Evaluation of the perinatal anxiety and its effect on delivery type in those who want to have a vaginal birth after a cesarean section.

OBJECTIVE: This study aimed to investigate the level of perinatal anxiety in pregnant women who considered vaginal birth after a cesarean section (VBAC) and evaluate its effect on the type of delivery. SUBJECTS AND METHODS: The study was planned as single-centered and analytical. It was performed with pregnant women planning VBAC, reached via Google Forms between February 23 and August 17, 2022. An online form consisting of the Patient Information Form and the Perinatal Anxiety Screening Scale-Turkish version (PASS-TR) was applied to the participants. The type of delivery was questioned by phone call. RESULTS: Ages of 162 pregnant women ranged from 22 to 40 years (mean=31.08±3.75). 54.9% (n=89) had a gestational week of 37 or more. 83.3% (n=135) had a vaginal delivery, and 54.3% (n=88) had a score of >16 on PASS-TR. PASS-TR total and subscale scores were higher in patients with known gynecological diseases (p<0.001). The total score of PASS-TR was higher in those aged between 18-30 years (p=0.027). The total number of pregnancies was higher in those with a PASS-TR score of ≤16 (p=0.007). There was no statistically significant difference between the total and subscale scores of PASS-TR with the type of delivery after cesarean section. CONCLUSIONS: Perinatal anxiety was determined in 54.3% of the pregnant women planning VBAC, and 83.3% had a successful vaginal delivery. Age, low gravida, and the presence of gynecological diseases were risk factors for anxiety. There was no relationship between the type of delivery after cesarean section and perinatal anxiety.

Visceral adipose tissue as an indicator of insulin resistance in nonobese patients with new onset type 2 diabetes mellitus.

BACKGROUND: Obesity and type 2 diabetes mellitus are characterized by insulin resistance. We determined the relationship between insulin resistance and visceral adipose tissue (VAT) and their correlation with bioimpedance analysis in nonobese new onset type 2 diabetes patients. METHODS: A number of 30 new onset type 2 diabetes patients and 20 healthy control subjects with similar features, age between 45 - 72 years old, BMI < 27 kg/m (2), C-peptide > 0.6 nmol/L, were included in study. Fasting blood glucose, HbA1c, serum lipids, BMI, insulin, C-peptide, HOMA-IR, bioimpedance analysis and visceral and subcutaneous adipose tissue (by computed tomography) were measured. RESULTS: In the patient group, VAT was significantly higher compared to healthy control group (33.17 +/- 10.23 % vs. 16.53 +/- 7.85 %, p < 0.001). In the patient group VAT was correlated with HOMA-IR (r = 0.62, p = 0.003), but no significant correlation was observed between VAT and bioimpedance analysis. CONCLUSIONS: The amount of VAT is significantly higher in nonobese new onset patients with type 2 diabetes than the healthy control group. In these patients, VAT measured by CT is an important indicator of insulin resistance. Although bioimpedance analysis can give an idea about total body fat and obesity, it is not sufficient in evaluating fat distribution and therefore is not effective in predicting insulin resistance.

Comparison of various insulin sensitivity indices in psoriatic patients and their relationship with type of psoriasis.

AIM: We aimed to identify insulin resistance and its possible association with types, duration and severity of psoriasis, and to evaluate various simple insulin-sensitivity indices and beta-cell function in psoriasis. METHODS: A cross-sectional study was performed in 110 non-obese adults (18-50 years old): 70 with psoriasis (53 type I, 17 type II psoriasis) and 40 healthy individuals. Blood glucose, insulin and C-peptide levels were measured. Oral glucose tolerance test (OGTT); insulin sensitivity and beta-cell function indices derived from a single sample and OGTT were determined and compared in three groups. RESULTS: Total, type I and type II psoriatics had IGT rates of 18.6%, 13.2% and 40%, respectively. In the control group IGT was only 2.5%. Homeostasis Model Assessment (HOMA) beta cell index, fasting insulin, Raynaud index, HOMA-IR and FIRI results were higher in total, type I and type II psoriatics than in controls (P < 0.05, for all). Fasting Belfiore index, QUICKY index, ISI HOMA and FIRI(-1) results were lower in total, type I and type II psoriatics than in controls (P < 0.05, for all), and type I psoriatics had higher levels of these indices than type II psoriatics (P < 0.05, for all). CONCLUSION: Our study showed that psoriatic patients were more insulin resistant than healthy subjects and type II psoriatics were more susceptible than type I psoriatics to develop IGT. We suggest that beta-cell function and insulin sensitivity indices are useful methods for measuring insulin resistance in psoriatics. We propose that OGTT should be applied especially in type II psoriatics because of increased rate of IGT in this group.