scholarly journals Comparison of autonomic function tests and high-sensitivity C-reactivity protein in overweight patients of polycystic ovarian syndrome and overweight controls

2021 ◽  
Vol 64 ◽  
pp. 303-308
Author(s):  
Sanghamitra Pattnaik ◽  
Supriya Gupta ◽  
Upma Saxena ◽  
Monika Matlani ◽  
Raj Kapoor
Keyword(s):  
Autonomic Dysfunction ◽  
Polycystic Ovarian Syndrome ◽  
Autonomic Function ◽  
High Sensitivity ◽  
Control Group ◽  
Autonomic Function Tests ◽  
Function Tests ◽  
The Difference ◽  
Hs Crp ◽  
Ovarian Syndrome

Objectives: Both polycystic ovarian syndrome (PCOS) and high body mass index (BMI) are associated with autonomic dysfunction. Most of the patients of PCOS have high BMI. Hence, BMI is likely to be a factor contributing to the autonomic dysfunction in PCOS. High-sensitivity C-reactive protein (hs-CRP) is a marker of inflammation and a predictor of future cardiovascular risk. PCOS patients have low-grade chronic inflammatory state. Coexistence of PCOS and obesity causes more increase in CRP, thereby further increasing the risk of cardiovascular morbidity. We have performed autonomic function tests and estimated hs-CRP in overweight patients of PCOS and compared our findings with the control group consisting of overweight normal subjects. Our aim is to find out whether the cardioautonomic and inflammatory changes seen in PCOS are due to the presence of increased weight or do the presence of increased weight add to the severity of these changes seen in PCOS. Materials and Methods: Cases consisted of 44 overweight patients of PCOS and controls included 44 healthy overweight subjects, all in the age group of 18–45 years. Autonomic function test consisted of three sympathetic and three parasympathetic reactivity tests. The following tests were done for parasympathetic reactivity: (a) Deep breathing test – expiration:inspiration ratio (E:I) was calculated. (b) Valsalva maneuver-Valsalva ratio was calculated. (c) Heart rate changes from lying to standing (LST) - 30:15 ratio was calculated. For assessing sympathetic reactivity, the following tests were used: (a) Isometric handgrip test – the difference between resting diastolic blood pressure (DBP) reading and the reading before release of hand grip is noted. (b) Cold pressor test (CPT) – The rise in DBP over the baseline DBP was noted. (c) Systolic BP (SBP) change in LST – the maximum fall in SBP was recorded. Measurement of serum hs-CRP was done using enzyme-linked immunosorbent assay. Results: We found that in the overweight PCOS group, there was a significant decrease in both sympathetic and parasympathetic reactivity than the overweight control group (p=0.000 for Valsalva ratio, 0.027 for 30:15 ratio, and 0.0005 for CPT). The difference between hs-CRP in controls and PCOS was also significant (P = 0.039). Conclusion: In our study, we concluded that the pathological changes due to PCOS could be attributed directly to the extent of inflammation measured by hs-CRP levels. These changes were not directly related to BMI as proven by comparing with controls (overweight non-PCOS subjects).

Effect of Sildenafil in Endometrial Ripening with Induction of Ovulation by Clomiphene Citrate in Polycystic Ovarian Syndrome; Double Blinded; Randomized Controlled Trial

2019 ◽  
Vol 2 (3) ◽  
pp. 01-10
Author(s):  
Dalia Mohammed Mohammed El-Khaldy ◽  
Mohamed Saeed Khallaf ◽  
Ahmed Mohamed Nour Eldin Hashad ◽  
Ibrahim Shazly Mohamed Amen Elshazly
Keyword(s):  
Randomized Controlled Trial ◽  
Polycystic Ovarian Syndrome ◽  
Controlled Trial ◽  
Clomiphene Citrate ◽  
Clinical Pregnancy ◽  
Sildenafil Citrate ◽  
Control Group ◽  
Induction Of Ovulation ◽  
Randomized Controlled ◽  
Ovarian Syndrome

