Endocrinology Research Articles

Medical Diseases in Pregnancy: An Acute on Chronic Focus

In the last decade or so obstetric care has evolved and become more complex. This can be attributed to a combination of factors including rising obesity rates, maternal age and medical treatment advances. Clinicians are caring for more pregnant women with chronic medical disease in addition to any de novo presentations which may occur, emphasising the need for the general medicine body to feel confident and skilled in the management of medical problems before, during and after pregnancy. One of the difficulties faced by clinicians in the assessment and management of pregnant women is the differentiation between symptoms of a normal pregnancy vs symptoms of clinical significance which warrant further investigation, particularly in mothers with background medical disease. Careful consideration and knowledge of normal pregnancy physiology is required when assessing a pregnant women/birthing person to avoid closed thinking and adverse outcomes. Unfortunately, clinician inertia around the care of pregnant women is a common feature in maternal mortality reviews. The most recent maternal mortality report discusses common themes around cardiovascular disease in pregnancy, alongside management of acute and acute-on-chronic presentations in the context of common endocrine, gastrointestinal and neurological disease in pregnancy. This article discusses some of these themes and the management of common medical problems in pregnancy.

Interrelationships between affective disorders in the form of depression and obesity and overweight - A systematic review

Both depression and obesity are significant health, social and economic problems. Depressive disorders were the second most common psychiatric disorder in 2017 after anxiety disorders. According to data published by the World Health Organization (WHO), depression affects about 280 million people worldwide, which is about 3.8 percent of the population. The etiology of depressive disorders is very complex and still not fully understood. The theories described so far complement each other. The factors underlying the development of depressive disorders can be divided into biological, psychological and other factors. Eating disorders in the form of overweight and obesity result from a loss of balance between anabolic and catabolic processes. This is most often led by insufficient physical activity and excess caloric intake. Hormonal disorders, genetic factors and environmental factors may also play an important role in the pathogenesis of obesity. The steadily increasing number of people suffering from depression and obesity prompts the search for links between these two seemingly unrelated disease entities. According to current knowledge, these diseases are bi-directionally linked by genetic, psychological, metabolic and social factors. Depression is associated with an increase in the risk of obesity by about 37% relative to those without depression. Obesity is associated with an increase in the risk of depressive disorders by about 18%. Understanding the links that exist between depressive disorders and obesity enables the search for new therapeutic options. The most important conclusion from the scientific research conducted so far is the advantage of simultaneous treatment of obesity and depression over treating these disease entities individually.

Aflatoxin Exposure-Caused Male Reproductive Toxicity: Molecular Mechanisms, Detoxification, and Future Directions

Widespread endocrine disorders and infertility caused by environmental and food pollutants have drawn considerable global attention. Aflatoxins (AFTs), a prominent class of mycotoxins, are recognized as one of the key contributors to environmental and food contamination. Aflatoxin B1 (AFB1) is the most potent and toxic pollutant among them and is known to cause multiple toxic effects, including neuro-, nephro-, hepato-, immune-, and genotoxicity. Recently, concerns have been raised regarding AFB1-induced infertility in both animals and humans. Exposure to AFB1 can disrupt the structure and functionality of reproductive organs, leading to gametogenesis impairment in males, subsequently reducing fertility. The potential molecular mechanisms have been demonstrated to involve oxidative stress, cell cycle arrest, apoptosis, inflammatory responses, and autophagy. Furthermore, several signaling pathways, including nuclear factor erythroid 2-related factor 2; NOD-, LRR-, and pyrin domain-containing protein 3; nuclear factor kappa-B; p53; p21; phosphoinositide 3-kinase/protein kinase B; the mammalian target of rapamycin; adenosine 5′-monophosphate-activated protein kinase; and mitochondrial apoptotic pathways, are implicated in these processes. Various interventions, including the use of small molecules, Chinese herbal extracts, probiotic supplementation, and camel milk, have shown efficacy in ameliorating AFB1-induced male reproductive toxicity, by targeting these signaling pathways. This review provides a comprehensive summary of the harmful impacts of AFB1 exposure on male reproductive organs in mammals, highlighting the potential molecular mechanisms and protective agents.

Use of potentially inappropriate psychotropic medicines among older adults in 23 residential aged care facilities in Australia: a retrospective cohort study.

