Objectives: Teenage pregnancy with gestational diabetes mellitus (GDM) offers a real challenge to the health system and needs a special care. We aimed to evaluate possible obstetrical and neonatal adverse events of different treatment protocols in adolescent GDM including lifestyle, metformin (MTF), and insulin. Methods: All teen pregnant women ≤ 19 years old visiting Baghdad Teaching Hospital throughout four years (from June 1, 2016 till May 31, 2020) diagnosed with GDM were included in this cohort study and followed-up closely throughout pregnancy and after delivery. Included adolescents were put on lifestyle alone during the first week of presentation. Adolescents who reached target glucose measurements were categorized into lifestyle group, while other adolescents were randomly allocated into MTF and insulin groups. Also, adolescent pregnant women without GDM were recruited as control group using computer randomization. Results: The GDM (110 cases) and control (121 individuals) groups had matched general features at recruitment except for diabetes family history. Also, GDM treatment groups had matched features. Glycemic readings (fasting and random) was significantly (p< 0.05) higher in insulin group having odds ratio (OR) of 1.41, and 1.57, respectively. In MTF group, significant protective OR was found in preeclampsia (OR=0.76, p< 0.05). MTF showed non-significant protective OR regarding prematurity and five minutes Apgar score>7 [(OR=0.83, p=0.24), and (OR=0.94, p=0.73), respectively], and significant protective association with large for gestational age and admission to neonatal intensive unit. Insulin had significantly higher prematurity, small for gestational age, and hypoglycemia [OR=1.89, 2.53, and 2.84, respectively]. Conclusion: Metformin (MTF) showed less pregnancy and neonatal complications in adolescent GDM than insulin and lifestyle. doi: https://doi.org/10.12669/pjms.37.4.3966 How to cite this:Jasim SK, Al-Momen H, Wahbi MA. Treatment options of Adolescent Gestational Diabetes: Effect on Outcome. Pak J Med Sci. 2021;37(4):1139-1144. doi: https://doi.org/10.12669/pjms.37.4.3966 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cesarean section, which was introduced into clinical practice as a lifesaving procedure for both the mother and the baby, is one of the most common surgeries performed in modern obstetrics. Formerly it was performed in interest of the mother; currently it is frequently done for fetal indication. As other procedures of some complexity, its use follows the health care inequity pattern of the world; underuse in low income setting, and adequate or even unnecessary use in middle and high income setting (1).
The first modern cesarean section was performed by German gynecologist Ferdinand Adolf Kehrer in 1881. Cesarean section is often performed when a vaginal delivery would put the baby's or mother's life or health at risk. Many are also pe
Prenatal markers are commonly used in practice to screen for some foetal abnormalities. They can be biochemical or ultrasonic markers in addition to the newly used cell free Deoxyribonucleic Acid (DNA) estimation. This review aimed to illustrate the applications of the prenatal screening, and the reliability of these tests in detecting the presence of abnormal chromosomes such as trisomy-21, trisomy-18, and trisomy-13 in addition to neural tube defects. Prenatal markers can also be used in the anticipation of some obstetrical complications depending on levels of these markers in the mother’s circulation. In the developed countries, prenatal screening tests are regularly used during antenatal care period. Neural tube defects, numer
... Show MoreThe Esterification kinetics of acetic acid with ethanol in the presence of sulfuric acid as a homogenous catalyst was studied with isothermal batch experiments at 50-60°C and at a different molar ratio of ethanol to acetic acid [EtOH/Ac]. Investigation of kinetics of the reaction indicated that the low of [EtOH/Ac] molar ratio is favored for esterification reaction, this is due to the reaction is catalyzed by acid. The maximum conversion, approximately 80% was obtained at 60°C for molar ratio of 10 EtOH/Ac. It was found that increasing temperature of the reaction, increases the rate constant and conversion at a certain mole ratio, that is due to the esterification is exothermic. Activity coefficients were calculated using UNIFAC progra
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The current research aims to identify the communicative competence of university students, to identify the levels of communicative competence among university students and which of these levels are more common, and to identify the significance of differences in communicative competence among university students according to the variables of gender and specialization. The study population consisted of (782) male and female students, as the statistical analysis sample was limited to (400) male and female students to extract the psychometric properties of the current research tool. The study sample included (382) male and female students at the University of Baghdad who were chosen by the stratified random
... Show MoreDiyala Governorate was recently exposed to high flood waves discharged from Hemrin Dam. Since the dam was at its full capacity during the flood period, these waves were discharged to the Diyala River. Because of the reduction in Diyala River capacity to 750m3/s, the cities and villages on both sides of the river banks were inundated. Thus, the study's objective is to design a flood escape out of the Diyala River, to discharge the flood wave through it. The flood escape simulation was done by using HEC- RAS software. Two hundred twenty-three cross sections for the escape and 30 cross-sections of the Diyala River were used as geometric data. Depending on the geological formation that the escape passed t
... Show MoreIn contemporary discourses the debate of most Western thinkers is about the efforts to clarify the normative foundations of democracy. And then, some political thinkers have adopted other models differ in terms of standards for traditional liberal democracy. Be the common goal of democracy will give the formation of a greater role than usual in political liberalism rather than limiting the participatory activity of citizens on the function to give permanent legitimacy to the exercise of state authority. The activity is to be permanently enshrined in the democratic public sphere and the issue must be understood as the source of all political decisions.
This research aims at identifying the level of Reflective Judgment for University students in term of gender and stage. To this end, the researcher used Khaleel's scale (2016) for the Reflective Judgment. The scale was administered to the sample of the study which is (200) male and female level first-fourth university students. The results have shown that university students are on the level five of the Reflective Judgment, and the first-stage students have reflective judgment more than fourth-stage students. In the light of these results, the researcher has come with a number of recommendations and suggestions.
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A mathematical model and associated computer program were developed to simulate the steady state operation of wiped film evaporators for the concentration of glycerol-water solution. In this model, various assumptions were made to facilitate the mathematical model of the wiped film evaporator. The fundamental phenomena described were: sensible heating of the solution and vaporization of water. Physical property data were coded into the computer program, which performs the calculations of this model. Randomly selected experiments were carried out in a small scale wiped film evaporator from ALVAL COMPANY, using different concentrations of the glycerol solution (10, 30 and 50 Wt. %) for different feed rates (30, 50, 80, 100 and 120 l/h) and
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