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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.
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OBJECTIVE: To investigate the efficacy of acupoint injection of Ropivacaine for labor analgesia and its effect on breastfeeding and prolactin secretion. METHODS: A total of 80 primipara who asked to receive labor analgesia were randomized into epidural analgesia group (n＝35) and acupoint injection group (n＝36), and other 36 primipara who refused to receive labor analgesia were subjected to the control group. The labor analgesia began to be performed when the puerpera's uterine orifice opened about ≥3 cm (the first stage of labor), including puerpera controlled epidural analgesia (PCEA, Sufentainil ＋ 0.1% Ropivacaine hydrochloride, 5 µg/mL at L3-L4 interspace, till the birth of fetus) or acupoint injection of Ropivacaine (0.2%, 1 mL/acupoint) at bilateral Hegu (LI4) and Sanyinjiao (SP6). The delivery situations such as the duration of labor, and number of cases who used oxytocin, obstetric-forceps-aided delivery, cesarean delivery were recorded. The serum prolactin concentration was assayed by using ELISA. The visual analogue scale (VAS) scores at the time points of T0 (about 3 cm widening of the orifice of uterus and before performing analgesia), T1 (30 min after labor analgesia), T2(about 10 cm widening of the orifice of uterus) and T3(coming out of fetal head). The duration of labor, ratio of use of oxytocin, onset time of breastfeeding, and times of breastfeeding within 24 postpartum hours were recorded accordingly. RESULTS: The VAS scores at time-points of T1, T2 and T3 were significantly lower in both epidural analgesia and acupoint injection groups in comparison with their own T0 and the control group (P0.05), and between the epidural analgesia group and control group in the serum prolactin levels (P>0.05)．. CONCLUSION: Injection of Ropivacaine at LI4 and SP6 is effective for labor analgesia and raising prolactin level, and favorable to breastfeeding in the early postpartum period.
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OBJECTIVE:To investigate clinical efficacy and safety of different dosages of bromocriptine in the treatment pro-lactinoma,and its effects on serum prolactin(PRL)and tumor volume. METHODS:A total of 60 patients with prolactinoma were selected from our hospital during Jan.-Dec. 2015 as research objects,and then divided into group A and B according to random number table,with 30 cases in each group. Both groups were given Bromocriptine mesilate tablets orally during meal. Group A was given medicine with initial dose of 2.5 mg/d,increasing to 3.75 mg/d 3 d later,increasing by 2.5 mg every week after 2-3 d,and then recovering to 3.75 mg/d till serum PRL level had been controlled. Group B was given medicine with initial dose of 1.25 mg/d, increasing to 2.5 mg/d 3 d later,increasing by 1.25-2.5 mg every week after 2-3 d,and then recovering to 2.5 mg/d till serum PRL level recovered to normal. Both groups were treated for consecutive 3 months. Clinical efficacies as well as serum level of PRL and tumor size were observed in 2 groups,and the occurrence of ADR was recorded. RESULTS:The total response rate of group A (83.33％) was higher than that of group B (66.67％),without statistical significance (P>0.05). Before treatment,there was no statistical significance in serum level of PRL and tumor size between 2 groups (P>0.05). After 1,2 months of treatment,serum levels of PRL in 2 groups were decreased significantly,and the group A was significantly lower than the group B,with statistical significance(P0.05). After treatment,tumor size of 2 groups were decreased significantly,and large adenoma and giant adenoma size in group A were significantly smaller than group B,with statisti-cal significance(P0.05). The inci-dence of ADR in group A(12 cases,40.00％)was significantly higher than group B(5 cases,16.67％),with statistical signifi-cance(P<0.05). CONCLUSIONS:Increasing dosages of bromocriptine no significant influence on therapeutic effect of prolactino-ma,but it can shorten the time of serum PRL level back to normal,and reduce the tumor size. The incidence of adverse reactions in-crease with the dosage.
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Neonatal septicemia is defined as a bacterial infection documented by a positive blood culture in the first 4 weeks of life. The clinical symptoms and signs are non specific and vague. So it is important to make diagnosis and to start treatment as early as possible to prevent serious morbidity and mortality caused by non-treatment or late treatment of septicemia. This study was conducted for a period of 3 years. 200 neonates under the age of 28 days were studied to find out hematological parameters including sepsis screen, hematological scoring system and serum procalcitonin levels in neonates suspicious of sepsis. We concluded that, though blood culture is a gold standard for the diagnosis of sepsis, combined use of sepsis markers increases the diagnostic accuracy in suspected cases and simultaneously prevents over treatment of clinically suspicious cases.
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Objective To explore the clinical efficacy and safety of paliperidone in treatment of schizophrenia and its influence on serum prolactin levels.Methods 52 cases of schizophrenia were diagnosed,and they were divid-ed into two groups according to randomized single-blind method.26 patients in the control group were given oral risperidone treatment, while 26 cases in the observation group were given oral paliperidone.The clinical treatment effect,incidence of adverse reactions and serum prolactin levels were compared.Results The total effective rate of the two groups showed no significant difference (χ2 =1.44,P>0.05).After 4 weeks,8 weeks,12 weeks treatment, the serum prolactin levels of the observation group were (42.86 ±17.54)μg/L,(35.47 ±18.29)μg/L,(26.14 ± 17.38)μg/L,which were significantly increased than before treatment[(10.21 ±4.09)μg/L](t =8.44,6.89, 6.03,all P<0.05),and compared with the control group at the respective time points,the differences were significant (t=8.23,8.01,7.67,all P<0.05).After 4 weeks,8 weeks,12 weeks treatment,the serum prolactin levels of the control group were (56.72 ±11.38)μg/L,(51.26 ±21.48)μg/L,(48.31 ±22.76)μg/L,which were significantly increased than before treatment (t=10.43,9.30,7.83,all P<0.05).The incidence rate of adverse reactions in the observation group was 23.08%,which was significantly lower than 53.85% of the control group,the difference was significant between the two groups (χ2 =10.34,P<0.05).Conclusion Paliperidone in the treatment of schizophre-nia had good curative effect, and it can effectively improve the serum prolactin levels in patients, and it had less adverse reactions,it was safe,which should be applied and promotion of great value.
