Current Issue : July - September Volume : 2017 Issue Number : 3 Articles : 6 Articles
Introduction: This study was done to evaluate other oral hypoglycemic medications;\nespecially the new ones in the management of PCOS patients as alternatives to the\nstandard medication used for this purpose Metformin. Patients and Methods: 105\npatients were enrolled and randomly distributed into 3 groups according to sequence\nof computer-generated block-random numbers. Each group included 35 patients.\nThis randomized double blind case controlled study was conducted at Tanta University\nHospital from December 1, 2015 to October, 1, 2016. In group A (study group 1)\nthe patients received Pioglitazobe 30 mg once a day for 6 months while in group B\n(study group 2) the patients received Vildagliptin 50mg once daily. In Group C\n(control group) the patients received Metformin 500 mg tds. for 6 months. The clinical\noutcome measures of the study were the improvement in the regularity of the\nmenstrual cycle, the BMI and the improvement in the modified Ferriman-Gallwey\n(F-G) score for hirsutism. The biochemical outcome measures will be the change in\nthe Serum Free testosterone, dehydroepiandrosterone (DHEA), fasting insulin level,\nGlcosylated hemoglobin (Hb A1c) and fasting Low Density Lipoproteins (LDL) levels.\nResults: Pioglitazobe in the study group 1 patients showed a significant reduction\nof BMI (p = 0.016), Ferriman-Gallwey score (p = 0.003), free testosterone level\n(p = 0.003), DHEA level (p = 0.001), fasting insulin level (p = 0.036) and Hb a1c level\n(p = 0.000), and also significant reduction of menstrual irregularities (p = 0.035).\nWhen compared to Metformin in the control group 3, there were significant reduction\nof BMI (p = 0.010), Ferriman-Gallwey score (p = 0.002), free testosterone level\n(p = 0.034), Hb a1c (p = 0.000) level and significant reduction of menstrual irregularities\n(p = 0.004) only. This means that the clinical and metabolic effect of Pioglitazobe\nis better than Metformin in PCOS patients. On the contrary there were disappointing\nresults of the new drug Vildagliptin in group 2; the patients in this group showed significant reduction of BMI (p = 0.001), Ferriman-Gallwey score (p = 0.046)\nand Hb a1c (p = 0.000) level only. Non significant effect on menstrual irregularities\nand non significant reduction of LDL level are noticed. But there is elevation of Ferriman-\nGallwey score, free testosterone level, DHEA level and fasting insulin level.\nConclusion: Pioglitazobe is an effective and safe alternative to Metformin in the management\nof PCOS patient although further studies including larger number of patients\nshould be done while Vildagliptin should be omitted for use in PCOS patients....
Monitoring of pregnant women before delivery routinely includes the non stress test (NST), which is often used in third trimester of pregnancy. Fetal heart rate (FHR) reactivity time differs in all cases. It is observed that maternal position may be the case for it. Aim of the study is to determine whether maternal position during NST influences the fetal parameters. To obtain post intervention data of fetal parameters of NST and to compare the difference related to fetal parameters of NST in three positions. Quasi experimental “three group” with ‘pretest’ and ‘post test’ approach was used. All antenatal mothers who are 32 to 40 weeks of gestation for non stress test for 20 minutes were selected. 30 samples were assigned in E1, E2 and E3 group. Purposive sampling technique was used. The effect of these positions on NST parameters among antenatal mothers was measured. Analysis of baseline characteristics was done through the descriptive statistics and correlation was done by ANOVA. There were statistically significant differences in No. of accelerations (p=0.021 < 0.05) between the three groups. The selected maternal positions are effective on fetal parameters of non stress test in antenatal mothers of 32-40 weeks of gestation. According to the correlation Left lateral and semi fowlers positions are effective than supine position for non stress test. There were arithmetical significant differences in Number of accelerations (p=0.021 < 0.05) between the three groups. Semi fowler’s position was identified as superior position for conducting NST....
Background: Knowledge of danger signs of obstetric complications during pregnancy, labour, and postnatal period\nis the first essential step for appropriate and timely referral. This study aimed to investigate predictors of knowledge\nabout obstetric danger signs during pregnancy, delivery, and postpartum period among mothers of reproductive\nage women who gave birth in the last 12 months.\nMethods: A quantitative community based cross-sectional study was employed during March 2016. The study\nincluded 493 mothers who were selected by multi-stage sampling technique. Data were collected by face-to-face\ninterview. Logistic regression analyses were employed to identify factors associated with knowledge of obstetric\ndanger signs. Variables with a p-value <0.05 were identified as statistically significant factors.\nResults: About forty-seven percent (46.7%), 27.8%, and 26.4% of the mothers were knowledgeable about obstetric\ndanger signs during pregnancy, delivery, and postpartum period, respectively. Vaginal bleeding was the most\nfrequently cited danger sign during the three periods. Mothers� secondary or above education level increased odds\nof knowledge about danger signs during pregnancy (AOR: 3.63; 95% CI 1.19, 11.07) and postpartum period\n(AOR: 5.31; 95% CI 2.13, 13.22). Additionally, being employed (AOR: 5.41; 95% CI 1.03, 28.32), delivery at health institution\n(AOR: 2.14; 95% CI 1.17, 3.92) and number of ANC visits were statistically significant factors.\nConclusion: Knowledge of mothers about obstetric danger signs was low in the study area. Empowering women,\nimproving the quality of health information about danger signs during ANC follow up, and promoting institutional\ndelivery are the recommended interventions....
