Female Awareness about Gestational Diabetes and its Health Risk Effect on Pregnancy Outcome among Women in the Kingdom of Saudi Arabia

Uncontrolled gestational diabetes mellitus causes severe maternal and fetal complications such as pre-eclampsia, macrosomic baby, fetal demise, neonatal hyperbilirubinemia, and hypoglycemia and also increases obesity and type 2 DM risk in offspring later in life. This study aimed to assess awareness of women in the Kingdom of Saudi Arabia regarding diabetes and its health risk effect on pregnancy outcome and to measure the prevalence of gestational DM among them. This is a comparative cross-sectional descriptive study conducted in Department of Obstetrics and Gynecology, Faculty of Medicine Umm Al Qura University involving 480 women living in the Kingdom of Saudi Arabia during June 2021-June 2022. Data was collected through an online questionnaire formulated to survey saudi women due to covid 19 pandemics measures. About 20% had DM. Prevalence of gestational DM was 11.5% among currently pregnant participants. 76% of participants had family history of diabetes. After doing linear regression of predictors for knowledge about gestational DM, gravidity and parity became non-significant, however being in medical field, husband in medical field, having DM, past or family history of DM remained significant (p<0.001, 0.045, <0.001, 0.002 and 0.006 respectively). The highest predictor is being in medical field (B =7.218), followed by having DM (B =2.697), followed by husband in medical field (B =2.159), past history of DM (B =1.945), then family history of DM (B =1.727). Health care efforts and interventions are required to increase the awareness especially about the importance of screening for gestational DM due to the bad sequences of gestational DM.

Is Contraception Usage Affected During Corona Virus Disease 2019 Pandemic Among Women in Saudi Arabia?

Background: Contraception has many benefits beside improvimg women health such as increasing child survival and improving perinatal outcomes due to interpregnancy interval regulation. Objectives: to assess the knowledge and attitude of Saudi women regarding the use of contraceptives, to measure the prevalence of contraception use, and to highlight factors affecting the use of contraception among women in the Kingdom of Saudi Arabia during covid 19 pandemic.Methods: This is a comparative cross-sectional descriptive study involving 432 saudi arabian women during the period from July 2021 to July 2022. Data was collected through an online questionnaire formulated to survey saudi women due to covid 19 pandemics measures.Results: Overall knowledge was good among 48% of participants. Regarding attitude towards contraception use. About 77.8% agreed to use contraception while only 3% disagreed. 90.7% had an experience with contraceptive methods either currently or previously. Coitus interruption was the commonest method used by about 20%, followed by COC (18%), then condom (12.5%). Predictors for higher use were husband higher education, gravidity of two to four and previous one to two cesarean section (AOR=10.048,283,20.047 respectively).Conclusion: Participants had good contraceptive knowledge and positive attitude towards contraception use. Proportion of contraceptive methods use was high among participants. We recommend more health education campaigns about the importance of contraception especially during the COVID 19 pandemic and among women who had previous cesarean section. We also recommend more research involving a representative sample from all regions of the kingdom.

NeuroSAFE PROOF. Update on a multi-centre, pragmatic, RCT for men undergoing robot-assisted radical prostatectomy: Trial in progress

