Gestational diabetes mellitus (GDM) is a controversial subject in obstetrics. It is defined by the National Diabetes Data Group in 1985 as carbohydrate intolerance of variable severity with onset or first recognition during pregnancy.1 The first case report of GDM appeared in 1824, which described a mother with thirst, polyuria and glycosuria and the death of a macrosomic infant from shoulder impaction. Historically, there has been a lot of controversy over most aspects of GDM, including screening, diagnosis, risks, treatment, and the relationship between GDM and type 2 diabetes mellitus. Recently, several major studies have substantially resolved these areas of controversy, eg, the Hyperglycaemia and Adverse Pregnancy Outcomes (HAPO) study,2 the Australian Carbohydrate Intolerance Study in Pregnant Women (ACHOIS),3 and the Maternal-Fetal Medicine Units Network treatment of mild gestational diabetes (MFMUN-GDM)4 clinical trials, which will be discussed further in this article.
Menopause is a health milestone, signalling a new phase in a woman’s life. It is a natural event characterized by the permanent cessation of menstruation due to loss of ovarian follicular function. Many women breeze through this life stage with little or no issues, while some have bothersome menopausal symptoms that require medical intervention.
Infertility generally affects one in seven couples and is a growing problem worldwide.1,2 This is illustrated by the increase in the number of assisted reproductive technology (ART) treatment cycles worldwide in 2009–2010, ranging from an increase of 5.9% to over 100%.3–5 Male subfertility is one of the major causes, as a sole factor accounting for 29.7% and as a contributor for another 10.3–29.7% in the United Kingdom and Hong Kong.3,5 There is some evidence suggesting that there might be a decline in semen concentration of men born in the 1930’s to 1980’s.6–8
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The inclusion of statins in managing chronic kidney disease (CKD) may help reduce patient mortality from stroke and possibly other cardiovascular events, according to an expert at the 7th Malaysian Endocrine and Metabolic Society (MEMS) Annual Congress.
Patients with hypercholesterolaemia with unchanging LDL-cholesterol levels after 6 weeks of statin treatment should be actively assessed for either statin intolerance or resistance, says an expert at the 7th Malaysian Endocrine and Metabolic Society (MEMS) Annual Congress.
This case scenario was presented at a grand round in the Department of Medicine, The University of Hong Kong. Unlike traditional grand rounds that directly or indirectly deal with clinical challenges posed by patients, this one was equally about doctors and how they care for their charges. All doctors who tend patients dread being implicated on the receiving end of medico-legal proceedings. This topic is therefore intimately linked to the professionalism of doctors, their standing in the community, and the ethical aspects of how they interact with patients and relatives.