scholarly journals A prospective study of insulin resistance among infertile women with polycystic ovarian syndrome

Author(s):  
M. Smitha ◽  
S. Jyothi ◽  
Anand Acharya

Background: Insulin plays a key role in producing hyperandronism and suppression of insulin secretion in women with PCOS is associated with decreased cytochrome P450c17α. cytochrome P450c17α is a bifunctional enzyme present in ovary is a key enzyme for androgen synthesis. Various studies have been conducted regarding association of insulin resistance with PCOS in infertile patients but there is no study is available about this in our area. So we have designed this study to evaluate insulin resistance in infertile patients with PCOS in rural Andhra Pradesh.Methods: The study population include 180 untreated patients who attended the infertility clinic in outpatient department of obstetrics with infertility due to different cause that include polycystic ovarian disorder also. They have been selected for this study randomly based on inclusion and exclusion criteria.Results: The mean value of glucose insulin ratio was 5.146+2.611 in group A and 8.62 + 5.55 in group B the P value was 0.004909. The mean of LH/FSH ratio was 1.78+0.423 in group A and 1.02 +0.042 in group B. The P value was <0.00001. The mean of HOMA IR was 8.375+ 2.68 in group A and 3.03+ 1.09 in group B, with P value <0.00001. The mean value of QUICKI was 0.2815+ 0.0002875 in group A and 0.347+0.10 in group B with P value <0.00001. Mean serum DHEAS level was 275.59 + 53.48 in infertile patient with PCOS and 208.48 + 36.11 in infertile patients without PCOS. The p value was 0.00012.Conclusions: Based on present study we would like to conclude that the body mass index was high among infertile women with PCOS and a greater number of women presented with acanthosis. There was decrease insulin sensitivity and increase insulin resistance among infertile women with poly cystic ovarian disease, in rural area of Andhra Pradesh and that is not different from the study of other part of world.

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Ayman Ali Abdel Fattah ◽  
Abdel Hay Rashad Elasy ◽  
Ahmed Helmy Hoseini ◽  
Tarek Abdel Rahman Abdel Hafez

Abstract Background Repair of a perforated tympanic membrane (myringoplasty) can facilitate normal middle ear function, resist infection, and help re-establish normal hearing. Autogenous graft materials are the most popular graft materials used in myringoplasty because of their easy acceptability by the body. This study is conducted to compare between temporalis fascia graft and fascia lata graft in myringoplasty for patients with tubo-tympanic dry perforation. Results A total of 60 patients with persistent dry tympanic membrane perforation were included in our study during the period from January 2018 to May 2020. Patients underwent myringoplasty with temporalis fascia (30 patients as group A) or fascia lata (30 patients as group B). Patients were scheduled for follow-up visits concerning graft status, ear discharge, and audiograms. The mean postoperative air-bone gap in group A was 17.5 ± 4 after 1 month and 8.6 ± 6.9 after 3 months, while in group B, the mean postoperative air-bone gap was 17.6 ± 4.9 after 1 month and 9.4 ± 7.5 after 3 months. There was 90% success in graft uptake in group A, while there was 80% success in group B. Conclusion Using temporalis fascia is still the best and most trustworthy technique of myringoplasty compared to fascia lata graft. However, fascia lata can be a good alternative to temporalis fascia especially in cases of revision myringoplasty, ears having large perforation, or near-total perforation where the chances of residual perforation are high because of the limited margin of remnant tympanic membrane overlapping the graft.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Emmanouil Chatzipetros ◽  
Spyros Damaskos ◽  
Konstantinos I. Tosios ◽  
Panos Christopoulos ◽  
Catherine Donta ◽  
...  

