Menstrual Irregularities Research Articles

Peculiarities of the menstrual cycle in girls living in the Murmansk region

The aim of the study. To assess the characteristics of the menstrual cycle and ovulation disorders in girls aged 15–17 years.Materials and methods. The study was carried out in 2022–2023 in the Murmansk region in Apatity. A total of 225 girls with average age of 16.5 ± 0.03 years took part in the study. The characteristics of the menstrual cycle and ovulation disorders were studied according to the guidelines of the International Federation of Gynecology and Obstetrics.Results of the study. In the study group, the onset of menarche (13.1 years) is observed at a later age compared to the girls living in other regions of Russia and neighboring countries (12.6–12.9 years). Every seventh girl has an irregular menstrual cycle, every fifth girl has a cycle duration of more than 38 days. Heavy menstruation occurs in every third girl, intermenstrual uterine bleeding – in every thirteenth girl. Half of the girls have painful periods (dysmenorrhea). Among ovulation disorders, the most common is abnormal uterine bleeding – 34.7 %. Also, intermenstrual uterine bleeding (8.0 %), primary amenorrhea (2.7 %) and polycystic ovary syndrome (1.3 %) are registered. Among gynecological pathology, in addition to ovulation disorders, we registered vulvovaginal candidiasis and paraurethral cyst.Conclusion. The analysis of the obtained results showed that only 20.4 % of girls do not have gynecological pathology, which to a certain extent indicates a low level of reproductive health of girls. Asaresult, it is necessary to diagnose and treat diseases which can cause the development of ovulation disorders more carefully and at earlier stages of sexual development. The work was carried out as part of the research topic No. FMEZ-2022-0012.

The Association Between Lifestyle and Symptoms of Polycystic Ovary Syndrome: A Study Conducted on Taif University Medical Students.

Introduction Polycystic ovary syndrome (PCOS) is a common endocrinological disorder affecting millions of women worldwide, often leading to significant physiological and psychological challenges among medical students because of unhealthy lifestyle behaviors. Methods A cross-sectional study was conducted among female medical students at Taif University in Saudi Arabia in January 2024 using an online questionnaire distributed via a Google form. Results Out of 243 participants, 23 students (9.5%) were diagnosed with PCOS. One hundred and fifty-six (64.9%) of females experienced skin symptoms, including acne and oily skin, mostly during exam periods. More than half (n=131, 54.4%) had generalized anxiety, and 42 students (17.4%) reported delays in the menstrual cycle. Significant associations were found between being diagnosed with PCOS and experiencing generalized anxiety(p=0.020), irregular menstrual cycles (p=0.004), having diabetes (p=0.006), family history of PCOS (p=0.001), and being aware of PCOS and lifestyle relation (p=0.022). Conclusion The study findings showed that Taif University medical students do not exhibit a noticeably increased prevalence of PCOS. Still, most students are at risk of developing PCOS due to thepositive family history of PCOS andexcessive generalized anxiety and females with irregularity in the menstrual cycle and those who have diabetes.

ROLE OF VIRUDDHAHARA IN CAUSING INFERTILITY- A CONCEPTUAL STUDY

In the present era, many lifestyle disorders are caused by unhealthy food habits and practices; infertility is one of them. The incidence has increased due to diversified daily routines, faulty food habits, and westernization, which affect the endocrine system and physiological factors. These issues can cause irregular menstruation, ovulation disorders, PCOS, fallopian tube blockage, endometriosis, hormonal disorders, and uterine abnormalities, ultimately leading to infertility. The Ayurvedic explanation of ‘Viruddhahara’ is a unique concept. Acharya Charaka mentioned Shandhya and Santanadosha while listing the diseases caused by Viruddhahara1 . Viruddhahara impairs Rasadhatu, which leads to the Dushti of its upadhatu, Artava(Menstrual blood). Long-term practice of Viruddhahara (unhealthy food habits) causes Artavadushti and also affects the ovum, menstrual blood, and ovarian hormones. Viruddhahara significantly affects the Garbhasambhava samagri. The practice of Satmya Ahara and Vihara can help avoid multiple causative factors of infertility, such as Beeja dosha, Artava or Shukradushti, and yonivyapat. Infertility is also caused by obesity and other diseases resulting from faulty food habits.

