Prenatal oestrogen-testosterone balance as a risk factor of migraine in adults

Background Migraine is a common neurological disease with extremely debilitating, but fully reversible symptoms. Women suffer from migraine more often than men. It was assumed that fluctuation of oestrogen level during menstrual cycle is one of many factors responsible for more frequent migraine attacks. The second-to-fourth digit ratio (2D:4D) is considered as an indicator of prenatal sex steroids. Balance of prenatal androgens (testosterone) and oestrogen has been studied in numerous diseases that are affected by hormones. However, the relationship between migraine and the sex steroids balance in prenatal development is still unexplained. The aim of this paper is to provide an evidence of relationship between prenatal oestrogen and testosterone exposure following 2D:4D digit ratio, and migraine prevalence in adults. Methods We examined a group of 151 adults (33 males, 118 females) with migraine and a control group of 111 adults (45 males, 66 females). 2D:4D digit ratio of both hands was measured using sliding Vernier calliper. Results Significant differences were found in the right hand. Female migraineurs had lower value of 2D:4D ratio than the control group and the right 2D:4D was lower than left 2D:4D (Δ2D:4D), suggesting prenatal testosterone dominance. The opposite relationship was observed in males. Male migraineurs had higher value of 2D:4D ratio and Δ2D:4D was greater than the control group, suggesting prenatal oestrogen dominance. Conclusions Our results suggest that depending on sex, different proportion of prenatal sex steroids might be a risk factor of migraine in adults. Women with migraine were presumably exposed in prenatal life to higher testosterone levels relative to oestrogen, while men with migraine were probably exposed in prenatal life to higher levels of oestrogen relative to testosterone.

An Unusual Cause of Thyrotoxicosis and Gynacomastia

We describe the case of a 24 year old man with metastatic non-seminomatous germ cell tumour who presented with hyperthyroidism and gynaecomastia associated with elevated human chorionic gonadotrophin(HCG). Following a 3 month history of gynaecomastia, flank pain, nausea and 7kg weight loss, the patient attended the emergency department with persistent vomiting. Initial laboratory investigations reported TSH <0.05mU/L (normal range 0.3-4.3) and free T4 29.5pmol/L (12-22), TPO antibodies negative, FSH <1 and LH 1 U/l, testosterone >52 nmol/L (9-29.0), bioactive prolactin 1048mU/L (63-245), SHBG 110.6 nmol/l (18.3-54.1), and oestradiol 3935pmol/L (<223). Clinical examination revealed bilateral tender gynaecomastia and supraclavicular lymphadenopathy. Testicular examination identified a left testis irregularity that was confirmed on ultrasound. Chest Radiograph revealed multiple bilateral opacities measuring up to 6 cm. Initial urine HCG was negative when tested on two occasions; however given suspicion for a HCG-secreting tumour, serum HCG was measured and reported as 503,944 IU/ml (<5) and AFP 17.6 IU/ml (0-5.0). The negative urine HCG is believed to be due to “hook effect”. CT revealed bulky retroperitoneal lymphadenopathy measuring 13 cm consistent with metastatic spread from the non-seminamatous germ cell tumour of testicular origin. Up front chemotherapy protocol with 4 cycles cisplatin based therapy was initiated given his disease burden and degree of symptoms. Radical orchidectomy was deferred until after chemotherapy - at which time germ cell tumour was only identified on immunohistochemistry staining. Over the 2 months following chemotherapy, all endocrinopathies resolved with corresponding reduction of HCG to 65.0 IU/ml. Symptoms of hyperthyroidism abated with treatment and his TFTs were biochemical normal. Oestrogen level also normalised with treatment. HCG-induced hyperthyroidism is a rare cause of hyperthyroidism. Endocrine manifestations occur in <5% germ cell tumour presentation but should be considered particularly when multiple endocrine abnormalities are present.

