Anti-mullerian hormon level and polycystic ovarian syndrome diagnosis

Polycystic ovarian syndrome [PCOS] is a common endocrinopathy that accompanied with long term complications. The early diagnosis of this syndrome can prevent it. The aim was to determine the role of anti-mullerian hormon [AMH] in PCOS diagnosis and to find cut off level of it. In this cross sectional study, 117 women between 20-40 years old were participated in two groups: 60 PCOS women [based on Rotterdam criteria consensus] as the case group and 57 normal ovulatory women as the control group. In day 2-4 of cycle, transvaginal sonography was performed and serum hormonal level of AMH, luteinizing hormone [LH], follicle stimulating hormone [FSH], estradiol [E[2]], testosterone, fasting blood sugar [FBS], thyroid stimulating hormone [TSH], and prolactin [PRL] were measured in all of participants. For all of them score of hirsutism [base on Freeman-Galloway scoring] was determined. There were statistically significant in irregular pattern of menstruation, AMH and FSH level, and presence of hirsutism between two groups. But regarding mean of age, body mass index, plasma level of PRL, TSH, LH, Testosterone, FBS, and E[2] differences were not significant. Construction by ROC curve present 3.15 ng/ml as AMH cut off with 70.37% sensitivity and 77.36% specificity in order to PCOS diagnosis. AMH with cut off level of 3.15 ng/ml with sensitivity 70.37% and specificity 77.36% could use for early diagnosis of PCOS patients

Echocardiographic assessment of adults with repaired tetralogy of fallot: a cardiovascular magnetic resonance comparison study

Surgical management of the tetralogy of Fallot [TOP] results in anatomic and functional abnormalities in the majority of patients. Right ventricular [RV] dilation from pulmonary regurgitation [PR], residual atrial and/or ventricular septal defect, tricuspid regurgitation, right ventricular outflow tract [RVOT] aneurysm, and pulmonary artery peripheral stenosis are some of the abnormalities frequently encountered in patients with repaired TOP. Cardiovascular magnetic resonance [CMR] can provide assessments of anatomical connections, biventricular function, flow measurement, and more, without ionizing radiation. Echocardiography is the most frequently used modality for the initial assessment and follow-up of most patients with CHD. We sought to evaluate adult patients with repaired TOP by transthoracic echocardiography and compare them with CMR. 156 patients [52 women, mean age= 23 +/- 5.5 years] late after TOP repair with severe PR were evaluated. Ventricular size and function and TOP -associated anomalies such as patent ductus arteriosus [PDA], peripheral pulmonary stenosis [PPS], and persistent left superior vena cava [LSVC] were evaluated by transthoracic echocardiography and CMR separately. Mean of LV ejection fraction by CMR was 52 +/- 9% and by echocardiography was 47 +/- 5.1%. We found a significant correlation between LVEF assessed by CMR and 2D visual assessment in multiple views. Mean of RVEF by CMR was 37 +/- 8% and RV end diastolic volume index was 161 +/- 57.3 mm[3]. Linear correlation between CMR-RVEF and RVEF measured by echocardiography was weak. There was almost perfect agreement between CMR and echocardiography for the diagnosis of LSVC [99.2%]. Agreement was 88.3% in the diagnosis of PDA, 66.4% in the diagnosis of PPS, and 93% in the diagnosis of the right aortic arch was. Adults late after repaired TOF have significantly reduced biventricular systolic function. Despite abnormal LV geometry, visual assessment of LV systolic function by an expert echocardiologist has an acceptable agreement compared to the quantitative measurement of LV systolic function by CMR. However, the correlation between CMR-RVEF and RVEF measured by echocardiography is weak. We found incremental diagnostic value of CMR in PPS and PDA. Atrial septal defect and ventricular septal defect are found more frequently by echocardiography