Psychotropic medications are frequently utilised in residential aged care facilities (RACFs). Longitudinal medication administration data can offer crucial insights into the potential inappropriate use of psychotropic medicines (PIPMs), guiding future quality improvement initiatives. This study aimed to determine the prevalence and predictors of PIPMs use and assess variation in PIPMs use by facility for residents of RACFs. We conducted a retrospective longitudinal cohort study using routinely collected electronic health data (2020-2021) relating to 3064 residents from 23 RACFs in New South Wales, Australia. The study included permanent residents aged ≥ 65 years and median length of stay was 483 days. The prevalence of PIPMs use was estimated using updated Beers criteria 2023. The extent of exposure to PIPMs was measured using two metrics i.e., number of days residents were exposed to PIPMs and the proportion of days covered by PIPMs. We used logistic regression model to determine factors associated with PIPM use. Funnel plots to visualised variation in PIPMs use across facilities. In total 40% (n = 1224) residents used at least one PIPM and 10% (n = 302) used ≥ 2. The most frequently used PIPMs categories were benzodiazepines and Z-drugs (27.4%), followed by first and second generation antipsychotics (17.2%). Certain diagnoses (dementia, pain, depression, anxiety, and endocrine disorders) were associated with the increased use of PIPMs. For example, residents with dementia were 1.94 times more likely to use ≥ 2 PIPMs (OR 1.94; 95% CI 1.50-2.51). The prevalence of at least one PIPM by residents in each facility ranged from 23.3 to 57.0% across facilities. The overall median number of days residents were exposed to PIPMs were 91 days (IQR 6-320) while the median proportion of days covered by at least one PIPM was 39.3% (IQR 2.6-86.6%). Residents in aged care facilities showed a high rate of PIPMs use with substantial variation across facilities. Quality improvement initiatives which target inappropriate psychotropic medication use are necessary, particularly considering the link between psychotropic drug use and adverse events such as falls.

Deciphering the Role of Androgen in the Dermatologic Manifestations of Polycystic Ovary Syndrome Patients: A State-of-the-Art Review

Polycystic ovary syndrome is a presvalent endocrine disorder affecting women globally, characterized by hormonal imbalance, metabolic disturbances, and reproductive dysfunction. Diagnosis relies on clinical evaluation, medical history assessment, physical examination, and laboratory tests, with the Rotterdam criteria being widely used. The pathophysiology of PCOS involves genetic predisposition, environmental factors, and lifestyle influences, with hormonal dysregulation, particularly elevated androgens, insulin resistance, and chronic inflammation, playing a pivotal role. These mechanisms not only contribute to reproductive and metabolic disturbances but also to the various cutaneous manifestations, such as acne, hirsutism, and alopecia. This review aims to analyze the role of androgens in the dermatological manifestations in patients with polycystic ovary syndrome, providing insights into underlying mechanisms and guiding the development of effective therapeutic strategies. By synthesizing available evidence, this review aims to deepen understanding of related dermatological manifestations and improve outcomes for affected individuals.

ENDOMETRIOSE E SEUS IMPACTOS NA FERTILIDADE FEMININA: UMA REVISÃO DE LITERATURA

Endometriosis, characterized by the growth of endometrial cells outside the uterine cavity, has a significant impact on women’s lives, especially during reproductive age. The progression of the disease is unpredictable, and despite having individual repercussions in each woman, it is a pathology known for directly affecting female fertility. Among the most relevant factors are pelvic adhesions, tubal obstruction, inflammatory factors, immunological alterations, genetic changes, as well as hormonal dysfunctions, which can impact ovarian function and embryo implantation. The article aimed to analyze the pathology of endometriosis and the pathophysiological aspects involved in the reduction of female fertility in women with endometriosis. It was widely discussed how infertility can occur in women with different stages of endometriosis, as well as addressing other forms of diagnosis and treatment of infertility in women. The article also points to genetic studies showing that epigenetic alterations impact endometrial function, being one of the theories cited for the development of infertility as a consequence of endometriosis. The analysis of data used for the study and preparation of this article showed that endometriosis can impact female fertility, highlighting the importance of expanding studies in this area to carry out an individualized approach for each patient and achieve positive results with the proposed treatment.

