ABSTRACT
Background: Polycystic ovarian syndrome (PCOS) characterized by anovulation and features of hyperandrogenism (clinical or biochemical) and insulin resistance. Metformin and myoinositol being insulin sensitizers improve clinical and biochemical parameters. This study was done to compare the effects of these drugs on clinical features and biochemical profile.Methods: A randomized, comparative, clinical study was conducted on 72 patients. The patients were randomized with the help of computer-generated random numbers and were allocated to either of the three treatment groups A, B and C. Patients in group A received metformin 500 mg TDS, group B received myoinositol 1000 mg BD, group C received combination of metformin 500 mg and myoinositol 550 mg BD for 24 weeks. At first visit patients detailed history and baseline investigations were recorded. Follow up was done 24 weeks after start of therapy to assess the improvement in clinical and biochemical profile.Results: There was significant improvement in menstrual irregularities, cutaneous manifestations, pregnancy rate, LH/FSH ratio, insulin sensitivity and HOMA-IR after 24 weeks of treatment in all three groups (p value <0.05), although there was greater improvement in cases treated with combination of metformin and myoinositol than metformin and myoinositol alone.Conclusions: The combination of metformin and myoinositol has resulted in more significant reduction in insulin resistance and improvement in metabolic and hormonal profile along with regularization of menstrual cycles and spontaneous conception than metformin and myoinositol alone.
ABSTRACT
The brachial plexus consists of a network of nerves that innervates the upper limbs and its musculature. We report a rare formation of the lateral cord of the brachial plexus observed during the dissection of a 47-year-old male cadaver at the Department of Anatomy, Vardhman Mahavir Medical College, New Delhi, India, in 2016. The lateral cord was exceptionally long with twin lateral pectoral nerves and twin lateral roots of the median nerve. The proximal lateral root of the median nerve was thin in comparison to the medial root of the median nerve. The distal lateral root of the median nerve was thicker and followed an unusual course through the coracobrachialis muscle. In the lower third of the arm, the median nerve and the brachial artery-along with its vena comitans-spanned through the brachialis muscle. Surgeons, anaesthesiologists, radiologists and anatomists should be aware of such anatomical variations as they may result in neurovascular compression
ABSTRACT
In this paper, a non-linear model is proposed and analyzed to study the effects of habitat characteristics favoring logistically growing carrier population leading to increased spread of typhoid fever. It is assumed that the cumulative density of habitat characteristics and the density of carrier population are governed by logistic models; the growth rate of the former increases as the density of human population increases. The model is analyzed by stability theory of differential equations and computer simulation. The analysis shows that as the density of the infective carrier population increases due to habitat characteristics, the spread of typhoid fever increases in comparison with the case without such factors