urban -slums community, who were not going to school, were included. Prevalence of ocular morbidity was 21.2%, Trachoma 4.9%, vitamin A deficiency 3.6 %, conjunctivitis 3.3%, refractive errors 3.3% squint 2.5% & color blindness 1.0%. Overall prevalence of ocular morbidity in government hospital and non-schoolings did not show any statistical significant difference. Conclusion: A high prevalence of ocular morbidity among non-schooling children was observed. School health services should be further expanded as child health check-up for the benefit of non-schooling children as well. [ABSTRACT FROM AUTHOR]

Background: Research has shown the growing importance of stress relaxation practices (SRPs) in many noncommunicable diseases. But there is little information on the prevalence of SRPs in Indian population. Objectives: To study the prevalence of different types of SRPs and their sociodemographic profile. Materials and Methods: A community-based cross-sectional study was carried out in Ahmedabad city, Gujarat, India. One ward from each zone of the city was selected by stratified sampling. All individuals above 20 years were included in the study. Detailed information regarding different SRPs practiced by the participants was collected in a standard pretested proforma by house-to-house survey. Univariate regression analysis was applied to compare the groups. Results: Of 1157 persons surveyed, 904 were included in the final analysis. Of these, 310 (34.3%) were doing SRPs and 594 (65.7%) were not doing any type of SRPs. Respondents doing SRPs were compared with non-SRP group. Significant (P<0.05) differences were noticed between the two groups; in females, it was (SRP 58.4% vs non-SRP 49.8%) in the age group 40 to 59 years (44.2 vs 33.8%), those from sedentary occupation (93.9% vs 85.4%), the persons belonging to upper socioeconomic status (70.6% vs 61.8%), and living in central and western zones (66.5% vs 24.6%) and had less number of diabetes (SRP 10.8% vs non-SRP 19.7%) and hypertension (20.7% vs 34.2%). People doing SRPs were able to maintain balance between work and other activities than non-SRPs group (198/310, 63.9% vs 42/594, 7.1%). Among SRPs, majority (243, 78.4%) were involved in religious activities followed by yoga, 36(11.6%), and meditation, 15 (4.8%). Conclusion: Persons practicing SRPs in Ahmedabad are more likely to be above 40 years of age, females, college educated, in sedentary occupation, from upper and middle class, married and living in new-west and central zones, and were less likely to have diabetes and hypertension as compared with those who do not practice SRPs. [ABSTRACT FROM AUTHOR]