Sex-Specific Cardiovascular Risk Factors and Treatment in Females With T2DM and CVD: Developments and Knowledge Gaps

Abstract Purpose There are large disparities in the impact of diabetes on cardiovascular disease (CVD) risk and outcomes by sex and gender. Achieving health equity requires understanding risks and medication efficacy in female patients, especially now, as novel pharmacologic treatments are transforming the diabetes and CVD treatment landscape. This review examines 2 bodies of research that can inform sex differences in CVD in patients with diabetes: female-specific risk factors for CVD and sex-related limitations of clinical trial research in evaluating novel diabetes and CVD treatments. Methods Two literature searches were performed using Ovid Medline(R) All. The first retrieved manuscripts covering sex and gender differences related to CVD risk and therapies and diabetes. The second focused on randomized controlled trial data on sex/gender differences and GLP-1/SGLT-2/DPP-4 drugs. Results Female-specific risk factors for CVD include early menarche, premature or early menopause, irregular cycles and polycystic ovary syndrome; pregnancy; adverse pregnancy outcomes; history of breast cancer; and autoimmune diseases. Clinical trials of novel pharmacological treatments for diabetes and CVD have undersampled female populations, and clinical characteristics of male and female participants have differed significantly. Thus, evidence to evaluate potential sex differences in treatment efficacy and side effects has been lacking. Conclusion To improve health of female patients with diabetes, sex-specific cardiovascular risk factors should be taken into account in screening and treatment decisions. Further, studies of cardiovascular and diabetes medications must ensure adequate representation by sex and report participant characteristics and outcomes by sex.

Comparison of the clinical efficacy of dienogest and drospirone/ethinyl estradiol in the treatment of ovarian endometriosis cysts

Background: Ovarian endometriosis cysts (OEC) are common chronic diseases occurring in women of reproductive age. Hormone therapy, including the use of oral contraceptives (COCs) and progestins, is widely employed in the treatment of endometriosis and OEC. Objective: This study aims to compare therapeutic effects of long-term daily use of dienogest (DNG, 2 mg) versus drospirenone (DRSP, 3 mg)/ethinyl estradiol (EE, 20 μg) daily on ovarian endometrial cysts, particularly focusing on cysts suppression. Methods: A retrospective analysis was conducted on 84 patients diagnosed with OEC, with 42 receiving DNG and 42 treated with DRSP/EE. After 6 months, assessments were made regarding pain symptoms, size of OEC, tumor markers, and adverse reactions. Results: After 6 months of treatment, both DNG and DRSP/EE effectively alleviated pain in patients with ovarian endometriotic cysts. DNG demonstrated more significant improvements than DRSP/EE in reducing tumor size, mainly in terms of higher drug efficacy and greater percentage of tumor shrinkage. However, DRSP/EE significantly reduced the expression of the tumor markers CA125 and CA199 in our study. Patients taking DNG had a higher likelihood of experiencing side effects than those on DRSP/EE, mainly vaginal bleeding and irregular menstrual periods. Conclusions: Both DNG and DRSP/EE are effective in treating ovarian endometrial cysts. DNG appears to be superior in terms of tumor reduction, while DRSP/EE more significantly decreases the expression of the tumor markers and has fewer side effects.

Influence of chronotype on sleep quality and menstrual regularity in nurses on monthly shift rotations.