Back ground: World Health Organization (WHO) defines infertility as a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. Worldwide, 8 to 12 percent of couples experience fertility problems. Causes of infertility in women were as follows: menstrual disorders (disorders of cycle length and flow) 62.6%, diseases (obesity, thyroid diseases, diabetes) 58.7%, impaired ovulation (hormonal disorders, oligoovulation and anovulation) 50.3%, uterine causes 16.7%, tubal factor 15.4%, and cervical causes 7.9%. In the male factor fertility there was semen abnormalities (44.6%), genetic factors (29.8%), anti-spermatogenesis agents (11%), and vascular disorders (17.2%). Aim of the Study: The purpose of this study is to evaluate the effect of sildenafil in endometrial ripening with induction of ovulation by clomiphene citrate in polycystic ovarian syndrome. Patients and methods: It is a randomized controlled trial on 65 infertile women with polycystic ovarian syndrome; patients were randomly divided into two equal groups. In control group, 31 patients were given oral sildenafil, one tablet every 12 hrs. From 2nd day of the cycle till 12th day and clomiphene citrate, one tablet every 12 hours, for 5 days from 3rd day of the menstrual cycle. In study group, 34 patients were given oral placebo, one tablet every 12 hrs. From 2nd day of the cycle till 12th day and clomiphene citrate, one tablet every 12 hours, for 5 days from 3rd day of the menstrual cycle. A transvaginal ultrasound was performed to evaluated the endometrial thickness before and after treatment, the follicularometeric was measured on day 11 and day13. Uterine artery Doppler was then measured. Qualitative serum B-hCG level was checked 14 days after ovulation to assess clinical pregnancy rate. Design: Prospective, Double blinded randomized controlled trial. Setting: Obstetrics & Gynecology outpatient clinic, Ain Shams University Hospital. Study duration: 3 months. Results: The present study was a double-blind, randomized, controlled study that was conducted on 65 women with PCOS who underwent induction of ovulation by Clomiphene citrate in outpatient clinic of Ain Shams University hospital. Conclusion: Our systematic review and meta-analysis showed that follicular supplementation of sildenafil citrate (oral or vaginal), alone or adjuvant therapy can be used for improving the EM and clinical pregnancy rate in women undergoing assisted reproduction. However, given the methodological limitations the current evidence does not support its use in clinical practice yet. Future high-quality RCT with large sample size to evaluate the sildenafil citrate effect in women undergoing assisted reproduction are needed. Future RCTs should focus on type of processing, stage of embryo, embryo quality, dosage, time of administration, type of control group, in order to identify the groups of patients who would benefit the most from this intervention and the most appropriate dosage, time, and type of sildenafil citrate which would have the most positive effect and the less possible side effects.

Effect of smoking on cardiovascular autonomic functions

2021 ◽  
Vol 9 (2) ◽  
pp. 3780-3784
Author(s):  
P.Vani ◽  
◽  
Sharan B Singh M ◽  
Keyword(s):  
Heart Rate ◽  
Autonomic Function ◽  
T Test ◽  
Resting Heart Rate ◽  
Autonomic Functions ◽  
Mean Values ◽  
Function Tests ◽  
Significant Difference ◽  
The Mean ◽  
The Difference

Introduction: Cigarette smoking is a prime risk factor for cardiovascular morbidity and mortality. Chronic smoking results in autonomic dysfunction leading to increased cardiovascular risk in smokers. The present study was planned to study the effect of smoking on the Cardiovascular Autonomic Functions among smokers. Materials and Methods: Fifty male subjects who were in the age group of 25 to 45 years. They were grouped into 25 smokers and 25 non-smokers. The participant subjects were selected among the staff members, residents and the patients from the routine OPD in SVIMS. Prior to study, they were informed about the procedure and the purpose of the study tests and written consents were obtained from them. The Cardiovascular Autonomic Function Tests were assessed by using a POLYGRAPH which was available in the department. Results and Conclusion: After applying the ‘t’-test for the difference between the two sample means, it was observed that there was a highly significant difference between the mean values of the BMI(i.e.p<0.01) and the para-sympathetic function tests among the smokers and the non – smokers(i.e.p<0.00). The Resting Heart Rate had significantly increased and the Deep breathing difference, the postural tachycardial index (Response to standing) and the Valsalva Ratio had significantly decreased in the smokers as compared to those in the non – smokers. After applying the ‘t’-test for the difference between the two sample means, it was observed that there was no significant difference between the mean values of the Postural hypotension test (i.e. p>0.05) and that there was a highly significant difference between the mean values of the Sustained handgrip test in the smokers and the non – smokers (i.e. p<0.00). KEY WORDS: Cardiovascular autonomic function tests, Smoking, Resting heart rate.

scholarly journals Investigation Trp64Arg polymorphism of the beta 3-adrenergic receptor gene in nonobese women with polycystic ovarian syndrome

