Clinica Terapeutica最新文献

{"title":"From the hands of the robot to the courtroom.","authors":"G Mercuri, E Mustè, E Galluccio, N Nicolotti, P Refolo, G Vetrugno, A Oliva","doi":"10.7417/CT.2025.5190","DOIUrl":"https://doi.org/10.7417/CT.2025.5190","url":null,"abstract":"<p><strong>Aims: </strong>The aim of this study was to evaluate the implications of robotic surgery on clinical risk and litigation at the Fondazione Policlinico \"A. Gemelli\" (FPG) to identify potential strategies to reduce future cases of controversies.</p><p><strong>Materials and methods: </strong>We examined claims related to robotic surgeries performed at FPG from 2015 to 2024. The complication rate for each procedure was evaluated and compared to that of laparoscopic procedures. Subsequently, trends in litigation related to robotic-assisted surgery were analysed, taking into account findings from international literature on the topic.</p><p><strong>Results: </strong>Our data demonstrate a 27% increase in claims, mainly involving Gynecology, Urology, and General Surgery. The primary causes of legal disputes were related to surgical errors and the need for additional procedures. The complication rate was higher in laparoscopic procedures compared to those performed with robotic assistance.</p><p><strong>Conclusions: </strong>The number of claims analysed shows a growing trend, although robotic surgery represents a small proportion of the total number of procedures performed. This finding should encourage healthcare facilities to adopt appropriate tools for assessing and monitoring risks associated with robot-assisted procedures. These tools will help strengthen the skills and training of healthcare workers, as well as improve doctor-patient communication, thus promoting a reduction in claims and an overall improvement in the healthcare experience.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 Suppl 1(2)","pages":"66-69"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the latest amendment to Law 40/2004 a positive evolution or a regressive move?","authors":"M Treglia, L Bassis, F Circosta, S Marinelli","doi":"10.7417/CT.2025.5212","DOIUrl":"10.7417/CT.2025.5212","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this article is to illustrate the changes introduced by the rulings of the Constitutional Court and the Court of Cassation concerning the law on medically assisted procreation (MAP) and to offer some considerations on Law No. 169/2024 (Criminalization of Surrogacy, November 4, 2024), which introduces the notion of \"universal crime\" for transnational surrogacy.</p><p><strong>Methods: </strong>The authors have analyzed Italian constitutional and legitimacy jurisprudence, as well as the European Court of Human Rights' rulings, to reflect on the law's compliance with constitutional principles regarding the use of criminal law and the safeguarding of the best interests of the child. The national legal database \"De Jure\" and international databases such as Scopus and PubMed were consulted using the following keywords as search strings: 1) assisted reproduc-tion AND Italian Constitutional Court; 2) assisted reproduction AND Italian Supreme Court; 3) assisted procreation AND Italian Supreme Court; 4) cross-border/international surrogacy, \"best interests of the child\", \"intended/social parents\". The authors eliminated duplicates, read the full text of relevant articles, extended the investigation to related works cited in references, and excluded those with purely medical content.</p><p><strong>Results: </strong>Twenty years after the enactment of Law N. 40/2004, many aspects remain controversial. These include: the fate of surplus embryos; the access of single individuals to MAP techniques; the possibility for same-sex couples to access MAP and be recognized as parents of the child. A delicate issue also concerns granting access to MAP for single individuals. As of today, this possibility seems highly unlikely, as having only one parent is not considered in the best inter-est of the child.</p><p><strong>Conclusions: </strong>Always in the interest of the child, it is necessary to decide on a case-by-case basis whether to recognize a non-genetically or biologically related homosexual person as a parent. These are all issues to which judges cannot provide an answer. This task falls to Parliament, which, with the law on surrogacy classified as a universal crime, has shown that it does not intend to make progress on these matters.