Low irisin and SREBP1-c levels may favor development of GDM in pregnant subjects. Further, low mature breast milk levels may act as a continued stressor from fetal to infant life as long as breast-feeding is continued. Further studies are required to identify the mechanistic relationship between these biomarkers and GDM.

SSF conceived the project, analyzed the data and wrote the paper. SS collected and followed study subject, performed the experiments and wrote the paper. EK and GMK wrote the paper. All authors approved the final version before submission and publication.

Introduction: Fibromyalgia is a common rheumatological disease that is difcult to diagnose , because of it's subjective symptoms and decient physician's knowledge of the disease . The purpose of this study is to assess knowledge, attitude and practice of family physicians regarding bromyalgia Methods: The study was a cross sectional with an online survey that was administered to general practitioners and family physicians in Eastern province, responses were obtained from 209 participants, knowledge about bromyalgia, attitude and practice were assessed Results: Regarding knowledge about bromyalgia, 89% of the respondents had poor knowledge. Attitudes revealed that More than half of the respondents (56%) thought that bromyalgia is easy to diagnosed. However, only 12.4% of the medical practitioners agreed that diagnosis of bromyalgia can be conducted in PHC setting and only 16.7% felt condent to use (ACR) criteria. Regarding management, about 27% believed they can manage bromyalgia . Only a quarter (24.9%) said they never manage any cases of bromyalgia. Conclusions: knowledge, attitude and practice regarding bromyalgia are poor which results in delay in the diagnosis and management.To overcome this delays in diagnosis and treatment and improve knowledge about bromyalgia, further education is needed