Evaluation of patients with polycystic ovarian syndrome at a tertiary care center

Background: It has been estimated that prevalence of PCOS ranges from 5-10% in reproductive females. Thus, it becomes most common endocrinopathy in this age group. Lack of ovulation and androgen over activity are key features of PCOS. The objective of this study was to patients with polycystic ovarian syndrome at a tertiary care center.Methods: Present study was following up study with 200 cases of PCOS. Rotterdam criteria were used for the diagnosis of the PCOS. This criterion includes three things. First is woman having in last year <6 periods of menstruation. Second is testosterone value >0.6 ng/ml and third is each ovary having >12 follicles with increased size and volume. Those cases with hypothyroidism, adrenal tumors, congenital adrenal hyperplasia etc were excluded from the present study. Those on steroid therapy were also excluded. Detailed history and clinical examination were carried out for included cases as well as required investigations.Results: Overall incidence of infertility was found as 27.9%. Out of these 200 cases, 44 (22%) had PCOS. Majority cases belonged to 20-24 years of age. Hirsutism was most common findings in clinical hyperandrogenism. Risk of insulin resistance syndrome was 4.79 times higher in obesity compared to not obese. Age, BMI, duration of infertility, ovarian volume, and menstrual pattern had effect on ovulation rate following laparoscopic ovarian drilling. Increasing duration of infertility and BMI had lower ovulation rate. Ovulation rate was highest when treated with clomiphene citrate alone than the combination therapy.Conclusions: Women with obesity have more chances of having PCOS as seen from the present study.

Hepatoprotective properties of Caesalpinia sappan Linn. heartwood on carbon tetrachloride induced toxicity.

Aim of the study was to investigate the methanol and aqueous extracts of heartwood of C. sappan for its hepatoprotective activity against CCl4 induced toxicity in freshly isolated rat hepatocytes and animals. Freshly isolated rat hepatocytes were exposed to CCl4 (1%) along with/without various concentrations of methanolic and aqueous extract of C. sappan (1000-800 µg/ml) and the levels of selected liver enzymes were estimated. Antihepatotoxic effect of methanolic extract was observed in freshly isolated rat hepatocytes at concentrations 1000-800 µg/ml and was found to be similar to that of standard drug silymarin. Wistar strain albino rat model was used for the investigation of in vivo hepatoprotective properties of aqueous and methanolic extract of C. sappan (100 and 200 mg/kg body weight). Liver damage was induced by ip administration of CCl4 (30%) suspended in olive oil (1 ml/kg body weight). Both the tested extracts showed potent hepatoprotective activity at 200 mg/kg body weight test dose which was comparable with that of the standard silymarin used in similar test dose. The methanolic and aqueous extract was able to restore the biochemical levels to normal which were altered due to CCl4 intoxication in freshly isolated rat hepatocytes and also in animals.

Efficacy of a low cost protocol in reducing noise levels in the neonatal intensive care unit.

Objective. To examine the effectiveness and cost of implementing a noise reduction protocol in a level III neonatal intensive care unit (NICU). Methods. A prospective longitudinal study was done in a level III NICU, wherein a noise reduction protocol that included behavioral and environmental modification was implemented. The noise levels were measured sequentially every hour for 15 days before and after this intervention. The statistical significance of the reduction in noise levels after implementation of the protocol was tested by paired sample student's t-test. Cost was calculated using the generalized cost effectiveness model of the World Health Organisation. The present study has 80 % power with 95 % confidence to measure 2 dB differences between groups for the maximum recommended of 50 dB. Results. The protocol in the present study reduced noise levels in all the rooms of the NICU to within 60 dB with high statistical significance (p< 0.001). The extent of noise reduction in the rooms of the NICU was as follows : ventilator room by 9.58 dB (95 % confidence interval: 6.73 – 12.42, p < 0.001) , stable room by 6.54 dB (95 % confidence interval: 2.92 – 4.16 , p < 0.001), isolation room by 2.26 dB (95 % confidence interval: 1.21 – 3.30, p < 0.001) , pre-term room by 2.37 dB(95 % confidence interval: 1.22 – 3.51, p < 0.001)and extreme preterm room by 2.09 dB (95 % confidence interval: 1.14 – 3.02, p < 0.001). The intervention was most cost-effective in the ventilator room, requiring Rs. 81.09 to reduce 1 dB and least effective in the extreme pre-term room requiring Rs. 371.61 to reduce 1 dB. Conclusion. The high efficacy and affordability of noise reduction protocols justify the need for implementation of these measures as a standard of care in neonatal intensive care units.

An evaluation of the color stability of tooth-colored restorative materials after bleaching using CIELAB color technique.

AIMS AND OBJECTIVE: The aim of this laboratory study was to evaluate the effect of three home bleaching agents: Vivastyle Paint On, Vivastyle, and Opalascence PF on the color stability of the microfilled composite Durafill, the nanofilled composite Filtek Z 350, and the glass ionomer cement Fuji II. MATERIALS AND METHODS: There were 3 groups in this study (n=40)-Group I: durafill, Group II: Filtek Z 350, and Group III: Fuji II. Each group was further subdivided into 4 subgroups (n=10), Subgroup A: bleaching with Vivastyle Paint On, Subgroup B: bleaching with Vivastyle, Subgroup C: bleaching with Opalascence PF, and Subgroup D: control specimens stored in distilled water. Bleaching was carried out following the manufacturer's instructions for a period of 14 days. At the end of the bleaching regimen, the specimens were tested for color change using the CIELAB technique and a reflectance spectrophotometer. RESULTS: The data was subjected to statistical analysis. A Kruskal-Wallis variance analysis and Mann Whitney U test were done to determine the significant color change of the restorative materials. All restorative materials demonstrated a significantly higher color change (DeltaE) with Vivastyle (P < 0.0001). The mean color change of GIC (11.4 +/- 0.3) was the highest among the materials followed by Durafill (7.5 +/- 0.1). Filtek z 350 (0.3 +/- 0.1) showed the least color change with all the bleaching agents. CONCLUSION: Glass ionomer cement showed the highest color change followed by the microfilled composite. The nanofilled composite was found to be highly stable in terms of color.

Spectral analysis of noise in the neonatal intensive care unit.

OBJECTIVE: To perform spectral analysis of noise generated by equipments and activities in a level III neonatal intensive care unit (NICU) and measure the real time sequential hourly noise levels over a 15 day period. METHODS: Noise generated in the NICU by individual equipments and activities were recorded with a digital spectral sound analyzer to perform spectral analysis over 0.5 - 8 KHz. Sequential hourly noise level measurements in all the rooms of the NICU were done for 15 days using a digital sound pressure level meter . Independent sample t test and one way ANOVA were used to examine the statistical significance of the results. The study has a 90 % power to detect at least 4 dB differences from the recommended maximum of 50 dB with 95 % confidence. RESULTS: The mean noise levels in the ventilator room and stable room were 19.99 dB (A) sound pressure level (SPL) and 11.81 dB (A) SPL higher than the maximum recommended of 50 dB (A) respectively ( p < 0.001). The equipments generated 19.11 dB SPL higher than the recommended norms in 1 - 8 KHz spectrum. The activities generated 21.49 dB SPL higher than the recommended norms in 1 - 8 KHz spectrum ( p< 0.001).The ventilator and nebulisers produced excess noise of 8.5 dB SPL at the 0.5 KHz spectrum. CONCLUSION: Noise level in the NICU is unacceptably high .Spectral analysis of equipment and activity noise have shown noise predominantly in the 1 - 8 KHz spectrum. These levels warrant immediate implementation of noise reduction protocols as a standard of care in the NICU.