Continuing Metformin in Early Pregnancy May reduce miscarriage risk and Benefit Women with PCOS: Study

A new study published in the American Journal of Obstetrics and Gynaecology revealed that for women with polycystic ovary syndrome (PCOS), continuing metformin during the first trimester significantly reduced miscarriage risk and improved clinical pregnancy and live birth rates.

PCOS has been linked to poor pregnancy outcomes, such as an increased risk of miscarriage and gestational diabetes. And the common medication being researched to help pregnant women with PCOS is metformin. Thus, to investigate the impact of preconception and first-trimester metformin usage on pregnancy outcomes in women with PCOS, this research was carried out.

From database creation until August 1st, 2024, searches were conducted throughout Embase, MEDLINE, and the Cochrane Central Register of Controlled Trials. In women with PCOS, metformin was compared to either a placebo or no therapy in randomized controlled studies that began preconception and lasted at least until a positive pregnancy test.

For the primary outcome of miscarriage and the secondary outcome of clinical pregnancy and live birth, the pooled odds ratio (OR) with 95% CI was computed. The Cochrane risk-of-bias tool for randomised trials (RoB-2) and the Grading of Recommendations, Assessment, Development, and Evaluation technique were used to evaluate the quality of the studies. Using Bucher’s approach, indirect comparisons were conducted for all significant outcomes regarding the time of metformin administration.

The meta-analysis comprised 12 reliable studies with 1,708 women, all of which were rated as low to moderate quality. When compared to either placebo or no treatment, women who received preconception metformin and continued it throughout the first trimester had higher clinical pregnancy rates (OR 1.57, 95% CI 1.11-2.23), a potential decrease in miscarriage (OR 0.64, 95% CI 0.32-1.25), and a potential increase in live birth (OR 1.24, 95% CI 0.59-2.61).

The women who discontinued using metformin after becoming pregnant experienced a higher clinical pregnancy rate (OR 1.35, 95% CI 1.01-1.80) and a possible increase in miscarriage rate (OR 1.46, 95% CI 0.73-2.90), when compared to placebo or no therapy.

There was a consistent trend in favor of continuing metformin through the first trimester as opposed to stopping it once pregnant, as evidenced by the following indirect comparisons: clinical pregnancy OR 1.16 (95% CI 0.74-1.83), miscarriage OR 0.44 (95% CI 0.17-1.16), and live birth OR 1.14 (95% CI 0.41-3.13).

Overall, women with PCOS may have higher live birth rates and a lower chance of miscarriage if they continue taking metformin during the first trimester. It seems that continuing metformin after a positive pregnancy test has more clinical benefits than discontinuing it. 

Reference:

Cheshire, J., Garg, A., Smith, P., Devall, A. J., Coomarasamy, A., & Dhillon-Smith, R. K. (2025). Preconception and first trimester metformin on pregnancy outcomes in women with polycystic ovary syndrome: a systematic review and meta-analysis. American Journal of Obstetrics and Gynecology. https://doi.org/10.1016/j.ajog.2025.05.038

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Fecal Microbiota Transplant as good as Vancomycin as Initial Treatment for C. diff, Study Finds

A new study published in the Annals of Internal Medicine showed that fecal microbiota transplant (FMT) was noninferior to vancomycin as a first-line treatment for Clostridioides difficile infection. FMT showed slightly higher cure rates without recurrence and comparable safety. Experts suggest that microbiota therapy could reduce antibiotic use, though its widespread adoption as initial treatment remains uncertain.

The most frequent cause of healthcare-associated diarrhea is Clostridioides difficile (formerly known as Clostridium) infection (CDI), which has a high mortality and recurrence rate. Additionally, treating recurring cases might be difficult. While fecal microbiota transplantation is advised for recurrent CDI, its function in initial CDI is not well understood. Thus, this study by Frederik Emil Juul and team looked in to the safety and effectiveness of FMT in primary CDI.

This study was conducted mostly in Norwegian hospitals and primary care centers. The main criteria were adults with CDI (defined as C. difficile toxin in stool and ≥3 loose stools per day) and no prior CDI within 365 days prior to recruitment. FMT without antibiotic pretreatment was compared to oral vancomycin, 125 mg four times a day for 10 days, as part of the intervention. Clinical cure (firm stools or <3 bowel movements per day) at day 14 and no illness recurrence within 60 days with the prescribed medication alone were the main endpoints.

