[Relationship between mealtime glucose excursions and glycemic control in type 2 diabetes mellitus patients]

Monitoring glycemic status, as performed by patients and healthy care providers, is considered the cornerstone of diabetes care. Recent studies have shown that fasting plasma glucose [FPG] measurements alone do not provide an overall picture of disease prognosis and associated complications. This study was designed to evaluate the possibility of utilizing post-prandial glucose excursion test as a predictor of glycemic control during treatment with oral hypoglycemic agents in type 2 diabetes mellitus. This study was carried on 24 patients with type 2 diabetes mellitus ranked into good glycemic control group [12 patients] and poor glycemic control group [12 patients] according to the criteria of evaluation of FPG. Twelve healthy subjects were selected and served as controls for comparison of the studied parameters. Fasting levels of plasma glucose, C-peptide, glycated hemoglobin and post-prandial glucose excursion profile were measured. The results indicated that fasting plasma glucose [FPG] can not be used as only predictor for determining proper acute and chronic glycemic control during drug therapy of type 2 D.M. and post-prandial glucose excursion [PPGE] test was recommended as a more suitable procedure for diagnosis and treatment follow up of type 2 D.M. patients. PPGE test can be considered as a more convenient way to follow glycemic control status during treatment of type 2 DM

Fetal echocardiography service in Qatar: establishment, challenges and outcome

A prospective observational study at the newly established Fetal Medicine Unit Hamad Hospital, Qatar, evaluated the impact of the service on the detection rate of critical congenital heart defects, patterns of referral and subsequent yield for structural congenital heart disease in a population with a significant proportion of high risk factors. Of 391 pregnant females examined between January 2003 and December 2004, 58 [14.8 percent] had fetal cardiac abnormalities of which 23 [5.8 percent of total referrals] had major structural malformations of the heart. Cases of fetal congenital heart disease had further evaluation using real time three-dimensional echocardiography [RT3DE] which is new equipment in the paediatric cardiology department. All cases with cardiac defects whether minor or major had follow up fetal echocardiography. Neonatal echocardiography confirmed the diagnosis in all cases with major defects [100 percent specificity]. False positive cases that were found to be normal post natal were 1 percent of the total cases referred [12 percent of cases with congenital malformation]. False negative cases were 1 percent and all had a small ventricular septal defect [VSD] except for one Down's syndrome with a very large VSD. Three patients needed urgent Caesarean section [CS] deliveries, one with complete heart block [HB] and two with supraventricular tachycardia [SVT]. One patient traveled abroad as the fetus had left isomerism and major cardiac defects and complete HB. Fifteen newborns had to receive prostaglandin based on the fetal diagnosis before being seen by paediatric cardiologists. There was no termination of pregnancy due to major cardiac defects even in cases of HLHS. The preliminary results of this clinic are very satisfactory and have affected favorably the outcome of the new-borns with congenital heart defects. It is hoped that the results of this study will encourage more referrals to the FMU

effect of calcium antagonists in controlling hypertension and its relation to the increased level of lipid peroxidation during pre-eclampsia

Thirty nine out patients with pre-eclampsia from Abu-Ghraib hospital were involved in this study to test the effect of calcium antagonists [nifedipine and verapamil] in lowering blood pressure and its relation to serum lipid peroxidation and serum glutathione level. Oral administration of each drugs resulted in lowering blood pressure, a decrease in the level of lipid peroxidation [decrease in MDA] concentration, and in increase serum GSH level. These observation suggest that, calcium antagonists may be effective in acutely reducing elevated blood pressure in pre-eclamptic patients, and that lipid peroxidation may play a role in the etiology of pre-eclampsia. pre-eclampsia, is a clinical syndrome which complicates pregnancy afer the twentieth weeks of gestation, is characterized by hypertension. Proteinuria, and edema [Whigham, 1978]. The etiology of it remains obscure. It has been suggested that lipid peroxidation may be involved [Hubel et al., 1989; Uotila et. al., 1993]. The pathologic features of pre-eclampsia were general agreement exists is that the syndrome is characterized by a decrease in PGI[2]: TXA[2] ratio. The cause of the decline is unknown but may have a genetic component [Moncada and Vane, 1979]. In 1985, Walsh demonstrated that the placenta of pre-eclamptic women produce a greater generation of TXA[2] about three times as much TXA[2] as the normal placenta. This study contrasted with the production rates of PGL[2]. Because of the biological actions of these eicosasnoids, this imbalance could significantly contribute to the increased vaso-constriction, platelet aggregation, increased lipid peroxide generation and reduced utero -placental blood flow characterized of pre-eclampsia [Saleh et al., 1987; Hubel et al., 1989]. The antihypertensive effect of calcium antagonists should cause uterine vasodilatation [Guazzi et al., 1983] and may have a role in inhibition of TXA[2] [Mehta, 1985]. This investigation was designed to evaluate the efficacy of calcium antagonists in controlling hypertension and its relation to the increased to the increased level of lipid peroxidation during pre-eclampsia.