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.
The professional skepticism is one of the fundamental concepts necessary for practicing the audit profession, without which the auditor can not reach a reasonable assurance as to the correctness of the evidence and the information obtained by the auditing department. The auditor's possession of the characteristics of professional skepticism and his practice of professional skepticism during the audit process lead to an increase The quality of audit and thus raise the confidence of the financial community in the audit profession again after the exposure of several crises led to the loss of financial society confidence in the audit profession.
The aim of the study is to measure the impact of professional sk
... Show MoreThis work was conducted to study the oxidation of phenol in aqueous solution using copper based catalyst with zinc as promoter and different carrier, i.e. γ-Alumina and silica. These catalysts were prepared by impregnation method.
The effect of catalyst composition, pH (5.6-9), phenol to catalyst concentration ratio (2-0.5), air feed rate (30-50) ml/s, stirring speed (400-800) rpm, and temperature (80-100) °C were examined in order to find the best conditions for phenol conversion.
The best operating conditions which lead to maximum phenol conversion (73.1%) are : 7.5 pH, 4/6 phenol to catalyst concentration, 40 ml/s air feed rate, 600 rpm stirring speed, and 100 °C reaction temperature. The reaction involved an induction period
The research aim to measure the impact of the Industry specialization of the auditors on the quality in audit in Iraqi auditing firms, as well as measuring the factors of Industry specialization in the Iraqi audit companies by measuring the market shares of Iraqi audit firms that audit the companies listed on the Iraqi Stock Exchange For 2010 to 2016, by surveying the opinions of (35) Audit firm on the impact of the Industry specialization of auditing firms in audit quality factors, The effect of the variables was revealed through the use of the survey form Distributed to Iraqi audit companies, The industry speci
... Show MoreFree cement refractory concrete is a type of refractory concrete with replacing alumina cement by bonding materials such as white kaolin, red kaolin and fumed silica. The free cement refractory concrete used in many applications like Petrochemicals, iron furnaces and cement production industries. The research clarifies the effect of steel fibers with two types crimped steel fibers and hooked steel
fibers with percentages 0.5%, 1% and 1.5% by volume from weight of bauxite aggregates. The additions of steel fibers with two types gave good properties in high temperatures where the specimens keep the dimension without failure and the properties made the best. the percentage of increasing for thermal conductivity was 44% for 1.5% crimped
Many studies have been made and still concerning the field of translation. Since the mid-90's a considerable amount of researches has tackled the problem of gender and its effect on the process and the product of translation. Simon (1996, p 508) points out that when comparing women and men as translators and writers through history, women seem to be the weaker side. This paves the way to feminist movements which produce prominent studies concerning gender as a concept and translator's gender as practice on the quality and the accuracy of the translation.
Flotow (in Meschia, 2012, p 1-4) outlines several issues that can be
... Show MoreEP/ metal composites were prepared as adhesives between two steel rods. Epoxy resin (EP) was used as a matrix with metal as fillers (Al, Cu, Fe,).
The preparation method for tensile adhesion tests includes two steel rods with adhesive composites between the rods to measure adhesion strength Sad and adhesion toughness Gad.
Results of tensile adhesion tests show that EP/ metals composite have maximum strength Sad for certain weight percentage of metals 2.95 and 9MPa at 10% for EP/Al and EP/Cu composite and 8.2MPa at 40% for EP/Fe composites
In this research, (MOORA) approach based– Taguchi design was used to convert the multi-performance problem into a single-performance problem for nine experiments which built (Taguchi (L9) orthogonal array) for carburization operation. The main variables that had a great effect on carburizing operation are carburization temperature (oC), carburization time (hrs.) and tempering temperature (oC). This study was also focused on calculating the amount of carbon penetration, the value of hardness and optimal values obtained during the optimization by Taguchi approach and MOORA method for multiple parameters. In this study, the carburization process was done in temperature between (850 to 950 ᵒC) for 2 to 6
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