comparative study of diane-35 plus spironolactone and diane -35 plus finasteride in cases of hirsutism and acne

To compare the efficacy and safety of Diane 35 plus spironolactone and Diane 35 plus finasteride in the treatment of hirsutism and acne. A prospective randomized clinical trial was conducted on 120 Indian women with hirsutism. Group I patients were heated with Diane 35 plus spironolactone 100 mg daily and group II patients with Diane 35 plus finasteride 5 mg daily for 12 months. Hirsutism and acne score were graded every 3 months, for 18 months. The basal gonadotropins levels and androgens level were measured before the study. Statistical analysis was done by Students t-test and repeated measure analysis followed by post hoc comparison. Reduction in hirsutism and acne scores assessed every 3 months was significant [p<0.001] and similar between the two groups, indicating that if treatment was prolonged for over 12 months, reduction scores would have been better. A significant decrease in the hirsutism score of 55.3% +/- 17.2 and 59.4% +/- 17.5 was observed after 12 months in groups I and II respectively. Total reduction in hirsutism and acne scores of both groups was similar [P>0.05]. Diane 35 plus spironolactone and Diane 35 plus finasteride are equally effective and safe in the treatment of hirsutism and acne. For belier outcomes, it is recommended that the treatment period be over 12 months

Computed tomography for evaluation of adrenal dysfunction A/C- year follow-up

To evaluate the computed tomography [CT] morphology of the adrenal glands of patients with adrenal dysfunction. CT examination of adrenal glands was performed in 331 consecutive patients with symptoms suggestive of adrenal dysfunction. CT was performed using 4-mm contiguous sections for the adrenal area. Intravenous contrast was injected in 78 cases of the adrenal mass lesions. We analyzed 331 consecutive CT scans performed over a 10-year period. One hundred and twenty-seven patients had hypercortisolism, 23 had unilateral adrenal tumor, 18 had bilateral adrenal hyperplasia and 86 had normal adrenals. The CT diagnosis was confirmed at surgery in all 23 unilateral adrenal tumors except in 1 case [tuberculosis in a hyperplastic adrenal gland]. Among the 91 cases of hypertension, 86 were being evaluated for pheochromocytoma and 5 for Conn's syndrome. Forty-three had adrenal pheochromocytoma [1 bilateral] and 10 had extra-adrenal pheochromocytoma detectable on CT. Two of the 5 cases of hyperaldosteronism [Conn's syndrome] had adrenal tumor. Adrenal enlargement was observed in 17 of the 33 cases of Addison's disease. Four of them were cases of histoplasmosis. CT scanning is a sensitive tool for the imaging of adrenal glands. Both neoplastic and inflammatory lesions can alter adrenal gland morphology. Our results highlight the importance of studying adrenal morphology. CT morphology is helpful to decide the modality of treatment