Correlation of serum androgen and gonadotropin with anti-mullerian hormone in polycystic ovarian syndrome in Eastern Indian population

Background: Ovarian steroidogenesis requires gonadotropin stimulation, Luteinizing Hormone (LH) is a key factor in the hyperandrogenaemia of the polycystic ovary syndrome. Progesterone is the primary regulator of Gonadotropin-Releasing Hormone (GnRH) pulse frequency; however, in the polycystic ovary syndrome, the GnRH pulse generator is relatively resistant to the negative feedback effects of progesterone.  Study aims to evaluate the association of Anti-mullerian hormone with serum androgen and gonadotropin level in adolescents and young women of Polycystic Ovary Syndrome (PCOS).Methods: This was a single centre observational Cross-sectional study carried out in the department of Endocrinology and metabolism, Medical College, Kolkata from March 2017 to January 2019. Total number of study subjects were 207 out of which 138 were cases.Results: The AMH had strong positive correlation with serum testosterone in both case and control groups (r 0.542, p<0.001 and r 0.57, p<0.001) respectively .After the adjustment of age and BMI , the AMH moderately positive  but extremely significant correlation with serum testosterone as compare to control.Conclusions: Hyperandrogenaemia and higher ratio of LH and FSH associated with higher serum AMH level is associated with the higher serum AMH in polycystic ovarian syndrome.

Prevalence of Left Ventricular Diastolic Dysfunction in Patients with Normal Systolic Function and its Relation with Other Risk Factors from Eastern India.

Impaired diastolic filling of left ventricle may be the important cause of symptoms ranging from mild to severe form of dyspnea with overt features of pulmonary edema which may be wrongly imparted to systolic failure. To study prevalence and severity of diastolic dysfunction and its relation with various risk factors. Methods: Patients from in and out patients department were subjected to detail history, estimation of BMI, blood sugar levels, BP measurement, echocardiographic assessment of cardiac function. Patients of isolated diastolic dysfunction were identified and the degree of diastolic dysfunction was correlated with functional class (NYHA grade) of the patients as well as various risk factors. Results: Out of 400 patients 16 (12.5%) asymptomatic patients had diastolic dysfunction (DD). Severity of diastolic dysfunction increased as the presenting NYHA grade was higher. In NYHA grades III and IV, 59% and 57% of the patients respectively had diastolic dysfunction .DD was significantly associated with diabetes (p<.0001), BMI (p =0.0002), dyslipidemia (p =0.0491), hypertension (p=0.0489). Conclusion: DD is a significant cardiac morbidity. Hypertension, diabetes, dyslipidemia and obesity have significant association with diastolic dysfunction. There is no randomized control trials for treatment for DD. Whether asymptomatic DD needs treatment is not known.

Changes in Microalbuminuria in Relation to Glycosylated Haemoglobin(HbAlc) and Duration in Type 2 Diabetes Mellitus.

Introduction : Diabetes Mellitus is a widely prevalent endocrine disease in the world and Nephropathy is one of the major complications that could lead to severe morbidity and mortality. Persistent microalbuminuria is the best predictor of development of macroalbuminuria and further development of end-stage renal disease as well as cardiovascular complications. The relation between microalbuminuria and glycosylated haemoglobin(HbA1c)as well as duration of diabetes are not clear and studies relating these parameters are few in our country. This study aims to understand this aspect. Aims & Objectives : Our objective is to observe the changes in microalbuminuria level in relation to various parameters of patients of type 2 Diabetes mellitus and to correlate the changes in microalbuminuria levels to HbA1c and duration of diabetes. Materials and Methods : The study was conducted in Medical College & Hospital, Kolkata. 40 patients of type 2 Diabetes mellitus fulfilling inclusion and exclusion criteria were included in this study. Results were analysed by SPSS software. Results : Microalbuminuria had positive correlation with BMI and Waist circumference (WC). No correlation was found between age and microalbuminuria.There was a significant and positive correlation found between microalbuminuria and duration of diabetes as well as microalbuminuria and HbA1c.