Mediatization of medicine and health: dysfunctional aspects

In this article, based on the results of empirical research conducted by employees of the Faculty of Sociology, Doctor of Sociological Sciences, Associate Professor T.V. Semina and graduate student A.A. Belov, the destructive influence of electronic and digital media on the health of Russian citizens is considered. In fact, we are talking about the “mediatization of medicine”, which is understood as “the process caused by the emergence of digital communication tools, as a result of which the masses have free access to medical information, and all issues related to human and social health are somehow mediated by electronic media”. The author emphasizes that quite often the media practices uncontrolled submission of quasi-medical information, signs of economic bias present in the media are expressed in the fact that the main source of income for the media is advertising, especially medicines and pharmaceuticals. At the same time, commercials advertising medicines on television are the most effective in influencing the audience. In 2019, T.V. Semina, Doctor of Sociology, Associate Professor of the Faculty of Sociology at Lomonosov Moscow State University, proved the destructive role of the media in the genesis of social conflict in the doctor–patient system. In April–July 2024, the author also undertook an empirical sociological study on the problems of constructing public health in the Russian Federation, in particular, the effectiveness of the impact of advertising materials placed in the media on the health-saving attitudes of Russians, he results of which are presented in the article. In general, the results of empirical studies conducted by T.V. Semina and confirmed by the author’s research convincingly prove the dysfunctionality of the media in relation to the health of Russian citizens, their negative impact on the consciousness of both healthy and sick people. The author emphasizes that it is not so difficult to protect health, but, unfortunately, many people do not even try to do this, guided by certain stereotypes imposed by the media. For example, that after a certain age, absolutely everyone has high blood pressure, overweight, hormonal and other disorders and should regularly take appropriate (widely advertised) medications or dietary supplements, the benefits of which have not been scientifically proven. Most importantly, the author notes, changes are needed in the development of self-preservation behavior among the population. The main task of the state is not only to develop an effective health care system, but also to promote a responsible attitude of citizens to their own health, which implies regular medical examinations, giving up bad habits, leading a healthy lifestyle involving “life on the move”, full sleep and cognitive activity.

Phytochemical Interventions for Polycystic Ovary Syndrome : (PCOS) Systematic Review

Worldwide, 2.2-26% Many women who are fertile experience PCOS, a complicated the Endocrine, metabolic, and genetic condition. Pale menstruation, infertility, hirsutism, acne, and insulin resistance are some of the symptoms of PCOS, which is typified by polycystic ovaries, persistent anovulation, and hyperandrogenism. While they come with risks and adverse effects, conventional treatments frequently target specific ailments. Herbal remedies, on the other hand, present a viable, low-risk substitute. The effectiveness of several botanicals, such as Ashoka, Shatavari, Lodhra, Guduchi and Haritki in reducing PCOS symptoms is highlighted in this review. These herbs improve ovarian morphology and lower hyperandrogenism; they also have hypoglycemic, anti-obesity, and hormone-regulating qualities. Other herbs that are useful for hormone imbalance, reproductive dysfunction, depression, menstruation include The plants Phyllanthus emblica and Bauhinia variegata. Bellirica terminalia. Hypericum perforatum with Tribulus terrestris. anomalies. Notably, there have been no documented adverse effects and these phytotherapeutic approaches are well tolerated. The goal of this review is to compile the body of research regarding the use of natural plants to treat PCOS, with a focus on the possibility of herbal formulations as a safe, effective, supplemental management strategy for condition.

The dietary phytochemical index and its relation to polycystic ovary syndrome: a case-control study.

