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Gestational Diabetes Mellitus
Gestational Diabetes Mellitus (GDM) is a condition characterized by elevated blood sugar levels during pregnancy, typically developing in the second or third trimester. It arises when the body cannot produce enough insulin to meet the increased demands of pregnancy, leading to insulin resistance. GDM poses risks to both the mother and the baby, including preeclampsia, preterm birth, and higher birth weight, which can complicate delivery. Mothers with GDM are also at increased risk for developing type 2 diabetes later in life. Management includes lifestyle modifications, such as diet and exercise, and, in some cases, medication to maintain blood glucose levels within a target range.
About the Speaker
Dr. Dina Nagodra Mithani
Endocrinologist, DENMARC Institute, Mumbai
Dr. Dina Nagodra Mithani is a highly qualified and experienced diabetes and endocrinology specialist with a comprehensive educational background and extensive international work experience. She holds postgraduate diplomas in endocrinology and diabetes from the University of South Wales, the International Diabetes Federation, the Royal College of Physicians, and Fortis CDOC, as well as a postgraduate certificate in stem cell and regenerative medicine from the University of Utrecht. Additionally, she has a Master of Science in Public and Tropical Health and was promoted for a PhD at the University of Medical Sciences and Technology in Sudan, where she also earned her Bachelor of Science in Medicine and Surgery. Dr. Mithani's career spans several countries, including roles at the DENMARC Institute in Mumbai, the Omdurman Military Hospital in Sudan, the Norfolk and Norwich University Hospital in the UK, and the Midland Regional Hospital in Ireland. She has provided diabetes and endocrinology services in various clinical settings, such as the Acute Medical Assessment Unit at Wexford General Hospital and the Abdalla Khalil Diabetes Center in Sudan. Her experience also includes working in intensive care at Imperial Private Hospital and serving with the State Ministry of Health in Khartoum. In addition to her clinical work, Dr. Mithani has contributed significantly to medical research, with publications in esteemed journals like the New England Journal of Medicine. Her research topics include diabetes in pregnancy, the relationship between diabetes and heart failure, diabetic neuropathy, cardiometabolic disease, and novel therapies for diabetes management. Dr. Mithani's dedication to her field is reflected in her ongoing efforts to improve diabetes care and outcomes for patients globally.
Upcoming Case Discussions
Approach to a Patient with Altered Mental Status
The evaluation of a patient with altered mental status begins with a detailed history. Because the patient may be unable to offer a history, it will be required to seek additional information from family, friends, or the primary medical team. The first step is to ascertain the timing of the mental status change and the circumstances surrounding it, such as medication/drug usage or trauma. An acute change in mental state is a medical emergency that necessitates an immediate, systematic evaluation. Airway, breathing, and circulation ("ABC's") should be evaluated in conjunction with an updated set of full vital signs and finger-stick blood glucose. Tachycardia may indicate a systemic infection, pulmonary embolism, or atrial fibrillation with high ventricular rate.
Thoracoabdominal Aortic Aneurysm Repair: Surgical Approach
A 31-year-old woman from Kenya presented at Indraprastha Apollo Hospitals, New Delhi, with occasional back and abdominal pain and was diagnosed with Takayasu’s arteritis, a thoracoabdominal aortic aneurysm (TAAA), and anti-nuclear antibodies (ANA) positivity. Her condition, complicated by the use of immunosuppressants and anticoagulants, posed significant medical challenges, particularly the high risk of aortic rupture. A multidisciplinary team optimized her care, addressing both her autoimmune disease and medication needs. The complex surgical repair of her TAAA was performed using a unique technique developed by Dr. Niranjan Hiremath, with support from Dr. B N Das, showcasing the hospital's expertise in managing high-risk aortic diseases. This case highlights the importance of innovative approaches and collaborative care in achieving successful outcomes for complex conditions.
Anemia in Dialysis Patients: Recent Evidence
The evaluation of a patient with altered mental status begins with a detailed history. Because the patient may be unable to offer a history, it will be required to seek additional information from family, friends, or the primary medical team. The first step is to ascertain the timing of the mental status change and the circumstances surrounding it, such as medication/drug usage or trauma. An acute change in mental state is a medical emergency that necessitates an immediate, systematic evaluation. Airway, breathing, and circulation ("ABC's") should be evaluated in conjunction with an updated set of full vital signs and finger-stick blood glucose. Tachycardia may indicate a systemic infection, pulmonary embolism, or atrial fibrillation with high ventricular rate.
Approach to Coronary Artery Diseases
Coronary artery disease (also known as coronary heart disease) is the leading cause of death for both men and women and the most frequent type of heart disease. This largely preventable condition causes hazardous thickening and narrowing of the coronary arteries—the channels that bring blood to the heart—interrupting the passage of oxygen and nutrients to the heart, resulting in major complications. Angina (chest pain) can result from coronary artery disease when there is insufficient blood flow. Over time, the heart needs to work harder, which can lead to heart failure (when the heart is unable to pump adequately) or arrhythmia. The injured arteries may become fully clogged or prone to clotting, resulting in a heart attack.
AI Solutions for Hospitals
AI in healthcare is the application of machine learning, natural language processing, deep learning, and other AI technologies to improve the experiences of both healthcare workers and patients. AI's data-processing and prediction skills allow health practitioners to better manage their resources and tackle many facets of healthcare in a more proactive manner. With these technology, doctors can make faster and more accurate diagnoses, health administrators can find electronic health information more quickly, and patients can receive more timely and individualized care.