100 of the 104 randomly assigned patients were eligible for analysis after receiving FMT or the initial dose of vancomycin. Nearly, 34 out of 51 patients (66.7%) who received FMT and 30 out of 49 (61.2%) who received vancomycin experienced clinical cure and no disease recurrence within 60 days without further treatment (difference, 5.4 percentage points [95.2% CI, −13.5 to 24.4 percentage points]; P for noninferiority < 0.001, denying the hypothesis that response to FMT is 25 percentage points lower than response to vancomycin).

4 patients in the vancomycin group and 11 in the FMT group received extra C difficile therapy. At day 14, 40 out of 51 patients (78.4%) with FMT and 30 out of 49 (61.2%) with vancomycin showed clinical cure and no recurrence with or without continued therapy (difference, 17.2 percentage points [95.2% CI, −0.7 to 35.1 percentage points]). 

Overall, FMT demonstrated similar safety and marginally greater cure rates without recurrence. Although its broad usage as a first line of treatment is yet unknown, experts point out that microbiota therapy may lessen the need for antibiotics. For primary CDI, FMT can be regarded as the first-line treatment.

Reference:

Juul, F. E., Bretthauer, M., Johnsen, P. H., Samy, F., Tonby, K., Berdal, J. E., Hoff, D. A. L., Ofstad, E. H., Abraham, A., Seip, B., Wiig, H., Rognstad, Ø. B., Glad, I. F., Valeur, J., Nissen-Lie, A. E., Ness-Jensen, E., Lund, K. M. A., Skjevling, L. K., Hanevik, K., … Garborg, K. K. (2025). Fecal Microbiota transplantation versus vancomycin for primary Clostridioides difficile infection : A randomized controlled trial. Annals of Internal Medicine. https://doi.org/10.7326/ANNALS-24-03285

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No Mortality Difference Found Between Oral and IV Rehydration in Malnourished Children: NEJM

Researchers discovered that intravenous (IV) rehydration therapy did not decrease mortality rates as compared to oral rehydration therapy in children with severe acute malnutrition (SAM) and dehydration from gastroenteritis. The study was published in The New England Journal of Medicine by Kathryn and colleagues. The results contradict conventional clinical practices and raise the possibility that well-managed IV rehydration is safe in this high-risk group.

This open-label, factorial superiority trial was completed in four African nations and included 272 children between 6 months and 12 years of age with SAM and dehydration caused by gastroenteritis. Participants were randomly assigned in a 2:1:1 ratio to one of three treatment arms:

  • Oral rehydration strategy, IV boluses reserved for shock (138 children)

  • Rapid IV rehydration, lactated Ringer’s solution at 100 ml/kg over 3–6 hours with boluses for shock (67 children)

  • Slow IV rehydration, same solution over 8 hours without boluses (67 children)

  • The main outcome was 96-hour mortality, and follow-up was extended to 28 days.

Key Findings

  • At 96 hours, deaths were 8% (11 of 138) for the oral and 7% (9 of 134) for the IV groups (5 rapid, 4 slow)

  • Risk ratio for 96-hour death: 1.02 (95% CI: 0.41–2.52; P=0.69)

  • At 28 days, 12% (17 of 138) in the oral and 10% (14 of 134) in the IV groups had died

  • Hazard ratio for 28-day death: 0.85 (95% CI: 0.41–1.78)

  • Nasogastric tubes were needed in 93% (126/135) of oral and 65% (82/126) of IV groups

  • Bolus IV fluids on admission were utilized in 9% (12/138) of oral, 10% (7/67) of rapid IV, and 0% of slow IV groups

  • Serious adverse events in 23% of oral, 21% of rapid IV, and 15% of slow IV groups

  • Notably, no pulmonary edema, heart failure, or fluid overload cases were observed

The research reported no divergence in mortality from oral versus intravenous rehydration regimens among malnourished children with dehydration due to gastroenteritis. With no fluid overload or complication evidence, these results concur with a reconsideration of treatment protocols to most likely enhance outcomes in this at-risk population.

