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Gestational diabetes mellitus (GDM) is characterized by glucose intolerance during pregnancy. GDM is associated with an increased incidence of congenital abnormalities usually aggravated by maternal magnesium deficiency. Magnesium is one of the essential trace elements for normal embryogenesis and foetal growth and its deficiency increases mortality and morbidity rate of mothers, embryos and neonates. The present study was undertaken to evaluate the association of serum magnesium with GDM in second and third trimester of pregnancy. This case-control study was conducted in Mymensingh Medical College Hospital during the period from July 2013 to June 2014 to evaluate the association of serum magnesium with GDM in Bangladeshi women. A total of 172 subjects were recruited in this study; among them eighty six women with GDM were selected as case (Group-I) and eighty six healthy pregnant women were taken as control (Group- II). The cases again were subdivided as Group Ia and Ib at second and third trimester respectively. Controls also were subdivided as Group IIa and IIb at second and third trimester respectively. Student's unpaired 't' test was used to compare the data between groups. For analytical purpose 95% confidence limit (p<0.05) was taken as level of significance. Serum magnesium level was significantly decreased in cases compared to that of controls. It was significantly lowered (p<0.001) in cases Gr-Ia (1.3884±0.255 mg/dl) than controls Gr-IIa (1.6651±0.304 mg/dl) at second trimester. The result was also significantly (p<0.001) lowered when compared between cases Gr-Ib (0.9349±0.145 mg/dl) and controls Gr-IIb (1.6674±0.308 mg/dl) at third trimester. The study shows that serum magnesium level is decreased in pregnancy with GDM. So estimation of serum magnesium level may be done in every GDM cases to reduce the incidence of magnesium related complications by timely intervention.Bangladesh J Med Biochem 2016; 9(2): 59-62

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INTRODUCTION: Adenoma detection rate (ADR) and its surrogate marker, mean withdrawal time (WT) of ≥ 6 min, is the current golden metric for colonoscopy quality. Serrated polyp detection rate (SPDR) is also an important marker for CRC. Longer WTs are linked with higher ADRs. We aim to assess if there is a correlation between SPDR and ADR, and if the same link exists between WTs and SPDR, as it exists for WT on ADR. METHODS: Screening colonoscopies between 2012 and 2017 were evaluated. Endoscopists with < 40 colonoscopies and procedures with polyps >6 mm, and/or WTs >30 min were excluded. Data was grouped into fellow (FG) and attending (AG) groups. The bivariate association of SPDR and ADR was calculated by correlation coefficients. Statistical analysis was performed using chi-squared tests, two-sample t-tests, and ANOVA t-testing. RESULTS: A total of 5951 procedures performed by 51 fellows and 13 attendings were assessed. The MWT was 15.4 min, SD 4.72, average total procedure time (TT) was 28.3 min, and average ADR was 40%. WT had a strong positive correlation with ADR and TT. The average SPDR was 0.1, SD 0.056. SPDR had a positive correlation with WT and ADR. There were significant differences between FG and AG in ADR, WT, TT and in regression models between the two for TT. There was no difference in the mean SPDR between groups. SPDR had a strong positive correlation with ADR and WT in the AG. There was no significant difference between bowel prep vs. SPDR between groups. CONCLUSION: Our study demonstrates a strong linear relationship between WT, ADR and TT. While FG have a higher ADR compared with AG at the cost of a longer WT, how much ADR changes as WT increases is not significant. AG and FG had similar SPDRs, however, only for AG were SPDR positively correlated with longer WTs and higher ADRs. We postulate that given the increased technical difficulty in detecting sessile polyps, AG are better equipped to improve SPDRs with increased WT. Bowel prep scores had no effect on SPDR, explained by exclusion criteria including only fully completed colonoscopies, and therefore subpar prep patients were likely pre-excluded. Our study highlights the importance of expertise and training in the identification of sessile polyps, the association between high ADR and SPDR, and the positive effect of WT on SPDR. Kahi et al., identified variability in SPDR ranging from 1% to 18%, compared with much less variability seen in ADRs. As a result, our findings are worthy of validation in larger multiple center studies.