Background: Prevalence of the diabetes among pregnant women is increasing, attributable to advance maternal age, multi foetal gestation, increased body mass index, strong family history, sedentary life style, change in the diet, continued immigration. Gestational diabetes has few symptoms, commonly diagnosed by screening during pregnancy. Methods: The present study was conducted at Department of Medicine and Department of Obstetrics and Gynaecology, Dr. S.N. Medical College, Jodhpur. Rajasthan, India. Results: Out of 476 patients attending the antenatal outdoor at the Umaid Hospital, Jodhpur, Rajasthan, India. The prevalence of gestational diabetes in present study was 7.98%, Incidence of GDM found to increase with increasing age with maximum prevalence (10.71%) in more than 30 years age group, with increasing parity, low socioeconomic strata and in urban population. With maximum prevalence amongst higher parities (12.5%) in >G5 and higher). The incidence was higher with history of PIH (36.36%), family H/O DM (33.3%), GDM (12.12%), perinatal losses (15.15%), anomalous baby (9.09%), high BMI (67%). GDM complicate the normal course of pregnancy with increased incidence of PIH (36.4), Polyhydramnios (27.2%), infections like vaginal candidiasis (24.2%) and UTI (39.3%). The infant of diabetic mother had 12 (32.29%), 9 (26.47%), 11 (32.35%), 8 (23.53%) 5 (14.70%) and 3 (8.82%) of hypoglycemia, respiratory distress, macrosomia, congenital anomalies, birth injuries, polycythaemia, and hypocalcaemia respectively in diabetic mothers with suboptimal glycaemic control during pregnancy. Conclusions: GDM continues to be an important obstetrical condition with significant feto-maternal morbidity. Complications in infant of diabetic mother are more common with those mothers who had poor glycaemic control.

Background: Low birth weight is one of the most serious challenges for maternal and child health in both developed and developing countries. It is the single most important factor that determines the changes of child survival. Nearly 50% of neonatal deaths occur among LBW babies. The survivors among them are at a higher risk of developing malnutrition, recurrent infections and neurodevelopment backwardness.Methods:The present study was conducted at Department of Pediatrics, Dr. S. N. Medical. College, Jodhpur. Study Design: Cross sectional study. Sample size: 8266 consecutive live birth babies were enrolled. Inclusion Criteria: A total number of 8266 consecutive live birth babies were enrolled a total number of 2542 Low birth weight babies were delivered with birth weight 2.5 Kg. or less. Exclusion Criteria: (i) IUD babies, (ii) Still born babies, (iii) Lodger babies.Results: Incidence of LBW babies were 30.725%, VLBW babies 2.71% and that of ELBW babies were 0.89%, Male, Female ratio was 1:1.09, 80% LBW babies were more than 1.8Kg, 73.05% babies were between 37-40 weeks of gestational age and 5.0% were extreme premature (<32 weeks) Teen aged mother and elderly mothers, Primi para and multiparty (4th and above) had increased incidence of LBW babies, 84.97% of LBW babies born normally, maximum number of mothers were from lower socioeconomic status (54.41%) were illiterate (41.8%). Tobacco addiction had adverse effects on birth weight. PIH was the most frequent complication (17.93%). Followed by APH (2.95%) and P.P.H. 1.41% Anemia was the most common (23.73%) medical illness followed by Chronic UTI 2.59%, TB 1.61% and RHD 1.18%.Conclusions:Interventions to improve intrauterine growth and gestational duration by providing adequate caloric supplementation before and during pregnancy, febrile illnesses prophylaxis, or treatment, reduce tobacco chewing in mothers, avoid child bearing in young adolescents and in late reproductive age, improving maternal education, general improvement in nutrition and socio-economic condition and Improving sanitation and water supply.

