pregnancy

Diabetic Ketoacidosis (DKA) is a life-threatening medical emergency. Euglycemic Diabetic Ketoacidosis (EDKA) is a condition that is relatively rare but if missed out can have grave consequences. The primary difference between the two conditions lies in the extent of hyperglycemia in both conditions. In EDKA, the blood glucose levels can be near normoglycemia as well. The clinical features are similar. Good glycemic control in pregnancy is an effective method of preventing complications of EDKA in pregnancy. For EDKA, the glucose levels in blood can be mildly raised, it poses a significant challenge to diagnose EDKA. Therefore, a high index of suspicion is the cornerstone of management of EDKA in pregnancy. The key diagnostic tests are serum electrolytes, arterial blood gas analysis, and ketone level measurements. The treatment includes fluid resuscitation, insulin therapy, acidosis correction, electrolyte monitoring and treating the underlying root cause. Continuous monitoring of both maternal and fetal well-being is crucial throughout treatment. A multidisciplinary and systematic approach to diagnosis and treatment is essential for an optimized outcome.

A woman undergoes a series of physiological states such as puberty, pregnancy and menarche. A number of anatomical, physiological and hormonal changes occur in pregnancy which not only affects the maternal health but also the health of the child. Oral health is an integral part of overall general health and is often neglected due to lack of knowledge and awareness and an unfavourable attitude.It definitely has its impact upon the systemic health and everyone should be aware about the same.This further needs due consideration in a pregnant women as peculiar oral changes and their impact on the new born infant pregnancy outcome have been discussed and documented with sufficient evidence.Much has been talked about common oral health issues during pregnancy like gingivitis, periodontitis, pyogenic granuloma etc and their management. Patient’s education regarding the oral hygiene and abnormal pregnancy outcome (pre-term birth, low body weight birth) is extremely essential. These conditions may be prevented by appropriate monitoring of dental health in pregnancy and also by providing dental care in such patients.Patients should be referred to the dental health care provider for dental needs during the time of pregnancy. A collaboration of dental and medical health care givers must be made and is an effective channel to provide the best possible treatment and management of these patients.This article discusses the importance of oral health care during pregnancy and how an integration between the medical and dental health provider can go a long way to attend the oral health concerns during this time.

Background: Polycystic ovary syndrome (PCOS) is a common complex; heterogeneous endocrine disorder characterized by irregular menses, hyperandrogenism, and infertility. Aims: To study the outcome of laparoscopic ovarian drilling in clinical presentations in form of cycle pattern, acne & Hirsiutism in addition to their conception among infertile Sudanese patients with PCOS.Methods: A hospital based cohort study which was conducted in two hospitals in Khartoum state, Sudan; Omdurman Maternity Hospital & Saad Abu Elela hospital from January to December 2018.Targeted 145 infertile patients diagnosed as PCOS based on Rotter-Dam criteria 2003 definition and who did not conceive after diet, lifestyle and clomiphene; underwent laparoscopic ovarian drilling (LOD).data was collected using semi-structured questionnaires before the drilling ,then the patient was followed in 3 month time concerning the Clinical Presentations, and Conception Results: 65(44.8%) out of 145 infertile patients age was between 21-30 yrs, 67(46.2%) were obese with BMI >30; 90 (62.1%) of participants had irregular cycle., Hirsiutism was seen in 55 (37.9%) and acne was observed in 89 (61.4%). After laparoscopic drilling, 55.2% of patients had normal cycle pattern, amenorrhea & menorrhagia dropped to 3.5% & 11.7% respectively. About 46.2% had normal weight .Acne was seen in 32(22.2%) & Hirsiutism present in 42(19.3%) and 43 (29.6%) get pregnancy, BMI, acne & Hirsiutism before and after LOD were correlated using Chi square P value was 0.001, 0.002, and 0.007 respectively which was significant at (P ≥0.05). Conclusion: The path physiology of PCOS improves, after LOD concerning clinical presentations, & conception. Management of PCOS is essential to address patient concerns, prevent metabolic, & endocrine complications.