Faculty Opinions recommendation of The predictive value of circulating anti-Müllerian hormone in women with polycystic ovarian syndrome receiving clomiphene citrate: a prospective observational study.

Author(s):  
Henry Burger
Author(s):  
Raja Shareef A. ◽  
P. V. S. Prasad ◽  
P. K. Kaviarasan

Background: Acne is one of the most common dermatological conditions encountered in day to day practice. Many recent studies have reported a strong association between acne and underlying systemic endocrine disorders, more particularly Poly cystic ovarian syndrome. But there is scarcity of literature on the subjects in Indian population. Hence the present study was conducted with an objective of studying the association between acne and polycystic ovarian syndrome, in women presenting with adult onset acne to a tertiary care teaching hospital.Methods: A prospective observational study was carried out in department of dermatology, Dhananalakshmi Srinivasan medical college and hospital, Permabalur from January 2016 to August 2017. The study population included women above 18 years of age clinically diagnosed with acne vulgaris. The presence of polycystic ovarian syndrome was assessed using Rotterdam criteria.Results: The final analysis had included 100 women with acne. The most common type of lesion observed was comedone in 91% of women. The other most common lesions were papule seen in 73%, pustule in 35% of women. The proportion with grade I, Grade II and grade III acne was 58%, 29% and 13% respectively. The prevalence of PCOS was 30% (95% CI 21.89% to 39.58%). PCOS had shown no statistically significant association with age, marital status and regularity of menstrual cycle. The factors which have shown statistically significant association were higher BMI, presence of Hirsutism and higher waist circumference.Conclusions: PCOS is highly prevalent among women with acne. Presence of hirsutism, obesity are strong risk factors for PCOS.


2021 ◽  
Vol 8 (2) ◽  
pp. 188-193
Author(s):  
Suresh Chandra Mondal ◽  
Pinaki Sarkar

To determine the efficacy of metformin on clinical profile and metabolic disorders in women with polycystic ovarian syndrome. Polycystic ovarian syndrome, is a heterogeneous endocrinological disorder affecting women of reproductive age and metformin was introduced to influence the pathogenesis.: A prospective observational study was conducted on 100 women with polycystic ovarian syndrome, attending department of gynaecology in a tertiary care setting and were divided into two group of 50 each. Metformin was used in 50 patients for one year. Rest 50 patients were advised about diet control and exercise. The parameters like body mass index (BMI), weight, hormonal imbalance, ovulation, and menstrual changes were analysed in both groups. Descriptive statistics for mean, SD were carried and chi-square test was used to test statistical significance using coGuide version V.1.0 and p value set at < 0.05.: The mean age was 25±10 years. Both the groups were comparable with respect to BMI and weight. There was a significant difference between the groups with respect to fasting insulin, which reduced to 7.44±1.12 from 11.97±2mIU/ml, testosterone levels reduced to 0.59±0.1 from 0.76±0.3 mIU/ml, luteinizing hormone levels reduced to 8.55±2 from 20.01±7.3 mIU/ml, and LH:FSH ratio reduced to 1.11±0.1 from 2.31±0.2 mIU/ml. In the metformin group, 22 (44%) participants were anovulation before treatment, and ovulation started in 15 (30%) after treatment which was not seen other group.Clinical, hormonal, and biochemical changes in polycystic ovarian syndrome may effectively be treated by metformin.


2020 ◽  
Vol 33 (5) ◽  
pp. 653-659
Author(s):  
Jia Song ◽  
Yun Cui ◽  
Chunxia Wang ◽  
Jiaying Dou ◽  
Huijie Miao ◽  
...  

AbstractBackgroundThyroid hormone plays an important role in the adaptation of metabolic function to critically ill. The relationship between thyroid hormone levels and the outcomes of septic shock is still unclear. The aim of this study was to assess the predictive value of thyroid hormone for prognosis in pediatric septic shock.MethodsWe performed a prospective observational study in a pediatric intensive care unit (PICU). Patients with septic shock were enrolled from August 2017 to July 2019. Clinical and laboratory indexes were collected, and thyroid hormone levels were measured on PICU admission.ResultsNinety-three patients who fulfilled the inclusion criteria were enrolled in this study. The incidence of nonthyroidal illness syndrome (NTIS) was 87.09% (81/93) in patients with septic shock. Multivariate logistic regression analysis showed that T4 level was independently associated with in-hospital mortality in patients with septic shock (OR: 0.965, 95% CI: 0.937–0.993, p = 0.017). The area under receiver operating characteristic (ROC) curve (AUC) for T4 was 0.762 (95% CI: 0.655–0.869). The cutoff threshold value of 58.71 nmol/L for T4 offered a sensitivity of 61.54% and a specificity of 85.07%, and patients with T4 < 58.71 nmol/L showed high mortality (60.0%). Moreover, T4 levels were negatively associated with the pediatric risk of mortality III scores (PRISM III), lactate (Lac) level in septic shock children.ConclusionsNonthyroidal illness syndrome is common in pediatric septic shock. T4 is an independent predictor for in-hospital mortality, and patients with T4 < 58.71 nmol/L on PICU admission could be with a risk of hospital mortality.


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

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.


2017 ◽  
Vol 9 (4) ◽  
pp. 336-340 ◽  
Author(s):  
Richa Singh ◽  
Meenal Jain ◽  
Poonam Yadav ◽  
Sarvesh Awasthi ◽  
Pallavi Raj

ABSTRACT Introduction The polycystic ovary syndrome (PCOS) is the most common condition associated with chronic anovulation affecting 4 to 6% of reproductive age women. Aim To compare the effectiveness of laparoscopic ovarian drilling (LOD) for ovulation induction with gonadotropins in clomiphene-resistant PCOS in terms of ovulation, pregnancy, live birth, abortion, multiple pregnancies, and complication like ovarian hyperstimulation syndrome (OHSS). Setting and design A prospective hospital-based randomized trial. Materials and methods It was a prospective study, which was carried out from January 2012 to May 2015. Totally, 89 women were evaluated in the study, out of which 44 women were in gonadotropin group and 45 were in LOD group. Statistical analysis Standard statistical analysis was done and significance of difference in results was tested by chi-square test. Results Ovulation rate in gonadotropin group was 75.0% at 6 months, whereas in LOD group, it was 20% at 3 months and was increased up to 66.66% after addition of clomiphene citrate and gonadotropin. The primary outcome in terms of pregnancy in gonadotropin group was 45.45% after 6 cycles and in LOD group was 11.11% after 3 cycles and 40.00% after 6 cycles with supplementation of clomiphene citrate and gonadotropin. Conclusion The ongoing pregnancy rate from ovulation induction with LOD alone was significantly less but if supplemented by clomiphene citrate and gonadotropin, it seems equivalent to ovulation induction with gonadotropin, but the former procedure carries a lower risk of multiple pregnancies. How to cite this article Yadav P, Singh S, Singh R, Jain M, Awasthi S, Raj P. To Study the Effect on Fertility Outcome by Gonadotropins vs Laparoscopic Ovarian Drilling in Clomiphene-resistant Cases of Polycystic Ovarian Syndrome. J South Asian Feder Obst Gynae 2017;9(4):336-340.


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