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Transient hyperprolectinemia has been reported to follow unprovoked seizures. This study was conducted in 90 children aged 1-18 years of age. The study comprised of four groups: Group-1 consisted of children with epilepsy which was further subdivided into GTCS, CPS and SPS. Group-2 comprised of children having febrile convulsions. Group-3 comprised of children suffering from non-epileptic paroxysmal events like breath holding spell, syncope and pseudoseizures or conversion reaction. Group-4 consisted of children who served as controls. Blood sample was collected within two hours of the event in all the groups. The exact interval between the event and the collection of blood sample was noted. Serum prolactin level was estimated by ELISA technique. In the present study, significant elevation of serum prolactin level was observed only in the Group-1 (28.77+15.49ng/ml) as compared to controls (9.53+2.45ng/ml) and the highest levels were observed in children with GTCS. Maximum elevation of prolactin was seen within 15 to 30 minutes post ictally. As the prolactin levels become normal after two hours of post ictal period, the test looses its significance.
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BACKGROUND: To investigate the clinical significance of interictal serum prolactin level (ISPL), especially in the medical intractability, in patients with complex partial seizure involving the temporal lobe. METHODS: Forty-one male patients older than 16 years, who had motionless staring, were selected. The patients were divided into paired groups according to medical intractability, secondary generalization, duration of disease, seizure frequency, number of antiepileptic drugs, hippocampal sclerosis in MRI, and interictal epileptiform discharge. Serum was sampled in the morning before breakfast, and ISPL was measured. RESULTS: ISPL of the medically intractable patients (11.43 +/- 1.25 ng/ml, n=23) was relatively higher than the treatable patients (9.67 +/- 1.52, n=18), but it was not statistically significant (p>0.05). ISPL of the patients with secondary generalization was significantly higher (11.58 +/- 1.10, n=33) than that of the patients without secondary generalization (6.84 +/- 1.39, n=8; p=0.049). The other factors did not make significant changes in ISPL (p>0.05). CONCLUSIONS: The medical intractability of epilepsy with clinically determined complex partial seizures involving temporal lobe did not change the ISPL. Therefore, ISPL may not be useful as a biochemical marker of the medical intractability of complex partial seizures involving the temporal lobe. However, there was the evidence suggesting that the secondary generalization of complex partial seizures may be an important factor to increase ISPL, which implies that more widespread robust activation of limbic structures may be needed to elevate ISPL.
Subject(s)
Humans , Male , Anticonvulsants , Biomarkers , Breakfast , Epilepsy , Generalization, Psychological , Magnetic Resonance Imaging , Prolactin , Sclerosis , Seizures , Temporal LobeABSTRACT
The clinical value of circulating prolactin as a marker for the diagnosis of primary breast cancer compared with other serum markers was evaluated in Thai women. Forty women with primary breast cancer, 20 women with benign breast disease and 20 normal women were included in the study. Single serum levels of prolactin, CEA, CA 15-3, MCA and c-erbB-2 were simultaneously measured. At 95% specificity, prolactin gave the highest diagnostic sensitivity (92.5%) compared with a sensitivity of 10-30% obtained from the other markers studied but did not correlate with any of them. Concentrations of CEA, CA 15-3, MCA and c-erbB-2 in 40 breast cancer tissue were related to each other by multiple regression analysis and they also showed good positive and negative agreement among subjects. Thus, measurement of a single marker among four of them should be economically and clinically appropriate. CEA when compared with other markers, showed a better relationship with clinicopathological parameters e.g. tumor diameter and axillary lymph node involvement. This preliminary study suggests that prolactin and CEA may be a good combination of paired serum markers for the early detection of breast cancer. A prospective study should be performed in order to demonstrate the exact relationship of elevated blood prolactin levels and the risk of breast cancer in the Thai population.
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Thirty-seven patients with prolactinoma treated over a seven-year period were retrospectively reviewed. During the same period, a total of 104 patients with pituitary adenoma were treated at our hospital, and among them, prolactinoma was the most frequently occurring tumor(35.6%); it was followed by nonfunctional adenoma and growth hormone-secreting adenoma. A female preponderance was observed with a male to female ratio of 1:3 .1. Prolactinoma patients were diagnosed at a younger age than pituitary adenoma patients in general; it seemed that the typical symptoms of prolactin excess facilitated early diagnosis. Tumors were classified as microadenoma(n=13) or macroadenoma(n=24) according to the their largest diameter as seen on CT or MRI images. Clinical symptoms were related to mass effect(visual field defect, loss of visual acuity, headache) and/or hormone excess(amenorrhea, galactorrhea). Mean preoperative serum prolactin level was 1027.9ng/ml(range, 39-14945), and this fell to a postoperative mean of 767.8ng/ml(2-10202). In patients with a preoperative serum prolactin level below 200ng/ml, ameorrhea improved in 76.5% of cases and serum prolactin level normalized in 73.7%, but in cases where this level was over 200ng/ml, amenorrhea improved in only 30% of cases and serum prolactin level returned to normal in only 22.2%. It appears that surgical outcome was mostly influenced by the preoperative serum prolactin level.