AN OBSERVATIONAL STUDY TO EVALUATE VASTRARANJANA IN ARTAVAPAREEKSHA

Objectives: Menstrual problems and infertility are the major problems affecting society nowadays. It can occur due to many reasons namely pathology of Garbhashaya, Artavavaha Dhamani, Dushta Artava etc. For the evalu- ation of structural abnormalities, various technologies like USG, HSG, Hormonal assay etc. are available. But no methods were developed yet to check the purity of Artava. In this background, the Vastraranjana concept men- tioned in the context of Shudha Rakta Lakshana can be considered as a useful tool for diagnosing Artava Dushti. The practicality of this Pareeksha if proved it envisages a new and simple diagnostic tool in Ayurveda. Methods- Menstrual blood samples-stained cotton clothes were washed, and changes were noted. Results- Dushita Artava was found to be causing a stain on the cloth. Conclusion- Changes in the character of Dosha produces Soshana Vidaha Ghanatha etc. of Artava which involve a change in pH, viscosity like elements creating a stain on the cloth. Keywords: Artava Pareeksha, Vastra Ranjana, Menstrual Cycle

Delayed Puberty in Girls with Primary Amenorrhea: A Report of Cases

Background:Female puberty starts when the pituitary hormone producing follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which will stimulate the ovaries to produce estrogen. Delayed puberty with primary amenorrhea in female is the lack of breast development followed by the absence of menses 3 years after the initiation of breast development. Sex chromosomes have an important role in determining the sex, germ cell differentiation of foetus, and reproductive functions of an offspring, thus, sex chromosomal aberrations frequently cause primary amenorrheaCase presentation: We report two delayed puberty cases with the chief complain of primary amenorrhea. Both cases showed hypoplasia of uterus and ovaries on pelvic imaging and hormonal assay showed low of FSH. The first case was gonadal dysgenesis with 46,XX karyotype and low level of estrogen and the second case was a turner syndrome with 45,X karyotype and normal level of estrogen. Conclusion:This study reported delayed puberty with primary amenorrhea cases due to different chromosomal aberration pattern which have similar clinical features. Therefore, cytogenetic examination is needed for any primary amenorrhea cases in order to accomplish the confirmatory diagnosis and for the clinicians to make a correct intervention and treatment.

A Study on Some Serum Biological Constituents during Different Days of Normal Oestrous Cycle of Manipuri Pony Mares

Background: The aim of this study was to estimate the serum biochemical (glucose, cholesterol, total protein, calcium, phosphorus and magnesium) and hormonal constituents (estrogen and progesterone) in female Manipuri pony mares during the different days of oestrous cycle. Methods: A total of 50 numbers of blood samples were collected from 10 numbers of apparently healthy, non-pregnant on the different days of oestrous cycle i.e. day 0, 4, 8, 14 and 18 by using commercial diagnostic kits. Result: The mean serum levels of glucose, cholesterol and phosphorus were found to be non-significant on the different days of oestrous cycle whereas the mean serum level of total protein and calcium was found significantly different (P less than 0.01). The serum magnesium level differed significantly (P less than 0.05) amongst the different days of oestrous cycle. Both estrogen and progesterone were also found to be significant (P less than 0.01) between the different days of oestrous cycle. The results showed significant influence on serum biochemical and hormonal assay during different days of oestrous cycle in female Manipuri pony.

Contraceptive Activity of Vitex doniana Stem Bark Methanol Extract in Female Albino Rats

Aims: The acceptability and accessibility of modern contraceptive drugs are limited especially in northern Nigeria. These contraceptives also have numerous side effects hence there is need to search for safe natural alternatives from medicinal plants. This research was aimed at evaluating the contraceptive effect of stem bark methanol extract of Vitex doniana in female albino rats. Place and Duration of Study: Department of Biochemistry, Faculty of Life Science, Kebbi State University of Science and Technology Aliero, Kebbi State, Nigeria. Between August 2019 to July 2020. Methodology: Vitex doniana stem bark was extracted with methanol and the extract was subjected to qualitative phytochemical screening. Acute toxicity (LD50) of V. doniana stem bark extract was determined using up and down method and anti-fertility effect was evaluated via (anti-ovulation, anti-implantation and serum hormonal assay). Results: The results for phytochemical screening showed the presence of alkaloids, flavonoids, tannins, steroids, glycoside, balsam and volatile oil. The LD50 of the extract was estimated to be greater than 5000 mg/kg as no mortality or any sign of toxicity are recorded within 14 days. The anti-fertility studies, methanol stem bark extract of Vitex doniana showed anti-ovulation activity through alteration of estrous cycle, changes in the histology of ovarian corpus luteum and decreasing number of follicles of extract treatment groups compared to control. Serum hormonal assay showed significant decrease (P<0.05) in oestrogen and progesterone level respectively in the extract treated groups compared to control group. Also, anti-implantation effect was observed in drug treated group (levenogesterel) and group treated with 400 mg/kg of V. doniana stem bark as there was no evidence of conception. Conclusion: The present study revealed that methanol stem bark extract of Vitex doniana is relatively nontoxic at acute dose and possess a moderate amount of antifertility agent.

