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
Background: Thyroid hormones play critical roles in differentiation, growth, and metabolism. Thyroid hormone play important role in development of Central Nervous System and in myelination of neurons. hypothyroidism is a chronic and insidious disease caused by failure of thyroid hormone production mostly due to inflammation, thyroidectomy, use of I131, and anti-hyperthyroidism drugs. Involvement of Peripheral nerve is frequent in hypothyroid patients. Objective of study: To evaluate the dysfunction of Sensory Nerve in Hypothyroid patients. Methods: 30 patients of hypothyroidism were included in the study, detailed history and clinical examination was performed. 30 normal subjects were included as control. Nerve Conduction Studies were performed in neurophysiology lab of Physiology dept of JNMC Aligarh. Results: While comparing the Sensory Nerve Conduction velocity of Median nerves between the two groups, the Sensory NCV of right Median (44.59±8.39) is found to be significantly decreased in hypothyroid subjects. While comparing the Sensory latency of Median nerve between the two groups, the latency of right median nerve (3.69±.69), left median nerve (3.43±.80) is significantly increased bilaterally in hypothyroid subjects. Conclusion: Hypothyroidism is a definite cause of neuropathy, it affects sensory nerves first than motor nerves. We suggest performing electrophysiological studies in hypothyroid patients, even asymptomatic patients in an early course of disease. So we can prevent the progression of neuropathy