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.
In the present work, a kinetic study was performed to the extraction of phosphate from Iraqi Akashat phosphate ore using organic acid. Leaching was studied using lactic acid for the separation of calcareous materials (mainly calcite). Reaction conditions were 2% by weight acid concentration and 5ml/gm of acid volume to ore weight ratio. Reaction time was taken in the range 2 to 30 minutes (step 2 minutes) to determine the reaction rate constant k based on the change in calcite concentration. To determine value of activation energy when reaction temperature is varied from 25 to 65 , another investigation was accomplished. Through the kinetic data, it was found that selective leaching was controlled by
... Show MoreBac kground: The transfer of the tibialis posterior tendon to the anterior aspect
of the ankle not only replaces the function of the paralyzed muscles, but also
removes the deforming force on the medial aspect of the foot.
Objec t i ves : In this study, we evaluated patients who underwent tibialis
posterior tendon transfer for the treatment of foot drop, and comparison through
interosseous membrane route versus anterior to lower tibia route of tibialis
posterior tendon transfer, with evaluation of the results according to carayon
criteria
Methods: Nine patients with foot drop secondary to different causes treated with
tibialis posterior tendon transfer from January 2011 to January 2012 were
followed up for a
Esterification reaction is most important reaction in biodiesel production. In this study, oleic acid was used as a suggested feedstock to study and simulate production of biodiesel. Batch esterification of oleic acid was carried out at operating conditions; temperature from 40 to 70 °C, ethanol to oleic acid molar ratio from 1/1 to 6/1, H2SO4 as the catalyst 1 and 5% wt of oleic acid, reaction time up to 180 min. The optimum conditions for the esterification reaction were molar ratio of ethanol/oleic acid 6/1, 5%wt H2SO4 relative to oleic acid, 70 °C, 90 min and conversion of oleic 0.92. The activation energy for the suggested model was 26625 J/mole for forward reaction and 42189 J/mole for equilibrium constant. The obtained results s
... Show MoreThe study aimed to reach the best rating for the views and variables in the totals characterized by qualities and characteristics common within each group and distinguish them from aggregates other for the purpose of distinguishing between Iraqi provinces which suffer from deprivation, for the purpose of identifying the status of those provinces in the early allowing interested parties and regulators to intervene to take appropriate corrective action in a timely manner. Style has been used cluster analysis Cluster analysis to reach the best rating to those totals from the provinces that suffer from problems, where the provinces were classified, based on the variables (Edu
... Show MoreLanguage contains various kinds of grammatical rules that are used to express thoughts and feelings. The present paper studies some of the German language grammatical rules as being the most important basics needed to master and develop the art of writing for the German language learners. Writing is one of the productive language learning skills that transform thoughts into a written form. Hence, constant exercising on the use of the language to master the grammatical rules enables German language learners to develop their creative writing skills.
The present study discusses the importance of grammatical exercises in developing the language learning abilities. The study provides a gener
... Show MoreThe organizational structure of relations between states is among the main features that distinguished the twentieth century as the era of international organization, especially after the increase in the number of political units after World War II in which regionalism was crystallized as a phenomenon. It is not modern, as there are many blocs such as the European Union that have developed in it, the idea of regional bloc is prominent, especially in Europe, as it emerged after a controversy revolved around what was called globalism in the face of Globalism vs. Regionalism. Regional, as the proponents of the global orientation saw the establishment of a global organization that includes all countries, as the best way to achieve inte
... Show MoreThe Main Outfall drain pumping station in Nassiriyah is an important part in operation system of the Main Outfall Drain (MOD) where it reduces the water levels in the U/S area of its and converted through Syphon freely under the Euphrates, its consists of several parts: U/S Basin, Station Building which contains 12 pumps, and Head Basin with Syphon, This station suffers from high levels especially in D/S area due to the current situation which is represented by establishing of dyke with pipes on MOD which located at 24 km from D/S of pumping station and Al-Khamisiyah Canal which located at 2.3 km from the U/S of dyke which feeds(Al Hammar Marsh) during drought season, several scenarios were adopted in order to expl
... Show MoreThe research material was prune plums (
During 9–10 September 2011 the ACE, Wind, and SOHO spacecraft measured the complex interaction between an interplanetary coronal mass ejection (ICME) and a corotating interaction region (CIR) associated with the heliospheric sector boundary. Except for a few short periods, the suprathermal electrons are unidirectional, suggesting that the ICME magnetic field has opened through interchange reconnection. Signatures of interaction are distributed throughout the event suggesting that the structures have become entangled or embedded. Since the ICME speed is relatively low, the strong forward shock must be caused by the ICME‐CIR interaction. Other interesting features are the upstream heating flux disc
A total of 589 fishes, belonging to 23 species were collected from eight different localities
in north and mid Iraq during 1993. The parasitological inspection of such fishes revealed the
presence of 59 parasite species and two fungi. Among such parasites, five monogenetic
trematodes were recorded on the gills of some fishes for the first time in Iraq. These
included:- Ancyrocephalus vanbenedenii on Liza abu from Tigris river at Al-Zaafaraniya,
south of Baghdad; Dactylogyrus anchoratus on Cyprinus carpio from Tigris river at Al –
Zaafaranya D. minutus on C. carpio from both Tigris river at Al-Zaafaraniya and Euphrates
river at Al-Qadisiya dam lake; Discocotyle sagittata on L. abu from both the drainage system
at