Background Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. GDM is characterized by insulin resistance or decreased glucose tolerance, which increases throughout pregnancy Objective To compare mode of delivery in women with gestational diabetes, treated by insulin versus metformin. Patients and Methods The current study was conducted in Ain Shams University Maternity Hospital in the period between August 2016 and August 2018. A total of 124 women were included in the study. Results Our study compared mode of delivery in women with gestational diabetes, treated by metformin versus insulin. Our study found that the incidence of cesarean section was statistically significantly higher in the insulin group compared to the metformin group. Fasting glucose levels were statistically significantly lower in the metformin group compared to the insulin group, albeit with minor clinical relevance. No statistically significant differences in postprandial glucose levels or glycosylated hemoglobin were found between the two groups.
Background: Diabetic retinopathy (DR), also known as diabetic eye disease, is a retinal damage that occurs due to diabetes. Blindness can be the end result of diabetic retinopathy.Objective: To evaluate the relation of macular thickness to glycosylated hemoglobin in patients with nonproliferative diabetic retinopathy. Patients and Methods:This study included 100 eyes of 100 patients with a diagnosis of type 2 DM. This was designed as an observational, cross-sectional and non-cohort study during the period from 6/2019 to 3/2020. One hundred eyes were divided into two equal groups: one group included diabetic patients with no diabetic retinopathy and the other group included diabetic patients with non-proliferative diabetic retinopathy. Patients were recruited from Retinal clinic in Al-Azhar University Hospital and asked to participate in this study. Results:The results showed that non-proliferative diabetic retinopathy (NPDR) group and group of no DR were comparable as regard age, sex and best corrected visual acuity (BCVA). There was a statistically insignificant difference between group of no DR and NPDR group, but group of no DR had shorter duration of DM, lower HbA1c level, lower macular thickness in all of the 9 standard early treatment diabetic retinopathy study (ETDRS) subfields, lower total macular volume (TMV) than NPDR Group. The results showed that central subfield macular thickness (CST) is positively and significantly related to glycosylated hemoglobin (HbA1c) level in each group of no DR and NPDR, and that severity of DR stage was significantly increased with increased HbA1c levels. The results also showed that there's significant positive association between severity of DR stage and macular thickness in all of the nine standard ETDRS subfields. There was a positive significant relation between duration of DM and HbA1c level in type 2 diabetic patients, while there was no significant relation between duration of DM and macular thickness. The results also showed significant inverse relation between insulin use and HbA1c level, and significant inverse relation between insulin use and prevalence of DR in type 2 diabetic patients. Conclusion:Increased incidence of DR, increased macular thickness and increased incidence of diabetic macular edema were associated with increased level of glycosylated hemoglobin in type II diabetic patients.
Objective. Evaluation of the efficacy of low-dose dexamethasone on ovarian response and pregnancy outcome in infertile patients with type A polycystic ovarian syndrome (PCOS). Patients and methods. The study included infertile patients with type A PCOS who were candidates for in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) using a fixed GnRH antagonist protocol. The patients were randomized into two groups: a low-dose steroid group of 80 women with type A PCOS undergoing a trial of IVF/ICSI who received two tablets of 0.5 mg dexamethasone every evening from the first day of gonadotropin administration till the night before oocyte retrieval with a GnRH antagonist controlled ovarian hyperstimulation (COH), and a placebo group of 80 women with type A PCOS undergoing IVF/ICSI who received two tablets of placebo from the first day of gonadotropin administration until the night of oocyte retrieval. Results. In the low-dose dexamethasone group, the duration of stimulation was statistically significantly shorter, and there were significantly fewer stimulation ampoules; however, E2 levels on the day of ovulation induction, fertilization rate, and the number of retrieved M2 and fertilized oocytes were significantly higher compared to the placebo group. On the other hand, there was no significant difference between both groups regarding the incidence of ovarian hyperstimulation syndrome (OHSS) and the rate of embryo transfer. Conclusion. Dexamethasone improves embryo quality and pregnancy rate; additionally, it minimizes the number of gonadotropin ampoules used for stimulation. Thus, we suggest the use of dexamethasone in women with PCOS undergoing IVF/ICSI treatment. Key words: low-dose dexamethasone; type A PCOS; IVF/ICSI; antagonist protocol
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