Reference:

Maitland, K., Ouattara, S. M., Sainna, H., Chara, A., Ogundipe, O. F., Sunyoto, T., Hamaluba, M., Olupot-Olupot, P., Alaroker, F., Connon, R., Saidou Maguina, A., Okiror, W., Amorut, D., Mwajombo, E., Oguda, E., Mogaka, C., Langendorf, C., Dewez, J. E., Ciglenecki, I., … GASTROSAM Trial Group. (2025). Intravenous rehydration for severe acute malnutrition with gastroenteritis. The New England Journal of Medicine. https://doi.org/10.1056/NEJMoa2505752

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‘Closed loop’ learning barriers prevent doctors from using life-saving bedside ultrasound

Many doctors abandon a potentially life-saving medical scanning technology soon after training, because systemic barriers prevent it from becoming part of their routine practice, a study published in Advances in Health Sciences Education has found.

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Children born to mothers over 45 face higher risk of premature birth and complications, study finds

Giving birth to a child after 40 is becoming more and more common—but it can entail an increased risk to the child. A new study based on data from over 300,000 births in Sweden shows that children of older mothers are more often born prematurely or with complications, especially when the mother is 45 years of age or older.

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Simple insulin resistance test may also predict cognitive decline in Alzheimer’s patients

Insulin resistance detected by routine triglyceride-glucose (TyG) index can flag people with early Alzheimer’s who are four times more likely to present rapid cognitive decline, according to new research presented at the European Academy of Neurology (EAN) Congress 2025.

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Tinnitus linked to impaired cognitive function

Individuals with versus those without tinnitus have significantly lower scores on cognitive function tests, according to a study published online May 29 in Frontiers in Neurology.

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Could fecal transplants cause long-term health problems?

Keeping a healthy mix of friendly microbes in the gut—known as eubiosis—is crucial for good health. When that delicate balance is thrown off—often by antibiotics, diet or illness—the result can be a range of issues, from digestive problems to more serious conditions like Crohn’s disease, ulcerative colitis, and even neurological and metabolic disorders.

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PGI Doctor Couple accused of assaulting minor adopted daughter

Chandigarh: Taking cognisance of a viral video reportedly showing a doctor couple from the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, allegedly thrashing their 13-year-old adopted daughter, the hospital authorities have confirmed receiving a complaint regarding the incident.

In the purported video, a man could be seen hitting the girl with some object. The girl could be heard shouting and seen trying to run, but the man held her and thrashed her, news agency PTI reported.

A woman, said to be the doctor’s wife, who is also the faculty at the PGIMER, could be seen standing in the video.

The incident reportedly took place a few days ago in Himachal Pradesh’s Shimla, where the family had gone on a vacation.

Also Read:Viral Video Shows Doctor Allegedly Thrashing Patient in District Hospital Mahoba, FIR Registered

The matter came to light after a complainant from Shimla wrote to the PGIMER about the incident, expressing concern about the girl’s safety.

Meanwhile, the Chandigarh Commission for Protection of Child Rights (CCPCR) has taken notice of the purported incident in which the doctor was caught on camera allegedly beating up his daughter and sought a report from the police and the child welfare committee in this regard.

As per a media report in the HT, Chandigarh Commission for Protection of Child Rights (CCPCR) chairperson Shipra Bansal said she has sought details from the Himachal Pradesh police where the incident took place and from the child welfare committee regarding the status of the 13-year-old child. She said the commission will take a call on how to proceed once they get all the information.

The PGIMER said it has forwarded the complaint to the child helpline of Chandigarh Police.

“This is a family dispute and a personal matter. We have received a complaint, which has been accordingly forwarded to the relevant authorities. However, the PGIMER is cooperating with the authorities,” said an official spokesperson of the PGIMER, reports PTI.

Also Read:PGI Chandigarh- Junior doctor slapped, kicked and beaten up by infant’s attendants

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Fact Check: Can saunf, adrak, ajwain, jeera, daalchini drink cure PCOD in 10 days?

