ABSTRACT
AIM: Aim of the study was to compare outcomes of pregnancy in gestational diabetes mellitus (GDM) treated with metformin, insulin, or diet. MATERIAL AND METHODS: The study included 48 women with GDM treated with metformin, 101 with insulin, and 200 women on a diet from the Outpatient Department of Endocrinology and University Clinic of Obstetrics and Gynecology in Skopje. RESULTS: The groups were comparable in age, smoking cigarettes and positive family history of diabetes. Mean glycosylated haemoglobin (HbA1c) at 37 gestation week, mean fasting, postprandial glycaemia, and gestational age at delivery were lower in diet and metformin than insulin group. No differences in mode of delivery were observed between the metformin and insulin group. Women in metformin group had a significantly lower incidence of LGA newborns than diet and insulin groups. The percent of SGA new-borns was higher in insulin group than diet and metformin groups. The incidence of neonatal hypoglycemia was statistically significantly higher in the insulin group than in the metformin and diet group. CONCLUSION: Metformin in women with GDM can improve maternal and neonatal outcomes compared with those treated with diet or insulin.
ABSTRACT
OBJECTIVE: There is a global call for formulations, which are better suited for children of different age categories and in a variety of settings. One key public health area of interest is age-appropriate paediatric antibiotics. We aimed to identify clinically relevant paediatric formulations of antibiotics listed on pertinent formularies that were not on the WHO Essential Medicines List for Children (EMLc). METHODS: We compared four medicines lists versus the EMLc and contrasted paediatric antibiotic formulations in relation to administration routes, dosage forms and/or drug strengths. The additional formulations on comparator lists that differed from the EMLc formulations were evaluated for their added clinical values and costs. RESULTS: The analysis was based on 26 EMLc antibiotics. Seven oral and two parenteral formulations were considered clinically relevant for paediatric use. Frequently quoted benefits of oral formulations included: filling the gap of unmet therapeutic needs in certain age/weight groups (phenoxymethylpenicillin and metronidazole oral liquids, and nitrofurantoin capsules), and simplified administration and supply advantages (amoxicillin dispersible tablets, clyndamycin capsules, cloxacillin tablets, and sulfamethoxazole+trimethoprim tablets). Lower doses of ampicillin and cefazolin powder for injection could simplify the dosing in newborns and infants, reduce the risk of medical errors, and decrease the waste of medicines, but may target only narrow age/weight groups. CONCLUSIONS: The identified additional formulations of paediatric antibiotics on comparator lists may offer clinical benefits for low-resource settings, including simplified administration and increased dosing accuracy. The complexity of both procuring and managing multiple strengths and formulations also needs to be considered.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Drug Compounding , Drugs, Essential , Age Factors , Child , Drug Administration Routes , Formularies as Topic , Humans , World Health OrganizationABSTRACT
INTRODUCTION: It has been shown that some adipocytokines and their mutual relationship can be indicators of fetal and neonatal growth. Physiological role of leptin and adiponectin in fetal and neonatal growth is not well established. OBJECTIVES: The aim of this study was to assess the correlation of the anthropometrics parameters and serum concentration of leptin and adiponectin levels in healthy newborns. METHODS: A cohort of 110 neonates, born after uncomplicated singleton pregnancies at term, were classified as AGA (n = 60), SGA (n = 30) and LGA (n = 20) according to the Lubchenco curves. Anthropometric parameters of the neonates: birth weight (BW), birth length (BL), body weight/body length ratio (BW/ BL), Body Mass Index (BMI) and Ponderal Index (II) were recorded after birth. RESULTS: Mean serum leptin and adiponectin levels in both sexes were not significantly different (male: 1.8 +/- 0.75; 29.5 +/- 22.89 and female: 2.0 +/- 0.99; 31.6 +/- 23.51 ng/mL). There was a significant difference between leptin levels in AGA and LGA newborns 11.9 +/- 0.84 vs. 3.1 +/- 1.50 ng/mL) (p < 0.05), and in adiponectin levels between AGA and LGA compared to SGA newborns (32. +/- 23.29 and 43.4 +/- 31.24 vs. 12.6 +/- 2.43 ng/mL, respectively; p < 0.05; p < 0.05). Leptin and adiponectin levels were positively correlated with BW (r = 0.63 and r = 0.41), BL (r = 0.63, r = 0.42), BW/BL (r = 0.61, r = 0.41), BMI (r = 0.54, r = 0.35), and PI (r = 0.47, r = 0.29, (p < 0.01). CONCLUSION: Significantly higher adiponectin levels were found in AGA neonates compared to SGA neonates. Leptin and adiponectine levels were positively correlated with birth weight. These findings suggest that these adipocytokines may be involved in fetal growth regulation.