This study aimed to investigate factors that influence the sleep quality and menstrual cycles of female rotating-shift nurses. A cross-sectional study was conducted in which 213 female rotating-shift nurses between the ages of 20 and 45 were recruited from a medical center in Taiwan from November 1, 2023, to December 31, 2023. Binary logistic regression analysis was performed with regard to sleep quality or menstrual cycle. Female rotating-shift nurses who perceived a higher level of stress (P < .001), were late chronotypes (P = .020), or were working the night shift (P = .006) were more likely to have poor sleep quality. Late-type nurses working the day shift were more likely to have poor sleep quality than were early- and intermediate-type nurses (P < .001). With regard to menstrual cycles, female rotating-shift nurses who perceived a higher level of stress (P = .008), were working the night shift (P < .001), or had poor sleep quality (P = .001) were more likely to have irregular menstrual cycles. Late-type nurses working the day shift were more likely to have irregular menstrual cycles than were early- and intermediate-type nurses (P = .013). A higher likelihood of poor sleep quality was found in female rotating-shift nurses when they perceived high levels of stress, and the interactions between chronotype and shift type could influence sleep quality. Shift type and the interactions between chronotype and shift type could also influence menstrual regularity.

The Effectiveness of Bariatric Surgery on Treating Infertility in Women-A Systematic Review and Meta-Analysis.

Background/Objectives: Obesity is a growing global health concern, which increases the risk of various diseases and has seen a rising prevalence over time. The global prevalence of obesity among adults has doubled over time. Obesity significantly impacts health by increasing the risk of a range of severe medical conditions. Cardiovascular diseases, such as heart attacks and strokes, are more prevalent in individuals with obesity due to factors like high blood pressure and abnormal cholesterol levels. This systematic review and meta-analysis sought to establish the effectiveness of bariatric surgery in treating infertility in women. Methods: This systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. A broad electronic search was conducted through PubMed, Web Science, and Medline databases for studies published between April 2017 and October 2023. The search strategy used the following terms: bariatric surgery, metabolic surgery, bariatric surgical procedures, stomach stapling, infertility, and fertility issues. The data were analyzed using the Revman version 5.1.2 software. Results: The results of the study show that despite the heterogeneity found in the studies, irregular menstrual cycles were found to reduce significantly in patients who underwent bariatric surgery (p = 0.01), with an RR of 0.22, at a 95% CI (0.06, 0.74). With regards to infertility, the results indicate that bariatric surgery reduced the level of infertility among the patients significantly (p = 0.00001), with an RR of 0.55, at a 95% CI (0.45, 0.68). Further, the results show bariatric surgery reduced rate of miscarriages among patients (p = 0.01), with an RR of 0.51, at a 95% CI (0.30, 0.86). Moreover, bariatric surgery reduced the level of congenital malfunction, but the effect was not statistically significant (p = 0.16), with an RR of 0.39, at a 95% CI (0.10, 1.45). However, the overall effect of bariatric surgery on treating infertility was found to be significantly effective (p = 0.0001), with an RR of 0.54, at a 95% CI (0.43, 0.68). This implies that bariatric surgery helps in weight loss, which improves ovulatory dysfunction and irregular menstruation while boosting spontaneous conception. Conclusions: This study found that bariatric surgery helps infertile women of a reproductive age to lose weight, which improves ovulatory dysfunction and irregular menstruation while boosting spontaneous conception. On the other hand, the study noted that after bariatric surgery, spontaneous conception can occur because of a decreased rate of miscarriage, increased fertility, reduced levels of congenital malfunction, and the restoration of regular menstrual cycles. Therefore, this study highlights the need to offer adequate preconception care and counselling to women who are about to be pregnant, both before and after bariatric surgery. Further, based on the fact that this study focused on general bariatric surgery, future research should focus on specific types of bariatric surgery to establish the most effective type of bariatric surgery in treating infertility in women.

Safety and effectiveness of controlled ovarian stimulation and oocyte retrieval during prepubertal and peripubertal period.