Polycystic ovary syndrome (PCOS), a hormonal disorder affecting women of reproductive age, can be significantly impacted by diet. This study explores the relationship between a diet rich in phytochemicals, measured by the Dietary Phytochemical Index (DPI), and PCOS, along with associated health markers. A case-control study design was implemented with 480 individuals diagnosed with PCOS based on the Rotterdam criteria, paired with 480 controls matched in terms of age and BMI. The evaluation encompassed dietary intake, anthropometric measurements, and hormonal/metabolic markers. Additionally, the DPI score was determined based on the consumption of phytochemical-rich foods. The study also examined PCOS-related complications like acne and irregular menstrual cycles, as well as mental health using the Beck Depression Inventory (BDI-II) scores. Women with PCOS had significantly lower DPI scores (32.42 vs 43.87, p < 0.001) compared to the control group, indicating a less phytochemical-rich diet. The DPI scores coincided with higher levels of hormones typically associated with PCOS, including Luteinizing Hormone (LH), Dehydroepiandrosterone Sulfate (DHEA-S), and testosterone. Additionally, these scores were associated with markers of metabolic dysfunction such as C-reactive Protein (CRP), Fasting Blood Sugar (FBS), and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), while positively correlating with Sex Hormone-Binding Globulin (SHBG) (all p < 0.050).). Higher DPI scores were associated with a significantly reduced risk of PCOS (OR: 0.13, 95% CI: 0.08, 0.23, P for trend: 0.001) and its complications, including acne and irregular menstrual cycles. Interestingly, a positive association emerged, suggesting better mental health (lower BDI-II scores) with higher DPI scores. In conclusion, this study indicates that lower DPI scores are associated with a higher incidence and severity of PCOS, suggesting that a phytochemical-rich diet could potentially benefit the management of PCOS by enhancing hormonal profiles, metabolic health, and mental well-being in women.

Oxidative Stress in Canine Diseases: A Comprehensive Review

Oxidative stress (OS), defined as a disruption in redox balance favoring oxidants, has emerged as a major contributor to numerous diseases in human and veterinary medicine. While several reviews have explored the implication of OS in human pathology, an exhaustive review of the canine species is lacking. This comprehensive review aims to summarize the existing literature on the role of OS in canine diseases, highlighting its potentially detrimental effect on various organs and systems. Some inconsistencies among studies exist, likely due to varying biomarkers and sample types. However, there is substantial evidence supporting the involvement of OS in the development or progression of numerous canine disorders, such as cardiovascular, oncologic, endocrine, gastrointestinal, hematologic, renal, neurologic, infectious, and parasitic diseases, among others. Additionally, this review discusses the efficacy of antioxidant and pro-oxidant therapeutic agents for these conditions. Dietary interventions to counteract OS in dogs have gained significant attention in recent years, although further research on the topic is needed. This review aims to serve as a foundational resource for future investigations in this promising field.

CORRELATION OF LEPTIN AND ADIPONECTIN LEVELS WITH METABOLIC AND HORMONAL PROFILES IN PCOS PATIENTS: A COMPARATIVE STUDY WITH NORMAL CONTROLS

Objective: Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder characterized by metabolic and reproductive abnormalities, including insulin resistance and hyperandrogenism. Leptin and adiponectin, two adipokines involved in metabolic regulation, are known to be dysregulated in PCOS. This study aims to investigate the correlation between leptin and adiponectin levels and their association with metabolic and hormonal profiles in PCOS patients compared to healthy controls. Methods: A prospective, observational study was conducted involving 120 women diagnosed with PCOS and 50 healthy controls. Leptin and adiponectin levels were measured using enzyme-linked immunosorbent assay (ELISA). The adiponectin-to-leptin ratio (ALR) was calculated, and correlations with BMI, LH/FSH ratio, and other metabolic parameters were analyzed. Data were analyzed using appropriate statistical methods. Results: Leptin levels were significantly higher in the PCOS group compared to controls (25.34 ng/ml vs. 11.16 ng/ml, p&lt;0.0001), while adiponectin levels were significantly lower (2.93 mcg/ml vs. 21.44 mcg/ml, p&lt;0.0001). The adiponectin-to-leptin ratio was markedly reduced in PCOS patients (0.13 vs. 2.05, p&lt;0.0001). A significant correlation was observed between the adiponectin/leptin ratio and the LH/FSH ratio (r = 0.2138, p = 0.019). Conclusion: This study highlights the dysregulation of leptin and adiponectin in PCOS, suggesting their potential role in metabolic and reproductive dysfunction. The adiponectin-to-leptin ratio emerges as a promising biomarker for insulin resistance and metabolic risk in PCOS patients.

Novel perspectives on the link between obesity and cancer risk: from mechanisms to clinical implications.