An Instagram reel claims that saunf, adrak, ajwain, jeera, daalchini drink cures PCOD in 10 days. The claim is FALSE

Claim

In an Instagram reel, it is claimed that saunf, adrak, ajwain, jeera, daalchini drink cures PCOD in 10 days. In the post by heenahealth786 it is said, “Do you have a problem with hormonal imbalance, PCOD, thyroid, no egg formation, or irregular periods? Then save this reel right now. Today I’m sharing a powerful remedy with you—a drink that will help fix all these problems and also support conception.

First, take a small thumb-sized piece of ginger and grate it. Take one glass of water and add the ginger to it. Then add one teaspoon each of carom seeds (ajwain), cumin seeds (jeera), and fennel seeds (saunf). Also, take a small piece of cinnamon—just a small rolled stick like the one shown on your screen.

Put everything into the water and boil it well. Boil it until the water reduces from one glass to half a glass. You need to drink this in the morning on an empty stomach. You can have it daily for a whole month. Continue even during your periods.

If you’re in the early stage of PCOD, you may start seeing results in just 10 days. But if you have severe PCOD or very stubborn periods that only come with medication, it may take longer—but this drink will definitely help.

I personally used this drink in my PCOD journey—it regulated my periods and even helped me conceive. So, Inshallah, it will help you too. Follow this remedy with a positive mindset.”

You can access the post here

Fact Check

The claim is FALSE. There is no scientific evidence or medical consensus to support the claim, and it is important to emphasize that PCOD is a chronic condition that cannot be cured.

What is PCOD?

Polycystic Ovarian Disease (PCOD) is a condition primarily caused by hormonal imbalances and genetic factors. In a typical menstrual cycle, the ovaries release mature eggs ready for fertilization. However, in PCOD, the ovaries often release immature or partially matured eggs, which may develop into fluid-filled cysts. This can cause the ovaries to become enlarged and swollen.

PCOD is also associated with an excess production of androgens (male hormones), leading to symptoms such as irregular periods, weight gain around the abdomen, thinning hair in a male-like pattern, and in some cases, infertility.

Can PCOD be cured?

According to UNICEF, PCOD is not curable due to its hormonal and genetic basis. However, its symptoms can be well-controlled through lifestyle changes, including a balanced diet, regular physical activity, and stress reduction techniques.

What are the Health Benefits of Saunf, Adrak, Ajwain, Jeera and Daalchini?

Fennel commonly known as Saunf in Hindi, is an herb from the Apiaceae family, with its seeds containing approximately 50% fiber. This versatile plant exhibits numerous pharmacological properties, including anti-allergic, analgesic, anti-inflammatory, antioxidant, antibacterial, anti-cancer, anti-stress, and cytotoxic activities. According to the U.S. Department of Agriculture, 100 grams of fennel seeds provide 345 kcal, 15.8 g of protein, 52.3 g of carbohydrates, 14.9 g of total fat, 39.8 g of dietary fiber, along with essential minerals such as 1200 mg of calcium, 18.5 mg of iron, 385 mg of magnesium, 487 mg of phosphorus, 1690 mg of potassium, and 88 mg of sodium.

Adrak also known as Ginger is widely recognized for its numerous health benefits and medicinal properties. Rich in bioactive compounds, ginger is valued for its potent antioxidant and anti-inflammatory effects, which help protect the body from oxidative stress and support the immune system. It plays a significant role in reducing inflammation and promoting muscle relaxation, making it beneficial for managing pain and discomfort. Additionally, ginger aids in boosting immunity and overall well-being through its immune-modulating properties. Its natural compounds provide therapeutic support, contributing to improved health and relief from various ailments, making it a valuable addition to a balanced diet.

Carom seeds, commonly referred to as ajwain, belong to the Apiaceae family and are widely valued for their medicinal and nutritional properties. Also known as bishop’s weed or ajowan caraway, these seeds offer a range of health benefits. They are rich in bioactive compounds that exhibit antibacterial, antifungal, anti-inflammatory, antioxidant, cytotoxic, antilithiasis, nematicidal, anthelmintic, and antifilarial activities. Nutritionally, carom seeds act as natural stimulants, sialagogues, stomachics, carminatives, and possess aromatic and antiseptic qualities, contributing to digestive health and overall well-being.

