To Compare Metformin Vs Insulin in Gestational Diabetes in Terms of Neonatal Hypoglycemia

2021 ◽  
Vol 15 (11) ◽  
pp. 2928-2929
Author(s):  
Saadia Mir ◽  
Raisham Saleem ◽  
Fouzia Saghir ◽  
Shafia Zaib Mir ◽  
Aisha Iqbal ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Controlled Trial ◽  
Regular Insulin ◽  
Neonatal Hypoglycemia ◽  
Insulin Group ◽  
Metformin Group ◽  
Group A ◽  
The Difference ◽  
Group B ◽  
Trial Setting

Aim: To compare metformin vs insulin in Gestational Diabetes in terms of neonatal hypoglycemia. Methodology: Study design: Randomized controlled trial Setting: Obstetrics / Gynecology Unit-l, Holy Family Hospital, Rawalpindi. Duration of study: 6 months i.e. 10-11-2017 to 10-05-2018 Data collection procedure: 240 patients were randomly allotted into two groups; A & B. Group A received metformin and group B received regular insulin. Patient was admitted at 36 wks onwards. Neonatal hypoglycemia was measured and entered in structured Performa. All the data was entered and analyzed through SPSS version 22. Results: In this study, the mean ± sd ages of patients were 28.7±5.05 years in insulin group while 28.01±4.37years in metformin group. Mean neonatal blood sugar level was 51.58±11.77mg/dl in insulin group while 57.37±10.61mg/dl in metformin group. The difference was significant (p<0.05). In this study, neonatal hypoglycemia was noted in 28 (23.3%) cases with insulin while in 1 (0.8%) case with metformin. The difference was significant (p<0.05). Conclusion: Metformin has better outcome than insulin in terms of less number of neonatal hypoglycemia. Key words: Gestational Diabetes, Metformin, Insulin, Neonatal Hypoglycemia

scholarly journals Comparison of Salbutamol and Salbutamol with ipratropium bromide in children with exacerbation of Asthma in terms of peak expiratory flow rate (PEFR).

2021 ◽  
Vol 28 (11) ◽  
pp. 1611-1615
Author(s):  
Sadaf Minhas ◽  
Saqib Aslam ◽  
Muhammad Azhar Farooq ◽  
Ayesha Anwar ◽  
Farhan Zahoor ◽  
...  
Keyword(s):  
Peak Expiratory Flow ◽  
Ipratropium Bromide ◽  
Controlled Trial ◽  
P Value ◽  
Significant Difference ◽  
Group A ◽  
Expiratory Flow ◽  
The Difference ◽  
Group B ◽  
Trial Setting

Objective: To compare the Salbutamol alone and Ipratropium Bromide supplemented Salbutamol in children with exacerbation of asthma in terms of PEFR. Study Design: Randomized Controlled Trial. Setting: Pediatrics Emergency, KRL Hospital Islamabad. Period: 1st August 2016 to 31 January 2017. Material & Methods: Group A patients were given only Salbutamol (0.15mg/kg per dose with minimum 2.5 mg, maximum 5 mg/dose). Group B was given Ipratropium Bromide supplemented Salbutamol (250 mcg/dose for <20 kg while 500 mcg/dose for >20kg of Ipratropium Bromide with same dose of Salbutamol as prescribed for Group A). Baseline spirometry was performed on each patient and after measurement of baseline peak expiratory flow. The outcome was measured by Peak flow meter and reassessed at 60 minutes. Results: Comparison of salbutamol alone and ipratropium bromide supplemented salbutamol in children with exacerbation of asthma in terms of PEFR shows that 40.5 + 4.28 in Group-A and 59.5 +4.75 in Group-B, P-value was calculated as 0.0001, showing a significant difference between the two groups while the difference in increase was recorded as 19%. Conclusion: We concluded that salbutamol alone is significantly less effective when compared with Ipratropium Bromide supplemented Salbutamol in children with exacerbation of asthma in terms of PEFR.

