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: Moral distress, as one of the most important issues in the nursing profession, can negatively affect the healthcare system Objectives: To examine the effect of moral distress on decision making. Methodology: A descriptive cross-sectional study a non-probability sampling method was used and a total sample collected was (126) ICU nurses Result: Moral distress among ICUs nurses were moderate and decision making was good Conclusion: Although nurses in ICUs perceive good decision making but suffered from moderate MD which affected their decision making. MD is still an important issue that nurses may face in ICUs Conclusion: Although nurses in ICUs perceive good decision making but suffered from moderate MD which affected the
... Show MoreThe purpose of this research was to investigate the beneficial effects of phosphatidylcholine in reducing changes in both lipid and protein profiles in addition to atherogenic index in adult rats with fructose-induced metabolic syndrome. Thirty-six mature Wistar Albino female rats (Rattus norvegicus) (aged 12-15 weeks and weighing 200±10 g) were divided randomly into four groups (G1, G2, G3, and G4); then variable treatments were orally administered for 62 days as follows: G1 (Control group), received distilled water; G2, treated with phosphatidylcholine (PC) orally (1 g/kg BW); G3 (Fr), orally dosed with 40% fructose and 25% fructose mixed with drinking water; G4 (Fr+PC), were also intubated with 40% fr
... Show MoreBackground: Patients who have both neurological impairment and kyphotic deformity can be treated medically, and this treatment can be achieved with anti-tuberculous drugs alone.
Objective: To evaluate conservative medical management of patients with tuberculosis of the spine (Pott disease). The prognostic significance of various clinical, radiological, and long-term follow-up findings in these patients was also evaluated.
Methods: Between January 2009 and January 2018 data were collected prospectively at The Neurosciences Hospital/ Baghdad/ Iraq in 44 patients with Pott disease in the thoracic and lumbar spine. These patients had no major neurological deficits or
... Show MoreThe banking system considered as one of the most important intermediate circle between creditor and debtors it is mean the most important funding rings in economic activity, whether finance takes the a consumer or investment form and therefore it is the main base to stimulate economic activity both on the demand side, both consumption and investment and therefore of the main motivating factors for economic growth.
The banking system depends in achieve its goals on the grants and loan recovery, or what is known credit process and according to what the importance referred to the role of the banking system, it is important to ensure the safety and efficiency of the mechanisms of banking device and safety is
... Show MoreSansevieriatrifasciata was studied as a potential biosorbent for chromium, copper and nickel removal in batch process from electroplating and tannery effluents. Different parameters influencing the biosorption process such as pH, contact time, and amount of biosorbent were optimized while using the 80 mm sized particles of the biosorbent. As high as 91.3 % Ni and 92.7 % Cu were removed at pH of 6 and 4.5 respectively, while optimum Cr removal of 91.34 % from electroplating and 94.6 % from tannery effluents was found at pH 6.0 and 4.0 respectively. Pseudo second order model was found to best fit the kinetic data for all the metals as evidenced by their greater R2 values. FTIR characterization of biosorbent revealed the presence of carboxyl a
... Show MoreBackground: Numerous methods have been described for achievement of Intermaxillary fixation in the treatment of fractures of facial skeleton. Conventional methods like Erich arch bars and eyelet wires are currently the most common methods for achieving intermaxillary fixation (IMF), however, they have their own disadvantages. Since 1989, IMF using intraoral self-tapping IMF screws has been introduced for treatment of mandibular fractures. The aim of this study was to evaluate the efficacy, advantages, disadvantages and potential complications associated with using of self-tapping IMF screws in the treatment of mandibular fractures. Material and Methods: Twenty patients with favorable mandibular fractures, attended to Oral and Maxillofacial
... Show MoreHerpes labialis is an infection caused by the herpes simplex virus, characterized by an eruption of small and usually painful blisters on the skin of the lips, mouth, gums, or the skin around the mouth. Although there is no successful treatment available, the local use of compounds with effective anti-inflammatory and cytoprotective effects may be of value in this respect. This project was designed to evaluate clinically the local use of silymarin, a group of flavonoids with powerful antioxidant, anti-inflammatory and cytoprotective activity, in the treatment of herpes simplex ulcer. Fifty three patients with herpes labialis ulcers (HLU) were enrolled in this randomized, single blinded, placebo controlled clinical study, and they were al
... Show MoreDairy wastewater generally contains fats, lactose, whey proteins, and nutrients. Casein precipitation causes the effluent to decompose into a dark, strong-smelling sludge. Fluid waste contains soluble organic matter, suspended solids, and gaseous organic matter, which cause undesirable taste and smell, grant tone and turbidity, and advance eutrophication, which plays an essential role in increasing biological oxygen demand (BOD) in water. It also contains detergents and disinfecting agents from the rinses and washing processes, which increase the need for chemical oxygen (COD). One of the characteristics of dairy effluents is their relatively high temperature, high organic contents, and wide pH range, so the discharge of wastewater into
... Show MoreBackground: Trigeminal neuralgia (TN), or Tic Douloureux, is one of the most common neuropathic pains. Gamma knife stereotactic radiosurgery (GNSRS) has been considered one of the procedures for treating primary TN. Objective: This study evaluates the effectiveness of GNSRS in treating primary TN in patients who are unresponsive to medical treatment in a single-center experience. Subjects and Methods: This study was conducted on 180 patients from January 2018 to October 2021. The study utilized the Barrow Neurological Institute (BNI) pain intensity score to assess pain before and after GNSRS treatment. Results: A total of 180 patients with primary TN were included in this study, 108 female with a 1.5:1 female: male ratio. Results
... Show MoreBackground: Hyperfunction of the muscles of the upper lip is considered as the most common cause of excessive gingival display (EGD). The aim of this study was to demonstrate the effectiveness of botulinum toxin (BT) injection as a conservative treatment for EGD due to muscular hyperfunction and to compare the outcome of 2 injection methods. Material and methods: This study included 40 participants who were randomly assigned into 2 groups of 20 each, The first group received 2.5IU BT injection at 1 point per side (2-points group), while the second group received a total of 5 IU of BT at 2 points per side (4-points group). The outcome variables were the reduction in the central and lateral gingival display expressed as the difference between
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