Unreported urinary and anal incontinence in women

To know the occurrence of unreported urinary and anal incontinence in women and its relation with age, parity, pregnancy, childbirth and other factors. A descriptive study. Study was conducted at department of Obstetrics and Gynaecology, Isra University Hospital, Hyderabad from January 2002 to December 2003. Convenience sample of 858 women was taken to fill in a pre-formed questionnaire. All those who presented with urinary or anal incontinence were excluded from the study. The main outcome measures included occurrence and duration of incontinence as well as its relation to age, parity and other factors. Out of 858 women included in the study, 207 [24.12%] women admitted to have incontinence; 205 [23.89%] had urinary incontinence, 21 [2.44%] women had anal incontinence and among these there were 19 [9.26%] women having combined urinary and anal incontinence. One hundred and thirty eight [67.31%] females were between 21-40 years of age and 109 [53.17%] were between para 1-5. Eighty-one [39.51%] subjects had urinary incontinence for 5-10 years and 09 [42.85%] females had anal incontinence for 10-15 years. Sixty-nine [33.65%] women related the onset of urinary incontinence and 13 [61.90%] related the beginning of anal incontinence to first vaginal delivery. Other events related to the onset of incontinence included first pregnancy, second vaginal delivery, chronic cough, obesity, vaginal prolapse and menopause. Many women attending the Obstetrical and Gynaecological Outpatients department have symptoms of urinary and anal incontinence, but do not complain about these unless asked specifically. It is therefore, important for the gynecologist to ask direct questions regarding bowel and bladder dysfunction to identify such patients

Polycystic ovarian syndrome and hyperinsulinaemia

To determine the occurrence of hyperinsulinaemia in women with polycystic ovarian syndrome [PCOS]. A descriptive study. Isra University Hospital, Hyderabad from January 2002 to December 2003. Total 64 subjects were recruited from gynaecological outpatients department, between the ages of 15 and 40 years with clinical diagnosis of polycystic ovarian syndrome, presenting with weight gain, oligomenorrhoea, secondary amenorrhoea, hirsuitism or infertility and either ultrasound evidence of PCOS or raised Leutinizing Hormone [LH]/ Follicular Stimulating Hormone [FSH] ratio. Patient's venous blood was checked for fasting serum insulin. Out of total 64 women selected, 37[57.81%] were between 21 - 30 years of age. Weight gain was the commonest presenting complain [84.37%] followed by oligomenorrhoea [79.68%]. Infertility was found in 46 women [71.87%] and hyperandrogenism was observed in 43 women [62.49%]. Thirty-nine women [60.93%] had ultrasound evidence of PCOS and 43 [67.18%] had LH / FSH ratio greater than 2:1. Hyperinsulinaemia was seen in 27 [42.19%] women. In this study, 27 women [42.19%] had hyperinsulinaemia which indicates significant insulin resistance. Thus, all the patients presenting with clinical or biochemical evidence of PCOS must undergo checking of fasting serum insulin levels