To compare the efficacy of progesterone between oral versus vaginal routes of administration in the treatment of first trimester threatened miscarriage

Objective: To determine the efficacy of oral versus vaginal progesterone in the treatment of the first trimester threatened miscarriage. Methodology: This randomized controlled trial study was conducted at Gynaecology and Obstetrics Department of Mardan Medical Complex, Mardan from September 2019 to March 2020. A total of 126 women between ages 18-45 years presenting in their first trimester with threatened miscarriage were included. All patients were randomly allocated in two equal groups A and B by lottery method (63 in each group). Patients in group A were given oral progesterone 10 mg bid for one week and group B patients were given vaginal progesterone 400 mg for one week under the supervision of obstetrician. All patients were followed up till 20th week of pregnancy. The efficacy of the drug was evaluated based on the absence of bleeding per vagina and pregnancy proceeding beyond 20 weeks of gestation. Results: A total of 126 women were included. The majority of the patients 64 (50.79%) were between 18 to 30 years of age. The mean age of women in group A was 30.52 ± 4.52 years and in group, B was 30.73 ± 4.23 years. Efficacy of Oral progesterone (group A) was seen in 57 (90.48%) women and of vaginal progesterone (group B) was seen in 46 (73.02%) women. This showed a highly significant difference between the two routes of administration with p-value of 0.01. Conclusion: Oral progesterone is more effective than vaginal progesterone in treating first trimester threatened miscarriage in terms of prevention of blood loss and continuing the pregnancy beyond 20 weeks

Prevalence of Diabetic Retinopathy and Correlation with HbA1c in Patients Admitted in Khyber Teaching Hospital Peshawar

Objective: To determine the prevalence of diabetic retinopathy in patients admitted in Khyber Teaching Hospital Peshawar and to correlate different stages of diabetic retinopathy with HbA1C levels. Methodology: This cross sectional study was conducted at Department of Ophthalmology, Khyber Teaching Hospital, MTI, Peshawar from December 2019 to May 2020. All patients over the age of 15 years who were diagnosed with diabetes mellitus were included in the study while patients with cataract or retinopathy due to other pathologies were excluded. All diabetic patients were admitted through outpatient department. In the ward their blood pressures were recorded and HbA1c levels were also measured. Visual acuity (VA) was checked. Screening for diabetic retinopathy was done by a consultant ophthalmologist by Optos Ultrawide Field Imaging of retina and Optical Coherence Tomography (OCT) of macula to establish stages of diabetic retinopathy and presence of diabetic macular edema respectively. Results: A total of 103 diabetic patients were included. Their retina was photographed, viewed and analyzed. Diabetic retinopathy, irrespective of the type, was found in 69 patients with a prevalence of 66.9%. Patients with lower ranges of HbA1c (below 6%) showed no evidence of DR. The clustering of majority of patients with diabetic retinopathy with HbA1c levels of 8 to 12 %, showed a significant relationship between high blood sugar levels and severity. Conclusion: In our study the higher frequency of retinopathy is alarming by considering it one of the leading causes of blindness in working class. It is highly recommended that routine ophthalmologic examination may be carried out along with optimal diabetic control