Neonatal outcomes in case of euglycemic control in gestational diabetes using insulin versus metformin. Randomized controlled trial

2021 ◽  
Vol 04 (01) ◽  
pp. 01-08
Author(s):  
Ahmed Mansour
Keyword(s):  
Randomized Controlled Trial ◽  
Birth Weight ◽  
Gestational Diabetes ◽  
Controlled Trial ◽  
Insulin Injection ◽  
Neonatal Outcomes ◽  
Insulin Group ◽  
Randomized Controlled ◽  
Metformin Group ◽  
Significant Difference

Background: Gestational diabetes mellitus (GDM) is a major global public health issue, with prevalence increasing in recent years due to the epidemic of obesity and type 2 diabetes. Aim of the Work: to compare different neonatal outcomes according to the different treatment modalities used in the management of GDM. Our hypothesis was that Metformin is as effective and safe as insulin in patients with gestational diabetes. Patients and Methods: The current non inferiority-Randomized controlled trial was conducted at Ain Shams Maternity hospital between June 2020 to February 2021. The study included 140 outpatient cases or admitted patients for antenatal care: Group A: women were given Metformin (Total 70) and Group B: Women were given insulin. (Total 70). Results: there was no significant difference between Metformin and Insulin groups regarding age, enrollment BMI, parity and family history of DM. There was no significant difference between Metformin and Insulin groups regarding gestational age at enrollment and delivery as well as pregnancy duration after intervention. BMI at delivery, BMI increase as well as BMI increase rate were significantly lower in Metformin group. There were no significant differences between Metformin and Insulin groups regarding fasting, two-hour postprandial and HbA1c blood glucose at enrollment and throughout treatment as well as their reduction after intervention. Maternal complications as hypoglycemia, hyperglycemia and preeclampsia were non-significantly less frequent among Metformin group than among Insulin group. Compliance to treatment was significantly more frequent among Metformin group than among Insulin group. Cesarean delivery was non­significantly less frequent among Metformin group than among Insulin group. There was no significant difference between Metformin and Insulin regarding birth weight APGAR-1, but APGAR-5 was significantly higher in Metformin group. Neonatal complications as IUFD, IUGR, macrosomia, congenital anomalies, neonatal hypoglycemia, respiratory distress and NICU admission were non-significantly less frequent among Metformin group. Conclusions: From the results of current study we can conclude that: Oral metformin was effective as insulin injection in control and management of GDM. BMI was controlled with oral metformin better than insulin injection. Maternal and neonatal complications specially birth weight were the same with both types of treatment. Women had better compliance to metformin treatment. Type of delivery wasn’t affected by type of treatment.

scholarly journals Accelerated method of casting for correction of clubfoot applicable?

2021 ◽  
Vol 28 (7) ◽  
pp. 963-966
Author(s):  
Farhad Alam ◽  
◽  
Abdul Latif Shahid ◽  
Islam Hussain ◽  
Abdul Latif Sami ◽  
...  
Keyword(s):  
Scoring System ◽  
Treatment Time ◽  
Controlled Trial ◽  
Ponseti Method ◽  
Serial Casting ◽  
Group A ◽  
Group B ◽  
Rural Parents ◽  
Financial Issues ◽  
Trial Setting

Objective: To see the results of accelerated method against standard Ponseti method for correction of clubfoot by using Pirani scoring system. Study Design: Randomized controlled trial. Setting: Children’s hospital and the institute of child’s health, Lahore. Period: June 2019 Dec 2019. Material & Method: 100 patients included in this study and divided into two groups. In group A (50 patients) correction was done by standard Ponseti method while accelerated method was applied in group B(50 patients). Weekly serial casting was done in group A while twice weekly in group B. Assessment was done by Pirani scoring system in both groups at beginning of correction, at each cast and at end of correction. Results: Average casting time for group A was 38 days while it was 20 days in group B. Correction rate was 94% in group A and 89% in group B. This difference was not found to be statistically significant (p=0.396). Conclusion: Accelerated method is applicable for correction of clubfoot because treatment time is shorter and results are similar to standard Ponseti method. Hence, this method should be adopted in Pakistan so that poor and rural parents can easily manage travel and financial issues because only 2 to 3 weeks are required for whole casting treatment.

scholarly journals Adrenaline and Dexamethasone, vs Adrenaline and Fluticasone, vs Adrenaline alone in Bronchiolitis: A Randomized Controlled Trial

2020 ◽  
pp. 20-28
Author(s):  
Jayendra R. Gohil ◽  
Atul M. Sheladiya ◽  
N. B. Adithya ◽  
Ratna D. Bhojak
Keyword(s):  
Hospital Stay ◽  
Clinical Symptoms ◽  
Controlled Trial ◽  
Length Of Hospital Stay ◽  
Primary Objective ◽  
Assessment Instrument ◽  
Clinical Severity ◽  
Group A ◽  
The Difference ◽  
Group B

