Evaluation of prolactin and insulin resistance in women with polycystic ovarian syndrome

Background: Polycystic ovarian syndrome has been one of a major public health problem in India that leads to medical consequences. It causes multifactorial in etiology such as menstrual dysfunction, hyperandrogenism, hirsutism, insulin resistance, dyslipidemia and obesity which increased risk of diabetes mellitus and cardiovascular disease. Prolactin has been reported as a potent lipogenic and diabetogenic factor, that affecting energy balance and fuel metabolism. The present study was designed to assess serum prolactin and insulin resistance in PCOS women and to compare them with healthy women as controls. Material and Methods: A comparative study including 50 women diagnosed as PCOS and 50 age and BMI matched healthy women as controls was conducted. The age group for the study was 18-35 years. Body Mass Index was calculated as a physical parameter. Fasting blood samples were drawn to assess serum prolactin, serum insulin, HbA1c and fasting blood sugar. Insulin resistance was calculated by homeostasis model assessment. Results: A significant increase in fasting serum insulin (p<0.001) and HOMA – IR (p<0.001) were found in patients with PCOS in comparison with controls. Mean BMI, prolactin, HbA1c and FBS were found elevated in the PCOS women but they were not statistically significant. No significant correlations were found between BMI, serum prolactin and serum insulin. Conclusions: The current study provides further evidence that significantly higher fasting insulin and HOMA in PCOS group indicates presence of IR. IR in PCOS group may have a potential role in the prediction of dysglycemic disease in women with PCOS. This study could not find any significant correlation between serum prolactin, serum insulin and BMI.

Serology and immunoglobulin profile in rheumatoid arthritis.

One hundred and twenty cases of clinically diagnosed rheumatoid arthritis, 80 non-rheumatoid cases suffering from various other diseases and 40 healthy individuals were investigated for the presence of rheumatoid factor, quantitation of serum immunoglobulin, demonstration of ANA and LE cell phenomenon. Microlatex agglutination test of serum for rheumatoid factor showed 56.6% positivity in rheumatoid group and 3.7% positivity in non-rheumatoid group. All three serum immunoglobulins (IgG, IgM, IgA) were raised in serum in significant titre in cases of rheumatoid arthritis, whereas only IgA lever was elevated in the group of non-rheumatoid diseases. ANA and LE cell phenomenon were observed in 11.7% and 4.4% cases of rheumatoid arthritis who had severe underlying disease. In non-rheumatoid group, only one of 6 cases of systemic lupus erythematosus showed rheumatoid factor and that too in an insignificant titre (less than 1:20). Synovium and synovial fluid contained plenty of plasma cells and lymphocytes. It has been observed that RF appears first in synovial fluid and it may take several months to a year to attain detectable level in serum.

Transrectal fine needle aspiration cytology of granulomatous prostatitis.

Transrectal fine needle aspiration cytology by Franzen technique was carried out from January, 1985 till January, 1992 on 567 patients having prostatomegaly which were suspicious of malignancy by clinical per rectal examination. Granulomatous prostatitis was diagnosed in 56 cases. Analysis showed 34 cases were tuberculous prostatitis and 22 cases were nonspecific granulomatous prostatitis. Comparison of aspiration cytology with bacteriological study of the aspirated material and histopathology showed correct diagnosis of granulomatous prostatitis by fine needle aspiration. The findings indicate that transrectal fine needle aspiration cytology is a reliable procedure for diagnosis of granulomatous prostatitis which can clinically mimic prostatic malignancy when it presents as a diffuse or nodular enlargement with firm to hard consistency.

Neonatal candidemia.

Fifty five clinically diagnosed cases of neonatal septicaemia of the nursery ward, Medical College Hospital Calcutta were subjected to blood culture on two consecutive days in all cases. Bacterial isolates were found in 34 (61.8%) cases as pure growth and candida species from 9 (16.4%) as pure culture. Remaining 12 samples did not yield any growth. Species distribution of candida showed C. albicans 6, C. parapsilosis 2, and C. guillermondii 1. Asphyxia neonatorum was the common feature in all cases of candidaemia. All neonates with candidal infection were low-birth-weight and premature. C. albicans, the predominant species (66.6%) recovered, was responsible for a localised outbreak of infection in the nursery.

Transferable drug resistance in Salmonella senftenberg.

Six Salmonella senftenberg strains were isolated from blood samples of patients clinically diagnosed to be suffering from enteric fever during the recent outbreak of enteric fever in and around Calcutta. All of them were multidrug resistant including chloramphenicol. The minimum inhibitory concentration (MIC) of the drugs in which they were resistant, were well above the normal level. All these strains were sensitive to cephalexin, gentamicin, furazolidone and ciprofloxacin. The transferable drug resistance test suggested that the strains were carrying transferable drug resistant gene containing ACSTK resistant factor.

Fine needle aspiration cytology (FNAC) in the diagnosis of solid renal masses--a study of 92 cases.

Percutaneous fine needle aspiration cytology (FNAC) was employed as preoperative diagnosis in 92 solid renal masses from June, 1984 till December, 1990. Ultrasonography guided FNAC was employed in 26 lesions. There were 79 malignant tumours, 3 benign tumours, 6 lesions were inflammatory and only necrotic material was seen in 4 cases. Correlation with histopathology showed diagnostic accuracy of 91.3%. There were two false positive reports. No complication was encountered in this study.

Some prospective observations on recent outbreak of typhoid fever in West Bengal.

The present study was designed to study the clinical behaviour of a recent epidemic of typhoid fever in West Bengal. Of 46 cases studied, 67% (31) had chloramphenicol resistant typhoid fever. The chloramphenicol-resistant cases were comparatively severe in nature with higher complication and mortality rates. Salmonella typhi resistant to chloramphenicol were also resistant to ampicillin, cloxaxillin and cotrimoxazole. Strains of Salmonella typhi sensitive to chloramphenicol retained their sensitivity to these other antimicrobials.

The role of transrectal fine needle aspiration cytology in the diagnosis of prostatic nodules suspicious of malignancy--a study of 126 cases.

Transrectal fine needle aspiration cytology by Franzen technique was carried out in 126 patients having enlarged prostate which were suspicious of malignancy by clinical per rectal examination. Analysis showed benign adenoleiomyomatous hyperplasia in 40 cases, chronic prostatitis in 4 cases, tuberculosis of prostate in 4 cases, malignancy in 76 cases and 2 cases were reported as suspicious of malignancy. Comparison of aspiration cytology with histopathology, serial serum acid phosphatase estimation, repeat a spiration cytology after hormone therapy with or without orchiectomy and clinical follow up showed accuracy of cytologic diagnosis of 98.4 per cent. False negative was 1.6 per cent. There was no false positive diagnosis. No complication was encountered in this procedure.