ABSTRACT
Iron deficiency anemia [IDA] during pregnancy, although associated with disturbances of hematological parameters, is now also considered as a source of oxidative stress [OS]. Present study aims to detect any alteration in superoxide dismutase [SOD] and glutathione peroxidase [GSH-Px] enzymes activity in pregnant women with IDA. Levels of GSH-Px and SOD were measured in 156 anemic, pregnant women and compared with similar levels in 20 non anemic, pregnant women. Activity of SOD was found to be reduced in the anemic group when compared with the control group. We found a non- significant increase in GSH-Px activities in the anemic group. These findings could be explained in terms of OS under hypoxic condition which preserves the activity of GSH-Px with a decrease activity of SOD. A positive association was seen between IDA during pregnancy and OS with results suggesting that, apart from the deficiency of iron, some other factors are also associated for the increased OS seen during pregnancy
ABSTRACT
Iron deficiency anemia [IDA] during pregnancy not only results in the disturbance of hematological parameters but has been found to be an additional cause of oxidative stress [OS]. Moreover, oral iron for IDA during pregnancy has been found to worsen the condition. Present study aims to detect any alteration in glutathione peroxidase [GSH-Px] activity as an enzymatic anti-oxidant and its association with oral iron supplements. For study, 40 anemic pregnant women were prescribed with 200mg ferrous sulphate for 12 weeks [wks].A significant improvement in hemoglobin [Hb] and serum ferritin concentration [SFC] was seen after treatment [p<0.05]. In contrast to the values for hematological parameters, GSH-PX was found to be same for control and anemic groups before iron supplements [p>0.05]. A significant decrease in GSH-PX levels of anemic women was seen after iron therapy when compared with both the initial values and the control group [p<0.05]. We found a positive association between oral iron administration and OS. Our results showed a strong association between oral iron supplements and SFC which supports the iron overload theory. It is therefore concluded that OS is associated with oral iron supplements during pregnancy
ABSTRACT
Objective: To evaluate and compare feto-maternal outcomes and glycemic control in metformin versus insulin treated gestational diabetics
Methods: The study was conducted in 2010-2012 as a part of M. Phil at Civil hospital, Lyari General Hospital and Mamji Hospital in Karachi. After written informed consent, 71 GDM diagnosed females with WHO criteria were enrolled. They were divided into two groups. Group-A, 32 females were given oral metformin 500 mg TDS while Group-B, 39 females were given insulin 0.8-0.9 mg/kg/day in two divided doses subcutaneously. Patients were followed till term. Feto-maternal outcomes were evaluated in 25 patients in each group who completed the study
Results: When groups were compared, newborns in Group-B were significantly more in weight [p=0.01], Significant numbers of babies were delivered after 38 weeks of pregnancy in Group-B [P=0.021]. There were two intrauterine deaths and significantly higher HbC at term in Group-B. [P=0.03]. FBS at term was nonsignificant [p=0.079] and there was more number of cesarean sections due to feto-maternal disproportion in Group-B [28% vs.2%]. Results analyzed for glycemic control before and after the treatment revealed that FBS was statistically less in Group-A [p=0.00] whereas for Group-B the value of FBS and HbCwas statistically high. [p=0.002 a 0.04 respectively]
Conclusion: Metformin has produced better effects on feto-maternal outcomes and glycemic control in comparison to Insulin in GDM
Subject(s)
Humans , Female , AdultABSTRACT
Objective: To evaluate the effect of leflunomide on laboratory parameters in patients of rheumatoid arthritis
Materials and Methods: A 24-week, single-blind study was carried out on 158 consecutive patients, aged 29-70 years, diagnosed with rheumatoid arthritis. They received tablet leflunomide 20 mg daily, orally. Laboratory tests were recorded at the initial visit and follow-ups. Leflunomide has been known to bring about changes in various blood parameters like hemoglobin, total white cell and platelet counts, erythrocyte sedimentation rate, serum creatinine and serum glutamic pyruvic transaminase levels. All patients were subjected to these laboratory tests
Results: At the end of the study at 24 weeks the hemoglobin was raised to 12.62 grams per deciliter [g/dl] from a baseline of 10.81 g/dl, white cell count fell to 6,728 per cubic mm [cmm] from 8,318 / cmm, the ESR fell to 39.01 millimeters of mercury [mm of Hg] in 1st hour from 82.10 mm of Hg, the platelet count fell to 2,37,419 / cmm from 2, 96,166 / cmm, the SGPT levels were raised to 38.01 international units per litre [IU/l] from 31.84 IU/l and the serum creatinine fell to 0.936 mg/dl from 0.937 mg/dl. All values, except serum creatinine, were found to be highly significant statistically [p<0.001]
Conclusion: Leflunomide showed significant effects on the laboratory parameters. These parameters may be utilized in patients follow up to monitor the drug response and as a marker of drug safety of leflunomide
ABSTRACT
To observe and compare placental histology for hypoxic changes in diet plus exercise alone versus dietplus exercise and insulin treatment in patients with Gestational Diabetes Mellitus [GDM]. Comparative / analytic study. The study was conducted in Lyari General Hospital and Mamji Hospital after approval from the Institutional Review Board [1KB] and Ethical Committee of Dow University of Health Sciences from Jan 2010- Jan 2011. After written informed consent, 30 patients were diagnosed to have GDM with RBS between 126-129 mg/dl were given diet control plus exercise therapy [Group A]. 39 GDM patients with RBS greater than 130 mg/dl were kept on diet plus exercise and insulin [Group B]. After delivery placentae were collected from 25 patients in each group. Histological slides of placentae were prepared and parameters of hypoxia such as villous immaturity, villous fibrinoid necrosis, syncytial knots, chorangiosis, calcification etc. were observed and compared between the two groups using light microscope. Results were evaluated by SPSS 16 using student t- test and chisquare test. Statistically non-significant results were obtained for the hypoxic parameters. However numerically more calcification was found in Group A while villous immaturity, villous fibrinoid necrosis and syncytial knots were present more in Group B. Histological examination of placentae showed presence of hypoxic features in both Group A and Group B patients with more propensities in diet plus exercise and insulin treated GDM group
Subject(s)
Humans , Female , Adult , Placenta , Hypoxia , Diet , Insulin , ExerciseABSTRACT
The burden of diabetic patients on healthcare has increased over the period of time. Management of diabetes presents a challenge to the physician. The availability of newer drugs, tested in high quality clinical trials, has marked a new era in the treatment of diabetes. Glucagon-like peptide 1 [GLP-1] analogs act by increasing the pancreatic beta-cell mass and subsequent insulin secretion. Dipeptidase-4 [DPP-4] inhibitors inhibit the enzyme that degrades GLP-1, resulting in the augmentation of GLP-1 in the body. Hence, the two drugs can be used synergistically. It was seen that severe hypoglycemia seldom occurred with GLP-1 analogues and DPP-4 inhibitors. Gastrointestinal upset and the development of antibodies to the drug in the body was mainly attributed to GLP-1 analogs. DPP-4 inhibitors showed increased risk of nasopharyngitis, urinary tract infections and headache. There is a need for further advances in our understanding, through randomized control clinical trials in larger settings, to establish the role and safety of these newer agents in the treatment of diabetes. The initiation of a modern set of medications may help us control type2 diabetes better