CONCEPTUAL STUDY OF THE EFFICACY OF LODHRA WITH HONEY GEL IN UPAPLUTA YONIYAPAD (VAGINAL CANDIDIASIS IN PREGNANCY)

Introduction: The pregnant women are more prone to vaginal infection like vulvovaginitis, which presents a challenge for doctor today. Pregnant state produces several normal and expected changes in all the ma-ternal organ systems, from which vaginal candidiasis is one. Vaginal secretion changes during pregnancy mainly vaginal PH. Vaginal secretions during pregnancy falls from a pH of greater than 7 (an alkaline pH) to 4 or 5 (an acid pH). Due to this change in vaginal pH candida albicans growth occurs. In pregnancy, there is higher oestrogen level and higher glycogen level which helps in growth of candida. According to Ayurveda if woman during pregnancy take Kapha aggravating Ahar and Vihar excessively and suppresses the urges of vomiting and respiration, the vitiated Vayu carries Kapha to genital tract affect the same and vaginal white discharge is seen in pregnant woman due to Kapha and Vata; This is known as "Upapluta Yonivyapad". Lodhra has Kashay Ras which help in decreasing Kapha Dosha and Madhu has Tridoshahar property which cures Upapluta Yonivyapad. Aim: The present study is aimed to assess the efficacy of Lodhra with Madhu gel in Upapluta Yonivyapad. Material and Methods: The present study is done, to analyze the effect of Lodhra and Madhu gel in Upapluta Yonivyapad. Study is performed with help of var-ious previous research paper published, from various authentic Ayurvedic and Modern books as well as Samhitas. Conclusion: In pregnancy, due to Kapha and Vata there is a change in vaginal pH and vaginal white discharge; Also, there is high estrogen level which cause vaginal candida. Lodhra has property of Kaphahar, analgesic, anti-inflammatory, antibacterial, antihelminthic. Madhu is one of the five elixirs of immortality (panchamrut) and has properties like: Tridoshahar, antiseptic, antimicrobial, antiallergic, anti-inflammatory. Thus, it balances the Dosha and result in decrease (vaginal candida) Upapluta Yonivyapad. Thus, Lodhra and Madhu gel can work effectively in Upapluta Yonivyapad.

The Effects of Ficus Carica Fruit on Bone Markers and Oestrogen Level of Post-Menopausal Osteoporotic Rats

Introduction: Post-menopausal osteoporosis is the most common type of osteoporosis, which occurs due to a deficiency of oestrogen following menopause. Considering the adverse effects of oestrogen replacement therapy, natural products may serve to replace the current conventional treatment. Ficus carica (FC) which is commonly known as fig may have a potential in treating post-menopausal osteoporosis due to their abundance of important minerals and bioactive compounds such as phenolic, flavonoid and anthocyanins. This study aimed to evaluate the effects of FC on bone metabolism of ovariectomized rats. Materials and Methods: Fifty-six female Spraque-Dawley rats were randomly divided into seven groups; SHAM operated (SHAM), ovariectomized control (OVX), ovariectomized + 64.5 µg/kg oestrogen (ERT), ovariectomized + 50 mg/kg aqueous extract of FC (AQ50), ovariectomized + 100 mg/kg aqueous extract of FC (AQ100), ovariectomized + 50 mg/kg raw FC (RW50), and ovariectomized + 100 mg/kg raw FC (RW100). After eight weeks of treatments, rats were euthanized and femurs were dissected out to measure bone osteocalcin, Ctelopeptide of type 1 collagen and bone estrogen level. Results: RW50 and RW100 showed an increasing trend in osteocalcin levels and also oestrogen level, but no significant difference between all groups. RW50 and RW100 also showed significantly reduced C-telopeptide of type 1 collagen levels compared to OVX group. Conclusion: These findings suggested that raw FC at the doses of 50 mg/kg and 100 mg/kg have potential to improve bone in treating post-menopausal osteoporosis. However, this need to be confirmed with higher doses.