Introduction & Objectives: Robot-assisted Radical Prostatectomy (RARP) is an effective cure for organ confined prostate cancer but is associated with considerable post-operative functional toxicity. The NeuroSAFE technique (intra-operative frozen section analysis of the neurovascular structure adjacent margin) may help improve functional outcomes by promoting optimal nerve-sparing (NS) RARP without compromising on oncological outcomes. NeuroSAFE technique has reported favourably in retrospective, single-centre studies but has never been evaluated prospectively by a randomised study. The NeuroSAFE PROOF Feasibility Study has succeeded in demonstrating feasibility and has been succeeded by the fully powered, definitive NeuroSAFE PROOF Randomized Controlled Trial (RCT) (NCT03317990). Materials & Methods: Potent men (IIEF-5>21) with localised prostate cancer at 4 regional uro-oncology centres in the UK (UCLH, Bristol, Sheffield and Glasgow) are eligible. Participants are randomised 1:1 to RARP with NS decision guided by standard of care (clinical information, DRE and pre-operative mpMRI surgical plan) vs. RARP with NS decision guided by standard of care information and the NeuroSAFE technique. The primary outcome is erectile function (EF) recovery assessed by IIEF-5 score at 12-months. Important secondary outcomes include detailed peri-operative outcomes, histological outcomes, post-operative complications, biochemical recurrence rates, urinary continence (assessed by ICIQ), health related quality of life (assessed by Rand-36 and EQ-5D-5L), and health economics. In order to demonstrate a difference of 15% in EF recovery rates between the arms, a total of 404 men will be randomised and treated. Patient follow-up will continue for 5 years after RARP. Results: At the time of writing, 160 men have been recruited and treated with RARP as per random allocation at 4 participating sites. The independent DMC has met twice to ensure the oncological safety of the trial and will continue to review the data at intervals. Covid-19 has led to significant challenges, including suspension of recruitment and difficulties performing follow-up. The trial team have developed new methods of recruitment, consent and follow-up to ensure conduct of the study remains in line with the highest standards of trial conduct, including electronic remote consent processes and remote collection of PROMs. Conclusions: The NeuroSAFE technique has been reported as a method to optimise outcomes for men undergoing RARP for over a decade, but, in the absence of Level 1 evidence, equipoise remains. Despite the Covid-19 pandemic recruitment continues to be favourable. We hope that our

Pneumothorax et pneumomédiastin, deux complications redoutables en cas de pneumonie virale à COVID-19

Introduction L’association pneumothorax et/ou pneumomédiastin à la pneumonie à COVID-19 a déjà été décrite. Le but de notre étude est de rechercher la particularité du pneumothorax et/ou pneumomédiastin au cours d’une pneumonie à COVID-19. Méthodes Étude rétrospective descriptive sur 16 malades hospitalisés pour pneumonie à COVID-19, compliquée de pneumothorax chez 12 cas et de pneumomédiastin chez le reste. Les patients ont été évaluer sur le plan épidémiologiques (l’âge, le sexe, le tabac, antécédents de pneumothorax et le délai de survenue du pneumothorax par rapport au début de la maladie), clinique (SpO2, besoin en oxygène) et radiologique (étendue de la pneumonie). Résultats Il s’agissait de 13 hommes et 3 femmes, âgés entre 28 et 89 ans avec un âge moyen de 58 ans. L’antécédent de pneumothorax est retrouvé chez 2 patients et la notion de tabagique chez 10 patients. Deux malades avaient en plus du pneumothorax, un pneumomédiastin dont un pneumothorax bilatéral minime d’un côté et de moyenne abondance du côté controlatéral. Le pneumothorax et/ou le pneumomédiastin est apparu entre le 7e jour et le 30e jour après le début des symptômes cliniques du COVID-19. L’étendue des lésions pulmonaires de l’infection SARS-CoV-2 variait entre 50 et 75 % chez tous les patients. Le pneumothorax est apparu chez 10 malades sous oxygénothérapie avec un débit entre 2 et 30 litres/min. Neuf malades recevaient de l’oxygène avec source murale dont un était sous VNI et un était sous extracteur d’oxygène à domicile. Le pneumothorax avait aggravé l’état respiratoire des patients avec augmentation des besoins en O2 avec détresse respiratoire et troubles neurologiques chez 3 cas. La TDM thoracique refaite en urgence chez 4 patients avait montré le pneumothorax. Alors que le drainage s’est fait à l’aveugle chez les patients aux ATCD de pneumothorax surtout que l’examen clinique montrait un syndrome d’épanchement pleural aérien. Le drainage pleural avait amélioré les besoins en O2. Quant au pneumomédiastin, il a régressé spontanément. On a déploré 6 décès malgré la régression du pneumothorax et ceci en raison de l’étendue des lésions de la pneumonie. Bonne évolution chez 10 patients avec peu séquelles. Conclusion Le pneumothorax et le pneumomédiastin sont deux complications graves au cours de la pneumonie à SARS-CoV-2. Elle nécessite une prise en charge en extrême urgence en raison de l’aggravation de l’insuffisance respiratoire aiguë. Le tableau brutal incité la recherche de ces complications.