Background: Pancreatitis is quite common problem, it may present either as abdominal emergency with fulminant course or as an indolent process leading to long-term medical as well as surgical complications often leading to poor prognosis if not intervened timely.Methods: The present study conducted in the department of medicine, Dr. S. N. medical college, Jodhpur. Participants after understanding the study protocol and procedure, asked to give their written consent for the study. A cross sectional hospital based study in patients admitted in various medical wards of Dr. S. N. medical college, Jodhpur. 50 patients with acute and chronic pancreatitis were studied.Results: In the present study, most common cause of acute pancreatitis is biliary disease (50%) followed by alcoholism (37.5%) and in chronic pancreatitis is alcoholism (80%). Acute pancreatitis was more common in males (62.5%, 25 males) whereas chronic pancreatitis in males (80%, 8 male). Abdominal pain is the most common symptom (97.5%) followed by nausea-vomiting (92.5%) in acute pancreatitis. The history of previous abdominal pain in 100% of cases followed by epigastria pain in 90% of cases, in chronic pancreatitis. The amylase and lipase were elevated in 90% of cases. The amylase and lipase levels did not correlate with the severity. 66.6% of patients had severe pancreatitis with a positive predictive value of 66.6%. The ultrasonography imaging of pancreas was helpful in 70% and 100% in acute and chronic pancreatitis respectively. The CT scan was a better imaging modality as compared to ultrasonography in acute pancreatitis, where as it scored over ultrasonography imaging in chronic pancreatitis with complications.Conclusions: Relevant clinical history, ultrasonography and computed tomography scan of pancreas are helpful in diagnosis of pancreatitis. The computed tomography scan was a better imaging modality as compared to ultrasonography.

Aim: To assess serum ascorbic acid and alpha-tocopherol levels in bidi smokers, tobacco chewers and tobacco nonusers. Materials and Methods: Forty smokers [25 subjects smoking ≤24 bidi /day (moderate) and 15 subjects smoking > 24 bidi/day (heavy) with a smoking habit of > 10 years, 20 subjects tobacco chewers ≥10 g tobacco/day) chewing for > 10 years] were included in the study.All selected subjects were normal with no symptoms of any disease. They were classified on the basis of age, BMI and with and without alcohol consuming habit. Serum ascorbic acid was measured by dinitrophenyl hydrazine reagent and alpha-tocopherol by ferric chloride oxidation. Result: Serum ascorbic acid levels in moderate smokers, heavy smokers, tobacco chewers and control,were 0.31 -+0.13, 0.26+0-.16, 0.40+0.2-6 and 0.50+-0.09.In the respective group's alpha-tocopherol levels were 0.674±0.46, 0.94±0.43, 0.95±0.61 and 1.39±0.73.Conclusion: Both bidi smoking and tobacco chewing decreased ascorbic acid and alpha-tocopherol levels. No discernible trends were found with BMI and alcohol.

Background: Obstructive Sleep Apnoea (OSA) has been too common yet under diagnosed clinical entity. It is associated with the metabolic syndrome, a cluster of cardio-metabolic parameters including central obesity, insulin resistance, hypertension and dyslipidemia. Obesity predisposes to both OSA and disorders in glucose metabolism. There is growing evidence that OSA confers an independent risk of adverse glucose metabolism. Methods: The present study conducted in the Department of Medicine at MDM Hospital attached to Dr. S.N. Medical College, Jodhpur, Rajasthan, India. Participants after understanding the study protocol and procedure, asked to give their written consent for the study. It was a cross sectional hospital based study in patients, screened at Diabetic clinic and those referred from the periphery. Berlin questionnaires and Epworth score are tools to screen for OSA attending the Medicine OPD and IPD, Dr. S. N. Medical College, Jodhpur. 50 patients with type 2 DM and 20 age and sex-matched controls were studied. Randomly selected T2DM subjects of age 20 to 75 years both sex with obesity, BMI>25 kg/m 2 , clinical history suggestive of OSA, Epworth score>6, Positive Berlin questionnaires were included in the study. Acute and unstable medical condition e.g. CHF, CRF, COPD, Recent stroke, Acute ACS, Pregnant women were excluded. Results: In the study OSA was prevalent in the diabetic population (54%), Mean age of the study population was 54.96±9.35 years. OSA was found to be increased with increasing age with maximum prevalence in ≥60 year's age group. OSA was more prevalent in the male population (64.29%), in urban population. Snoring, observed sleep apnoea, restless sleep/insomnia, excessive daytime sleepiness and non-refreshing sleep were significantly associated with OSA. (P<0.001). Prevalence of OSA was more in high BMI group (≥35 kg/m 2 ), OSA increased with increase in neck circumference. OSA was more in subjects with uncontrolled diabetes (blood sugar>200 mg/dl), smokers and alcoholics. Conclusions: This study shows that OSA has a high prevalence in subjects with T2DM and identify several factors that may be associated with its presence in the diabetic population. OSA can be usefully and easily assessed in an outpatient setting by using a portable device such as Apnea Link. Clinicians should increase patients' awareness of the signs and symptoms of OSA and refer for sleep studies when appropriate. Once diagnosed, patients should be encouraged to adhere to CPAP treatment in order to halt progression and prevent complications.