ABSTRACT
Background: metformin reduces maternal and neonatal weight gain in gestational diabetes mellitus; however, this effect is poorly investigated in non-diabetic women
Objective: we performed this meta-analysis to investigate the effect of metformin intake during pregnancy on maternal and neonatal outcomes in obese non-diabetic women
Materials and Methods: we searched Medline, EMBASE, and Cochrane CENTRAL for eligible randomized controlled trials addressing the efficacy of metformin in pregnant obese non-diabetic women. Data were extracted and analyzed using RevMan software [Version 5.3]. Neonatal birth weight was the key outcome. Secondary outcomes included maternal weight gain, the incidence of preeclampsia, and neonatal adverse effects [miscarriage, stillbirth and congenital anomalies]
Results: pooled data from two RCTs [n=843] showed that metformin caused a significant reduction in maternal gestational weight gain [MD-1.35, 95% CI: [2.08, -0.630]], compared to placebo. The summary effect-estimate did not favor either of the two groups in terms of reduction of neonatal birth weight Z score [MD-0.09, 95% CI: [0.23, 0.06]]. Metformin was associated with 41% reduction in the risk of preeclampsia; however, this reduction was not statistically significant [RR 0.59, 95% CI: [0.03, 11.46]]. None of the neonatal adverse events including stillbirth [RR 1.14, 95% CI: 0.42, 3.10]] and congenital anomalies [RR= 1.36, 95% CI: [0.58, 3.21]] differed significantly between the two groups
Conclusion: for obese pregnant women, metformin could decrease gestational weight gain with no significant reduction in neonatal birth weight. In light of the current evidence, metformin should not be used to prevent poor pregnancy outcomes in obese non-diabetic women
ABSTRACT
Acute urethritis is one of the most common STD Syndromes diagnosed in men. This study was to identify Neisseria Gonorrhea, Chlamydia trachomatis and Mycoplasma genitalium in acute male urethritis using Multiplex PCR technique and to compare urethral discharge versus urine as samples for diagnosis of urethritis. Evaluation of different microbiological techniques used for the diagnosis of gonococcal urethritis was also studied. Thirty adult males attending in the Venereal Disease Clinics, Ain Shams University Hospitals complaining of symptoms suggestive of acute urethritis were included in the study. Urethral discharge and first voided urine samples were subjected to wet and Gram stained smears, Gonococcal culture and Multiplex PCR for detection of Neisseria gonorrhea, Chlamydia trachomatis and Mycoplasma genitalium. Causative organisms of urethritis were identified in 22 out of the 30 studied patients [73.3%]. Gonococcal urethritis was diagnosed in 7 cases [23.3%], while non gonococcal urethritis due to Chlamydia trachomatis and Mycoplasma genitalium was detected in 10 [33.3%] cases. Simultaneous gonococcal and non gonococcal urethritis was identified in 5 cases [16.7%]. While the sensitivity of Gram stain for diagnosis of Gonococci was 75% while specificity was 100%. Culture, sensitivity and specificity were 58.2% and 100%, respectively, in comparison to the standard PCR test. Urethral discharge samples showed higher sensitivity compared to urine samples for detection of causative organisms of urethritis using PCR technique [78.9% Vs 45.4%, P
Subject(s)
Humans , Male , Acute Disease , Chlamydia trachomatis , Mycoplasma Infections , Polymerase Chain Reaction , Sensitivity and Specificity , Mycoplasma genitaliumABSTRACT
This study aimed at screening immune status of Health Care Workers [HCWs] against measles, mumps, rubella, and varicella, and assessing the reliability of the history of previous illness due to these infections or vaccination against them as an indicator of the immune status, as checked by laboratory tests. Demographic data, history of previous illnesses and previous vaccinations were collected using a self-administered questionnaire. Also, serologic screening was done for these infections. Antibodies tested using ELISA. Among tested hospital staff, 71.8%, 60.3%, 47.9% and 68.4% reported history of infection or vaccination against measles, mumps, rubella and varicella respectively, while laboratory results proved that 4.5%, 10.8%, 12.9% and 11.3% were susceptible respectively. Susceptibility was most frequent among housekeeping staff against measles and varicella, while administrative staff were the most susceptibles to mumps, and nurses were the most susceptibles to rubella. Sensitivity of past history of illness as an indicator of the immune status, was found to be [85%, 83%, 66%, 86%]; Specificity was [81%, 81%, 89%, 87%]; Positive Predictive value [PV] was [99%, 98%, 98%, 98%] and Negative PV was [16%, 29%, 22%, 39%] for measles, mumps, rubella and varicella respectively. Screening for measles, mumps, rubella and varicella among hospital staff is mandatory to detect those who are susceptible for infections and should be vaccinated, and so preventing transmission of these infections to their colleagues or patients