Background and Objectives: There is no consensus over which drug best reduces symptoms in Bronchiolitis syndrome. The primary objective of our study is to establish comparative effect of adrenaline nebulisation alone and combination of adrenaline nebulisation plus injectable dexamethasone and adrenaline nebulisation plus fluticasone nebulisation in the treatment of clinical cases of bronchiolitis. Methods: 100 patients diagnosed clinically as bronchiolitis were enrolled in study from 1 month to 24 months of age. Patients were enrolled by purposive sampling. Patients with respiratory distress assessment instrument score [RDAI] of 4 to 15 were chosen, randomized into three groups and treatment given till patient fullfilled discharge criteria. Group A (n=33) were given nebulised adrenaline alone, Group B (n=34) were given nebulised adrenaline plus injectable dexamethasone and Group C (n=33) were given nebulised adrenaline plus nebulised fluticasone. Results: The mean reduction in clinical severity-RDAI score was 1.75 ±0.86 in Group A, 2.30 ± 0.68 in Group B and 1.42 ± 0.9 in Group C when measured in terms of difference in clinical scores between day 1 and 2 (p=0.0003). Mean duration of hospital stay in the group A was (4.93±1.95 days), Group C (4.78±1.83) and Group B (3.91 ±1.37 days). The difference of stay between the Groups A and B was 1.02±0.58 days vs 0.87± 0.46 days in groups B and C (p-0.0048). Reduction in the length of hospital stay in group B was 22% compared to Group A & 19% compared to Group C (p-0.0048). Side effects were tachycardia in six patients. Conclusion: Combination of adrenaline nebulization and injectable dexamethasone was found significantly better as compared to nebulised adrenaline plus nebulised fluticasone and nebulised adrenaline alone in patients of clinical bronchiolitis in reducing severity of clinical symptoms and duration of hospitalization.

scholarly journals GESTATIONAL DIABETES

2015 ◽  
Vol 22 (10) ◽  
pp. 1298-1303
Author(s):  
Tayyaba Majeed ◽  
Rabia Adnan ◽  
Irum Mubshar ◽  
Hamis Mahmood ◽  
Kanwal Saba ◽  
...  
Keyword(s):  
Oral Route ◽  
Outcome Study ◽  
Neonatal Hypoglycemia ◽  
Consecutive Sampling ◽  
Pregnant Females ◽  
Group A ◽  
The Mean ◽  
The Difference ◽  
Group B ◽  
Study Setting

Objectives: To compare the efficacy of Metformin with insulin in gestationaldiabetes mellitus in terms of fetomaternal outcome. Study Deign: Randomized clinicaltrial study. Setting: Lady Aitchison Hospital Lahore. Period: January 2014 to March 2015.Methodology: Total 500 pregnant females with GDM were included in the study through nonprobability,consecutive sampling. Patients were divided into 2 equal groups (A: B). Patientsin group A were given tablet metformin 500 mg by oral route and group B was administratedregular injection Insulin by subcutaneous route. Results: The mean age of females was32.14±6.13 years. The mean gestational age was 31.07±3.8 weeks. There were 78 (15.6%)females who had 0 parity, 107 (21.4%) females had parity 1, 175 (35%) females had parity2, 95 (19%) females had parity 3, 33 (6.6%) females had parity 4 and 12 (2.4%) femaleshad parity 5.There were 54 (10.8%) cases had PTB, out of which 12 (4.8%) had PTB withmetformin while 42 (16.8%) had PTB with insulin. There were 115 (23%) neonates requiredNICU admission, out of which 37 (14.8%) neonates with metforminand78 (31.2%) neonateswith insulin. There were 87 (17%) neonates who had neonatal hypoglycemia, out of which23 (9.2%) neonates with metformin and64 (25.6%) neonates with insulin. The difference wassignificant between both groups for all fetal outcomes (P<0.05). Conclusion: The metforminis more effective in preventing adverse fetal and maternal outcome as compared to insulin.

scholarly journals LOWER URETERIC STONES EXPULSION;

2017 ◽  
Vol 24 (09) ◽  
pp. 1331-1335
Author(s):  
Khalid Hussain ◽  
Maria Tarique ◽  
Attiq ur Rehman Khan ◽  
Asim Bukhari ◽  
Bilal Akhter ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Oral Treatment ◽  
P Value ◽  
X Rays ◽  
Female Ratio ◽  
Group A ◽  
Insignificant Difference ◽  
The Mean ◽  
Group B ◽  
Trial Setting

