Polycystic Ovarian Disease Patients Research Articles

Impact of metformin versus metformin plus omega_3 on inflammatory outcomes in a tester of Iraqi women with PCOS

Background: Polycystic ovary syndrome signifies a state of chronic inflammation, which is partly caused by excessive visceral adipose tissue and the pro-inflammatory mechanisms associated with it. Interestingly, even normal-weight women with PCOS exhibit long-lasting low-flat inflammation characterized via raised ranks cytokines of pro-inflammatory. This can be attributed to the presence of surplus visceral adipose tissue and intraperitoneal fat depots in normal-weight PCOS patients as well. Aim of the study: To estimate the influence of metformin and omega-3 treatment on serum ranks of IL-18 and highly sensitive CRP in females with PCOS. Patients and methods: The present interventional prospective study included 90 sick with an age assortment of 18 to less than 40 years. Those patients were analyzed with polycystic ovarian disease (PCOS) founded on Rotterdam principles (Rotterdam, 2004) by 2 specialists in obstetrics and gynecology. The patients were recruited from the Maternity and Pediatrics Teaching Hospital in Adiwaniyah Province, Iraq. The training is outmoded back to September the 21st 2023 and extended to March 31st 2024. Results: Following treatment, both metformin+Omega3 and metformin alone were able to reduce mean IL-18 significantly (p < 0.001 versus p < 0.001, separately); however, the amount of decrease caused by combination was more than that caused by metformin alone significantly, 158.62 pg/ml versus 71.14 pg/ml , respectively (p = 0.048). Both metformin+Omega3 and metformin alone were able to reduce mean hs-CRP significantly (p < 0.001 versus p < 0.001, respectively); however, the amount of decrease caused through combination was more than that caused by metformin alone significantly, 157.69 mg/L versus 61.27 mg/L , separately (p = 0.032). Conclusion: The use of Omega3 has an efficient and safe synergistic effect when added to metformin in reducing IL-18 and hs-CRP in sick with PCOS, thus, suggesting an anti-inflammatory property for such combination.

Frequency of Subclinical Hypothyroidism among Patients of Polycysitic Ovarian Syndrome (PCOS)

Introduction: Polycystic ovarian syndrome (PCOS) is the most common form of chronic anovulation associated with androgen excess; perhaps occurring in 5-10% of reproductive women. PCOS is viewed as a heterogeneous disorder of multifactorial etiology. It is also associated with increased metabolic and cardiovascular risk factors. Subclinical hypothyroidism is “mild” thyroid failure in which thyroid stimulating hormone (TSH) is elevated and free thyroxine (fT4) is normal. Objective: To determine the frequency of subclinical hypothyroidism among patients of polycystic ovarian disease presenting in the outpatient department of tertiary care hospital. Study Setting: The Study was conducted in Mayo Hospital, Lahore. Duration of Study: June 5, 2019 to January 3, 2020 Study Design: Cross-Sectional Study Methods: All polycystic ovarian disease patients were enrolled. Blood samples of the patients were taken by using aseptic techniques and sent to pathology laboratory for measurement of serum TSH level. The frequency of subclinical hypothyroidism among patients of polycystic ovarian disease was identified. Data were entered and analyzed using SPSS v25.0. Data were stratified for age and BMI to deal with effect modifiers. For post stratification, Chi-square test was applied to see the significance. A p-value≤0.05 was considered significant. Results: Total 136 patients with polycystic ovarian disease were selected for this study. Mean age was 28.4±7.9 years. Among 136 patients, 26(19.1%) had subclinical hypothyroidism. By stratification of subclinical hypothyroidism, it was found that age >30 years and obese had significant effect having subclinical hypothyroidism (p=0.00001, p=0.001). Conclusion: Subclinical hypothyroidism may be a modifiable risk factor, associated with polycystic ovarian disease. Steps should be taken to minimize more this risk factor by screening and early intervention. Key Words: Subclinical Hypothyroidism, Polycystic Ovarian Disease.