Cumin also known as jeera has been traditionally utilized in households for its medicinal properties and is known to offer various health benefits. Cumin is rich in antioxidants, iron, and fiber, aiding digestion and boosting the immune system. It can help in improving blood sugar control and has anti-inflammatory properties. Studies have shown that Cumin may help in the enhancement of memory and may aid in reducing cholesterol levels, contributing to overall health and wellness. The health benefits of cumin seeds may include anti-inflammatory, nephroprotective, antioxidant, and anti-diabetic properties. Additionally, cumin extracts can improve liver function tests in patients with non-alcoholic fatty liver disease.

Cinnamon also known as daalchini is known as the eternal tree of tropical medicine and is a popular spice used daily around the world. It is packed with beneficial compounds, including cinnamaldehyde, cinnamic acid, and cinnamate, which contribute to its numerous health-promoting properties. Cinnamon is known for its antioxidant, anti-inflammatory, antidiabetic, antimicrobial, and heart-protective effects. It may also help lower cholesterol levels and support overall heart health. Additionally, research suggests that cinnamon could have potential benefits for brain health, including conditions like Parkinson’s and Alzheimer’s diseases.

Can saunf, adrak, ajwain, jeera, daalchini drink cure PCOD in 10 days?

There is no scientific evidence that a herbal drink containing saunf, adrak, ajwain, jeera, and daalchini can cure Polycystic Ovarian Disease (PCOD)  let alone within 10 days. While some of these ingredients may have supportive benefits for management, PCOD is a complex, chronic condition that requires a comprehensive approach, not a quick-fix remedy.

Fennel seeds (Saunf) have been shown to help alleviate menstrual pain, as demonstrated in a study by Shabnam Omidvar et. al., which found that fennel can effectively help reduce pain and discomfort during periods.

Emerging research points to the potential benefits of cinnamon (daalchini) in managing PCOD. A systematic review and meta-analysis by Fatemeh Heydarpour et. al. indicates that cinnamon supplementation may help improve metabolic parameters in women with the condition.

While cinnamon may aid in managing PCOD and fennel seeds might help relieve menstrual pain, there is no scientific evidence or medical consensus to support the claim that a combination of saunf, adrak, ajwain, jeera, and daalchini can “cure PCOD in 10 days.”

Dr Rajni Bagai, Consultant – Gynaecology & Obstetrics, Narayana Hospital, Howrah & Chunavati said, “Studies done on the effect of cinnamon, fennel, cumin, carom, ginger etc on obesity and PCOS have involved small numbers of patients , which makes the statistical validity dubious. While cinnamon and ginger have been associated with decreased insulin resistance, fennel seeds with increased oestrogen levels, ginger with anti-inflammatory properties and carom (ajwain) with combined hormonal effects, dosages have not been defined and there are no studies showing that these will cure PCOD in a short time such as 10 days.”

Dr Upasana Palo, Consultant, Gynaecologic Oncology and Robotic Surgery, Narayana Hospital RN Tagore Hospital further added, “Nowadays, PCOD has become one of the greatest concerns in women’s life which greatly affects their health and fertility. It may cause several health complications such as irregular menstruation, obesity, infertility, obstructive sleep apnea, acne and cardiovascular diseases. Several factors may contribute to the pathogenesis of PCOD such as insulin resistance, obesity, and sympathetic stimulation. Several studies evidenced that several Indian spices including E. cardamomum, play a crucial role in the management of PCOS and associated symptoms. It is suggested that PCOD patient should consume a high protein diet that is present in most of the spices. A balance healthy diet with regular exercise and lifestyle modification is essential in PCOD. However, it is also suggested that spices may decrease insulin resistance, regulate the menstrual cycle, improves lipid profile, and also decrease the weight in PCOS patients. However, they alone cannot cure PCOD in just 10 days as it can be only managed and not cured.”

Medical Dialogues Final Take

The claim that a drink made from saunf, adrak, ajwain, jeera, and daalchini can “cure PCOD in 10 days” is entirely false. Some ingredients like cinnamon and fennel seeds may provide minor symptomatic relief, but PCOD is a chronic endocrine condition that needs sustained medical, nutritional, and lifestyle intervention and can be only managed and not cured.

Hence, the claim is FALSE.

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