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Oral Anti-diabetic Agents as an Alternative Treatment of Diabetes in Pregnancy
Tarafdar Runa Laila,
Sheikh Salahuddin Ahmed
Issue:
Volume 4, Issue 2, March 2016
Pages:
13-19
Received:
11 February 2016
Accepted:
23 February 2016
Published:
4 March 2016
Abstract: Diabetes is the commonest medical condition in pregnancy. The initial treatment of gestational and Type 2 diabetes in pregnancy is dietary and lifestyle measures. Upon failure of this, pharmacological treatment is advocated which is insulin due to its unparalleled efficacy and safety. But insulin has got some drawbacks like suboptimal patient adherence specially in developing countries. Considering this, studies are done with oral anti-diabetic agents (OAA) among which glyburide and metformin are common. The purpose of this review article is to summarize the different studies done with the OAA specially glyburide and metformin and to critically evaluate the results. Information was collected by searching pub med for related studies, abstracts and articles. Studies on glyburide show little or no transfer across the placenta while metformin cross readily. However animal studies have found no evidence to suggest that glyburide and metformin are teratogenic. In pregnancy glyburide was found to be safe and efficacious with a success rate of 80-85% and there was less incidence of maternal hypoglycemia than insulin. Some studies reported higher rate of preeclampsia, neonatal jaundice and macrosomia. Metformin was associated with reduced neonatal hypoglycemia, maternal hypoglycemia and weight gain with improved treatment satisfaction. However it was observed that failure occurred more with these two drugs in those pregnant women who were early diagnosed cases of gestational diabetes mellitus( <25 weeks), having past history of gestational diabetes mellitus, obese, elderly and with high blood sugar profile specially fasting sample. Prescription of any OAA in pregnancy should be accompanied by full information of the drug including its lack of long term safety data. With the exception of glyburide and metformin there is insufficient data to recommend treatment with any other currently available OAA during pregnancy.
Abstract: Diabetes is the commonest medical condition in pregnancy. The initial treatment of gestational and Type 2 diabetes in pregnancy is dietary and lifestyle measures. Upon failure of this, pharmacological treatment is advocated which is insulin due to its unparalleled efficacy and safety. But insulin has got some drawbacks like suboptimal patient adher...
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Serum Erythropoietin Level in Chronic Kidney Disease Patients with Anemia: A Baseline Study at Chittagong Medical College, Chittagong, Bangladesh
Mizanur Rahman,
Mahmudul Haque,
ASM Towhidul Alam,
Md. Nurul Amin,
K. M. Huria Parveen,
Naila Al Mahmuda,
Md. Golam Abbas
Issue:
Volume 4, Issue 2, March 2016
Pages:
20-25
Received:
11 February 2016
Accepted:
24 February 2016
Published:
17 March 2016
Abstract: Chronic kidney disease (CKD) is a serious condition associated with premature mortality, decreased quality of life, and increased health-care expenditures. A failure to produce sufficient Erythropoietin (EPO) accounts for the moderate to severe anemia observed in chronic kidney disease. Decreased EPO production is attributed to destruction of renal production sites. A cross-sectional descriptive study was designed for determination of erythropoietin level in chronic kidney disease patients with anemia. At the same time measurement of serum iron and serum ferritin to establish anemia. Serum concentration of erythropoietin was the parameter taken to evaluate the kidney status. This study was carried out in the Nephrology ward, Chittagong Medical College Hospital (CMCH), Chittagong, Bangladesh during the period of January 2012 to December 2012. Total Sixty Patients having hemoglobin level < 11 gm/dl and serum creatinine > 3 mg/dl taken as a case of chronic kidney disease with anemia. Mean Hemoglobin level found 8.67gm/dl [± 1.39SD(standard deviation), Serum creatinine level found 8.21 mg/dl (±3.25 SD), Serum erythropoietin level found 2.67 miu (mili international unit)/ml (± 2.36 SD), Serum iron level found 13.78 µg/dl (±2.58 SD). Serum ferritin level found 73.35ng/mL (± 26.81SD). It is also observed that Pearson’s correlation coefficient (r) between erythropoietin and hemoglobin is – 0.190 (r=0.036, p value=0.145), which is not significant. Correlation coefficient between erythropoietin and creatinine is – 0.082 (r=0.007 p value = 0.532), which is not significant. Correlation coefficient between erythropoietin and iron is 0.021 (r=4.549, p value =0.872), which is not significant but shows weakly positive correlation. Correlation coefficient between erythropoietin and ferritin is 0.005 (r=2.723 p value=0.968) which is not significant but also shows weakly positive correlation.