Abstract Background This study aims at determining the biological effect of 75/25 w/w nano-hydroxyapatite/chitosan (nHAp/CS) scaffolds on bone regeneration, in terms of fraction of bone regeneration (FBR), total number of osteocytes (Ost), and osteocyte cell density (CD), as well as its biodegradability. Methods Two critical-size defects (CSDs) were bilaterally trephined in the parietal bone of 36 adult Sprague-Dawley rats (18 males and 18 females); the left remained empty (group A), while the right CSD was filled with nHAp/CS scaffold (group B). Two female rats died postoperatively. Twelve, 11, and 11 rats were euthanized at 2, 4, and 8 weeks post-surgery, respectively. Subsequently, 34 specimens were resected containing both CSDs. Histological and histomorphometric analyses were performed to determine the FBR, calculated as [the sum of areas of newly formed bone in lateral and central regions of interest (ROIs)]/area of the original defect, as well as the Ost and the CD (Ost/mm2) in each ROI of both groups (A and B). Moreover, biodegradability of the nHAp/CS scaffolds was estimated via the surface area of the biomaterial (BmA) in the 2nd, 4th, and 8th week post-surgery. Results The FBR of group B increased significantly from 2nd to 8th week compared to group A (P = 0.009). Both the mean CD and the mean Ost values of group B increased compared to group A (P = 0.004 and P < 0.05 respectively). Moreover, the mean value of BmA decreased from 2nd to 8th week (P = 0.001). Conclusions Based on histological and histomorphometric results, we support that 75/25 w/w nHAp/CS scaffolds provide an effective space for new bone formation.


2012 ◽  
Vol 19 (05) ◽  
pp. 710-714
Author(s):  
Muhammad ASGHER ◽  
ASIM GHAURI ◽  
MUHAMMAD ABDULLAH ◽  
Tariq Abassi

Objective: To compare the analgesic effects of combination of 0.5% Lidocaine plus Ketorolac in intravenous regionalanaesthesia technique with those of Lidocaine (0.5%) alone to prevent post operative pain after intravenous regional anaesthesia (Biersblock). Study design: Randomized Control Trial. Place and duration of study: The study was carried out at Department of Anaesthesiology,Intensive Care and pain management, Combined Military hospital, Rawalpindi from July 2008 to February 2009. Patients and Methods: Thestudy was conducted after complete evaluation of risk / benefit ratio to the patients. On the basis of random number method the patients weredivided into two equal groups (group A and group B). The number of patients in each group was 75. Group A was assigned Lidocaine in a dose of200mg 40ml of 0.5% solution and group B was assigned injection Ketorolac 30mg added to Lidocaine in a dose of 200mg 40ml of 0.5% solution.The patients were kept in post anaesthesia care unit for two hours and pain intensity was measured by visual analogue scale(VAS) on 15,30minutes,1hour, 1.5 and at 2 hours after the cuff deflation. The analgesic efficacy recorded on the basis of visual analog scale of two groups, wascompared using student’s t - test. p value of less than 0.05 was considered statistically significant. Results: In group A 33 males and 42 femaleswere enrolled for the study while in group B there were 38 males and 37 females. The mean age of the patients in group A was 34.31 ± 6.03years while in group B was 32.99 ± 6.08 years. Patients were also classified according to ASA classification in which 87 patients were classifiedas ASA – I and 63 patients as ASA – II. Group B which received Ketorolac in addition to Lidocaine for Bier’s block had low visual analogue scoresas compared to group A which received only Lidocaine for Bier’s block. P values obtained after the comparison of the mean VAS of two groupsat 15 minutes, 30 minutes, 1 hour, 1.5 hours and 2 hours were all less than 0.05 (0.002 for 15 minutes, 0.004 for 30 minutes, 0.001 for 1 hour,0.004 for 1.5 hours and 0.001 for 2 hours). Conclusions: Ketorolac improves the postoperative analgesia markedly when used with Lidocainein intravenous regional anaesthesia.


2020 ◽  
Vol 57 (1) ◽  
pp. 299-305
Author(s):  
Ruxandra Margarit ◽  
Livia Alice Tanasescu ◽  
Dana Bodnar ◽  
Camelia Gabriela Ion ◽  
Mihai Burlibasa ◽  
...  

