Background Gestational diabetes mellitus (GDM) is a common medical complication of pregnancy that can have harmful impacts on maternal and neonatal outcomes. Literature shows that elevated serum maternal ferritin levels may cause dysregulation in glucose metabolism in GDM. This study aims to determine the association between serum ferritin, iron and hemoglobin levels in GDM patients at the time of delivery as well as cord hemoglobin and iron levels in newborns. Methods In this case-control study, a total of 100 patients were included i.e., 50 cases (GDM) and 50 controls (non-GDM) having aged-matched individuals of normal pregnancy. The hemoglobin, iron and serum ferritin, and hsCRP levels of the mother were determined using maternal blood. A cord blood sample was taken to determine neonatal iron and hemoglobin levels. Results The study participants mean age was 29.2 ± 5.6 years. The ferritin levels of GDM mothers (42.3 ± 6.7) were significantly higher than non-GDM patients (34.4 ± 3.8) with p<0.001. Similarly, Cord hemoglobin levels of newborns of GDM mothers were significantly higher than newborns of non-GDM patients (p<0.01). In GDM mothers, maternal ferritin levels were inversely correlated to cord hemoglobin levels (r= - 0.29, p =0.004). Conclusions Elevated maternal serum ferritin levels are linked to increased oxidative stress and effects fetal intrauterine and post-partum health. The placental iron transfer and fetal hemoglobin synthesis will be affected by oxidative stress.
Objective: To determine the perinatal outcome of first and second twin delivered vaginally in terms of frequency of poor APGAR score and NICU admission in the patient at term in a tertiary care health facility.Introduction: This study aims to improve the perinatal outcome of twin pregnancies through awareness of the need for antenatal care, the recommendation of regular antenatal visits, early recognition of complications, and the presence of neonatal intensive care facilities to improve neonatal outcome by knowing the burden of adverse outcomes in our population.Materials and Methods: This is a descriptive study, conducted at the Department of Obstetrics and Gynaecology at DHQ Hospital, Rawalpindi from January 2019 to June 2019.A total of 91 individuals (female pregnant ladies) who delivered twins (Dichorionic Diamniotic) babies through normal vaginally were selected for descriptive study in the Department of Obstetrics and Gynaecology, DHQ hospital Rawalpindi. All consecutive patients admitted in the labour ward with twin pregnancies were included. Before delivery, the fetal wellbeing of both the twins was evaluated also by ultrasonography. Data collection was done by interview schedule from the patients. Data were analyzed using descriptive statistics using SPSS version 17. For all the quantitative variables like age, gestational age and intertwine interval in seconds.Results: Out of 6278 deliveries during the study period, 91 twin births gave a frequency of 15.16/1000 births. Patients' mean age was 30.14+2.64 years, and mean gestational age was 37.47+0.72 weeks. The mean inter twin delivery interval (mins) in the study was 23.74+4.75. Perinatal outcome of first and second twin in terms of frequency of poor APGAR score and NICU admission in a patient at term was 09 (9.9%) and 27 (29.7%), (p<0.001) respectively.Conclusion: The study concludes that there was a high risk of perinatal outcomes in the second twin as compared to the first twin delivered vaginally. Poor Apgar score and neonatal intensive care admission were more so for the second twin.
The incidence of QT prolongation in CLD patients is greater than 45% compared to approximately 5% in the general population. Multiple researches have revealed that end-stage liver disease is related with a variety of changes in electrophysiological parameters; especially in our population, a higher incidence of QT interval prolongation is observed. Prolonged QT intervals in chronic liver disease patients are related with augmented mortality and morbidity. Objective: To determine the frequency of QT prolongation in patients with chronic liver disease. Methods: A cross-sectional and descriptive study. 96 total patients aged 20-85 years of both sexes with chronic liver disease (CLD) were included. Patients with a history of coronary artery disease and the use of any anti-arrhythmic medication were excluded from the study. The 12-lead ECG was performed and interpreted by an electrophysiologist with over five years of experience. The Bazett-based QT interval (QTc) was automatically obtained using a computerized electrocardiograph to avoid inter-observer variability. Results: 20 to 60 years was the patients age in this study, with 39.44 ± 9.91 years of mean age. The maximum patients, 86 (89.58%), were 20-40 years of age. Among the 96 patients, 17 (17.71%) were female and 79 (82.17%) were male, with a M: F ratio of 1.3: 1. While the incidence of QT prolongation was found in 47 (48.96%) patients, 49 (51.04%) patients did not have QT prolongation. Conclusions: In this study it was found that the frequency of QT prolongation is quite high in patients with chronic liver disease
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