Laparoscopic Ovarian Drilling in Polycystic Ovarian disease patients: is it hazardous?

Objective: to evaluate the outcomes of endoscopic ovarian drilling (LOD) on the Anti Mullerian hormone (AMH)plasma levels, potential changes of the stromal ovarianblood flow, and antral follicular count by three-dimensionalpower Doppler ultrasonography in an-ovulatory polycysticovarian disease (PCOD) and if this can explain the ovariandrilling mechanism of action.Methods: The prospective, comparative (case control) research was completed on fifty patients from Bab El-ShaareaUniversity Hospital (El Sayed Galal). They were selectedfrom infertility and family planning clinics. Women wereassigned into one of two equal groups (each 25 patients).The first included infertile women, resistant to clomiphenecitrate and scheduled for drilling. The second includedhealthy women from the family planning clinic, who wereseeking for contraception. The main outcomes were AMHlevels, Doppler indices and Antral follicular counts beforeand after drilling. The secondary outcome in the studygroup included occurrence of ovulation, chemical and clinical pregnancy rate within 6 months after drilling.Results: The mean initial AMH, doppler indices and antral follicular counts were singingly higher among studythan control group. AMH and AFC significantly reduced incases after than before drilling [2.8 to 3.9], [13.9 to 15.8].Ovarian FI, VI, and VFI significantly decreased after thanbefore drilling. In the study group, 20 (80%) had ovulation,and 13 (52%) got pregnant within 6 months of the operation.Regression analysis showed that initial AMH, initial AFC,initial VFI, post-LOD AMH, post-LOD AFC, post-LOD VI,post-LOD FI and post-LOD VFI were significant indicatorsof successful ovulation and successful pregnancy within 6months after drilling.Conclusion: Endoscopic ovarian drilling had a significantdecreasing effect on serum AMH, AFC, and Ovarian Doppler indices in PCOD patient not responding to clomiphenecitrate. The initial values of AMH, AFC and VFI; besidespost-drilling values of AMH, AFC, VI, FI, and VFI weresignificant indicators of ovulation after drilling.

Frequency of Subclinical Hypothyroidism among Patients of Polycysitic Ovarian Syndrome (PCOS)

Introduction: Polycystic ovarian disorder is the most frequent kind of persistent anovulation caused by androgen extra, affecting 6-12% of fertile women. PCOS is seen as a complex condition through a variable origin. It has also been linked to greater in metabolic and cardiovascular risk factors. The purpose of our research was to determine the frequency of subclinical hypothyroidism among patients of polycystic ovarian disease presenting in the outpatient department of tertiary care hospital Methods: The Study was a cross-sectional study which was conducted in Gynecology & Obstetrics Department, Lady Aitchison Hospital, Lahore. All polycystic ovarian disease patients were enrolled. Participants' blood samples were drawn utilizing aseptic methods and transported to a pathology laboratory for serum TSH levels to be measured. Subclinical hypothyroidism was found to be common in polycystic ovarian individuals diagnosed. SPSS v24 was used to enter and evaluate data. The Chi-square method was conducted to test the relevance of post-stratification. A p-value of 0.06 was believed important. Results: Total 136 cases with polycystic ovarian disease were selected for this study. Mean age was 28.4±7.9 years. Among 136 patients, 26(19.1%) had subclinical hypothyroidism. By stratification of subclinical hypothyroidism, it was found that age >30 years and obese had extensive effect having subclinical hypothyroidism (p=0.00001, p=0.002). Conclusion: Subclinical hypothyroidism may be a modifiable risk factor, associated with polycystic ovarian disease. Steps should be taken to minimize more this risk factor by screening and early intervention. Keywords: Subclinical Hypothyroidism, Polycystic Ovarian Disease.

