Pregnant women with Polycystic ovarian syndrome and Diabetes have Adverse Pregnancy Outcomes: Study

A recent study found that
pre-existing diabetes can have adverse outcomes during pregnancy when
associated with polycystic ovarian syndrome. The study results were published
in the European Journal of Obstetrics & Gynecology and Reproductive Biology.

Polycystic ovarian syndrome
(PCOS) is the most prevalent endocrine disorder among reproductive-age women.
It can result in various reproductive and metabolic consequences. Women with
PCOS have high complications during pregnancy and perinatal period. Previous
literature showed the association between preexisting diabetes and increased
adverse outcomes. Increased rates of preeclampsia, cesarean delivery, operative
delivery, and spontaneous preterm birth have been observed in women with preexisting
diabetes mellitus (DM). Due to common pathogenesis, PCOS is often found to
coexist with type 2 diabetes. However, there is ambiguity on the association between
pregestational DM and pregnancy outcomes in PCOS. Hence, researchers conducted a
study to establish the association between the two.

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A retrospective population-based
study was carried out by using data from the Healthcare Cost and Utilization
Project Nationwide Inpatient Sample (HCUP-NIS) database. Using the ICD-9, all
deliveries between 2004 and 2014 were studied. During this period about 14,882
women had a diagnosis of PCOS, of which 673 (4.7%) had a diagnosis of
pregestational diabetes. Demographics were compared using the Chi-squared tests.
Multivariate logistic regression analysis was performed to calculate unadjusted
and adjusted odds ratios (aORs) and corresponding 95% confidence intervals
(CI), controlling for confounding effects.

Findings:

  • Women with PCOS and pre-gestational DM were more
    likely to develop pregnancy complications.
  • After controlling for confounding demographics,
    the pregnancy outcomes were found to be pregnancy-induced hypertension,
    preeclampsia, preeclampsia or eclampsia superimposed on pre-existing
    hypertension, and placenta previa.
  • Women with PCOS who had pregestational diabetes
    were at increased risk of preterm delivery and delivery by cesarean section.
  • No difference was found in the rate of women between
    the two groups who gave birth to small for gestational age (SGA) infants, the
    rate of intrauterine fetal demises (IUFD), and the rate of infants with
    congenital anomalies.
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Thus, the study concluded that pregestational
diabetes in women with PCOS increased the risk of pregnancy complications like pregnancy-induced
hypertension, preeclampsia, preeclampsia or eclampsia superimposed on
pre-existing hypertension, and placenta previa. The researchers highlight the
importance of considering the effect of preexisting diabetes in managing
pregnant women with PCOS to optimize perinatal care.

Further reading: Association
between pre-gestational diabetes in women with polycystic ovary syndrome and
adverse obstetric outcomes. Doi: https://doi.org/10.1016/j.ejogrb.2024.11.021.

Take home points:

  • Women with PCOS and pre-gestational diabetes
    develop adverse pregnancy outcomes.
  • These include pregnancy-induced hypertension,
    preeclampsia, preeclampsia or eclampsia superimposed on pre-existing
    hypertension, placenta previa, preterm delivery, and delivery by cesarean
    section.
  • Hence, the effect of pre-existing DM and PCOS on
    pregnancy outcomes should be considered when counseling and planning care for
    pregnant women for improved outcomes.

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Frequent recreational cannabis use associated with caries and tooth loss, suggests study

Frequent recreational cannabis use associated with caries and tooth loss, suggests a study published in the Journal of the American Dental Association.

This study aimed to examine the association of frequent recreational cannabis (FRC) use with untreated coronal caries, untreated root surface caries, and severe tooth loss. This cross-sectional study analyzed data obtained from 5,656 people, aged 18 through 59 years, who participated in the National Health and Nutrition Examination Survey from 2015 through 2018. FRC use was defined as self-reported use of marijuana or hashish at least once per month for the past 12 months. Log-binomial and logistic regression analyses were conducted before and after controlling for sociodemographic and behavioral factors to examine the association between FRC use and untreated coronal caries, root surface caries, and severe tooth loss. Results: Compared with non–FRC users, people reporting FRC use had 17% higher probabilities of having untreated coronal caries (95% CI, 1.02 to 1.35), 55% higher odds of having untreated root surface caries (95% CI, 1.21 to 1.99), and 41% higher odds of having severe tooth loss (95% CI, 1.00 to 1.99) after controlling for age, sex, race or ethnicity, nativity, education, family income to poverty ratio, and alcohol consumption. This study suggests that FRC use is associated with increased coronal caries, root surface caries, and severe tooth loss in the US adult population. Further longitudinal studies are warranted to assess the impact of varying frequencies, quantities, and forms of cannabis use. Dental care professionals should be aware that FRC use may be associated with caries and tooth loss.

Reference:

Frequent recreational cannabis use and its association with caries and severe tooth loss

Clonan, Ellyce et al. The Journal of the American Dental Association, Volume 0, Issue 0

Keywords:

Frequent, recreational, cannabis use, associated, caries, tooth loss, suggests, study, Cannabis, NHANES, dental caries, tooth loss

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Women who suffer pregnancy complications have fewer children, reveals research

Women who suffer severe complications during their first pregnancy or delivery are less inclined to have more babies, a study published in JAMA by researchers at Karolinska Institutet reports. Given the recent steady decline in birth rate in Sweden, the researchers propose monitoring in antenatal care to address the problem.

“The clinical monitoring of these women is essential, and they need individualised advice on possible future pregnancies,” says the study’s first author Eleni Tsamantioti, doctoral student at the Department of Medicine in Solna, Karolinska Institutet.

Birth rates and fertility have both been in steady decline in Sweden over the past years. In this new population-based study, the researchers have studied the association between severe maternal morbidity in first-time mothers and the likelihood of their having a second baby. The study comprised over a million women in Sweden who had their first baby between 1999 and 2021.

“We found that the likelihood of having more children was much lower in women who had experienced severe complications during their first pregnancy, delivery or postnatal period,” says the study’s last author Neda Razaz, associate professor at the same department. “Such events can often have a physical and mental impact on women for a long time to come.”

All in all, 3.5 per cent of the first-time mothers in the study suffered serious complications and were 12 per cent less likely to have a second baby. Most impacted were women who had experienced cardiac complications, a ruptured uterus or severe mental health problems, who were 50 per cent less likely to have another birth than women who had not experienced such complications.

Women who needed respiratory care or who suffered a cerebrovascular accident like stroke or intracranial haemorrhage were 40 per cent less likely to have a second baby. Acute kidney failure, severe preeclampsia and blood clotting were also associated with a lower probability of a second pregnancy. The researchers also compared the women with any sisters they had to control for familial factors.

“The reasons are hard to speculate on and may result from multiple factors, such as decreased desire for more children, trauma, infertility related to psychiatric medications, or lack of health counselling,” says Tsamantioti. “Proper support and monitoring by antenatal care staff is therefore essential for women who have suffered serious health problems during pregnancy or delivery.”

Reference:

Tsamantioti E, Sandström A, Lindblad Wollmann C, Snowden JM, Razaz N. Association of Severe Maternal Morbidity With Subsequent Birth. JAMA. Published online November 25, 2024. doi:10.1001/jama.2024.20957.

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Study sheds new light on what causes long-term disability after a stroke, offers new path toward possible treatment

A recent study by Simon Fraser University researchers has revealed how an overlooked type of indirect brain damage contributes to ongoing disability after a stroke.

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A tropical disease in Switzerland: Call for coordinated action on Chagas disease

The Swiss Tropical and Public Health Institute (Swiss TPH), in collaboration with the World Health Organization and other partners, conducted a comprehensive review of Chagas disease in Switzerland. Although typically found in Latin America, Chagas disease affects between 2,000 and 4,000 people in Switzerland. The review, published in the Swiss Medical Weekly, underscores the need for improved screening and health care strategies to eliminate Chagas disease in Switzerland.

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Yoga has many health benefits as you age—but is it also the secret to longevity?

Yoga has been linked to numerous health benefits. But is it also the secret to a long life? This is what Daisy Taylor, a centenarian from Chelmsford, England, reports.

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Rheumatoid arthritis associated with increased risk for new heart failure

Rheumatoid arthritis (RA) is associated with a higher rate of heart failure subtypes, according to a study published online Dec. 9 in Arthritis Care & Research.

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Without clean water, Pacific Islanders turn to sugary drinks—tackling this could reduce obesity

One in two people in the Pacific Islands is classified as overweight (with a body mass index of 25–29) or obese (a BMI of 30 or above). This is a problem because obesity increases the risk of health conditions such as diabetes, heart disease, strokes and some cancers.

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Indian Pharma Market to Hit Rs 2.38 Lakh Crore by 2025: Pharmarack Report

New Delhi: The Indian Pharma Market (IPM) is set to grow by 8.2% in 2025, reaching Rs 2.38 lakh crore under a realistic scenario, according to the Market Growth Compass Report by Pharmarack.

This follows an 8% growth in 2024 and a five-year CAGR of 10.4%, driven primarily by price increases and new product launches.

As per the report, key drivers include evolving therapy behaviors post-COVID, normalization of disease patterns since 2022, and the increasing impact of innovative molecule launches and generics as patents expire. Policy interventions like the National List of Essential Medicines (NLEM) updates and bans on fixed-dose combinations (FDCs) further shape market dynamics.

Additionally, growing awareness of obesity treatments, a shift toward over-the-counter (OTC) products, and rising online sales significantly contribute to the changing market landscape.