The aim of our study was to compare the fracture resistance of teeth presenting non-carious cervical lesions restored with different types of esthetic composite materials. 20 extracted unspoiled maxillary first molars were mechanically cleaned and immersed in saline solution containing 0.1% thymol at 4�C for a period of 48 hours. Cervical cavities with a cervical-occlusal diameter of 2 mm and a mesial-distal diameter of 3mm were filled with ormocer, flow nano-composite, nano-composite and compomer. Fracture resistance was tested with a universal loading machine (Lloyd Instruments), with a maximum force of 5 kN and a crosshead speed of 1.0 mm/min; the authors used NEXYGEN Data Analysis Software and ANOVA method. For the group A (commercial grade ormocer), the smallest load that determined the sample failure was 650 N and the highest load was 1050 N, the mean value being 858 N � 150.89 N. For the group B (commercial grade flow nano-composite), the smallest load is 530 N, the highest load is 800 N, mean value being 654 N � 112.6 N. For the group C (commercial grade nano-composite), the smallest load is 680 N, the highest load is 1200 N, mean value being 926 N � 209.35 N. For the group D (commercial grade compomer), the smallest load is 1100 N, highest load is 1250N, mean value being 1180 N � 62.04 N. A p value of 0.000311 (p[0.05) shows that there are significant differences between the four groups. Conclusions. The best fracture resistance of teeth presenting non-carious cervical lesions, restored with different types of esthetic composite materials is assured by the compomer, followed by the nano-composite, which proved to be superior to ormocer. The flow nano-composite gives the lowest fracture resistance.


2003 ◽  
Vol 5 (1) ◽  
pp. 13-18
Author(s):  
s. m. stace ◽  
s. m. huggett ◽  
b. k. denton ◽  
a. m. harries

the aim of this study was to establish whether hydration prior to radiopharmaceutical injection, in addition to post injection hydration, contributed any value to image quality during bone scintigraphy. two hundred patients referred for bone imaging over a four month period were randomised into two groups. group a was issued with instructions to hydrate pre and post injection, and group b was only advised to hydrate between injection and scan. equal regions of interest (roi) were then drawn on each image: firstly over the femoral diaphysis, and secondly over the contra-lateral adductor area. the total number of gamma counts from the bone roi and the soft tissue roi was then expressed as a ratio, and a mean value for each group was established.the mean ratio for group a was found to be 2.25, and for group b 2.30. a t test of variance confirmed that there was no statistical difference between the ratios of the groups (t = 50.272, n = 5100, p = 50.618). it was concluded that hydration levels prior to bone scintigraphy injection, where it is preserved post injection, have no significant effect on the bone-soft tissue (b:st) ratio in the image.


2021 ◽  
Vol 28 (05) ◽  
pp. 749-754
Author(s):  
Nadia Sharif ◽  
Uzma Manzoor ◽  
Saadia Bano ◽  
Uzma Shahzaad

Objective: To compare the efficacy of Letrozole and clomiphene citrate in Patients of Anovulation polycystic ovarian syndrome with Infertility. Study Design: Randomized Controlled Trial Setting: Department of Obstetrics and Gynecology Independent Medical College Faisalabad. Period: 30-09-2019 to 29-6-2020. Material & Methods: This study included 100 patients with 50 patients in each group. Group A received 2.5 to 5mg letrozole in each cycle from day 3 to 7. Group B received clomiphene citrate 50 to 100 mg incremental dose depending on ovarian response. Both Drugs were given for consecutive 3 to 6 cycles to see response. Main outcome Measure included optimal follicle size (> 18mm), endometrial thickness, and pregnancy rate. Epidemiological data and efficacy outcome measures were recorded on a Performa. Statistical analysis was done using SPSS version 13. Chi-square test applied and p-value <o.o5 was considered significant. Both group included primary infertility patients. Results: The mean age of patients was 28.03+ 3.02 years. Mean age of group A patients was 29.04+3.44 and 28.47+3.90 group B patients. Mono ovulation in group A patients (88.9%) and 27 in group b patients (60.0%). The mean endometrial thickness was 9.6mm + 1.6 in letrozole group and 6.9mm + 1.2 in clomiphene citrate group A. In group A 18% got pregnant from Letrozole group and 1.1% from the group B. Conclusion: Efficacy was significantly higher in group A Patients received letrozole as compared to patients echo received clomiphene citrate. The effects of Letrozole showed better outcome in terms of Ovulation Induction Endometrial Thickness and Pregnancy rate.