Anti-androgenic Impact of Nauclea latifolia on Testicular Weight, Testosterone, Follicle Stimulating Hormone and Glycogen Granules of the Testes

Purpose: Over time, plants have been a major source of medicine to treat and cure various ailments and diseases. In many cases, the dosages and standardization of these herbal products have been so ignored that it results in these products causing damages to certain organs of the body unnoticed. The impact of ethanolic leaf extract of Nauclea latifolia on the testes was determined using Wistar rats. Method: 500, 1000 and 1500 mg of ethanolic leaf extract of Nauclea latifolia /kg body weight was administered for 21 days to 4 groups of animals (n=10). Blood sample was taken for hormonal assay, testicular weight measured, and histological procedure done, and the tissues stained with PAS. Results: Result from hormonal assay showed reduced level of testosterone and follicle stimulating hormone. After histological staining using periodic acid Schiff method (PAS) and subsequent examination using a compound microscope, there was a reduced level of glycogen granules in all the Nauclea latifolia groups. Findings from this study also showed that the ethanolic leaf extract of Nauclea latifolia at all doses significantly reduced testicular weight (p<0.05). Conclusion: This study reveals that Nauclea latifolia is anti-androgenic.

P–593 Self-monitoring of hormones via a urine-based hormonal assay — a topical endeavour into telemedicine in medically-assisted reproduction (MAR)

Study question How can cycle monitoring using a urine-based hormonal assay device improve current clinical practice in medically assisted reproduction (MAR)? Summary answer A urine-based hormonal assay has the potential to overcome the inconvenience of blood tests and reduce the frequency of appointments, waiting times and patient burden. What is known already Cycle monitoring via ultrasound and serum-based hormonal assays during MAR can provide information on the ovarian response and assist in optimising treatment strategies and reducing complications, such as ovarian hyperstimulation syndrome (OHSS). However, blood tests may cause inconvenience to patients due to repeated venepuncture and the need for frequent clinic appointments. Urine-based assays have been historically used by fertility specialists in clinics, but since got replaced by more practical and automated serum-based assays. Novel technology utilising rapid chromatographic immunoassay to test urinary reproductive hormones in a home setting could provide an alternative to current serum-based testing at clinics. Study design, size, duration A questionnaire was disseminated among 24 fertility specialists (2019–2020) on the use of ultrasound and serum-based hormone monitoring in clinical practice. In addition, the literature on the reliability of urine-based hormonal assays compared to serum-based hormonal assays during MAR was reviewed in order to examine if urine-based hormonal monitoring could be re-introduced in clinical practice using novel state-of-the-art technology. Participants/materials, setting, methods All 24 surveyed fertility specialists responded, representing 10 countries from across Europe, Asia and Latin America. Questions assessed the frequency and role of hormonal monitoring, the hormones tested and the drawbacks of blood tests. The PubMed search engine was used to search the Medline database for publications between 1960–2020 with (MeSH-) search terms related to cycle monitoring (e.g. fertility monitoring, controlled ovarian stimulation, ovulation confirmation) and hormonal assays (e.g. estrone–3-glucuronide or E1–3G). Main results and the role of chance The survey confirmed that many fertility practitioners (n = 22/24) routinely conducted hormone monitoring during MAR, primarily for guiding dose adjustments (n = 20/24) and indicating risk of OHSS (n = 20/24). The reported drawbacks of blood tests included validity of results from different service providers, long waiting times and discomfort to patients due to travelling to clinics for tests and repeated venepunctures. The hormones routinely checked were E2 (n = 22/22), P4 (n = 18/22) and LH (n = 15/22). The literature review revealed a relatively high correlation (correlation coefficients 0.85–0.95) between serum E2 and urinary E1–3G in gonadotrophin stimulated cycles (Lessing 1987, Catalan 1989, Rapi 1992 and Alper 1994). No studies assessed the correlation between serum P4 and urinary PdG or between serum LH and urinary LH in stimulated cycles. In natural cycles, the correlation coefficients between serum P4 and urinary PdG seemed to be slightly higher than those between serum E2 and urinary E1–3G (0.73–0.94 vs. 0.54–0.88) (Denari 1981, Munro 1991, Roos 2015, Stanczyk 1980). One study reported a moderate correlation coefficient (0.72) between serum and urinary LH in natural cycles (Roos 2015). Limitations, reasons for caution There is risk of selection-bias for fertility specialists included in survey, however, the 100% response rate is reassuring. The correlation coefficients between serum- and urine-based hormonal assay and the cost-effectiveness and time-efficiency of urinary assay should be confirmed in further clinical studies using a novel state-of-the-art remote urinary monitoring device. Wider implications of the findings: Remote hormonal monitoring can be part of a novel digital health solution that includes remote ultrasound and tele-counselling to link clinics and patients at home. Especially during the unprecedented times of the COVID–19 pandemic, the prospect of remote monitoring system has the potential to improve patient experience during fertility treatment. Trial registration number Not applicable