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 2","pages":"241-245"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TVUS coated with power Doppler in endometrial hyperplasia in pre and postmenopausal women presenting with an abnormal uterine bleeding (A Cohort Study).","authors":"A Z Boshra, M A Abd Elhalim, M A Hamdi, M E Fadila, A A Mohamed, G I A Yasser, S E Mohamed, R M Heba, S M E Mariam, M M Heba, H A Y Doaa, A B Shaimaa, H A M E Nela, F S Ahmed, M A A Walaa, B Mahmoud, A Osama, I E S Ghada","doi":"10.7417/CT.2025.5205","DOIUrl":"10.7417/CT.2025.5205","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to determine if power Doppler added to grey scale TVS can replace invasive methods for predicting endometrial pathology in pre- and postmenopausal women with abnormal uterine bleeding (AUB).</p><p><strong>Materials and methods: </strong>Following a thorough history and physical examination, 200 women (>45 year old) with pre- or postmeno-pausal AUB underwent evaluation with TVS, power Doppler, and hysteroscopic endometrial biopsy in this cohort study. Histopathology was regarded as the gold standard, and it was contrasted with other instruments such power Doppler greyscale TVS. Furthermore it was computed the positive and negative predictive values (NPV and PPV), specificity, sensitivity, and specificity.</p><p><strong>Results: </strong>TVPDUS diagnosed endometrial hyperplasia in 145 cases (72.5%). Endometrial hyperplasia was diagnosed in 158 (79%) cases by histopathological results including either simple cystic hyperplasia in 145 cases, simple atypical hyperplasia in 10 cases and 3 cases were complex hyperplasia. The accuracy, sensitivity, specificity, PPV, and NPV were 88.25%, 90.7%, 84%, 97.7%, and 84 % in premenopause while was 100 % in postmenopausal women in all reported results. hyperplasia. The accuracy, sensitivity, specificity, PPV, and NPV were 88.25%, 90.7%, 84%, 97.7%, and 84 % in premenopause.</p><p><strong>Conclusion: </strong>High resolution TVS with PD is an appropriate diagnostic tool in both pre and post menopausal females presenting with an abnormal uterine bleeding, and assessing endometrial hyperplasia. However, further studies by histopathological examinations are needed for demonstrating its accuracy in diagnosing EH.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 2","pages":"195-200"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual abuse or traffic accidental trauma? Analysis of a case.","authors":"M Focardi, B Defraia, I Bianchi, V Gori, M Romanelli, G Ferretti, L Nanni, S Losi","doi":"10.7417/CT.2025.5176","DOIUrl":"https://doi.org/10.7417/CT.2025.5176","url":null,"abstract":"<p><strong>Abstract: </strong>The authors present a complex case of a 5-year-old child who was involved in a traffic accident as a pedestrian hit by a car and reported widespread injuries mostly extrinsic at the anal level, suspected sexual abuse. As reflected in the literature (1), about 1 in 4 children are victims of abuse in their lifetime, and anogenital injuries are included in the clinical signs of suspected sexual abuse. In fact, we learn from the 2023 (2) update on the interpretation of clinical signs in cases of suspected child sexual abuse that a perianal laceration with exposure of the tissues underlying the dermis is suggestive of sexual abuse unless there is a plausible cause linking it to accidental trauma. In the present case, the medico-legal assessment and evaluation was carried out one month after the event and involved a forensic physician and pediatrician from the GAIA (Gruppo Abusi Infanzia e adolescenza) service at IRCCS Meyer. Anorectal or genital injury in children does not always have a clear and immediately well-framed diagnosis. It is essential that health care personnel consider various diagnostic hypotheses (sexual abuse, trauma, pathology, etc.) and be properly educated to manage and investigate such occurrences. In fact, even today, there is much confusion about how to frame these cases. Often sexual abuse is underdiagnosed while other times it is misdiagnosed, leading to dramatic consequences for both the child and the family.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 Suppl 1(2)","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac valve hemangioma in two cases of sudden infant death.","authors":"B Defraia, A M Buccoliero, I Bianchi, S Faccioli, R Grifoni, M Focardi","doi":"10.7417/CT.2025.5178","DOIUrl":"https://doi.org/10.7417/CT.2025.5178","url":null,"abstract":"<p><strong>Abstract: </strong>SIDS (the sudden death of an infant <1 year of age) is a specific subcategory of Sudden Unexpected Infant Death (SUID). In Italy, managing SUID should be ruled by the National Protocol (7th October, 2014) however autopsies are not performed in all cases of sudden unexpected infant deaths. Autopsies should be