Author(s):  
Senthilnathan Prof.Dr.C.V. ◽  
Vaishnavi G. ◽  
Keerthana G. ◽  
NandhaKumar S. ◽  
Kotteeswaran Prof.Dr.

Hyperhidrosis is an excessive production of sweat more than the physiological amount necessary to maintain thermal homeostasis. Primary focal hyperhidrosis is a disorder of unknown etiology, causing excessive, bilateral, symmetrical sweating on the soles of the foot is called plantar hyperhidrosis. The condition results not only in physical impairment, but also interferes with professional and social life. Although not life-threatening, it is very uncomfortable and cause embarrassment and psychological trauma. Iontophoresis is a helpful method, which includes the presentation of particles into the body tissue through the skin. The essential principle is to place the ion particles under an electrode with the same charge, i.e. negative ion placed under cathode and positive ion placed under anode. This complete process is also known as “technique of ion transfer” into the body tissues by using electrical current as a driving force. It is a comparative study with pre and post intervention. 30 subjects with plantar hyperhidrosis were selected based on the inclusion criteria. The study duration was for about 4 weeks30 subjects of age group between 15 – 25 years with idiopathic plantar hyperhidrosis of both male and female subjects were included in this study. Subjects with cardiac and respiratory disorders, pregnant or lactating, any cuts, abrasions, eczema or infections on plantar aspect, metal implants like pacemakers, Hypersensitivity to the active substance were excluded. The subjects were divided into 3 group Group A treated with iontophoresis using tap water alone. Group B were treated with iontophoresis using tap water along with 3%-5% of anticholinergic drug, glycopyrronium bromide solution. Group C were treated with iontophoresis using tap water along with 1% of indomethacin (NSAID). The result of this study shows that there were significant changes in outcome measures. On comparing Mean values of Group A, Group B & Group C on Minor test (Starch - Iodine Test) tap Water along with Glycopyrronium Bromide (Group B) shows 1.60 which has the Lower Mean value is effective than Group A and Group C .On comparing Mean values of Group A, Group B & Group C on Visual Analog Scale score tap Water along with Glycopyrronium Bromide (Group B) shows 3.80 which has the Lower Mean value is effective than Group A and Group C. On comparing Mean values of Group A, Group B & Group C on Hyperhidrosis Disease Severity Scale tap Water along with Glycopyrronium Bromide (Group B) shows 1.40 which has the Lower Mean value is effective than Group A and Group C. On comparing all the three groups, Group B shows better result than Group C and Group A in outcome measure. This study concluded that Tap water along with glycopyrronium bromide reduces the excessive sweating and decrease the sweating symptoms in subjects with plantar hyperhidrosis.


2020 ◽  
Author(s):  
Obeagu Emmanuel Ifeanyi

The hematological features of Gongronema latifolium, aqueous leaves extract was evaluated using standard methods. After 10 days of consecutive infusions into 9 experimental animals (rabbits). The rabbits were monitored and the following parameters determined; hemoglobin (HB), PCV, Platelet, WBC, Differential White Blood Cell. The Rabbits were grouped into 4, one consisting of control (group A), group B was fed with 0.5 mg/kg, group C with 1.0 mg/kg, and Group D with 1.5mg/kg of the aqueous extract of Gongronemalatifolium. The mean values obtained for hemoglobin estimation for the control group is 5.9 ± 4.1 g/dl, 9.1 ± 2.9 g/dl for group B 10.2 ± 1.8 g/dl for group C and 12.8 ± 0.1 g/dl for group D with no significant increase on the PCV estimation, the mean value for the control (group A) is 17.7 ± 12.3%, 27.3 ± 8.7% for group B, group C (30.6 ± 5.4%) and D (28.4 ± 0.3) show increase that statistically significant (p > 0.01). the platelet counts of group C (600 ± 0 x 109/L) and D(600 ± 0 x 109/L) show significant increase (p > 0.01) when compared with the control (600 ± 00). But the platelet value of group B (550 ± 50 x 109/L) shows no difference. No significant changes were observed in the White Blood Counts of the test groups B (3.5 ± 0.5 x 109/L), C (1.9 + 2.1 x 109/L) and D(3.6 ± 0.4) when compared with the control group (2.9 ± 1.9). The values obtained from the differential White Blood Counts (Neutrophils, Lymphocytes, Eosinophils and Monocytes) were not significant. Therefore, Gongronemalatifolium, when properly taken as a nutritional diet, causes beneficial changes on hemoglobin, packed cell volumes and platelet counts of consumers.