2020 ◽  
Author(s):  
Farideh Zafari Zangeneh ◽  
Maryam Sarmast Shoushtari ◽  
Sahar Shojaee ◽  
Elahe Aboutorabi
Keyword(s):  
Amino Acid ◽  
Amino Acid Sequence ◽  
Adrenergic Receptor ◽  
Polycystic Ovarian Syndrome ◽  
Receptor Gene ◽  
Gene Bank ◽  
Control Group ◽  
Trp64arg Polymorphism ◽  
Ovarian Syndrome ◽  
Adrenergic Receptor Gene

Background: Polycystic ovary syndrome (PCOS) is a multifactorial and heterogeneous disease that has a potent inheritable component based on familial clustering. Despite many studies in the genetic field of PCOS, the genes that are involved in the causes of this syndrome have not been thoroughly investigated. Objective: The purpose of this study was to establish the occurrence of the Trp64Arg polymorphism of beta3 adrenergic receptor in non-obese women with PCOS. Materials and Methods: This cross-sectional study was performed on 100 women with PCOS and normal women as the control group in Imam Khomeini Hospital of Tehran in 2016-2017. Peripheral blood sample (2 cc) was obtained from two groups for genomic DNA based on the gene bank. Polymorphisms were genotyped by of using ADRB3 Trp64Arg. Then the DNA was extracted by genomic kiagen kit. The primer was analyzed for PCR based on gene bank by using Primer3 software and then confirmed by primer Blast tool at NCBI site to conformity to the beta-3 adrenergic receptor gene. The protein changes were assessment by the Clastal W software. Results: The sequence analysis presented in NCBI, transcript variant 1, with the code NM_000025.2, shows changes in the amino acid sequence of exon 1 in women with PCOS. Polymorphism in the codon 64 encoding the amino acid tryptophan (W) occurred in the nucleotide c.T190C, which changed the nucleotide T to C and then the amino acid sequence of the tryptophan was altered to arginine pW64R. Conclusion: T-C polymorphism is evident in the codon 64 of the adrenergic β3 receptor in patients with PCOS. Therefore, Beta3 adrenergic receptor gene polymorphism (Thr164Ile) associates with this syndrome in nonobese women. Key words: Codon 64, Beta-3 adrenergic receptor, Polymorphism, Polycystic ovarian syndrome.

The Value of Cardiovascular Autonomic Function Tests: 10 Years Experience in Diabetes

Diabetes Care ◽  
1985 ◽  
Vol 8 (5) ◽  
pp. 491-498 ◽  
Author(s):  
D. J. Ewing ◽  
C. N. Martyn ◽  
R. J. Young ◽  
B. F. Clarke
Keyword(s):  
Autonomic Function ◽  
Autonomic Function Tests ◽  
Cardiovascular Autonomic Function ◽  
Function Tests

A COMPARATIVE STUDY OF LEVELS OF HIGH SENSITIVITY CREACTIVE PROTEIN (hs-CRP) IN DIABETIC AND NON- DIABETIC POPULATION OF CENTRAL INDIA

2021 ◽  
pp. 31-32
Author(s):  
Parag Gupta ◽  
Lal Pranay Singh
Keyword(s):  
Diabetes Mellitus ◽  
Central India ◽  
High Sensitivity ◽  
Control Group ◽  
Low Grade ◽  
Medical College ◽  
Diabetic Population ◽  
Hs Crp ◽  
And Control

Background: Diabetes mellitus is the most common metabolic disorder characterized by metabolic abnormalities and long term complications. It is characterized by hyperglycemia resulting from defect in insulin secretion and in its action. It has become a leading cause of morbidity and mortality world over. hs- CRP is a marker of low-grade inammation and it is raised in patients with type 2 DM. The present study was undertaken with the objective of studying the relation of High Sensitivity CRP (hs-CRP) in patients of type 2 Diabetes Mellitus and in non-diseased population. Methods: This was a comparative observational study, conducted at Diabetic clinic, Index Medical College, Indore during August 2014 to July 2015. Cases and control were selected as per the inclusion criteria. Statistical analysis was done using SPSS v20. Mean age of the group was 48years. The mean hs CRP in the diabe Results: tic group was 0.45 compared with 0.35, in the control group. hs CRP levels are directly related to insulin resistance and is Conclusion: highly associated with diabetic population.

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