Is itsafe and effective to perform controlled ovarian stimulation (COS) and oocyte retrieval (OR) in prepubertal and peripubertal patients? In this retrospective cohort study, data of 20 pre-/peripubertal patients who underwent COS and OR for the purpose of oocyte cryopreservation (OC) between 2008 and 2023 were reviewed.Following COS, all OR procedures were performed transabdominally using a vaginal ultrasound probe. Ovarian reserve was assessed by serum FSH, LH, estradiol, AMH, and antral follicle counts (AFC) in all subjects. All mature oocytes were vitrified. Mean age of the patients was 15.05 ± 1.87, mean AMH was 0.84 ± 0.8ng/ml, mean FSH was 6.39 ± 3.95IU/L, mean estradiol was 61.6 ± 51.9pg/ml, mean LH was 4.69 ± 3.46IU/L, and mean AFC was 5.5 ± 5.82. Among the patients, 12 had regular menstrual cycle, 5 had irregular menstrual cycle, whereas 3 patients still did not have their menarche yet. The indications for OC were as follows: primary ovarian insufficiency (n = 7), ovarian surgery for ovarian tumors (n = 5) or ovarian torsion (n = 1), mosaic Turner syndrome (n = 2), acute lymphoblastic leukemia (n = 1) anaplastic B-cell lymphoma (n = 1), Ewing's sarcoma (n = 1), Noonan syndrome (n = 1), and Thalassemia (n = 1). The mean number of oocytes retrieved, MII oocytes frozen, and maturation rate were 5.11 ± 5.0, 3.92 ± 4.48, and 75.1 ± 25.6%, respectively.Stepwise linear regression analysis demonstrated a positive correlation between AFC and number of total oocytes retrieved and number of MII oocytes. In the case diagnosed with Noonan syndrome, all 7 retrieved oocytes were MI and all frozen at MI phase. No patient had any complication related to COS or OR. Even though number of the enrolled subjects is limited and mean AMH is lower in our cohort, we demonstrated that performing COS and OR is safe in pre-/peripubertal patients. If required, transabdominal route can be performed in this age group for OR. AFC appears as a prognostic factor for stimulation outcome in this age group. Pediatric patients or young adolescents at risk for primary ovarian insufficiency should not bediscouragedfrom utilizing OC.

A Novel Invasive Weed Optimization and its Variant for the Detection of Polycystic Ovary Syndrome

Introduction: This study intends to provide a novel Invasive Weed Optimization (IWO) algorithm for the detection of Polycystic Ovary Syndrome (PCOS) from ultrasound ovarian images. PCOS is an intricate anarchy described by hyperandrogenemia and irregular menstruation. Indian women are increasingly finding reproductive disorders, namely PCOS. Methods: The women having PCOS grow more small follicles in their ovaries. The radiologists take a look into women's ovaries by use of ultrasound scanning equipment to manually count the number of follicles and their size for fertility treatment. These may lead to error diagnosis. Results: This paper proposed an automatic follicle detection system for identifying PCOS in the ovary using IWO. The performance of IWO is improved in Modified Invasive Weed Optimization (MIWO). This algorithm imitates the biological weeds' behavior. The MIWO is employed to obtain the optimal threshold by maximizing the between-class variance of the modified Otsu method. The efficiency of the proposed method has been compared with the well-known optimization technique called Particle Swarm Optimization (PSO) and with IWO. Conclusion: Experimental results proved that the MIWO finds an optimal threshold higher than that of IWO and PSO.

Menstrual pattern of Adolescence

OBJECTIVE: This analysis helps to find out the pattern of menstruation among college students in Tamilnadu India. Materials and Methods: In this cross-sectional study, a survey was conducted in various colleges in Dindigul District. These questionnaires were based on socioeconomic data, menarche, menstrual cycle flow, and their perception of menstruation. Results: The age of menarche was 77.7% of the students attaining earlier (9-12). Dysmenorrhea (65%), premenstrual syndrome (PMS) (71.2%), and irregular cycles (33.8%) were found to be common problems among teenagers. Conclusion: Adolescents need to be educated about menstrual health and menstrual disorder.

Metabolic and hormonal profiling in polycystic ovarian syndrome: insights into INSR gene variations.