Objectives: To compare Tamsulosin versus ESWL for lower ureteric stonesexpulsion. Study Design: Randomized controlled trial. Setting: Outpatient Department ofUrology at Services Hospital, Lahore. Period: January 2015 to December 2015. Material& Methods: Total 50 patients were enrolled in study. Patients were divided into 2 groups.In group A, 25 patients received daily oral treatment of 0.4mg Tamsulosin for 28 days, andin group B, 25 patients were treated with ESWL. A stone-free condition, was defined as thecomplete absence of any stone based on plain abdominal X-rays observed and during followupvisits at the time of treatment of stone was noted. Results: The mean age of the patientswere recorded as 33.20±9.23 years. There were 40(80%) males and 10(20%) females with maleto female ratio of 4:1. Out of 50 patients, 16(32%) presented with hematuria, 3(6%) had feverwhile 31(62%) appeared with no complication status. Out of 50 patients, 21(42%) presentedwith expulsion time 08-14 days in which 14(28%) were from tamsulosin group and 07(14%)were from ESWL group, similarly 19(38%) patients appeared with expulsion time of 15-28 daysin which 10(20%) were from tamsulosin group and 09(18%) were from ESWL group. Statisticallythere is insignificant difference between the groups i.e. p-value=0.28 Ns. Conclusion: Thisstudy suggests that the tamsulosin helps in the earlier clearance of stone fragments andreduces the complications as compared to ESWL.

scholarly journals COMPARISON OF ONDANSETRON AND METOCLOPRAMIDE IN PATIENTS UNDERGOING LAPAROSCOPIC CHOLECYSTECTOMY UNDER GENERAL ANESTHESIA.

2019 ◽  
Vol 26 (07) ◽  
pp. 1197-1202
Author(s):  
Hajra Shuja ◽  
Mehmood Ali Shah ◽  
Sadaf Bokhari
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
General Anesthesia ◽  
Controlled Trial ◽  
Study Groups ◽  
P Value ◽  
Significant Difference ◽  
High Incidence ◽  
Group A ◽  
Group B ◽  
Trial Setting

Background: Laparoscopic cholecystectomy is a standard treatment for cholelithiasis. It is a safe and effective treatment in many cases. General anesthesia has a high incidence for PONV. But anti-emetic drugs can help in preventing PONV. Objectives: To compare the efficacy of ondansetron and metoclopramide in patients undergoing laparoscopic cholecystectomy under general anesthesia. Study Design: Randomized controlled trial. Setting: Department of Anaesthesia, Sheikh Zayed Hospital, Lahore. Period: 6 months i.e. from 15-2-2017 to 15-8-2017. Material & Methods: The patients were divided into two groups. Ondansetron was given to group A patients within 15 minutes of induction, and metoclopramide to group B patients within 15 minutes of induction. Then patients were shifted to the ward after surgery and followed-up for 24 hours for assessment of PONV. All the data was entered and analyzed on SPSS version 20. Results: The mean age of patients in group A was 38.40±12.07 years and in group B was 42.63±11.77 years. The efficacy achieved in 53 were from group A and 39 were from group B Statistically significant difference was found between the study groups i.e. p-value=0.003. Conclusion: Ondansetron showed significantly better efficacy than metoclopramide in preventing PONV after laparoscopic cholecystectomy under general anesthesia.

scholarly journals COMPARISION OF CEMENTED VERSUS UNCEMENTED HEMIARTHOROPLASTY OF THE HIP.

2019 ◽  
Vol 26 (07) ◽  
pp. 1057-1061
Author(s):  
Dr. Hafiz Salman Saeed ◽  
Farhad Alam ◽  
Muhammad Yousaf ◽  
Iqra Fayyaz
Keyword(s):  
Controlled Trial ◽  
P Value ◽  
Orthopaedic Department ◽  
Residual Pain ◽  
Uncemented Hemiarthroplasty ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Trial Setting

The objective of this study was to compare the mean residual pain after cemented versus uncemented hemiarthroplasty of hip. Study Design: Randomized Controlled Trial. Setting: Orthopaedic Department, Allied Hospital, Faisalabad. Period: September 2016 to October 2017. Materials and Methods: Total 150 patients were admitted in orthopedic Department of Allied Hospital Faisalabad according to inclusion & exclusion criteria. After taking informed written consent, all patients were divided into two groups randomly. Cementedhemiarthroplasty was done in Group A patients and uncemented hemiarthroplasty was done in group B patient. All procedures were done by surgeon who has minimum 5yrs post fellowship experience. Monthly Follow up was done and residual pain was noticed at the end of 6th month. All the data was analyzed by using SPSS version 20.0. Results: In this study, in Group-A the patients between 65-75 years of age were 57.33% (n=43) and between 76-85 of age were 42.67% (n=32). In Group B the patients between 65-75 years of age were 56%(n=42) and between 76-85 years were 44% (n=33). The mean+sd was calculated and it is 73.49+4.99 years in Group-A patients and 73.73+4.74 years in Group-B patients. In Group A, males were 61.33% (n=46) and female were 38.67% (n=29). In Group B, males were 57.33% (n=43) and female were 42.67% (n=32). When we compared the residual pain after cemented versus uncemented hemiarthroplasty of the hip, it shows 1.69+0.35 in Group-A patients and 2.62+0.30 in Group-B patients. When we calculated p-value it was 0.0001 showing a significantdifference. Conclusion: It is concluded that residual pain in cemented hemiarthroplasty is lower than uncemented hemiarthroplasty. 

