Background Gestational diabetes mellitus (GDM), defined as glucose intolerance with onset or first recognition in pregnancy, is a common complication of pregnancy. The American Diabetes Association 2017 redefined GDM as follows: ‘diabetes diagnosed in the second and third trimesters of pregnancy.’ It is estimated by the International Diabetes Federation that 21.3 million or 16.2% of live births to women in 2017 had some form of hyperglycemia in pregnancy. An estimated 86.4% of those cases were due to GDM. Aim The aim was to evaluate the prevalence of gestational diabetes using Diabetes in Pregnancy Study Group India criteria and to determine the magnitude of gestational diabetes among pregnant women at 24–28 weeks gestation attending Al-Fath Primary Health-care Center in Assiut Governorate to identify the possible risk factors of GDM among this group of pregnant women and to increase awareness about GDM and importance of early detection in primary health-care providers and among population as a whole. Patients and methods A cross-sectional clinical study which included 500 pregnant women not known to have diabetes mellitus before gestation, who attended the Al-Fath Primary Health-care Center in Assiut Governorate between the period of July 2015 and July 2016.. Non-fasting oral glucose tolerance test at 24–28 weeks gestation using 75 g glucose anhydrous in 250–300 ml water and woman was considered to have GDM if 2h-postprandial blood glucose exceeded 140 mg/dl (Diabetes in Pregnancy Study Group India criteria) and HBA1C was indicated only if 2 h Blood sugar greater than or equal to 200 g/dl to exclude pre-pregnancy diabetes from GDM. This study was part of a Gestational Diabetes Care in Upper Egypt project in collaboration with World Diabetes Foundation 13–797. Results The present study included 500 pregnant women, 8% of them had GDM, 24 (60%) GDM women had significantly different risk factors for GDM, 10 of them (25%) had a family history of GDM, eight of them (20%) had multiple risk factors, and four (10%) women had a previous history of twins. A high percentage of GDM women (about 40%) had no definite risk factor and this encourages universal screening of GDM to pick up more and more cases of GDM. Increased age of pregnant women (>30 years, 40%) is a significant risk factor for GDM. BMI was significantly higher in those with GDM (85%), As regards dietary habits, significant difference between women with GDM and those without GDM presented only with excess consumption of sweets/desserts. Conclusion The prevalence of GDM in the Al-Fath district of Assiut was 8%, in which a family history of diabetes mellitus was the most frequent risk factor for GDM. Presence of multiple risk factors, previous history of twins, advanced maternal age, and increased BMI were other risk factors for GDM. Sweet/deserts were the most frequent type of food among GDM women.

Purpose To evaluate the association of various metabolic risk factors with percent mammographic breast density (PMD), and to assess the advantage of screening mammogram in type 2 diabetes mellitus (T2DM) postmenopausal diabetic women. Patients and methods This was a cross-sectional study which included 90 postmenopausal women, who were divided into two groups: group I included 60 patients diagnosed with T2DM and group II included 30 controls. All participants were subjected to history taking, clinical assessment, fasting serum glucose, glycated hemoglobin, Homeostatic Model Assessment 2-IR calculation, serum lipid profile, and screening mammogram (PMD). Results There was significant inverse associations between PMD and weight (P=0.006, 0.022, 0.010), BMI (P=0.003, 0.015, 0.001), and waist circumference (P=0.001, 0.019, 0.001) in cases, control, and total sample, respectively. After adjustment for weight in the total sample, the extremely dense group (breast imaging-reporting and data system D) was only associated with age of menarche (odds ratio, 0.404), while in cases group, breast imaging-reporting and data system D was only significantly associated with waist circumference (odds ratio, 0.756). Conclusions PMD levels were not increased in the presence of multiple metabolic risks, pointing to an alternative pathway explaining the increased risk of cancer breast in T2DM postmenopausal women.

Introduction Rheumatoid arthritis (RA) is a systemic inflammatory disorder that most commonly affects the joints. Interstitial lung disease (ILD) is the most common pulmonary manifestation of RA-associated ILD. Patients with RA typically have circulating auto-antibodies, the most common being rheumatoid factor and anti-cyclic citrullinated protein antibodies (ACPA). Aim To determine the occurrence of ILD in patients with RA and its relation to anti-citrullinated protein antibodies. Patients and methods The study was conducted on 40 patients diagnosed according to ACR/EULAR 2010 criteria for diagnosis of RA. They were divided into two groups according to ACPA positivity: group I included 20 patients with RA who were ACPA positive, and group II included 20 patients with RA who were ACPA negative. Exclusion criteria Patients with interstitial pneumonia, asbestos exposure, other connective tissue diseases such as systemic lupus erythematosus and systemic sclerosis, autoimmune hepatitis, and hepatitis C virus infection were excluded. Patients and methods The participates underwent thorough medical history taking, full clinical examination, disease activity score-28 based on C-reactive protein and functional assessment questionnaire (Health Assessment Questionnaire) score, complete blood count, SGPT, SPOT, urea, creatinine, erythrocyte sedimentation rate first hour and rheumatoid factor, ACPA titer, high-resolution computed tomography of the chest, radiological examination for both hands and feet, BMI, ECHO, pulmonary function tests, and assessment of pulmonary artery pressure. An informed consent was taken from all patients in the study. Results ACPA-positive patients with RA are accompanied with a statistically significant restrictive pattern of pulmonary function tests. Positive high-resolution computed tomography findings indicate RA-ILD. Conclusions In RA, high titer of ACPA may be related to the development of ILD.