Polycystic Ovary Syndrome (PCOS) is a hormonal disorder characterized by irregular periods, excess androgen levels, and polycystic ovaries, affecting many women of reproductive age. This study employed statistical and molecular analyses to compare hormone and metabolic markers between PCOS patients and controls. Sanger sequencing identified two INSR gene variants linked to high insulin and pre-diabetic conditions. Statistically, no significant age differences were detected (p = 0.492) between the overall PCOS patient pool and controls. However, a substantial variation in Vitamin D levels was observed within PCOS patients compared to controls (p = 0.0006), suggesting an association with PCOS. Correlations between Vitamin D and insulin, as well as HbA1c levels (R2 = 0.141 and 0.143, respectively), suggest Vitamin D's potential impact on glycemic control. Significant differences were found in HbA1c (p < 0.0001), insulin (p < 0.0001), and LDL (p = 0.0004) levels between PCOS patients and controls, highlighting marked disparities in these metabolic markers. LH levels also showed a significant contrast (p < 0.0001), while progesterone levels displayed a notable difference (p = 0.007) between the two groups. Correlation analyses within PCOS patients demonstrated associations among LDL, HbA1c, and insulin, with no such correlations observed in control cases. Additionally, Sanger sequencing identified two INSR gene variants, c.3614C > T (p.Pro1205Leu) and c.3355C > T (p.Arg1119Trp), associated with high insulin, LH, and pre-diabetic conditions. These amino acid changes may trigger metabolic imbalances and hormonal irregularities, potentially contributing to the development of PCOS. The findings highlight the multifaceted nature of PCOS, revealing significant metabolic, hormonal, and genetic differences compared to controls. These insights may inform tailored interventions and management strategies for the complex associations characteristic of PCOS.

Mechanism study of YangJing ZhongYu decoction on regulating mitochondrial dynamics of ovarian granular cells and improving diminished ovarian reserve

ObjectiveDiminished ovarian reserve (DOR) encompasses both reproductive and endocrine disorders, resulting in a decline in female fertility. This paper explored the mechanism of Yangjing Zhongyu Decoction (YJZYD) regulating mitochondrial dynamics of ovarian granulosa cells (GCs) to improve DOR.MethodsDOR patients were treated with YJZYD, with ovarian volume (OV), antral follicle count (AFC), and endometrial thickness (EMT) detected. C57BL/6 female mice were treated by cyclophosphamide (Cy) intraperitoneal injection and YJZYD solution daily gavage, with serum anti-Mullerian hormone (AMH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) levels determined. Ovarian GCs (KGN) were interfered with 4-Hydroperoxy-Cyclophosphamide (4-HC) and treated with the MAPK/ERK pathway inhibitor or activator.ResultsDOR patients showed increased levels of serum AMH, E2, OV, AFC and EMT, while reduced FSH and LH levels after YJZYD treatment. After Cy induction, DOR mice exhibited irregular estrous cycles, diminished serum AMH and E2 levels, elevated FSH and LH levels, reduced follicle number and atresia follicle number, disorderly arranged GCs, and severe interstitial fibrosis. After 4-HC treatment, KGN proliferation and Bcl-2, MFN1, and MFN2 were suppressed, while apoptotic rate, Bax, Cleaved-caspase-3, and p-Drp1 (Ser616) levels, and mitochondrial fission and quantity increased. YJZYD promoted 4-HC-treated KGN proliferation, boosted mitochondrial fusion, and inhibited apoptosis and mitochondrial fission via the MAPK/ERK pathway.ConclusionYJZYD promoted ovarian GC proliferation and mitochondrial fusion, suppressed cell apoptosis and mitochondrial fission, and effectively improved DOR in mice by activating the MAPK/ERK pathway, providing a theoretical basis for the clinical application value of YJZYD in DOR treatment.

Application of small animal ultrasound imaging technology for identification of polycystic ovary syndrome in a mouse model