Risk estimation of gestational diabetes and diabetes mellitus of type -2 because of PCOD through Mathematical and Artificial Intelligence models

Pre-existence of PCOD (polycystic ovarian disease) cause the severity of diabetes during pregnancy as gestational diabetes (GD) and post-pregnancy diabetes mellitus of type -2 (DMT-2). Early detection of PCOD may help manage the severity of diabetes mellitus in pregnancy and postnatal. This analysis conveyed to understand the pervasiveness of PCOD and its complication with diabetes mellitus and body mass index (BMI). A contextual and statistical study of the data extracted from kaggle.com in 541 patients (180 with PCOD and 361 without PCOD) of southern India has been done. The random forest (RF) technique of Artificial Intelligence (AI) model has been used to analyze the correlations among parameters. In the body mass index, 42% of 180 PCOD patients have ≥ 27 kg/m2 body mass, as waist-hip ratios are in the range of 0.80 – 1.00. With pre-existence PCOD, 35% of women are pregnant. It has observed that 84% pregnant women have the risk of developing gestational diabetes, and few women have the chance to develop diabetes mellitus of type-2. The results were analyzed by RF technique of AI through Karl Pearson’s coefficient of correlation. The patients struggling with PCOD, facing high BMI and high waist-hip ratio (0.80 – 1.00) risk of gestational diabetes, thereof early detection and diagnosis of PCOD will reduce the risk of development of GD and DMT-2.

Prevalence of polycystic ovarian syndrome and its association with circulatory gonadotropins (luteinizing hormone and follicle-stimulating hormone) and prolactin in different reproductive age groups: A brief survey

Polycystic ovarian syndrome can affect fertility due to anovulatory cycles, luteal phase defects, hyperprolactinemia, and sex hormone imbalance, it remains untreated. The present study aims prevalence of polycystic ovarian disease (PCOD) of clinical/subclinical infertile women, different age groups and to analyze the association between circulatory level of gonadotropins, luteinizing hormone and follicle-stimulating hormone (LH and FSH) and prolactin (PRL) in polycystic ovary syndrome (PCOS) women of different reproductive age and its impact on fertility of women. The hormonal reports for LH, FSH, and PRL of 100 female patients were analyzed. Women suffering from oligomenorrhea and amenorrhea are given priority in this study. These samples were categorized into five different age groups of 15–20 years, 21–25 years, 26–30 years, 31–35 years, and 36–40 years. Obtained hormonal data of LH, FSH, and PRL were pooled and the average was taken to compare with the normal range of hormone. A significant age-dependent variation observed in circulatory serum levels of gonadotropins (LH and FSH) and PRL. The study reveals that the highest PCOD patients were observed in the age group of 21–25 years. Whereas, 30% to 15–20 years, 60% to 21–25 years, 40% to 26–30 years, 30 % to 31–35 years, and 20 % to 36–40 years of reproductive age group. Most affected population of PCOS women ranges in between 21 and 25 age groups, whereas the 36–40 age group was least affected. Age-related alteration in the circulatory level of PRL (hyperprolactinemia) and pulsatility of LH and FSH can be considered as the important factor regulating neuronal mechanisms of hypophyseal gonadal and peripheral endocrine feedback.

Impact of promoting healthy lifestyle interventions among adolescents, young adults with polycystic ovarian disease in resource limited settings

Polycystic Ovarian Disease (PCOD) is a reproductive metabolic disorder caused by hormonal imbalances within women of fertile age. Mainstay for treating patients with PCOD includes pharmacological therapy and lifestyle modifications. Lifestyle modifications that play a key role in the management of PCOD are weight management, reduction in stress, physical activity, body mass index and dietary changes. There is sparse information regarding the impact of these interventional parameters among the PCOD women in the literature. This study aims to determine the impact of healthy lifestyle modifications in the management of PCOD among young adults and adolescents. It was a prospective interventional study conducted in the Gynaecology outpatient department in Government General Hospital, Kadapa over the time of 6 months from June 2019 to November 2019. Counseling on lifestyle changes and implementation of healthy lifestyle interventions were given to the study population by using the standard questionnaire forms and post counseling changes were collected after 90 days of visit to the clinic. The statistical significance was done by using the unpaired t-test and graph pad version 8.3.0. The total sample of 30 PCOD patients was compared to before patient counseling on lifestyle modifications and after follow-up. The total population was categorized into 2 groups as adolescents (10%) and young adults (27%). The current study showed that there is a significant association between dietary intervention (p <0.0113) and physical activity scores (p<0.029) among the PCOD patients. In PCOD patient’s healthy lifestyle modifications like dietary interventions and Physical activity serves as an effective treatment strategy adjunct to pharmacological therapy and improved the patient reproductive health.