Author(s):  
Muhammad Ahmad ◽  
Syed Tatheer Abbas ◽  
Amna Javaid ◽  
Naveed Arshad ◽  
Falak Shair

Objectives: To assess the comparison of harmonic scalpel versus Milligan Morgan technique in patients undergoing haemorrhoidectomy. Methodology: This randomized controlled trial study was conducted at General Hospital, Lahore, from March 2019 to September 2019. Informed consent was obtained from eligible 60 patients. Patients were randomly divided into two equal groups. In group-A, haemorrhoidectomy was conducted according to the harmonic scalpel method. In group-B, open haemorrhoidectomy was performed by the Milligan Morgan procedure. Data was assembled through a designed questionnaire and investigated via SPSS version 25. Data were stratified for descriptive statistics, level of haemorrhoids and period of haemorrhoids. Post-stratification, independent sample t-test was used. Results: Mean age of both groups patients were 44.6±7.6 and 43.8±8.2 years, respectively. In group-A, mean operative time was 20.8±2.8 minutes, while 26.5±2.8 minutes in group-B, which was statistically significant with p-value of 0.001. In group-A, mean convalescence period was 9.7±2.9 days, while 13.4±3.7 days in group-B, which was statistically significant with p-value of 0.001. The mean convalescence period with harmonic scalpel method was 7.4 days (range 5–14, SD 3.6) versus 18.6 days (range 7–30, SD 5.4) with Milligan Morgan technique (P?0.001). This research observed that harmonic scalpel method required almost six weeks for complete wound healing, whereas in  Milligan Morgan technique, complete wound healing was achieved after three months (P<0.05). Conclusion: Harmonic scalpel haemorrhoidectomy found an advantageous method when assessing the operative time and convalescence period. Hence, Harmonic scalpel haemorrhoidectomy can be adapted as a safe and effective alternative method for treating symptomatic haemorrhoids. Continuous...


2019 ◽  
Vol 37 (4) ◽  
pp. 435-441
Author(s):  
Amanda Oliva Gobato ◽  
Ana Carolina Junqueira Vasques ◽  
Antonio Fernando Ribeiro ◽  
Roberto Massao Yamada ◽  
Gabriel Hessel

ABSTRACT Objective: To determine the prevalence of hepatic steatosis (HS) in children and adolescents with cystic fibrosis (CF) and associate it with nutritional status. Methods: Cross-sectional study with children and adolescents with CF diagnosis. Weight and height were used to calculate the body mass index (BMI) and subsequent classification of the nutritional status. The midarm circumference (MAC), triceps skinfold thickness (TSF) and midarm muscle circumference (MAMC) were used to evaluate body composition. Abdominal ultrasonography was performed for diagnosis of HS. The statistical tests used were Student’s t test, Mann-Whitney test and chi-square test with significance level of 5%. Results: 50 patients with CF were evaluated, 18 (36%) were diagnosed with HS (Group A) and 32 (64%) without HS (Group B). The mean age of Group A was 13,2±4,9 years old and Group B 11,7±4,9; for BMI, the value for Group A was 18,0±4,1 and Group B was 15,7±3,8; the TSF of Group A was 8,4±3,5 mm and Group B was 7,0±2,5 mm. For these variables, there was no significant difference between the groups. The mean of MAC and MAMC differed significantly between the groups, being higher in the HS group, with p values of 0,047 and 0,043. Conclusions: The frequency of HS in patients with CF is high and it is not related to malnutrition, according to the parameters of BMI, TSF and MAMC. The values of MAC and MAMC indicated a greater reserve of muscle mass in patients with HS.


Sign in / Sign up

Export Citation Format

Share Document