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 removal of COD from wastewater generated by petroleum refinery has been investigated by adopting electrocoagulation (EC) combined with adsorption using activated carbon (AC) derived from avocado seeds. The process variables influencing COD removal were studied: current density (2–10 mA/cm2), pH (4–9), and AC dosage (0.2–1 g/L). Response surface methodology (RSM) based on Box–Behnken design (BBD) was used to construct a mathematical model of the EC/AC process. Results showed that current density has the major effect on the COD removal with a percent of contribution 32.78% followed by pH while AC dosage has not a remarkable effect due to the good characteristics of AC derived from avocado seeds. Increasing current density gives be
... Show MoreA study was performed to evaluate heavy metals removal from sewage sludge using lime. The processes of stabilization using alkaline chemicals operating on a simple principle of raising pH to 12 or higher, with sufficient mixing and suitable contact time to ensure that immobilization can reduce heavy metals. A 0.157 m3 tank was designed to treat Al-Rustemeyia wastewater treatment plant sludge. Characteristics of raw sludge were examined through two parameters: pH and heavy metal analysis. Different lime doses of (0- 25) g CaO/100 g sludge were mixed manually with raw sludge in a rotating drum. The samples were analyzed two hours after mixing. pH and heavy metals results were compared with EPA and National Iraqi Stand
... Show MoreTwo types of adsorbents were used to treat oily wastewater, activated carbon and zeolite. The removal efficiencies of these materials were compared to each other. The results showed that activated carbon performed some better properties in removal of oil. The experimental methods which were employed in this investigation included batch and column studies. The former was used to evaluate the rate and equilibrium of carbon and zeolie adsorption, while the latter was used to determine treatment efficiencies and performance characteristics. Expanded bed adsorber was constructed in the column studies. In this study, the adsorption behavior of vegetable oil (corn oil) onto activated carbon and zeolite was examined as a function of the concentr
... Show MoreBACKGROUND: In 1972 complete description of the
inflammation of posterior third of the vocal cords was
done, with barium swallow confirming Gastro
Esophageal Disease [CRED] & subsequent successful
symptomatic treatment with antacid. The possible
association between GERD & chronic laryngitis was
initially known as acid laryngitis .2
*from the Department of ENT, Hawlear Medical College, Hawlear university. Department of ENT, Rezgary Teaching Hospital, Erbil.
Correspondence to :
Dr.Said Mustafa Said
Corespondence Address to : Dr.Said Mustafa Said _ E- mail: Email [email protected] Mob. 07504563829
Recived at : 15 th Dec 2009 Accepted at : 3ed Nov 2010
OBJECTIVE: To record the common presentat
... Show MoreCO2 Laser (10600nm) is the recent method in the management of challenging skin scar resulting from trauma, burn and surgical wound. The aim of this study was to evaluate the efficacy & safety of fractional CO2 laser (10600nm) in treatment of skin scar. Materials and Methods:Twenty patients with different types of scars treated with fractional CO2 (10600nm) laser, (10 patients) were given additional intralesional Triamcinolone. Results: All of the twenty patients included in this study showed some sort of improvements in scar texture, height and pliability and all of the ten patients who received intralesional Triamcinolone after laser show complete satisfaction. Conclusion:Fractional CO2 (10600nm) laser can be used as alternative, ef
... Show MoreThe present study was conducted with a view to determine whether focal laser therapy result in visual recovery and regression of macular edema in patients with non proliferative diabetic retinopathy and maculopathy ,and whether combined focal and scatter laser therapy in patients with proliferative diabetic retinopathy and maculopathy results in visual recovery ,regression of macular edema and regression of the risk factors. In the present work, a frequency doubled Nd: YAG laser was used for the treatment of diabetic retinopathy. The study evaluates 41 eyes of 33 diabetic patients both with Insulin Dependent Diabetes Mellitus IDDM, (n=16) and Non Insulin Dependent Diabetes Mellitus NIDDM, (n=17) with diabetic retinopathy divided into two
... Show MoreEnamel White Spot Lesions (EWSLs) are a common dental condition characterized by being opaque or chalky white in appearance. In this review, an overview of the etiology, prevention, and treatment techniques for EWSLs is presented. Enamel demineralization caused by bacteria in dental plaque which releases acids upon the consumption of fermentable carbohydrates causing mineral loss is thought to be the main cause of those lesions, which could be predisposed through orthodontic treatment, poor diet, inadequate oral hygiene and certain medical conditions. So, sustaining an adequate carbohydrate consumption, proper fluoride exposure and good oral hygiene are some of the practices which aid in these lesions’ prevention. Although the suc
... Show MoreThis is prospective study began in Jan. 2003 and concluded in April 2004, was undertaken to examine the benefits of 810 nm diode laser in treatment of four patient with bilateral vocal cord paralysis also to compare the results with conventional treatment Material and methods: 810 nm diode laser 15 watts was used in these cases under general anesthesia, and induction of anesthetic drug done through tracheostomy tube in all patients. All patients were decanulated “Tracheostomy tube removed”, the voice of all preserved within normal. Laser surgery in this case has more benefit and advantage than conventional methods even if the patient need more than on session of laser operation because of high success rate, less complication and easy
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