Patient-centric approach through “Multi-Purpose Behavior Therapy (MPBT)” room for improving patient's satisfaction and decreasing work load in Hospitals: An analysis from available evidence

Many studies from India have documented that patients are not satisfied with their treatment provided in the hospitals. The common reasons of patient's dissatisfaction are overcrowding, long waiting time to meet doctors, short consultation period (2 minutes), absence of a congenial environment, and communication gap. It is well known fact that there is frustration with systemic problems of government hospitals, from poor budgetary allocation to shortage of health care staff. It is evident from management studies that, if we have to give better output without changes in the input level we have to improve our existing processes. Improvement of any system is possible by proper system analysis, system design and effective implementation. In hospitals also, our aim is to design and implement a customized and comprehensive care plan, giving more emphasis on the patient's problems than on their diagnosis. Person centered care is underpinned by values of respect for persons, individuals right to self-determination, understanding, empathy, tow way communication and eye to eye contact. Newer concepts like social prescribing in patient care have been implemented in the Multi-Purpose Behavior Therapy (MPBT) room project at PGIMER, Chandigarh for urinary incontinence, dysmenorrhea, osteoarthritis and polycystic ovarian disease patients. Our results indicate that it is feasible to impart health promotion orientation in gynae OPD and orthopedic OPD through counselling of patients for de-medicalization of management of their health problems. Doctors also reported reduced workload. However, this model can be adopted in any clinical department for improving patient satisfaction and decrease workload in hospitals..

Comparative study between fixed and flexible GnRH antagonist protocol versus GnRH agonist long protocol in polycystic ovarian disease patients treated with IVF

Comparative study between fixed and flexible GnRH antagonist protocol versus GnRH agonist long protocol in polycystic ovarian disease patients treated with IVF

Comparative study between fixed and flexible GnRH antagonist protocol versus GnRH agonist long protocol in polycystic ovarian disease patients treated with IVF

The objective of the present study was to compare and evaluate the effectiveness and safety of GnRH agonist long protocol compared with the GnRH antagonist (fixed and flexible) protocols in polycystic ovary syndrome (PCOS) patients undergoing in vitro fertilization (IVF)/ intracytoplasmic sperm injection (ICSI) cycles. This study was carried out on 60 patients with polycystic ovarian disease undergoing ICSI, their age ranged from (20 to 40 years). The cases were selected from The International Center for Population Study and Research (ICPS), Al-Azhar University. Eligible patients who accepted to take part in the study were randomized into 3 study group: Group A: 20 patients were included in agonist protocol, Group B: 20 patients were included in fixed antagonist protocol and Group C: 20 patients were included in flexible antagonist protocol. The results obtained from this study indicated no statistically significant differences regarding the pregnancy rates or regarding the developing of ovarian hyperstimulation syndrome (OHSS) complication in the studied population; so larger studies with larger sample size and longer duration are needed to clarify the roles of different IVF protocols.

A Cross-sectional Study on the Proportion of Anxiety and Depression and Determinants of Quality of Life in Polycystic Ovarian Disease.

Background:The polycystic ovary syndrome is a disorder characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphologic features. Earlier studies have shown that depression was significantly increased in the polycystic ovarian disease (PCOD) group and also that PCOD women had marked reduction in quality of life, impaired emotional well-being, and reduced sexual satisfaction. This study was undertaken with the objectives of studying the proportion of anxiety and depression and assessing the quality of life and its correlates in women with PCOD.Materials and Methods:A cross-sectional observational study on 64 PCOD patients using a pro forma for collecting sociodemographic and clinical details, Hamilton Depression Rating Scale, Hamilton Rating Scale for Anxiety, Ferriman–Gallewey score for hirsutism and WHO-quality of life (QOL) BREF.Results:Depression was seen in 93.5% of the subjects and anxiety in 100% of the subjects. The patients were also seen to have a lower quality of life. Lower scores were obtained in the psychological domain (68.80 ± 12.87). Presence and severity of depression and anxiety were found to have a negative correlation with QOL in all domains but maximally affecting the social relationships domain (P ≤ 0.001 and <0.001, respectively). Severity of hirsutism and nulliparity was found to have association with QOL in the psychological domain.Conclusion:The majority of women with PCOD in this study were found to have depression and anxiety. They were also seen to have a lower quality of life. Depression, anxiety, and hirsutism were found to have a negative correlation with QOL in all domains.

Sonohysterographic Findings of Endometrial Carcinomas in Women with Polycystic Ovarian Disease

To describe the sonohysterographic features of endometrial carcinomas in women with polycystic ovarian disease (PCOD) and to determine the diagnostic role of sonohysterography (SH) in the evaluation of these lesions. SH findings of 48 PCOD patients with histologically confirmed endometrial carcinomas were evaluated. The mean age was 33.5 years (range 22-45 years). Histology included endometrioid type in 47 cases and Grade 1 in 43 cases, and 43 patients was stage IA. 20 Patients had high dose progestin treatment and 28 patients undergo surgery. SH demonstrated the endometrial thickening in 35 cases, endometrial mass in 6 cases, and endometrial thickening with mass in 7 cases. The endometrial thickness ranged from 5.5 to 27 mm (mean 9.6 mm) and the mass size ranged from 2 to 4.3 cm (mean 2.9 cm). They appeared as a diffuse polypoid thickening and a sessile mass with an inhomogeneous hyperechogenicity, an irregular surface, and obliteration of the cavity. The tumor involved only to the endometrium in 32 cases and there were superficial myometrial invasion in 14 cases, deep myometrial invasion in 2 cases, and cervical invasion in 3 cases. The SH features of endometrial carcinomas associated with PCOD included a diffuse polypoid endometrial thickening and a sessile endometrial mass with an inhomogeneous hyperechogenicity, an irregular surface, obliteration of the cavity, and absent myometrial invasion. SH may provide more diagnostic value in the evaluation of endometrial carcinomas in women with PCOD.

The effectiveness of Hespan in reducing the incidence of severe hyperstimulation syndrome in polycystic ovarian disease patients

Abstract Objective: Prophylactic IV administration of 6% hydroxyethyl starch solution (HES) has been shown to help in preventing moderate-severe ovarian hyperstimulation syndrome (OHSS) in patients at risk. This prospective study evaluates the effectiveness of HES extended use in preventing severe OHSS in patients with or without Polycystic Ovary Syndrome (PCOS) undergoing assisted reproductive technology. Setting: The study group included 45 patients with PCOS (Group 1) and the control group consisted of 98 non-PCOS patients (Group 2). Materials and methods: Patients in both groups received multiple HES doses to reduce risk of severe OHSS. The inclusion criteria included having serum estradiol (E2) ⩾ 3000 pg/mL and/or ⩾20 total follicles on day of HCG and to have an embryo transfer done. HES (500–1000 cc) was given daily starting on the day of oocyte retrieval for a mean number of 3.2 ± 0.8 days. Results: The percentage of patients who developed severe OHSS requiring pigtail catheter insertion or vaginal aspiration was significantly higher in Group 1 vs Group 2 (15.6% vs. 4.1%, P = 0.017). Conclusion: Prophylactic use of multiple doses of HES appears to be more effective in preventing severe OHSS in non-PCOS patients, but may have limited effect in PCOS patients.

The Metabolic Syndrome in Polycystic Ovarian Disease

Polycystic ovarian disease (PCOS) is the most common endocrine disorder among women in genital activity (prevalence: 5 and 10%). It is a frequent cause of hirsutism and infertility in women and affects 3-10% of women overall population. Whatever the age of onset, PCOS predisposes to metabolic and early cardiovascular complications. The PCOS is frequently associated with obesity, insulin resistance and hyperinsulinemia. There is a greater risk of glucose intolerance, diabetes mellitus (10%) and hyperlipidemia (more than half of women). The aim of our study was to report the frequency of metabolic syndrome (MS) in PCOS and specify its clinical and biological characteristics. This is a prospective, descriptive study which concerned 66 primary PCOS patients. The frequency of metabolic syndrome was 48.5%. The average age was 33.9 ± 9.22 years (16 – 45) Just under half of the patients (42.4%) were obese at diagnosis. The mean BMI was 32.4 kg / m2 ± 0.3. A slightly more than 2/3 of PCOS patients (72.6%) have a and roidobesity. The average waist circumference PCOS patients was 87.5 ± 0.1 cm. Nearly a third of patients have abnormal glucose tolerance. They have an average triglycerides, mean arterial pressure, mean blood glucose, insulin and an average index HOMA significantly higher (p: 10- 3). Their HDL level is significantly reduced (p <10-3). A little over a quarter of PCOS patients with metabolic syndrome: 37.5%) have all of the risk factors for MS at diagnosis.

Inositol versus metformin administration in polycystic ovarian disease patients

Inositol versus metformin administration in polycystic ovarian disease patients

Intrauterine insemination versus fallopian tube sperm perfusion in non-tubal infertility

BackgroundControlled ovarian hyperstimulation (COH) combined with intrauterine insemination (IUI), using a volume of 0.5 ml of inseminate is commonly offered to couples with non-tubal sub fertility. Another method is Fallopian tube sperm perfusion (FSP) which is based on a pressure injection of 4ml of sperm suspension while attempting to seal the cervix to prevent semen reflux. This technique ensures the presence of higher sperm density in the fallopian tubes at the time of ovulation than standard IUI. The aim of this study was to compare the efficiency of standard intrauterine insemination (IUI) and Fallopian tube sperm perfusion (FSP) in the treatment of non-tubal infertility. Methods200 consecutive patients with infertility in 404 stimulated cycles were included in the study. Those randomized to standard IUI included 100 patients in 184 cycles [158 clomiphene citrate/human menopausal gonadotrophin cycles and 26 Letrozole/FSH cycles exclusively for polycystic ovarian disease patients] (group A). Patients subjected to FSP included 100 patients in 220 cycles (193 clomiphene citrate/human menopausal gonadotrophin cycles and 27 Letrozole/FSH cycles exclusively for polycystic ovarian disease patients] (group B). Swim up semen preparation technique was used in all cases. Insemination was performed in both groups 34–37h after hCG administration. Standard IUI was performed using 0.5ml of inseminate. In FSP 4ml inseminate was used. ResultsIn group A (184 IUI cycles in 100 patients), 22 clinical pregnancies (presence of gestational sac with fetal cardiac activity) occurred (11.95% per cycle over four cycles). In group B, (220 cycles of FSP in 100 patients), 48 clinical pregnancies occurred (21.81% per cycle over four cycles) and this difference was statistically significant (p<0.05). ConclusionsFor non-tubal sub fertility, the results indicate clear benefit for FSP (Fallopian tube sperm perfusion) over IUI (Intrauterine insemination).

Ovulation induction by antiestrogens in an Indian tropical vespertillionid bat, Scotophilus heathi

The ovulation induction property of ICI 182,780 a pure antiestrogen and enclomiphene citrate (ENC) was carried out in Scotophilus heathi, an Indian tropical vespertillionid bat, during December to February i.e., preovulatory period. This bat ovulates two ova naturally and shows ovulatory asynchrony. The study showed that 100 ìg of ENC followed by 10 IU hCG resulted in significantly lower number of ovulation. Whereas, the pure antiestrogen ICI 182,780 at a dose of 100 ìg followed by 10 IU hCG resulted in ovulation induction (4.2 ± 0.4), which is significantly different in comparison to other groups. This is possibly the first report of ovulation induction using this pure antiestrogen i.e., ICI 182,780 in any bat as well as in any animal model that exhibits temporary anovulation similar to polycystic ovary disease (PCOD). This antiestrogen may be useful to induce ovulation in PCOD patients.

Is laparoscopy necessary before assisted reproductive technology?

Laparoscopy is widely used during infertility work-up, although it is sometimes unnecessary. This review highlights when laparoscopic intervention should be used in women undergoing assisted reproductive technology cycles. There is no evidence for an increase in pregnancy rates in assisted reproductive technology cycles following surgical treatment of pelvic adhesions or endometriosis with laparoscopy. If the patient has bilateral visible hydrosalpinges, laparoscopy may be an option for evaluation of the tubes and treatment with salpingectomy in order to enhance the chance of pregnancy before commencing an assisted reproductive technology cycle. Laparoscopic ovarian drilling before assisted reproductive technology may be considered a therapeutic option in polycystic ovary disease patients who previously had severe ovarian hyperstimulation syndrome. Finally, laparoscopy may be useful in replacing the transposed ovaries to their original sites in the pelvic cavity in previously treated cancer patients so that monitoring of the controlled ovarian hyperstimulation and the oocyte aspiration would be much easier during the assisted reproductive technology cycles. Laparoscopy should be considered before assisted reproductive technology cycles if the procedure diagnoses and treats a pelvic pathology at the same time and if laparoscopic intervention increases the chance of pregnancy following these cycles.

Normal p21Ras/MAP kinase pathway expression and function in PBMC from patients with polycystic ovary disease

Polycystic ovary disease (PCOD) is associated with insulin resistance and increased prevalence of type II diabetes mellitus (T2DM). The p21Ras/MAP kinase is a major intracellular signaling pathway mediating insulin signaling in insulin responsive tissues. The expression, regulation and function of the p21Ras/MAP kinase pathway in PCOD patients were examined. Peripheral blood mononuclear cells (PBMC) were isolated from ten patients with PCOD and ten controls. The expression of p21Ras and its regulatory proteins; hSOS1 and p120GAP were studied. The basal and phytohemaglutinin (PHA) or insulin stimulated phosphorylation of MAP kinase was determined. Expression of p21Ras, and its regulatory proteins hSOS1 and p120GAP were similar in PCOD patients and controls. Basal, PHA and insulin stimulated phosphorylation of MAP kinase, were also comparable in the two groups as well as their PBMC proliferative response. These data indicate that the expression and overall function of the p21Ras/MAP kinase pathway remain intact in non-diabetic patients with PCOD.

Investigation On The Effects Of Bromocriptine And Dexamethasone In Polycystic Ovarian Disease With Clomiphene Citrate Resistance

Objective: To compare the use of Bromocriptine or Dexamethasone with clomiphene in polycystic ovarian disease (PCOD) patients with clomiphene resistance. Design: Prospective study. Setting: Medical Science Department in Shiraz University. Methods: A total of 133 infertile PCOD patients were seen in two years and 44 patients had clomiphene citrate resistance with the prolactin and dihydro-epiandrostrone sulfate levels were in normal range. These patients were divided into two groups of 22 each. The first group was treated with clomiphene 100 mg per day in the 5th to 9th days of cycle and with Bromocriptine 2.5 mg twice per day for three months. The second group was treated with clomiphene dosage as mentioned earlier and with dexamethasone 0.5 mg single dose nightly for three months. Result: After treatment, regular menses resumed in 68.2% of first group and 50.0% of second group. The pregnancy rates were 40.0% and 22.7% respectively. Conclusion: Bromocriptine showed higher rates of resumption of menses and pregnancy than dexamethasone when used in conjunction with clomiphene for polycystic ovarian disease (PCOD) patients with clomiphene resistance.