performed, properly and in a timely manner in every SUID case since representing a crucial point in monitoring the phenomenon, providing an important contribution to research, and supporting bereaved families. The complexity of diagnosing SUID cases necessitates a well-structured organization to ensure a thorough approach. Many fatalities can be attributed to cardiovascular abnormalities identified through both macro and microscopic examinations, such as cardiomyopathies, congenital heart defects, coronary artery anomalies, and myocarditis. However, it is important to note that even after comprehensive autopsies and investigations, approximately one-third of these deaths remain unexplained. Cardiac hemangiomas (CH) are defined by the presence of benign proliferative endothelial cells that line blood vessels, accompanied by enhanced vascularization. Microscopically, these tumors exhibit vascular channels that are lined with endothelial cells displaying moderate pleomorphism, occasionally featuring atypical nuclei and localized tuft formations. Limited case reports indicate that CH can infiltrate the heart's conductive tissue, raising concerns about their clinical significance due to the potential for severe complications, including syncope, stroke, and even sudden death. The authors present two cases of sudden infant death in two see-mingly healthy infants, during which cardiac valve hemangiomas were identified in post-mortem examinations. Expanding awareness of such cases can significantly aid in the diagnosis of this condition, whether during the antenatal phase or at autopsy, thereby helping to mitigate the risk of recurrence in future pregnancies, which is notably heightened.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 Suppl 1(2)","pages":"8-13"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An unusual case of cut throat injury and poisoning by penconazole - suicide or homicide? Medico-legal considerations and toxicological aspects.","authors":"R Barranco, G Gaggero, A Salomone, F Ventura","doi":"10.7417/CT.2025.5177","DOIUrl":"https://doi.org/10.7417/CT.2025.5177","url":null,"abstract":"<p><strong>Abstract: </strong>In some circumstances, forensic pathologists encounter cases of violent death where distinguishing between homicide, suicide, or accidental death is particularly complex. A multidisciplinary approach is essential to correctly identify the manner, circumstances, and cause of death. Often, the analysis of complex suicides raises doubts about the circumstances of death. In particular, the differential diagnosis between complex suicide and homicide is not always easy. We present here a case of a 73-year-old man found moribund in a rural farmhouse with a cut throat injury. Death occurred shortly after arrival at the hospital. The autopsy and toxicological results also documented penconazole poisoning. The case highlights the complexity of assessing the cause and manner of death in certain instances, requiring the integration of all available autopsy data and investigative information. Furthermore, the histological and toxicological data seem to suggest a severe nephrotoxicity of penconazole in humans. This aspect can have a strong clinical and toxicological relevance, also in terms of safety and biological monitoring.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 Suppl 1(2)","pages":"4-7"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of testamentary capacity: a systematic review of legal, neuropsychological, and bioethical perspectives across jurisdictions.","authors":"F Damato, M Lippi, V Adelini, F Orsini, M Arcangeli","doi":"10.7417/CT.2025.5194","DOIUrl":"https://doi.org/10.7417/CT.2025.5194","url":null,"abstract":"<p><strong>Background: </strong>Testamentary capacity (TC) refers to an individual's legal and cognitive ability to create or modify a valid will. The assessment of TC becomes particularly challenging in individuals with neurodegenerative and psychiatric disorders. While many jurisdictions have established legal criteria for evaluating TC, diagnostic and evaluative processes vary significantly across countries. This review synthesizes existing research on TC assessments, focusing on the methodologies, bioethical considerations, and legal frameworks utilized in different countries. Special emphasis is placed on the importance of evaluating cognitive abilities, including memory, comprehension, and decision-making, which are crucial for determining TC.