Correlation between First Trimester Serum Uric Acid Concentration and Its association with Gestational Diabetes Mellitus

INTRODUCTION: Diabetes is one of the common medical disorders in India and is not so uncommon to encounter in the pregnant women. It is associated with high perinatal mortality and morbidity if it is not well controlled. Early diagnosis and treatment is very important to prevent fetal and maternal complications. AIM OF THE STUDY: To detect correlation between first trimester serum uric acid and its association with Gestational Diabetes Mellitus (GDM). MATERIALS AND METHODS: Study conducted in institute of Obstetrics and Gynaecology, Chennai, in which 200 antenatal women were recruited for prospective study and maternal serum uric acid was measured before 13 weeks of pregnancy. All patients will undergo Oral Glucose Challenge Test (OGCT) between 22-24 weeks of gestation, if the value is > 200, then the patients are considered as having GDM. If OGCT > 140 mg/ dl patient at increased risk of GDM, then they undergo 100gm GTT to confirm GDM. RESULT: Out of 200 patients, 111 patients had elevated serum uric acid > 3.6 mg/dl, among them 91 patients developed GDM. The Receiver Operator Curve showed serum uric acid as a predictor of GDM with Area under Curve of 0.819[95% CI: (0.759-0.870)] with a sensitivity of 87.5%, specificity of 79.2% at an Optimum criterion > 3.6 mg/dl. First trimester uric acid concentrations > 3.6 mg/dl were associated with a trend towards increased risk of developing gestational diabetes (adjusted ODDS RATIO =5. 95%CI: 0.759-.870) compared to women with concentrations below this level. It was statistically significant, p value was 0.0001. CONCLUSION: We concluded from this study, there is risk of development of GDM with elevated levels of serum uric acid in the first trimester. This relationship is independent of age, parity, BMI and family history of diabetes mellitus though there is association of these variables (advanced maternal age, high parity, increased BMI and positive family history) with GDM. Uric acid levels at < 13 weeks of gestation is more significantly associated with risk of development of GDM

Development and Validation of Multi-Modality Instructional Model

Development of models of teaching is the recent innovation in teaching. An important purpose of discussing models of teaching is to assist the teacher to have a wide range of approaches for creating a proper interactive environment for learning. An intelligent use of these approaches enables the teacher to adopt him to the learning needs of the students. A number of educationist and psychologists have proposed model approach to teaching. A model of teaching consists of guidelines for designing educational activities and environments. Model of teaching is a plan that can also be utilized to shape courses of studies, to design instructional material and to guide instruction. Joyce and Weil, (1972) [19] explained Teaching of model is a pattern or plan, which can be a curriculum or courses to select instructional materials and to guide a teachers actions. Educators and psychologist have design several types of teaching models which provides suitable guidelines to the teachers for modifying the behaviour of the learners. As a matter of facts some sorts of models of teaching have been existence since times immemorial. In simple language a models of teaching may be defined as a blueprint designed in advance for providing necessary structure and direction to the teacher for realizing the stipulated objectives. After the investigator completed the determination of the steps the model was presented to the panel of experts. The panel of experts scrutinized and validated the steps of the model and gave their opinion about the fitness of the model for application. They further commented to conduct a pilot study with the application of the model From the pilot try out of the model it was found to be effective for application in classroom teaching. &nbsp

Asepsis in Operative Dentistry and Endodontics

Operative (Conservative) dentistry and endodontics are specialties of dentistry where the operator is exposed to various infectious agents either via contact with infected tissues, fluids or aerosol. The potential for cross infection to happen at the dental office is great and every dentist must have a thorough knowledge of the concepts of sterilization and disinfection. Disposables should be used wherever possible. Furthermore, the water supply to the dental chair units and water outlets can house biofilms of microbes and should be considered as possible sources of infection. This review discusses the importance of following strict aseptic protocols from the perspective of operative dentistry and endodontics