Roli Gautam, MD

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Gestational diabetes is a serious concern in pregnancy for both the fetus and mother. In this tutorial, review the epidemiology, classification, pathogenesis of glucose intolerance, consequences for mother and fetus, fetal evaluation, screening and more.

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Gestational diabetes is a serious concern in pregnancy for both the fetus and mother. In this educational tutorial, review the epidemiology, classification, pathogenesis of glucose intolerance, consequences for mother and fetus, fetal evaluation, screening and more.

Educational Tutorial: GDM & DM in Pregnancy

 young woman with tuberculosis should become pregnant to improve her outcome!! 

 Tuberculosis was  harmful   during pregnancy, and termination of pregnancy - recommended

   
• 2 billion infected, i.e. 1 in 3  of global population   
• 9.4 million (139/lakh) new cases  in 2008, 80% in 22 high-burden countries    
• 4 m new sm+ve PTB (61/lakh) casesin 2008   
• Global incidence of TB has peaked  in 2004 and is declining.   
• 1.77m deaths in 2007, 98% in  low-income countries   
•  MDR-TB -prevalence in new cases around 3.6% 

WHO
 10 facts about tuberculosis
 23 March 2009


   
• Tuberculosis (TB) is contagious and spreads  through the air.   
•  If not  treated, each person with active TB can infect on average 10 to 15 people a  year.    

   
• > 2billion people, equal to 1/3 of the  world’s total population, are infected.    
• 1 out of 10 of those people will become sick  with active TB in his or her lifetime.    
• People living with HIV are at a much greater  risk   

   
• 1.77 million died from TB in 2007 (including  456 000 people with HIV), equal to about 4800 deaths a day.    
• disease of poverty, affecting mostly young  adults in their most productive years.    
• vast majority of TB deaths are in the  developing world, with more than half occurring in Asia.   

   
• TB is a leading killer among people living  with HIV, who have weakened immune systems.   



   
• There were 9.27 million new TB cases in 2007,  of which 80% were in just 22 countries. Per capita, the global TB incidence  rate is falling, but the rate of decline is very slow - less than 1%.   



   
• TB is a worldwide pandemic. Among the 15  countries with the highest estimated TB incidence rates, 13 are in Africa,  while half of all new cases are in six Asian countries (Bangladesh, China,  India, Indonesia, Pakistan and the Philippines).   

   
• Multidrug-resistant TB (MDR-TB) is a form of  TB that does not respond to the standard treatments using first-line drugs.    
• MDR-TB is present in virtually all countries  surveyed by WHO and its partners.   

   
• estimated 511 000 new MDR-TB cases in 2007  with three countries accounting for 56% of all cases globally: China, India and  the Russian Federation.    
• Extensively drug-resistant TB (XDR-TB) occurs  when resistance to 2nd -line drugs develops.   
•  It is  extremely difficult to treat and cases have been confirmed in more than 50  countries.    

   
• WHO’s Stop TB Strategy aims to reach all pts    
• MDG: target - reduce by 2015 the prevalence  of & deaths due to TB by 50% relative to 1990 and reverse the trend in  incidence.    
• The strategy emphasizes the need for proper  health systems and the importance of effective primary health care to address  the TB epidemic.    

   
• The Global Plan to Stop TB 2006-2015,  launched January 2006, aims to achieve the MDG target with an investment of US$  67 billion. This represents more than a ¾ increase in investment from 2005. The  estimated funding gap is US$ 40 billion.   

     
     • Estimated incidence 
• 1.96 million new cases annually
       • 0.8 million new smear positive cases annually         
• 75 new smear positive PTB cases/1lakh  population per year         
• Estimated prevalence of TB disease 
• 3.8 million bacillary cases in 2000
• 1.7 million new smear positive cases in 2000       
       • Estimated mortality 
• 330,000 deaths due to TB each year         
• Over 1000 deaths a day         
• 2 deaths every 3 minutes               

     
• Prevalence of TB infection      
• 40% (~400m) infected with 

Author | Roli Gautam, MD

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