Existing epidemiologic and clinical studies have demonstrated that obesity is associated with the risk of a variety of cancers. In recent years, an increasing number of experimental and clinical studies have unraveled the complex relationship between obesity and cancer risk and the underlying mechanisms. Obesity-induced abnormalities in immunity and biochemical metabolism, including chronic inflammation, hormonal disorders, dysregulation of adipokines, and microbial dysbiosis, may be important contributors to cancer development and progression. These contributors play different roles in cancer development and progression at different sites. Lifestyle changes, weight loss medications, and bariatric surgery are key approaches for weight-centered, obesity-related cancer prevention. Treatment of obesity-related inflammation and hormonal or metabolic dysregulation with medications has also shown promise in preventing obesity-related cancers. In this review, we summarize the mechanisms through which obesity affects the risk of cancer at different sites and explore intervention strategies for the prevention of obesity-associated cancers, concluding with unresolved questions and future directions regarding the link between obesity and cancer. The aim is to provide valuable theoretical foundations and insights for the in-depth exploration of the complex relationship between obesity and cancer risk and its clinical applications.

Hemorrhagic Transformation Incidence in Ischemic Stroke with Hyperthyroidism Rick Factor Accompanied by Atrial Fibrillation

Hemorrhagic transformation (HT) is one of the most common life-threatening complications of ischemic stroke. It occurs when peripheral blood extravasates through the damaged blood-brain barrier (BBB) ​​into the brain parenchyma after ischemic stroke. Hyperthyroidism, the most common endocrine disorder, occurs in 0.5−2% of the general population. Hyperthyroidism is known to trigger several cardiovascular system effects, one of which is the occurrence of atrial fibrillation (AF). There is a study that says that the incidence of HT in ischemic stroke patients with AF increases by 22.6%. A 48-year-old man with complaints of weakness of the left arm and leg, dysarthria and dysphagia with onset 2 hours before coming to the emergency department. Radiological examination showed bleeding with surrounding infarction and hyperthyroidism with AF was found. Hyperthyroidism is associated with AF which will increase the incidence of extensive ischemic stroke and the risk of experiencing HT due to damage to the BBB. Keywords: Hemorrhagic transformation (HT); ischemic stroke; hyperthyroidism; atrial fibrillation (AF); risk factors

The Association Between Elevated Thyroid-Stimulating Hormone Levels and Prolonged Length of Stay Among Adult Diabetic Patients Hospitalized in Internal Medicine Departments: A Large Historical Cohort Study

Background/Objectives: Type 2 diabetes mellitus (DM2) and hypothyroidism are two of the most common endocrine disorders in clinical practice. Hospital length of stay (LOS) is a quality metric of the health systems. We evaluated the association between elevated thyroid-stimulating hormone (TSH) levels and prolonged LOS among all adult patients (age ≥ 18 years) with DM admitted to our Internal Medicine departments between 2014 and 2022. Methods: Data on patient characteristics, LOS, and in-hospital mortality were collected. A TSH level &gt; 4.7 μIU/mL was considered as being elevated. A LOS &gt; 75th percentile and in-hospital mortality were defined as being prolonged. Univariate and multivariable analyses were applied, and propensity score matching controlled for differences between patients with normal and those with elevated TSH levels. Results: Of the 19,066 study participants (median age 75.6 years, IQR 75.9–83.3), 1524 (7.9%) had elevated TSH levels, and prolonged LOS was significantly more common among them (before matching: 38.6% vs. 29.1%, p &lt; 0.001; after matching: 38.7% vs. 32.6%, p = 0.001). After adjustment for potential confounders, elevated TSH levels were also associated with prolonged LOS (OR = 1.22, 95% CI 1.07–1.39, p = 0.002). Conclusions: Elevated TSH levels in diabetic patients hospitalized in Internal Medicine departments are associated with prolonged LOS, emphasizing the importance of identifying hypothyroidism among them.

Can Mammalian Reproductive Health Withstand Massive Exposure to Polystyrene Micro- and Nanoplastic Derivatives? A Systematic Review

The widespread use of plastics has increased environmental pollution by micro- and nanoplastics (MNPs), especially polystyrene micro- and nanoplastics (PS-MNPs). These particles are persistent, bioaccumulative, and linked to endocrine-disrupting toxicity, posing risks to reproductive health. This review examines the effects of PS-MNPs on mammalian reproductive systems, focusing on oxidative stress, inflammation, and hormonal imbalances. A comprehensive search in the Web of Science Core Collection, following PRISMA 2020 guidelines, identified studies on the impact of PS-MNPs on mammalian fertility, including oogenesis, spermatogenesis, and folliculogenesis. An analysis of 194 publications revealed significant reproductive harm, such as reduced ovarian size, depleted follicular reserves, increased apoptosis in somatic cells, and disrupted estrous cycles in females, along with impaired sperm quality and hormonal imbalances in males. These effects were linked to endocrine disruption, oxidative stress, and inflammation, leading to cellular and molecular damage. Further research is urgently needed to understand PS-MNPs toxicity mechanisms, develop interventions, and assess long-term reproductive health impacts across generations, highlighting the need to address these challenges given the growing environmental exposure.