Factors related to follicular oxidative stress in intracytoplasmic sperm injection cycles and its effects on granulosa cells

Summary The aim of the present study was to investigate several common conditions that may potentially be correlated with follicular oxidative status during an intracytoplasmic sperm injection (ICSI) cycle and that include the serum oestrogen level on the day of oocyte pick-up, maternal age and pregnancy outcome. Patients that were enrolled in the study were classified randomly into three groups using their numerical order. The first group were classified based on maternal age (<35 and ≥35 years) (n = 398), the second group on the serum oestradiol (E2) level on the day of human chorionic gonadotropin (hCG) administration (levels >90th percentile and ≤ 90th percentile) (n = 491) and the third group on pregnancy outcome (positive/negative) (n = 376). The groups were matched for the other variables (stimulation protocol, dose of gonadotropin, duration of stimulation, antral follicle count, body mass index, basal follicle stimulating hormone (FSH), and E2 levels and day of hCG trigger) to prevent the possible contribution of those parameters to the results. Each group was matched for other variables (stimulation protocol, dose of gonadotrophin, duration of stimulation, antral follicle count, body mass index, basal FSH and E2 levels and day of hCG trigger) that may have affected the outcome, except for the parameter under investigation. Maternal age (P = 0.044,168 r = 0.418), oestrogen level on day of hCG administration (P = 0.001, r = 0.436) and pregnancy outcome (AUC = 0.65, P = 0.071) were found to be correlated with follicular oxidative status. The results obtained will help us to shield patients from possible situations that may cause oxidative stress and therefore adverse outcomes of an ICSI cycle.

The Effects of Nicotine on Foetal Loss, Postnatal Growth and Plasma Oestrogen and Progesterone Levels in Rats

Introduction: The present study aims to investigate the effects of nicotine on foetal loss, postnatal growth and corresponding levels of oestrogen and progesterone in pregnant rats. Method: Subcutaneous injection of nicotine tartrate (7.5 mg/kg/day) was administered to groups of pregnant rats; with treatment scheduled from day 1 through day 5, day 5 through day 9 or day 1 through day 9 of pregnancy. On day 10 of pregnancy, laparotomy was performed to count the number of blastocyst implantation sites. During parturition, the number of viable pups was recounted and statistically compared with the controls. One group of rats which received nicotine from day 1 through day 9 of pregnancy was sacrificed on day 16 of pregnancy, and circulating levels of oestrogen and progesterone were measured. Upon delivery, the birth weight of the pups was measured, and their weights were recorded until weaning. Result: There was a significant increase in foetal loss particularly in rats which received nicotine from day 5 through day 9 and from day 1 through day 9 of pregnancy. There was also significantly lower birth weight of pups in all groups; however, this pattern did not continue until weaning. Plasma oestrogen level was significantly elevated with a significant decrease in the plasma progesterone level. Conclusion: Nicotine administration during pregnancy showed an increase in foetal loss with a corresponding increase in oestrogen and decrease in progesterone levels. Although the birth weight of the pups was low, there was catch-up growth in the pups.

Identification and clinico-gynaecological characterization of reproductive disorders in crossbred cows under field conditions

