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.
This study was aimed to develop an optimized Dy determination method using differential pulse voltammetry (DPV). The Plackett-Burman (PB) experimental design was used to select significant factors that affect the electrical current response, which were further optimized using the response surface method-central composite design (RSM-CCD). The type of electrolyte solution and amplitude modulation were found as two most significant factors, among the nine factors tested, which enhance the current response based on PB design. Further optimization using RSM-CCD shows that the optimum values for the tw
... Show MoreCoronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a pandemic worldwide. On a daily basis the number of deaths associated with COVID-19 is rapidly increasing. The main transmission route of SARS-CoV-2 is through the air (airborne transmission). This review details the airborne transmission of SARS-CoV-2, the aerodynamics, and different modes of transmission (e.g. droplets, droplet nuclei, and aerosol particles). SARS-CoV-2 can be transmitted by an infected person during activities such as expiration, coughing, sneezing, and talking. During such activities and some medical procedures, aerosols and droplets contaminated with SARS-CoV-2 particles are formed. Depending on their
... Show MoreWhen the flange of a reinforced concrete spandrel beam is in tension, current design codes and specifications enable a portion of the bonded flexure tension reinforcement to be distributed over an effective flange width. The flexural behavior of the RC L-shaped spandrel beam when reinforcement is laterally displaced in the tension flange is investigated experimentally and numerically in this work. Numerical analysis utilizing the finite element method is performed on discretized flanged beam models validated using experimentally verified L-shaped beam specimens to achieve study objectives. A parametric study was carried out to evaluate the influence of various factors on the beam’s flexure behavior. Results showed that
... Show MoreThe recent advances in technology, the increased dependence on electrical energy and the emergence of the fourth industrial revolution (Industry 4.0) were all factors in the increased need for smart, efficient and reliable energy systems. This introduced the concept of the Smart Grid (SG). A SG is a potential replacement for older power grids, capable of adapting and distributing energy based on demand. SG systems are complex. They combine various components and have high requirements for real time reliable operation. This paper attempts to provide an overview of SG systems, by outlining SG architecture and various components. It also introduces communication technologies, integration and network management tools that are involved in SG sys
... Show MoreIn this study, a cholera model with asymptomatic carriers was examined. A Holling type-II functional response function was used to describe disease transmission. For analyzing the dynamical behavior of cholera disease, a fractional-order model was developed. First, the positivity and boundedness of the system's solutions were established. The local stability of the equilibrium points was also analyzed. Second, a Lyapunov function was used to construct the global asymptotic stability of the system for both endemic and disease-free equilibrium points. Finally, numerical simulations and sensitivity analysis were carried out using matlab software to demonstrate the accuracy and validate the obtained results.
This paper demonstrates an experimental and numerical study aimed at comparing the influence of openings of different configurations on the flexural behavior of reinforced concrete gable roof beams. The experimental program consisted of testing six simply supported gable beams subjected to mid-point concentrated load. The variable which has been investigated in this work was opening's configuration (quadrilateral or circular) with the same upper and lower chords depth. The results indicate improvement in the beams’ flexural behavior when circular openings were used compared with that of quadrilateral openings, represented by an increase in ultimate load capacity and a decrease in deflection at the service limit. Also, there was an
... Show MoreAmino and fatty acids in the liver tissue of Uromastyx aegyptius microlepis during the periods of hibernation (December) and activity (May) were estimate by a high performance liquid chromatography, liver of a lizard during the activity and hibernation seasons, contained 18 amino acids, which include, 10 essential amino acids and 8 non-essential amino acids, and the liver in the male lizard contained five fatty acids during each season, the concentration rates of all the amino acids during the activity season were higher than their counterparts during the hibernation season, the total concentrations of essential and non-essential amino acids during the activity season were 19434.8 µg/ml, which was greater than the total concentrations leve
... Show MoreThe aim of the present study is to provide the adequate knowledge about the role of time management in facilitate the work requirements for employees of the administrative department at the Ministry of Higher Education and Scientific Research. The research depend on studying four important dimensions which are (time planning, time organization, time direction and time observation). In addition to study other five dimensions which are (new procedures, clear procedures, short procedures, the available information and the simplicity of the methods
used).Questionnaire sheets consist of (38 questions) distributed to (170) employees and (146) sheets only were considered in the study. SPSS program was used
... Show MoreBackground: presence of lingual vascular foramina and canals in the interforaminal region may increase the risk ofsurgical complications during implant placement or any surgical procedure in this area. Aim of this study is the radiological evaluation of the anatomic characteristic of the lingual foramina and their vascular canals in the anterior of the mandible using cone beam computed tomography. Materials and Methods: Prospective study including 72 Iraqi subjects (31 male and 41 female) ranging from 20 to 59 years, all subjects attended Al-Sharaa dental clinic in AL-Najaf AL-Ashraf city, scanned with CBCT from September 2016 to February 2017. Using 3dimentional and sagittal cross section to detect lingual foramina and their vascular canal
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