Background and AimsPolycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age, characterized by irregular menstrual periods, elevated levels of androgens, and polycystic ovaries, leading to various symptoms and complications such as infertility, metabolic issues, and increased risk of diabetes and heart disease. This study aimed to compare traditional histological methods and ultrasound imaging for consistency in identifying PCOS in a mouse model. The shortest time to construct the PCOS model using letrozole was determined. MethodsFemale C57/BL mice were randomly divided into three groups: Group A received normal saline and a regular diet; Group B received 1 mg/kg/day of letrozole with a regular diet; and Group C received 1 mg/kg/day of letrozole with a high-fat diet. All mice were administered letrozole by intragastric gavage daily for five weeks. The traditional identification method included measuring body weight, examining vaginal smears, monitoring the estrous cycle, measuring serum androgen levels, and performing H&E staining of ovarian tissues. The PCOS model was evaluated using ultrasound imaging to identify and monitor follicles. The significance of the difference between the traditional identification method and the ultrasonic method was calculated using the nonparametric McNemar test, and consistency between the two methods was assessed with the kappa-coefficient test. On this basis, the ultrasound imaging technology was used to monitor the model-making process for 2, 3 and 4 weeks, and to monitor the parameters of the ovary and follicles to judge the shortest time that gavage letrozole caused the appearance of vesicular follicles in the mouse ovary. ResultsThe traditional identification method showed no PCOS phenotype in group A mice, while groups B and C showed multiple ovarian cystic follicles, indicating successful model induction. The ultrasound imaging results were consistent with the traditional method, showing no PCOS in group A and multiple cystic follicles in groups B and C. The McNemar test revealed no significant difference between the traditional and ultrasonic identification methods. The kappa-coefficient test assessed consistency, yielding a value of 0.903, indicating strong agreement between the methods. The ovarian area, diameter, and the number and diameter of cystic follicles were not significantly changed at two weeks in the letrozole group compared with the control group. At three weeks, there were significant increases in the number and in the diameter of vesicular follicles compared with control cells. At four weeks, the number and diameter, the maximum cross-sectional area and diameter of the ovary were significantly increased compared with the control group. ConclusionsThe ultrasound and traditional methods provide consistent results for identifying PCOS in a mouse model. Construction of the PCOS model by letrozole gavage takes at least three weeks.

Nuciferine protects hyperandrogen-injured ovarian granulosa cells by inhibiting ferroptosis via SOX2-mediated activation of the SLC7A11/GPX4 axis.

Polycystic ovary syndrome (PCOS) is a common endocrine disorder that can cause menstrual irregularities, infertility, polycystic ovaries, and metabolic abnormalities. Female reproductive health and quality of life are significantly affected by PCOS, which has recently been associated with ferroptosis in granulosa cells (GCs). Nuciferine (NF) is a naturally extracted substance with multiple pharmacological activities, which is reported with anti-ferroptosis function. Herein, the influence of NF for androgen-induced ferroptosis in GCs was investigated to explore the potential value of NF on treating PCOS. 10 μM NF and 20 μM NF were employed for treating KGN cells according to cell viability results. KGN cells were treated with 10 μM dehydroepiandrosterone (DHEA) for 1 day, followed by introducing 10 μM NF and 20 μM NF for 24 h. Strikingly reduced cell viability, increased lactate dehydrogenase release and reactive oxygen species (ROS) production, enhanced apoptosis, upregulated Bax, downregulated Bcl-2, restrained malondialdehyde contents, and declined superoxide dismutase activity were observed in DHEA-treated KGN cells, which were significantly reversed by NF. Significantly repressed GPX4, SLC7A11, and SOX2 levels, as well as increased ACSL4 levels and Fe2+ levels in DHEA-treated KGN cells, were notably rescued by NF. Furthermore, the inhibitory effect of NF on ROS production and ferroptosis in DHEA-treated KGN cells was partially abrogated by silencing SOX2. Collectively, NF protected DHEA-injured ovarian GCs by inhibiting ferroptosis via upregulating SOX2.

Exploring the benefits of astaxanthin as a functional food ingredient: Its effects on oxidative stress and reproductive outcomes in women with PCOS - A systematic review and single-arm meta-analysis of randomized clinical trials.