The present study was conducted on a total of 909 crossbred cows maintained in various private farms from Kamrup, Darrang and Lakhimpur districts of Assam. Breeding records provided by the farmers and characteristic genital changes detected on per rectum examination of 133 reported infertile cows were analyzed. The study revealed that the incidence of infertility due to different types of reproductive disorders was 14.63 per cent in cross bred cow under field conditions. Common clinically detectable reproductive disorders were repeat breeding with uterine infection, repeat breeding without uterine infection, true anoestrus and silent oestrus with the percentage frequencies of 36.09, 23.30, 20.30 and 17.29 respectively when estimated out of total number of infertile cows. Less frequent reproductive disorders were pyometra, ovarian cyst, infantile genitalia and ovario-bursal adhesion occurring in the frequencies of 36.09, 23.30, 20.30 and 17.29 per cent respectively. Irrespective of type the incidence of anoestrus and repeat breeding was 37.59 and 59.39 per cent respectively. Palpable corpus luteum was present in the ovary of silent oestrous cows but totally absent in cows affected with true anoestrus. Mucopurulent vaginal discharge was a distinct clinically detectable genital characteristic observed in 62.50 per cent repeat breeder cows with uterine infection. Of the infertile cows 53.38 per cent had body condition score between 2.5 and 3.5 and 46.61 per cent had the score less than 2.5. Out of repeat breeder cows with uterine infection 43.66 per cent had good body condition and 27.41 per cent poor body condition. Level of serum calcium, zinc, leptin, ghrelin and IGF-1 did not vary significantly between types of infertility. Level of phosphorus and iron was lower in cows affected with repeat breeding due to infection. Serum oestrogen level remained low in cows affected with silent oestrus and true anoestrus while level of progesterone was higher in cows affected with silent oestrus.

Management of bph (vatashthila) by varun bark decoction (kwatha). : a case report

(Vatashthila) Benign prostate hypertrophy (BPH) is one of the disease frequently seen in ageing male above 50 years old. Ageing occurs as the testosteron level decreases and oestrogen level increases. The prostate gland which is normally about the size and shape of a walnut wraps around the urethra between the pubic bone and rectum below the bladder. Main function of prostate gland is to store and produce seminal fluid. A mans prostate gland usually start to enlarge after middle age, this menifest as a benign (non cancerous) enlargement of prostate that blocks the flow of urine through the urethra. In early stage of prostate enlargement the bladder muscles forces urine through the narrow urethra that counteracting more powerfully. As a result the bladder muscles become thicker and more sensitive causing more to urinate more often. It is estimated that each year in U.S. about 1.7million of people have to visit hospital due to menifestation of this disease among these 4000 have surgical intervention. In Ayurveda the enlargement of the prostate is called vatashthila this enlargement usually caused by imbalence of vata dosha. By ayurvedic treatment, we can definitely prevent the prognosis of BPH in early onset age. In this study varun bark is used for the management of vatashthila, bark of varun believed to have antioxident, anti-inflammatory, antimicrobial and urinary-renal supportive qualities.

The influence of plant-based nutrition and level of oestrogen on life satisfaction

Previous studies have shown that people benefit more from vegetarian or vegan diets than from an omnivorous diet, not only in physical but also in mental health. Studies have also reported substantial evidence that particular disorders can be triggered by preferred food choices. For example, consumption of animal products increases the intake of arachidonic acid which can induce depressive moods. On the other hand, nutrition can have positive effects, e.g. polyunsaturated N-3 fatty acids have several somatic health benefits not only on cardiovascular diseases, but also on depression. Similarly, a diet with a high content of tryptophan (a serotonin predecessor) can change mood by altering the synthesis of different neurotransmitters. In this pilot study, (i) omnivores (n=45), (ii) vegetarians (n=13) and (iii) vegans (n=7) were compared for their levels of satisfaction in everyday life, as measured on the Oxford Happiness Scale. The effect of oestrogen was analysed as a confounding variable. Between the three styles of nutrition, only small differences were found. All groups achieved an average of more than 4 points on a 6-stage Likert-scale (1=not happy, 6 = very happy), which lies in the range of moderately happy. The mean score of all three groups was 4.30 ±0.84. The difference between the omnivore, (4.23 ±0.69) and the vegetarian groups, (4.29 ±1.24) was very small, but the vegan group achieved a score well above 5, (5.20 ±0.17). In an ANCOVA, the effect of nutrition style on happiness was close to being significant, [p=0.066]. In addition, estimated oestrogen level had significant effects on satisfaction in everyday life, [p=0.047]. Conclusion: Further research on a larger sample is justified to determine if life satisfaction is influenced by nutrition style when controlled for oestrogen levels.