Efficacy of probiotics to prevent necrotizing enterocolitis in low birth weight preterm neonates.

2021 ◽  
Vol 28 (03) ◽  
pp. 328-332
Author(s):  
Shagufta Niazi ◽  
Farrukh Saeed ◽  
Shahla Tariq ◽  
Muhammad Azhar Farooq ◽  
Sanaullah Khan ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Necrotizing Enterocolitis ◽  
Controlled Trial ◽  
Study Groups ◽  
Preterm Neonates ◽  
Randomized Controlled ◽  
Group A ◽  
Group B ◽  
Trial Setting

Objective: To compare the efficacy of probiotics in prevention of necrotizing enterocolitis (NEC) among low birth weight (LBW) preterm neonates. Study Design: Randomized controlled trial. Setting: Department of Pediatric Medicine, Unit-II, Services Hospital, Lahore. Period: September 2019 to February 2020. Material and Methods: A total of 260 LBW preterm neonates were enrolled. All the neonates were allocated to 2 groups with equal number of cases (130 in each group). Group-A was given probiotics whereas placebo was administered in Group-B. All the cases were admitted and follow ups were made up until 7th day. Occurrence of NEC was recorded among both groups. Results: Out of a total of 260 LBW preterm neonates, 142 (54.6%) were male and118 (45.4%) female. Overall, mean age was noted to be 1.48+0.50 days. Table-I shows that there was no statistical difference among neonates of both study groups in terms of age, gestational age and birth weight (p>0.05). Five (3.8%) neonates in Group-A and 14 (10.8%) in Group-B were found to have NEC. Efficacy of treatment in Group-A was significantly higher in comparison to Group-B. Conclusion: Probiotics are effective in the prevention of NEC in preterm LBW neonates. Prophylactic usage of probiotics among preterm neonates is noted to be helpful in avoiding development of NEC.

scholarly journals Investigation the Effects of Metformin versus Insulin on Neonatal and Maternal Outcomes in Women with Gestational Diabetes Mellitus: A Randomized Clinical Trail

2016 ◽  
Vol 9 (4) ◽  
pp. 272 ◽  
Author(s):  
Mahin Najafian ◽  
Mojgan Barati ◽  
Sara Masihi ◽  
Ailin Fardipor
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Neonatal Outcomes ◽  
Neonatal Hypoglycemia ◽  
Singleton Pregnancy ◽  
Insulin Group ◽  
Metformin Group ◽  
Maternal And Neonatal Outcomes ◽  
The Mean

The aim of this study was to evaluate the effectiveness of metformin versus insulin in the glycemic control and to investigate the maternal and neonatal outcomes in in women with gestational diabetes mellitus. Pregnant women with gestational diabetes were randomized to either receive metformin (n=70) or insulin (n=70). Inclusion criteria were singleton pregnancy, following healthy diet and performing exercise for at least one week without satisfactory blood glucose level, no risk factor contributing to lactic acidosis, and no anatomic and/or chromosome anomalies. Two patients were excluded from the study due to lost to follow-up. The mean score of BMI and FBS after treatment was similar between two groups. But, the mean score of 2 hours blood sugar in insulin group (104.38±7.06 mg/dl) was significantly higher than metformin group (97.5±5.98 mg/dl) (P&lt;0.0001). The weight gain in metformin group was slightly lower than insulin group. (P=0.123). The proportion of neonatal hypoglycemia in insulin group was higher than metformin group (20 vs 3, P=0.002). Other neonatal outcomes such as IUGR, IUFD, fetal anomaly, polyhydramnios, macrosomia, oligohydramnios, and NICU stay did not differ significantly between two groups. In conclusion, metformin had compatible effect with insulin in decreasing adverse maternal and neonatal outcomes even in some parameters such as neonatal hypoglycemia it works better. Totally, metformin is safe and effectiveness in controlling the gestational diabetes mellitus.

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