Abstract: Chronic kidney disease (CKD) is a serious condition associated with premature mortality, decreased quality of life, and increased health-care expenditures. A failure to produce sufficient Erythropoietin (EPO) accounts for the moderate to severe anemia observed in chronic kidney disease. Decreased EPO production is attributed to destruction of renal...
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Analysis Level of Serum Estradiol Hormone of Pregnant Women with Melasma
Andi Miranti,
Anis Irawan Anwar,
Khairuddin Djawad,
Ilhamjaya Patellongi,
Siswanto Wahab,
Nusratuddin Abdullah
Issue:
Volume 4, Issue 2, March 2016
Pages:
26-29
Received:
15 February 2016
Accepted:
29 February 2016
Published:
21 March 2016
Abstract: Hormonal changes in pregnancy are the important etiology of melasma. The presence of melasma in more than 75% of pregnancies. At the end of pregnancy, estrogen levels increase. Estrogen, especially estradiol triggers increased synthesis of melanin. This paper is aimed to determine the relationship between estradiol hormone with melasma and the type ofmelasma in pregnant women. This study used a cross-sectional study design to determine the relationship of estradiol hormone with melasma. It was conducted from September-November 2015. Skin examination was performed on 64 pregnant women (15-49 years old) who suffered from melasma in the third trimester and who did not, and the blood was drawn to measure the level of serum estradiol hormone. The study results that the levels of estradiol was slightly higher in women with melasma than those without melasma (13811.7 vs 12820.5), but not statistically significant (p>0.05). There was slightly higher levels of estradiol in women with the mixed type of melasma than the other types (14444.10 vs 14047.25 and 12243.50), but it was not statistically significant (p>0.05). Estradiol levels correlated significantly (p<0.05) with maternal age (r = 0.238) and gestational age (r = 0.435); but did not correlate significantly (p>0.05) with MASI (Melasma Area Severity Index) score and the type of melasma. The study concluded that estradiol levels in women with melasma are higher than not melasma and in mothers with type mix melasma were higher than other types, but not statistically significant. Estradiol level correlated with maternal age and gestational age.
Abstract: Hormonal changes in pregnancy are the important etiology of melasma. The presence of melasma in more than 75% of pregnancies. At the end of pregnancy, estrogen levels increase. Estrogen, especially estradiol triggers increased synthesis of melanin. This paper is aimed to determine the relationship between estradiol hormone with melasma and the type...
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Comparative Levels of Immunoglobulin A Urethral Mucosa in Asymptomatic Chlamydia trachomatis Infections in the Prison
Ade Indrayani,
Andi Muhammad Adam,
Faridha Ilyas,
Safruddin Amin,
Burhanuddin Bahar,
Rizalinda Sjahrir
Issue:
Volume 4, Issue 2, March 2016
Pages:
30-33
Received:
8 February 2016
Accepted:
29 February 2016
Published:
28 March 2016
Abstract: Investigation of mucosa immunoglobulin A (IgA) can be used to determine the prevalence of Chlamydia trachomatis (CT) infection, in addition to examination of Polymerase Chain Reaction (PCR) particularly in asymptomatic cases. This research is aimed to compare the levels of IgA mucosal urethral in asymptomatic Chlamydia trachomatis infection and non-infection in male prisoners based on PCR examination in the prison. The methods used was urethral swab specimens collected from 43 asymptomatic male prisoners at the Sidrap Prison in December 2015 and then were examined using PCR method, followed by examination of mucosal IgA levels. The results indicate prevalence of CT based on PCR examination is 2.3%. Based on the examination of PCR, mucosal IgA levels in infected by CT six-fold higher than non-infectious with a mean ± SB (4.45) vs (0.77 ± 0.52) with p = 0.09. Based on the examination of mucosal IgA, the level of infected IgA is four-fold higher than non-infectious with a mean ± SB (2.48 ± 1.41) vs (0.64 ± 0.21), with p < 0.001. The combination of a positive PCR results and/or IgA positive with urethral specimen indicate infection of CT, but PCR and IgA in CT infections are not interchangeable but both constitute complementary examination.
Abstract: Investigation of mucosa immunoglobulin A (IgA) can be used to determine the prevalence of Chlamydia trachomatis (CT) infection, in addition to examination of Polymerase Chain Reaction (PCR) particularly in asymptomatic cases. This research is aimed to compare the levels of IgA mucosal urethral in asymptomatic Chlamydia trachomatis infection and non...
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