A comprehensive target panel allows to extend the genetic spectrum of neuroendocrine tumors.

Neuroendocrine tumors (NETs) frequently have a genetic basis, and the range of genes implicated in NETs development continues to expand. Application of targeted gene panels (TGP) in next-generation sequencing (NGS) is a central strategy for elucidating novel variants associated with NETs development. In this study, we conducted comprehensive molecular-genetic analyses using TGP on a cohort of 93 patients diagnosed with various NETs subtypes, mainly accompanied by various endocrine syndromes: insulinoma (n=26), pheochromocytoma and paraganglioma (PPGL) (n=38), parathyroid adenoma (n=18, including three with insulinoma), and NETs of other locations (n=14). The TGP encompassed genes linked to diverse NETs and other hereditary endocrine disorders, with subsequent variant classification according to the American College of Medical Genetics and Genomics guidelines. Among the identified variants, 20 were found in genes previously linked to specific tumor types, and 10 were found in genes with a limited likelihood and unclear molecular mechanisms of association with observed NETs. Remarkably, 13 variants were discovered in genes not previously associated with the NETs observed in our patients. These genes, such as ABCC8, KCNJ11, KLF11, HABP2, and APC, were implicated in insulinoma; ZNRF3, GNAS, and KCNJ5 were linked with PPGL; parathyroid adenomas were related to variants in SDHB and TP53; while NETs of other locations displayed variants in APC and ABCC8. Our study demonstrates that utilizing broad TGP in examining patients with various functioning NETs, facilitates the identification of new germinal variants in genes that may contribute to the diseases. The verification of revealed findings requires research in vaster sample.

Select Endocrine Disorders and Exosomes in Early PDAC Diagnosis

Disturbances in carbohydrate metabolism are suggested to be the early symptoms of pancreatic ductal adenocarcinoma (PDAC). The accumulated data suggests that endocrine function-related biomarkers may represent a breakthrough in the early detection of PDAC. Factors which may predispose one to the development of PDAC are insulin resistance and hyperinsulinemia. Elevated insulin levels induce the onset of carcinogenesis by altering the differentiation and function of islet cells through stimulating growth factors, including insulin-like growth factors (IGFs). Impaired β cell function, along with the impact of PDAC-released factors (e.g., adrenomedullin (ADM), IGF-1, and macrophage inhibitory factor (MIF) on pancreatic islets, may contribute to the induction of diabetes associated with PDAC. Recently, exosomes have attracted worldwide attention due to their role in varied features of cell function, particularly in cancer progression. Exosomes comprise of small extracellular vesicles produced by almost all cells. These vesicles contain a vast array of biomolecules, including proteins and microRNAs. Exosomes participate in cancer growth and promote angiogenesis. They promote tumorigenesis and metastasis, and are associated with the acquisition of cancer cells resistant to chemotherapy. Data have been accumulating recently on the role of exosomes in the rapid recognition, prognosis and potential therapy of pancreatic cancer.

BS O02 - Impact of Bariatric surgery on Obesity Indices and Reproductive Hormones: A Prospective Study in Morbidly Obese Women

