Background: We aimed to assess the utility of HbA1c in the early detection of gestational diabetes (GDM) in the first trimester.Methods: This prospective study was performed on 700 pregnant women in the perinatology clinic at a tertiary university hospital from March 2018 to March 2020. For all pregnant women, HbA1c and fasting blood glucose (FBG) levels were examined during the first trimester. Then, a GDM screening test was done within 24–28 weeks of pregnancy using a 100 g oral glucose tolerance test (OGTT) as the gold standard test. The GDM diagnosis was made according to the American Diabetes Association (ADA) criteria. Sensitivity, specificity, positive (PPV), and negative predictive value (NPV) of HbA1c and FBG were calculated using the receiver operating characteristic (ROC) curve.Results: Of 700 participants, one hundred and fifteen (16.4%) women had GDM. The GDM patients were significantly older and had a higher pre-gestational body mass index and pregnancy weight gain compared to the non-GDM participants. The sensitivity and specificity for ruling out GDM at an HbA1c cut-off value of 4.85% was 92.2 and 32.8%, respectively, with a 95.5% NPV and a 21.2% PPV. Furthermore, sensitivity and specificity for diagnosing GDM at an HbA1c cut-off value of 5.45% was 54.8 and 96.8%, respectively, with a 91.5% NPV and a 76.8% PPV. Using HbA1c could decline OGTT in 40.4% of the pregnant women (28.7% with HbA1c < 4.85 and 11.7% with HbA1c ≥ 5.45%).Conclusion: It seems that the first-trimester HbA1c cannot replace OGTT for the diagnosis of GDM because of its insufficient sensitivity and specificity. However, women with higher first-trimester HbA1c had a high risk for GDM incidence.

This cross-sectional population-based study was conducted to elucidate the prevalence of vitamin D deficiency, bone turnover marker’s variation and i

The recent surge in COVID-19 cases has exposed health care workers (HCWs) to a wide range of psychological stressors and predisposed them to anxiety-related disorders. Here, we investigated the anxiety level in this population. This multi-center, cross-sectional study was performed on 1038 HCWs in 14 hospitals during the COVID-19 pandemic. Beck anxiety inventory (BAI) was used to measure the level of anxiety in this population. In all, 1038 hospital staffs with a mean age of 36.30±8.23 years old participated in this study. Most participants were 31 to 40 years old (43.2), female (87.6%), and nurses (49.5%). The BAI scores for the participants were in a positive skew distribution, with a score range of 0-63, a median of 12 and a mean value of 15.30±11.43. Of the 1038 hospital staff, 411 (39.6%) had moderate to severe anxiety. The anxiety level was significantly higher in health care workers ≤40 years old, women, and nurses. Gender, age, and working positions had the most relation with anxiety, respectively. It seems that HCWs experienced a high level of anxiety in the COVID-19 outbreak. One of the important measures in each epidemic is doing supportive care to maintain the mental well-being of HCWs, especially in higher risk groups, including younger HCWs, women, and nurses.

Background: To evaluate the effects of vitamin D (vitD) supplement on uterine fibroid growth.Materials and Methods: A randomized blinded clinical trial was conducted at a tertiary university-based hospitalfrom August 2017 to September 2018. Totally, 204 women were enrolled into the study. They had at least one uterinefibroid >10 mm on transvaginal ultrasound and their vitD level was insufficient (i.e. 20-30 ng/ml). The interventiongroup was treated with vitD 50000 U supplements for two months. After 2 months, ultrasound screening and vitDlevel measurement was done in both groups.Results: At first, the mean serum vitD levels in intervention and control group were 23.62 and 23.20 ng/ml, respectively.After 8 weeks, the mean serum vitD levels in the control and intervention group were 22.72 and 28.56 ng/mlrespectively (p <0.05). Also, mean fibroma diameter in the intervention group before and after 8 weeks of vitD supplementationwas 43 ± 4.68 and 42.6 ± 1.31 mm, respectively. Mean uterine fibroid diameter in the control group whichdid not receive vitD supplements, before and after 8 weeks was 41.98 ± 5.25 and 47.81 ± 3.42 mm, respectively. Thevariation in the mean size of the uterine fibroid between the control and intervention group which was respectivelyabout 5.83 mm increase and 0.48 mm decrease, was significant (p <0.001).Conclusion: Our results showed that vitD supplementation prevents fibroid growth. It seems that vitD supplementis a simple, safe and inexpensive modality for leiomyoma growth prevention (Registration number:IRCT201703122576N15).