Also Read: Indian Pharma Market Grows at 9.9 Percent, Vaccine Sales See Sharp Decline: Pharmatrac Report

Therapy-wise, cardiac and gastrointestinal segments are at the forefront of growth, with projected increases of 8.3% and 9.6%, respectively, in 2025. Other notable areas include respiratory therapies at 8.7% and anti-neoplastics at 9.8%. However, vaccines stand out as a declining category, expected to drop by 1.8% under the realistic scenario, highlighting segment-specific challenges.

Three scenarios—optimistic, realistic, and pessimistic—were explored to provide comprehensive insights. The optimistic scenario projects Rs. 239,893 crore (9% growth), driven by rapid adoption of new therapies, while the pessimistic scenario suggests Rs. 236,285 crore (7.4% growth), accounting for slower market adoption and other constraints.

Also Read: Indian Pharma Market Posts Robust 10.7 Percent Growth In November, Foracort Tops Sales: IQVIA

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SC Recognises Dearth of Super Speciality Doctors in Dental Science, Grants Relief to Dentists Facing Admission Cancellation

New Delhi: Observing that there is a ‘dearth of Super-Speciality Doctors’ in the field of dentistry, the Supreme Court in a recent order granted relief to MDS (Master of Dental Surgery) graduates of the 2016-2019 batch in the dental colleges of Madhya Pradesh by regularising their admission and directing the State Government authorities to issue necessary degrees to them.

While considering an appeal filed by the MDS graduates, who challenged the Madhya Pradesh High Court‘s order cancelling their admission taken in 2016, the top court bench of Justices BR Gavai and KV Viswanathan observed, “It is commonly known that there is a dearth of super specialty doctors even in the field of dental science. If the admission of the appellants is not regularized the education undertaken by them would go in waste.”

“Therefore, in the peculiar facts and circumstances of the case, we are inclined to allow the appeal and quash and set aside the impugned order passed by the High Court as well as the orders passed by the Regulatory Authority and the Appellate Authority. Ordered accordingly,” ordered the top court bench.

The petitioner students pursued their Bachelor of Dental Surgery (BDS) course from the States of Karnataka, Gujarat, and Maharashtra. They took admission for Master of Dental Surgery (MDS) in the dental colleges situated in the State of Madhya Pradesh. However, their admissions were cancelled by the Regulatory Authority on the ground that they did not participate in the counselling process and violated the Supreme Court order dated 17.03.2016.

Also Read: Supreme Court relief to disabled MBBS aspirant, supernumerary seat to be created

Consequently, the Appellate Authority affirmed the order of the Regulatory Authority cancelling the admission of the petitioner students. Aggrieved by this, the students approached the Madhya Pradesh High Court, which granted an interim order by virtue of which, the petitioners completed their MDS Course from 2016 to 2019.

After the petitioners completed their MDS course, the plea was dismissed by the Division Bench of the High Court, upholding the order of the Regulatory Authority as well as the Appellate Authority. Following this, the students approached the Supreme Court bench seeking relief.

The counsels for the State of Madhya Pradesh and Dental Council of India opposed the plea on the ground that the admission was in violation of the Supreme Court order. They also argued that the petitioners were granted admission by backdoor entries as they did not participate in the counselling process. 

However, the Supreme Court bench rejected this argument observing that other similarly situated students who completed their BDS (Bachelor in Dental Surgery) from the same State and same college, were not disturbed on the ground that they had completed their BDS from the State of Madhya Pradesh.

“No doubt that the principle of negative equality would not be applicable while considering the grant of relief under Article 226 of the Constitution of India. However, the fact remains that similarly circumstanced students, who have passed their BDS Course from the State of Madhya Pradesh have got their Post Graduate Degrees (MDS Course),” observed the Supreme Court bench.

Even though the State counsel argued that in the case of the students from the State of Madhya Pradesh, only two factors had been violated, while the in the cases of the petitioners, three factors were violated.

Referring to the argument that the admissions were not regularized by the State but by the Regulatory Authority, the bench noted,

“We find that the approach adopted by the Regulatory Authority which has been confirmed by the Appellate Authority and the High Court to the effect that since the number of illegalities in cases of the appellants were higher than the number of illegalities in the case of the students who have passed their BDS from the State of Madhya Pradesh, the appellants admission would not be regularized, is not a correct approach. In any case, the appellants have completed the MDS course and they have successfully cleared the examination.”

Therefore, highlighting the dearth of super speciality doctors even in the field of dental science, the top court bench allowed the appeal and directed that the appellants’ admission be regularised with the issuance of necessary degrees.

However, the Apex Court clarified that “Needless to state that as observed hereinabove, we are passing the aforesaid order in the peculiar facts and circumstances of the case and it shall not be treated as a precedent in any other matter.”

To view the Supreme Court order, click on the link below:

https://medicaldialogues.in/pdf_upload/supreme-court-mds-degree-265270.pdf

Also Read: Supreme Court allows disabled-OBC student’s admission to Rajasthan Medical College

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