Polycystic ovary syndrome (PCOS) is a prevalent gynecological-endocrinological disorder characterized by hyperandrogenism, menstrual irregularities, and metabolic disturbances. Recent research has highlighted the role of oxidative stress and chronic inflammation in exacerbating PCOS symptoms and impeding reproductive outcomes. Astaxanthin, a potent antioxidant found in marine organisms, has been suggested as a potential therapeutic intervention due to its ability to reduce oxidative stress and inflammation. This meta-analysis systematically reviews randomized controlled trials assessing the impact of astaxanthin supplementation on oxidative stress and reproductive outcomes in women with PCOS. Data from four trials were analyzed, focusing on markers of oxidative stress and reproductive health metrics. The meta-analysis utilized fixed and random-effects models to synthesize results, with heterogeneity assessed using Chi-square and I2 statistics. The findings indicate that while astaxanthin significantly improves markers of total antioxidant capacity (TAC) in follicular fluid, it does not show a consistent effect on other oxidative stress biomarkers such as malondialdehyde (MDA), catalase (CAT), or superoxide dismutase (SOD). Reproductive outcomes, including oocyte quality and the number of high-quality embryos, showed moderate improvements, although effects on fertilization rates and pregnancy outcomes were insignificant. The analysis highlights variability in study designs and dosing, suggesting a need for further research with standardized protocols and larger sample sizes. Future studies should focus on determining optimal dosing, exploring mechanistic pathways, and investigating the combined effects of astaxanthin with other interventions. Longitudinal studies are needed to assess long-term benefits and safety, and personalized approaches could enhance treatment efficacy for individualswithPCOS.

Demonstrative irregular fatigue cycle counting by rainflow method implementation using a Python program

Demonstrative irregular fatigue cycle counting by rainflow method implementation using a Python program

Unraveling the Mysteries of PCOS: A Comprehensive Investigation into Causes, Mechanisms, and Molecular Docking Analysis with Dolichos biflorus Linn.

Abstract: Polycystic ovary syndrome (PCOS) presents as a complex endocrine and metabolic disorder characterized by anovulation, infertility, obesity, insulin resistance, and polycystic ovaries. Various factors contribute to PCOS risk, including lifestyle choices, diet, environmental pollutants, genetics, gut dysbiosis, neuroendocrine changes, and obesity. These factors can impact hyperinsulinemia, oxidative stress, hyperandrogenism, decreased folliculogenesis, and irregular menstrual cycles, ultimately contributing to metabolic syndrome. Conventional treatments for PCOS often carry significant side effects, prompting exploration into Ayurvedic alternatives. This review concentrates on molecular docking studies of phytochemicals sourced from Dolichos Biflorus Linn. against key proteins implicated in PCOS pathogenesis. Identification, modeling, and evaluation of target proteins were conducted, followed by the assessment of their interactions with selected phytochemicals and additional ADMET analysis. Molecular docking studies utilizing Auto Dock Vina software were then performed to forecast the binding affinities of these phytochemicals to the active sites of the specified targets.

Efficacy and safety of systemic spironolactone for acne in female patients in Sulaymaniyah teaching center of dermatology

Background and objectives: Acne vulgaris is a common disease in which hormone plays a role in its pathogenesis. Spironolactone, an androgen receptor blocker is used to treat acne. This study aims to evaluate the efficacy and safety of systemic spironolactone for acne in female patients in our local area. Methods: Open-label therapeutic trial study performed in the Sulaymaniyah teaching center of dermatology between 1/2/2022 - 1/9/2022, on a total of 47 patients aged 12-38 years old. Patients were divided into two groups in regard to age. Hormonal profile was assessed for all the patients. The 4-grade European classification system was used to classify the acne severity. Spironolactone 100 mg once daily at morning was given to them with follow up monthly for 3 months. Clinical response of the drug was assessed through a decrease in the number of the lesions. Signs and symptoms of the side effects were checked monthly. Results: In a total of 47 patients, 22 patients were ? 25 years and 25 patients were &gt;25 years. A significant difference was recorded in the response rate among the patients' ages and hormonal status of them as 83.3%, 61.1% and 50% of the complete response was in those who were &gt;25 years old and had abnormal testosterone and DHEA-s levels respectively. 100% of non-responder patients were below 25 years old with normal hormonal levels. 55.32% of the patients had no side-effect and menstrual irregularity was the most commonly reported side effect. Conclusion: Spironolactone is statistically considered an effective and safe line for the treatment of acne vulgaris particularly for acne in female over 25 with abnormal hormonal levels.