</p><p><strong>Methods: </strong>A systematic review was conducted in accordance with the PRISMA guidelines. Articles were identified through searches in the PubMed, Scopus, and Web of Science databases, supplemented by grey literature from Google Scholar. The search strategy employed Boolean keyword combinations related to testamentary capacity (TC), dementia, cognitive assessment, and bioethics. Studies that addressed bioethical considerations and provided specific measures for TC evaluation were included.</p><p><strong>Results: </strong>The analysis revealed significant variability in both legal and medical approaches to testamentary capacity (TC) assessments across different countries. Some studies emphasize the importance of the \"lucid interval\" in dementia patients, suggesting that fluctuating pecognitive abilities can influence will-making decisions (Shulman et al., 2015). Other research focuses on the legal implications of deathbed wills, where diminished cognitive functioning near the end of life complicates TC evaluations (Purser & Rosenfeld, 2016). Neurolaw has provided a framework for understanding the impact of historical cases, such as Banks v Goodfellow (1870), which continues to serve as a reference point for modern assessments (Bennett, 2016). The role of neuropsychological tools in evaluating undue influence and cognitive abilities also emerged as a critical factor (Kaufmann, 2016). Recent advances in artificial intelligence (AI) present both opportunities and challenges for TC evaluations, particularly in the context of dementia (Economou & Kontos, 2023).</p><p><strong>Conclusion: </strong>The review highlights significant variability in testamentary capacity (TC) assessment methodologies across different countries. While legal precedents such as Banks v Goodfellow (Bennett, 2016) continue to influence current practice, the introduction of AI and other modern tools presents both opportunities and ethical challenges for future assessments (Economou & Kontos, 2023). Incorporating consistent bioethical frameworks and standardized neuropsychological assessments could help ensure more reliable and equitable TC evaluations across various jurisdictions.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 Suppl 1(2)","pages":"89-100"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can appearance be deceiving? A Strange Case of Nasal AVM.","authors":"D A Cotroneo, I Russo, A Pallante, L Di Mauro, M Chisari","doi":"10.7417/CT.2025.5179","DOIUrl":"https://doi.org/10.7417/CT.2025.5179","url":null,"abstract":"<p><strong>Abstract: </strong>Article 5 of Law No. 24/2017 regulates good clinical-assistance practices and guidelines aimed at improving the quality of healthcare services and enhancing patient protection. The aim of this study is to highlight the importance of the pre-existing condition of an individual who suffers harm from an unlawful act in order to achieve an accurate damage assessment. Specifically, when a pre-existing impairment affects the organ or system injured by the unlawful act, the principle of differential damage can be legitimately applied. This principle allows for the distinction between the damage directly caused by the unlawful act and the pre-existing condition, enabling a more precise evaluation of the harm suffered. A 40-year-old woman with a high-flow vascular malformation of the nasal apex, classified as Schobinger stage III/IV, was referred to our medical team. She underwent an arteriographic examination and an initial embolization attempt, followed by a second attempt, both performed without further diagnostic investigations and without any benefit. Seeking treatment elsewhere, she underwent subtotal resection of the nose, with the histological examination revealing \"ulcerated and infiltrating angiosarcoma of the nasal skin and striated muscle.\" She was then subjected to radiotherapy and chemotherapy. The failure to perform a biopsy necessitated a more destructive resection from both an anatomical and functional standpoint, as it was performed approximately one year later. The patient's prior condition played a crucial role in the assessment of damage: optimal medical-surgical treatment would still have resulted in significant permanent post-operative outcomes, including the loss of a large part of the nose (Class III). However, the greater biological damage resulting from the inadequate conduct of the medical staff caused significant aesthetic harm, culminating in the complete loss of the nose (Class IV). Therefore, she was recognized as having a permanent differential biological damage of 15%, representing greater damage starting from 20% (an outcome she would have experienced even with the best treatment) up to 35% of current biological damage, which is considered stabilized.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 Suppl 1(2)","pages":"14-18"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards a new concept's applicability in the context of positive practice: The impact of route in Obstetric anesthesia.","authors":"A A Tarek, M A I Doaa, S E Amira, M A Suzan, L E Rasha, M G Marwa, A M Osama, M A Fatma, M E Mahmoud, Y E Mayada, M I Nashwa, M A Hend, A D Mohamed, F A Manal, M E Mostafa, A S G Samah, G M Mahmoud, S G Abeer","doi":"10.7417/CT.2025.5200","DOIUrl":"10.7417/CT.2025.5200","url":null,"abstract":"<p><strong>Patients and methods: </strong>We recruited 200 primigravida women with GA or SA who were scheduled for an elective lower segment caesarean section during the period from January 2021 till January 2023 in Alzhraa, Alhussein university hospital, Minia and Fayoum university hospital and Saudi German hospital, Saudi Arabia. The patient made the decision on the kind of anaesthetic. The self-administered EuroQoL-5 Dimensions-3 Levels (EQ-5D-3L) questionnaire was used by participants to assess their current state of health at four different intervals: six hours prior to a caesarean delivery, 24 hours following a caesarean delivery, one week following a caesarean delivery, and one month following a caesarean delivery. Patients also graded their health using the EQ visual analogue scale (EQ-VAS), which goes from 0 (the worst possible health condition) to 10 (the best possible health status).</p><p><strong>Results: </strong>A greater number of women who underwent spinal anaesthesia said that following the operation, their \"mobility,\" \"usual activities,\" and \"pain/discomfort\" were \"no problem\". Recurring measurement analysis showed that although the two groups' EQ-VAS scores were initially identical, they both declined over time with different slopes, producing differing values 24 hours after CS. After that, both groups' scores increased with time, being rather similar one month after CS.</p><p><strong>Conclusion: </strong>Spinal anaesthesia is a better than general anesthesia for caesarean sections because, apart from avoiding the risk of a failed intubation and general anaesthesia, it also provides new mothers with mobility, effective pain relief, and quick access to their daily activities.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 2","pages":"160-166"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changing Paradigms: Neonatal Outcomes after Oral Metformin versus Insulin in the Control of Gestational Diabetes Mellitus (Randomized controlled trial).","authors":"A E Abd El Tawwab, M S Mahmoud, H A El-Kady, A A Elashiry, H G Elsayed, M F Seifelnasr","doi":"10.7417/CT.2025.5197","DOIUrl":"10.7417/CT.2025.5197","url":null,"abstract":"<p><strong>Background: </strong>Although metformin can cross the placenta, its utility in treating gestational diabetes mellitus (GDM) is still debatable.</p><p><strong>Aim: </strong>The purpose of this study was to assess how metformin and insulin affect the outcomes for mothers and newborns in GDM patients.</p><p><strong>Patients and methods: </strong>200 individuals with gestational diabetes who were enrolled in the outpatient clinic at Fayoum University Hospitals (obstetrics and gynecology clinic and family medicine clinic) between March 2024 and August 2024 were the subjects of this randomized controlled research. Patients who satisfied the inclusion and exclusion criteria were randomized to receive either insulin or metformin therapy groups. Blood glucose levels were measured both at enrollment and follow-up appointments. Both maternal and fetal outcomes were the results.</p><p><strong>Results: </strong>Fasting blood sugar, glycated hemoglobin and 2 hours' postprandial blood sugar did not show significant differences (P >0.05) between the two groups. Additionally, Metformin was beneficial in reducing neonatal birth weight. Also, neonates in the metformin-treated group suffered fewer rates of neonatal hypoglycemia and NICU admission. Maternal hypoglycemia was lower in the metformin group, and patient compliance was higher in the same group (P <0.05).</p><p><strong>Conclusions: </strong>We may draw the following conclusions from the current study's results that oral metformin was just as effective in managing and controlling gestational diabetes mellitus as insulin injection. Oral metformin was more effective at controlling maternal and fetal hypoglycemia and neonatal birth weight than insulin injection. Complications for mothers and newborns were similar for both treatment modalities. Moreover, treatment with metformin was more complied with by women.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 2","pages":"148-149"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}