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 marketing logistic chain, as an integrated system aimed to balance the achievement of its main opposite objectives which represented in the access to the best service presented to the customer with lowest possible logistic costs especially the transportation costs, where encourages the researcher to choose the second objective as a field of this study in order to reduce the transportation costs in the final link of marketing logistic chain which related to delivering of fuel oil to the customer that falls within organizational responsibilities of the company under consideration (Oil Marketing Company) and also known in a brief name by (SOMO) through two methods, the first is by functioning quantative techniques by using trans
... Show MoreGod Almighty set out to build mosques, and he commanded to seek their architecture, and the competition for them, and allocate them with types of worship that are not valid in others, and to preserve their sanctity and not to be degraded and taken for mundane purposes and special benefits, because they are considered one of the most prominent features of Islam and the rituals of Islamic society, so this research came to show the rule Sharia in various and contemporary issues that are needed by the imams of the mosques, their rulers, and those responsible for them. Among the issues in which they have examined comparative juristic research and reached the most correct opinion are:
Building mosques over or under buildings and factories i
Abstract
The pressures of life have become a tangible phenomenon in all societies in varying degrees. This disparity determines several factors, including the nature of societies, the level of their urbanization, the intensity of interaction, the intensity of conflict, and the increasing rate of change in those societies. many people name The modern era in which we live the “era of pressures", where one of the most important of these changes is the “new Coronavirus 19-COVID”, which has spread widely throughout the world, as the pandemic, has affected all aspects of daily life, including the educational and academic process, academic activities have been suspended in universities, which caused sudden change
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... Show MoreThe study included the description of external body parts and the male genitalia for the male of rusty flour beetle Tribolium castaneum (Herbst,1797) and the studied was supported by illustrations