Recurrent Galactorrhoea: A consequence of unheeded primary hypothyroidism

Background: Primary hypothyroidism can lead to hyperprolactinemia through several mechanisms in both men and women, manifesting as galactorrhoea, loss of libido, and infertility in both sexes, as oligomenorrhea/amenorrhea in women, and as gynecomastia and erectile dysfunction in men. Case presentation: Here presented is a 28-year-old Nigerian woman with a history of recurrent bilateral painless galactorrhoea of 12 years’ duration and persistent low mood. Physical examination was unremarkable. The hormonal assay revealed elevated thyroid-stimulating hormone, elevated serum prolactin, low thyroxine, and low triiodothyronine levels. Magnetic resonance imaging of the brain revealed normal findings. A diagnosis of hyperprolactinemia secondary to primary hypothyroidism was made. Pharmacological therapy began with thyroid hormone replacement therapy and a dopamine agonist: 75 micrograms of levothyroxine daily and 0.5 micrograms of cabergoline twice weekly for 8 weeks. After 8 weeks of pharmacological therapy, hormonal assay revealed values within the reference range with significant symptomatic improvement evidenced by cessation of galactorrhoea and low mood. Conclusion: Primary hypothyroidism has been proven to be one of the numerous causes of hyperprolactinemia and it could be unheeded in a patient who does not present with the typical signs and symptoms of primary hypothyroidism.

Differential molecular and hormonal changes in oocytes, granulosa cells and follicular fluid of pregnant and non-pregnant camels

Summary This study aimed to compare the expression of genes regulating follicles development, survival and steroid hormones secretion in oocytes and granulosa cells (GCs) and study the correlation between their expression and follicular fluid (FF) levels of progesterone (P4) in pregnant and non-pregnant camels. In total, 138 ovarian pairs from slaughtered camels were used. Gene expression and hormonal assay were determined using real-time polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA), respectively. The obtained results revealed that the number of follicles (3–8 mm) was significantly (P < 0.05) lower in pregnant, compared with non-pregnant, camels. P4 level in the FF was significantly (P < 0.05) higher in pregnant, compared with non-pregnant, camels. However, no significant (P > 0.05) difference was noticed in the oestradiol (E2) level. STAR, PTEN, IGF1 and BCL2 mRNA levels were significantly higher in GCs and significantly lower in oocytes of pregnant, compared with non-pregnant, camels. However, follicle-stimulating hormone receptor (FSHR) mRNA level was significantly lower in GCs and oocytes, and the BMP15 mRNA level was significantly lower in oocytes of pregnant, compared with non-pregnant, camels. P4 level in FF was positively correlated with STAR, PTEN, IGF1 and BCL2 mRNA levels in GCs and negatively correlated with BMP15 mRNA levels in oocytes and FSHR mRNA levels in GCs and oocytes of pregnant camels. It could be concluded that pregnancy-induced variations in oocytes and GC expression of BMP15, IGF1, FSHR, STAR, BCL2, and PTEN genes might be associated with a decrease in the number of follicles and an increase in the FF level of P4.

ADRENAL ANGIOMYOLIPOMA: A SURGICAL RARITY

Adrenal Angiomyolipoma's are extremely rare forms of lipomatous tumours of adrenal gland. They may go undetected for years without symptoms. The patient may become symptomatic, once the tumour has gained a signicant size, mainly back pain. We are reporting our case which is a one of a kind benign Adrenal tumour. Adrenal Angiomylipomas are found as incidentalomas in patients, generally presenting with mild to no symptoms, leading to a long delay before they are diagnosed. However, early diagnosis is key, not only to alleviate symptoms but to also prevent a future surgical disaster due to rupture causing cardiovascular shock if large enough. Our patient presented with dull aching ank pain without any systemic symptoms. The diagnosis requires a multifocal approach to be conrmed including hormonal assay and radiological testing whereas following a “clinical only” approach maybe insufcient and often mislead a clinician from establishing an accurate diagnosis. These patients could be offered laparoscopic resection at specialized centres with minimal risk of complication and early uneventful recovery.

MR imaging in Kallmann syndrome: a case report

Background A rare genetic disorder called Kallmann syndrome results from a defect in the neuronal migration of olfactory axons and gonadotropin-releasing hormone neurons. MR imaging helps in confirming the diagnosis of Kallmann syndrome with characteristic morphological findings in the brain, in clinically suspicious cases of hypogonadotropic hypogonadism with anosmia/hyposmia. Case presentation A 15-year-old male teenager presented with complaints of a small penis and anosmia. Hormonal assay of gonadotropins and testosterone revealed low serum concentrations. MRI brain revealed the absence of the olfactory bulbs in the olfactory grooves and hypoplastic olfactory sulcus. With the gonadotropic hormonal assay showing low levels and characteristic MR imaging features of absent olfactory tracts and olfactory sulcus, the diagnosis of Kallmann syndrome was confirmed. Conclusions Morphological abnormalities of olfactory tracts and olfactory sulcus can be accurately depicted with MR imaging through anterior fossa in the coronal plane. Therefore, MR imaging of the brain plays a significant role in diagnosing uncommon Kallmann syndrome and other associated brain abnormalities.