Background: Modern cervical cancer screening increasingly relies on the use of molecular techniques detecting\nhigh-risk oncogenic human papillomavirus (hr-HPV). A major challenge for developing countries like Ghana has\nbeen the unavailability and costs of HPV DNA-based testing. This study compares the performance of careHPV,\na semi-rapid and affordable qualitative detection assay for 14 hr-HPV genotypes, with HPV genotyping, for the\ndetection of cytological cervical squamous intraepithelial lesions (SIL).\nMethods: A study comparing between frequency matched HIV-1 seropositive and HIV-seronegative women was\nconducted in the Cape Coast Teaching Hospital, Ghana. A systematic sampling method was used to select women\nattending clinics in the hospital. Cervical samples were tested for HPV by careHPV and Anyplex-II HPV28 genotyping\nassay, and by conventional cytology.\nResults: A total of 175 paired results (94 from HIV-1 seropositive and 81 from HIV-seronegative women) were\nanalyzed based on the ability of both tests to detect the 14 hr-HPV types included in the careHPV assay. The\ninter-assay concordance was 94.3% (95%CI: 89.7ââ?¬â??97.2%, kappa = 0.88), similar by HIV serostatus. The careHPV\nassay was equally sensitive among HIV-1 seropositive and seronegative women (97.3% vs. 95.7%, p = 0.50) and slightly\nmore specific among HIV-seronegative women (85.0% vs. 93.1%, p = 0.10). careHPV had good sensitivity (87.5%) but\nlow specificity (52.1%) for the detection of low SIL or greater lesions, but its performance was superior to genotyping\n(87.5 and 38.8%, respectively). Reproducibility of careHPV, tested on 97 samples by the same individual was 82.5%\n(95%CI: 73.4ââ?¬â??89.4%)....
Objective : To study whether there is a relation between the application of corticosteroids\nand occurrence of postmenopausal bleeding. Also we want to determine\nwhether corticosteroids can cause an irregularity in a previously regular\nmenstruation cycle. Design and Setting : Prospective cohort study in the\ndepartment of anesthesiology. Patients : 209 women who received a single dosage\nof corticosteroids as treatment for pain. Interventions : None, observational\ncohort study; all women received standard care. Main outcome measures\n: Postmenopausal blood loss or disruption of menstruation cycle. Result :\nPostmenopausal blood loss or disruption of menstruation cycle were both\nmore common 6 weeks after administration of corticosteroids, but were\nsometimes also reported 2 weeks after administration of corticosteroids. Conclusion\n: After administration of corticosteroids in a postmenopausal woman\nan episode of menstruation like bleeding can be expected. This is probably\ndue to a transient drop of androstenedione. In premenopausal women a transient\nchange in menstruation cycle can be observed....
Purpose: Serum calprotectin and prealbumin have been previously linked\nwith ovarian cancer. However, to date, their effectiveness in the diagnosis of\nthe disease remains uncertain. The purpose of the present study is to determine\nwhether serum prealbumin and calprotectin correlate with the stage and\ntype of histologic diagnosis. Materials-Methods: In the present study, we included\n80 women aged 30 - 45 years that had either primary ovarian cancer\n(Stages 1 and 2) with elevated levels of CA-125 (n = 40) or were healthy (n =\n40). Serum calprotectin and prealbumin levels were assessed using ELISA kits.\nStatistical analysis was performed with SPSS v.20.0 statistical software. Results:\nBoth plasma prealbumin and calprotectin levels were significantly different\nin patients with ovarian cancer compared to healthy controls. Specifically,\nserum prealbumin levels showed a level towards decreasing as the stage\nof the disease advanced (21.2 (15.5 - 30.6) in healthy controls, 12.8 (6.9 - 16)\nfor patients with stage 1 disease and 9.9 (4.0 - 15.5) for patients with stage 2\ndisease p < 0.001). Its sensitivity was 100% and specificity 82.5%. Serum calprotectin,\non the other hand, had an increasing motif (550 (100 - 2780) for\nhealthy controls, 3320 (2580 - 7930) for patients with stage 1 disease and 3825\n(2350 - 5990) for stage 2 disease p < 0.001). Similarly, its sensitivity was 100%\nand specificity 77.5%. Conclusions: Both prealbumin and calprotectin seem\nto be useful markers for the identification of patients suffering from ovarian\ncancer....
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