Adding metformin to insulin therapy in women with insulin-resistant diabetes mellitus with pregnancy seems to be effective in proper glycemic control in a considerable proportion of women, along with benefits of reduced hospital stay, reduced frequency of maternal hypoglycemia as well as reduced frequency of neonatal hypoglycemia, NICU admission and neonatal respiratory distress syndrome.
To determine prostate cancer detection rates in a haematuria clinic and provide an insight into the usefulness of PSA testing in the haematuria clinic.
Patients and methods:The records of all male patients (n = 749) seen in the haematuria clinic over a 2-year period were analysed. Results: Of the 749 men, 511 (68%) had a PSA measured. In total, 28 cases of prostate cancer were diagnosed (3.7% of total). In the 50-69 age group, 263 out of 350 men (75%) had a PSA test. 11 cancers were diagnosed in this group (which was 3.1% of all patients or 4.2% of those screened in this age group). Conclusion: Our screening rates were slightly lower than those in the ProtecT, ERSPC and PLCO studies. Our overall cancer detection rate of 3.1% (for the 50-69 year olds) is comparable to those from ERSPC (8.2%), ProtecT (2.2%) and PLCO (1.4%). The data would suggest that there is not an excess of prostate cancer in patients with haematuria. PSA testing should be accompanied by a full and frank discussion about the benefits and risks of PSA screening which is not always practical in the haematuria clinic.
Objective
To assess whether metoclopramide is effective in shortening the duration of the first stage of labor in primiparous women.
Methods
The present randomized, double‐blind, placebo‐controlled trial was conducted at King Faisal Hospital, Saudi Arabia (between July 30, 2013, and September 1, 2016), and sequentially recruited young nulliparous women admitted in spontaneous active labor with or without ruptured membranes. Eligible participants were randomly assigned to receive a slow intravenous injection of either metoclopramide or placebo and consistently managed according to the local institutional intrapartum protocol and received identical monitoring and supportive care. The primary outcome was the cervical dilatation rate.
Results
Fifty‐nine women were included in the metoclopramide group and 52 in the placebo group. The first stage of labor was significantly shorter in the metoclopramide group (203 minutes vs 230 minutes in the placebo group, P=0.019), with a faster cervical dilatation rate (2.4 ± 0.4 cm/h vs 1.9 ± 0.5 cm/h in the placebo group, P<0.001) and shorter interval from treatment administration until full cervical dilatation. There was a significantly higher probability of faster delivery among women who were treated with metoclopramide (log‐rank test, χ2=5.997, P=0.014).
Conclusion
Metoclopramide safely reduced the duration of the first stage of labor and was not associated with major maternal or neonatal adverse outcomes.
ClinicalTrials.gov
NCT01937234
Our results support previous studies which indicate the presence of meconium can be associated with chronic fetal hypoxia as demonstrated by elevated fetal NRBC levels.
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