Abstract Background Obesity, defined by a BMI of 30 kg/m² or higher, is influenced by genetics, socio-economic, and cultural factors. Genetic predispositions affect metabolism and energy regulation, while environmental factors like sedentary lifestyles and poor food environments worsen obesity. Obesity disrupts hormonal balances, impacting sex hormone levels and menstrual cycles, leading to infertility in women. This hormonal imbalance affects oocyte quality and ovulation. Bariatric surgery offers significant weight loss and metabolic improvements, enhancing reproductive hormone profiles and insulin sensitivity. Our study explores how sleeve gastrectomy affects BMI and hormone levels, aiming to understand its impact on obesity management and reproductive health. Method This prospective observational study examines the effects of laparoscopic sleeve gastrectomy on reproductive hormones and ovarian function in 32 morbidly obese women, adhering to Helsinki Declaration ethics. Participants, aged 18-50 with no menopause or chronic illness, consented to the study. Exclusions included those with polycystic ovary syndrome, recent reproductive organ surgery, or recent infertility medications. The study assessed changes in BMI, antral follicles, anti-Müllerian hormone, and reproductive hormones before surgery and at 6 and 12 months post-surgery. Blood samples and transvaginal ultrasounds were conducted preoperatively and at 6 and 12 months postoperatively to monitor outcomes. Results The study involved participants with an average age of 33 and a mean BMI of 42.12. Significant changes were observed post-sleeve gastrectomy at 6 and 12 months (p &amp;lt; 0.001). At 6 months, BMI decreased by 9.24 units, AMH levels dropped from 3 to 2.5 ng/mL, and antral follicle counts in both ovaries declined. By 12 months, BMI decreased by 16.47 units, AMH levels fell to 2 ng/mL, and antral follicle counts further reduced. Hormonal changes included increases in FSH, LH, and estradiol, while SHBG levels rose, and free testosterone levels decreased significantly. Conclusion Individual hormone responses to weight loss and surgery necessitate personalized obesity treatments. Tailoring surgical approaches and care to hormonal profiles can optimize outcomes and reduce complications. Monitoring AMH levels post-surgery can offer insights into reproductive effects, aiding clinical management and counseling for women with obesity-related infertility. We highlight the significant impact of sleeve gastrectomy on physiological parameters in obese individuals, especially regarding reproductive health and metabolic regulation. The findings enhance understanding of the changes associated with bariatric surgery and its potential benefits for metabolic and reproductive health.

Clinical Effectiveness of Viddha Karma in PCOS: A Case Report

ABSTRACT Polycystic ovary syndrome (PCOS) is a common hormonal disorder affecting women of reproductive age. Ayurveda, an ancient Indian medical system, offers a comprehensive approach to addressing PCOS, including treatments like Viddha Karma. In the case of PCOS, Viddha Karma aims to relieve symptoms and enhance overall well-being. A 27 -year-old unmarried female patient came with complaints of irregular and scanty menses for the past 3-4 years, along with severe abdominal pain during the first 1-3 days of menstruation. She was treated with Shaman Chikitsa and Viddha Karma for 8 months. The patient’s menstrual cycle become regular, the volume of bleeding increased to a normal level, and she experienced a weight reduction of 5 kg. The examination of Viddha Karma principles in the management of PCOS emphasizes its potential as a supplementary treatment that tackles the underlying causes and promotes overall well-being. However, further research and clinical trials are necessary to gain a comprehensive understanding of its effectiveness.

Optimizing Surgical Outcomes: A Case Series on BREAST-V for Treating Breast Asymmetries.

Breast asymmetry occurs when there is a discrepancy in the shape, volume, or positioning of the breasts. Various factors, including unequal development of breast buds, endocrine disorders, chest wall deformities, and surgical or posttraumatic sequelae, can contribute to this condition. Although breast asymmetry is common, clinically severe cases are rare and often require surgical correction because of potential postural, aesthetic, and psychological issues. Accurate assessment of the breast volume is crucial for planning and evaluating surgical interventions. This prospective, non-randomized, interventional study was conducted between 2019 and 2024 at the Breast Reconstruction Section of the Federal University of São Paulo, Brazil. Forty patients with breast asymmetry were evaluated using the BREAST-V, which calculates the breast volume based on three linear measurements. Patients underwent various surgical procedures, including augmentation, reduction mammoplasty, and mastopexy, tailored to their specific type of asymmetry. Preoperative and postoperative breast volumes were compared to assess the effectiveness of surgical correction RESULTS: The study included 40 participants, with an average age of 25.2 years. The mean preoperative breast volumes were 469.6g (right) and 448.8g (left). The postoperative volumes decreased to 338.3g (right) and 331.1g (left), showing an average reduction in asymmetry of 72.9%. The minimal clinically important difference (MCID) for pre-treatment asymmetry was 65.4g. The BREAST-V tool has significant potential for the objective assessment of breast asymmetry. Reliable volumetric measurements can aid in surgical planning and postoperative evaluation, ultimately enhancing the clinical outcomes. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .