effect of metformin on the endocrine variables in clomiphene resistant polycystic ovarian disease

To investigate the effect of metformin on the endocrine variables in clomiphene resistant polycystic ovarian disease [PCOD]. Departments of Obstetrics and Gynaecology, Internal Medicine and Clinical Pathology, Faculty of Medicine, Tanta University, Egypt. Thirty-three infertile women due to PCOD were enrolled and divided into 23 cases received oral metformin 850 ma/ twice daily for 8 weeks and 10 cases received placebo for the same period. Basic hormonal parameters, serum glucose and insulin were tested before and after treatment. Metformin led to 65% improvement in acne score, 57% menstrual improvement and significant reduction of serum LH androstenedione, DHEAS, free testosterone, glucose and insulin. Highly significant elevation of SHBG was observed. The mean fasting insulin dropped from 28 uU/ml before to 16 uU/ml after therapy and this drop was significantly correlated to changes in testosterone, free testosterone, SHBG and glucose. Metformin may be suggested as a therapy for women with colomiphene resistant polycystic ovarian disease. It can ameliorate hyperinsulinemia, hyperadrogenemia with their impacton the restoration of regular menses and ovulation; and hence improving the pregnancy capability

Bed utilzation in the department of obstetrics and gynaecology in Tanta University Hospital

Tha aim of the study was to assess the efficiency of bed utilization in the Department of Obstetrics and Gynaecology of Tanta University Hospital during the year 1992. There was 1190 admission occuping 16097 hospital bed days. These patients consumed an average of 13.5 days in hospital. The bed occupancy rate and the bed turn over rate were lower than expected [61.25 and 16.53 days] while the turn over interval was lengthly [8.56 days]. In all groups of patients, the average length of stay was beyond the proper period of hospitalization as manifestated in patients with fistula [59.8 days per case]; followed by prolapse [34.33 days], and fibroid uterus [27.12 days]. Even missed loop admissions occupied 17.22 days on average. These results pointed to misutilization of hospital beds. Identification and prevention of causes of such misutilization in the Department of Obstetrics and Gynaecology could improve resource utilization and prevent hazards of prolonged hospitalisation