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.
Background/Aim: Knee osteoarthritis is a frequently crippling chronic condition. Numerous pharmacological medications have been successfully utilised to treat knee osteoarthritis. This research aimed to compare the efficiency of metformin and serratiopeptidase in treating and preventing osteoarthritis development via distinct mechanisms. Methods: Between 1 January and 30 May 2019, a randomised-clinical-trial was done at Al-Kindy Hospital on 80 osteoarthritis patients, divided in two groups. Group I was given metformin 850 mg orally, whereas Group II was given serratiopeptidase 20 mg and metformin 850 mg orally. Parameters in these groups were compared with forty healthy normal controls. Results: Following treatment, patients in Grou
... Show MoreThe aim of the present study is to investigate whether or not xanthine oxidase (XO)–derived reactive oxygen species (ROS) may play a role in the pathogenesis of alloxan (ALX)–induced diabetes in rats using the specific XO inhibitor and hydroxyl radical scavenger, allopurinol
The involvement of oxidative stress in ALX – diabetes was assessed by the measurement of plasma and various tissues lipid peroxides levels ( using thiobarbituric acid ( TBA ) reactive substances ). Furthermore, the ability of allopurinol to influence these and other biochemical parameters, including plasma and urine ketones levels were also investigated in diabetic rats.
Rats were divided into four groups: control, untreated diabe
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Background: Diabetes mellitus is the most common endocrine illness, affecting an increasing number of people all over the world. It is caused by a lack, or inadequate synthesis of insulin by the pancreas leading to an increase in blood glucose concentrations. Type 2 diabetes mellitus is the most strongly linked disease to obesity of all disorders. The number of obesity-related diabetes is predicted to reach 300 million by 2025. The term 'diabesity' was coined as a result of this strong link, therefore, weight loss is seen as a key therapeutic goal in the prevention and management of type 2 diabetes mellitus. Liraglutide is a glucagon-like peptide-1 (GLP-1) receptor agon
... Show MoreThe aim of the currnet study to examine the effect of subclinical hypothyroidism (SCH) in diabetic patients on coagulation parameters. This retrospective case–control study involves 130 patients diagnosed with type 2 diabetes mellitus (T2DM), divided into 65 T2DM with newly diagnosed SCH and 65 euthyroid (EUT) T2DM patients without SCH. Fibrinogen (FIB) was significantly higher in SCH (508.2 ± 63.0 mg/dL) than EUT (428.1 ± 44.8 mg/dL). In the SCH patients, FIB correlated with several parameters, such as age (β = 0.396), body mass index (β = 0.578), glycated hemoglobin (β = 0.281), and activated partial thromboplastin time (β = 0.276). In conclusion SCH in DM patients appears to increase the magnitude of coagulopathy.
... Show MoreOBJECTIVE: Synthetic vertebral body replacement has been widely used recently to treat different spinal conditions affecting the anterior column. They arrange from trauma, infections, and even tumor conditions. In this study, we assess the functional outcome of this modality in different spinal conditions. PATIENTS AND METHODS: Thirty-six cases operated from October 2010 to December 2017. Twelve patients had spinal type A3 fractures, 11 cases with spinal tuberculosis (TB), and 13 cases with spinal tumors. They were followed clinically for a mean period of 2.4 years. RESULTS: All the cases were approached anteriorly. Seven cases had a post-operative infection. No neurological worsening reported. We had dramatic neurologic
... Show MoreBackground: Oxidative stress may contribute to the etiology of hypertension in humans. Oxidative stress is an imbalance between reactive oxygen species (ROS) and antioxidant defense mechanisms, causing damage to biological macromolecules and dysregulation of normal metabolism and physiology. Amlodipine as an antihypertensive agent is a long-acting calcium channel blocker that dilates blood vessels and improves blood flow. The aim of this study was to assess the oxidative stress in hypertensive patients on Amlodipine treatment through the assessment of salivary Malondialdehyde (MDA) and superoxide dismutase (SOD) as a marker of oxidative stress.
Mat
... Show MoreThe effect of thickness variation on some physical properties of hematite α-Fe2O3 thin films was investigated. An Fe2O3 bulk in the form of pellet was prepared by cold pressing of Fe2O3 powder with subsequent sintering at 800 . Thin films with various thicknesses were obtained on glass substrates by pulsed laser deposition technique. The films properties were characterized by XRD, and FT-IR. The deposited iron oxide thin films showed a single hematite phase with polycrystalline rhombohedral crystal structure .The thickness of films were estimated by using spectrometer to be (185-232) nm. Using Debye Scherrerś formula, the average grain size for the samples was found to be (18-32) nm. Atomic force microscopy indicated that the films had
... Show MoreObjective: To assess prospectively functional outcome of interlocked intramedullary nailing fixation in management of closed tibia shaft fractures. Methodology: This prospective study included 134 patients with closed shaft tibia fractures with age 18-60 years and isolated closed fracture of shaft of tibia. The fractures were fixed by interlocking intramedullary nail. At follow-up after 12 months postoperatively, the functional outcome was assessed radiographically for the sign of union and clinically according to Klemm-Borner criteria. Results: The mean age was 38.55 years. Out of 134 patients, 55.2% were male. The cause was road traffic accident in 44.8%, majority of the fracture occur in the mid-shaft (41.8%), and oblique fracture was th
... Show MoreBackground: urethrocutaneous fistula after hypospadias surgery repair is the most common complication and remains a frustrating problem for surgeon and the patient. The problem is exacerbated because the urethrocutaneous fistula may recur which adds more demands surgery.
Objectives: The purpose of this study is to evaluate of the use of oral mucosal graft for management of recurrent urethrocutaneous fistula after hypospadias repair.
Patients and Methods: twelfth patients with age ranging from 4 year to 15 years were presented with history of recurrent fistula. Most of fistula were located in proximal penile and penoscrotal region (58.3%) . those patients were repaired by using oral mucosal graft with mean postoperative follow up pe
Background: urethrocutaneous fistula after hypospadias surgery repair is the most common complication and remains a frustrating problem for surgeon and the patient. The problem is exacerbated because the urethrocutaneous fistula may recur which adds more demands surgery. Objectives: The purpose of this study is to evaluate of the use of oral mucosal graft for management of recurrent urethrocutaneous fistula after hypospadias repair. Patients and Methods: twelfth patients with age ranging from 4 year to 15 years were presented with history of recurrent fistula. Most of fistula were located in proximal penile and penoscrotal region (58.3%) . those patients were repaired by using oral mucosal graft with mean postoperative follow up period up t
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