Ovarian Insufficiency in Adolescent Females with Transfusion-Dependent β-Thalassemia: Pituitary versus Ovarian Iron Overload

Introduction: Females with transfusion-dependent β-thalassemia (TDT) display menstrual irregularities and subfertility at certain points in their lives, even if well-chelated, representing a significant physical and psychological burden. Little is known about the effects of pituitary and ovarian iron contents on ovarian reserve and function. Hence, this study aimed to assess ovarian reserve and pituitary-gonadal axis function in adolescent females with TDT and correlate them with pituitary and ovarian volume, pituitary iron load, and serum ferritin. Methods: Fifty adolescent females with TDT were compared to 50 age-matched healthy females. Age of diagnosis of TDT, transfusion index, type of chelation therapy, age at menarche, and Tanner breast stage were assessed. Serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), anti-Müllerian hormone (AMH), and ferritin were measured. Magnetic resonance imaging (MRI) pituitary iron content R2* and T2* were measured, and 3-D transabdominal ovarian ultrasound performed. Results: The mean age of the studied females with TDT was 14.54 ± 2.24 years. Ovarian insufficiency was found in 20 of them (40%). Compared to controls, adolescent females with TDT had significantly delayed age of menarche, AMH, FSH, LH, antral follicle count (AFC), and ovarian volume. Upon comparing those with ovarian insufficiency and those without, adolescents with TDT having ovarian insufficiency had significantly higher serum ferritin and pituitary MRI-R2* than those without insufficiency. Multivariate-logistic regression showed that pituitary MRI-R2* was the most significant independent variable associated with ovarian insufficiency among adolescent females with TDT. Conclusion: Adolescent females with TDT have decreased ovarian reserve, AFC, and gonadotropins that are correlated with serum ferritin, pituitary iron load, and ovarian volume. Hence, regular ovarian reserve assessment should be implemented as a part of endocrinological follow-up of females with TDT advising procedures to preserve fertility to those who are likely to have ovarian insufficiency.

A Study of Non-alcoholic Fatty Liver Disease in Patients With Hypothyroidism: A Cross-Sectional Study in a Tertiary Care Hospital.

Background Hypothyroidism occurs when the thyroid gland is underactive and fails to produce sufficient thyroid hormones. It can affect multiple organs including the heart, brain, liver, kidneys, and reproductive system, leading to symptoms such as fatigue, cognitive impairment, elevated cholesterol, fluid retention, fatty liver, and menstrual irregularities. Given the higher prevalence of fatty liver disease in patients with hypothyroidism, it is important to evaluate the need for routine screening for fatty liver in these patients. Materials and methods This observational, cross-sectional study was conducted at Dr. D. Y. Patil Medical Hospital, Pune, Maharashtra, India, from October 2022 to June 2024. The study included 60 patients aged over 12 years who were known or recently diagnosed with hypothyroidism. Patients with type 2 diabetes mellitus, pregnant women, or those with chronic liver disease were excluded. Data collected included physical examination findings and laboratory test results. Fatty liver was diagnosed using magnetic resonance elastography. Statistical analysis was performed using IBM SPSS statistics for Windows, version 20 (IBM Corp., Armonk, New York). The statistical significance of parametric data was evaluated using the Chi-square test. A p-value less than 0.05 and a confidence interval of 95% were considered statistically significant. Result The study population had an average age of about 45 years, with most participants aged between 40 and 49 years. The majority of the participants were female, making up over 83% of the group, while males constituted about 17%. The most commonly reported symptom was weight gain, followed by constipation and fatigue. For individuals with fatty liver, the average thyroid-stimulating hormone (TSH) level was notably higher compared to those without fatty liver.Additionally, low-density lipoprotein (LDL) levels were higher in individuals with non-alcoholic fatty liver disease (NAFLD) compared to those without. Both TSHand LDL levels showed a statistically significant association with the occurrence of NAFLD. Conclusion Hypothyroidism was more prevalent in females and in the age group 40-49 years. There was a statistical significance between TSHand the occurrence of NAFLD. In this study,statistical significance was also found between LDLand the occurrence of NAFLD.