To see the role of metformin in decreasing hyperinsulinemia and body weight and presentation of poly cystic ovarian disease

Objective: The objective of this study is to evaluate the role of metformin in decreasing hyperinsulinemia and body weight in our population and see the pattern of presentation of PCOD

Study Design: Observational / Descriptive study

Place and Duration of Study: This descriptive study was held in the Gynecology Department of Peoples University of Medical and Health Science, Nawabshah Pakistan from 2nd Jan 2013 to Nov 2014

Materials and Methods: Overall 329 cases satisfying the inclusion criteria were incorporated in the study. Criteria for inclusion were founded upon presence on U/S with two or further of the given criteria like hyperandrogenism, hirsutism, and oligomenorrhea and proportion of reversed LH: FSH

After receiving well-informed consent, demographic data and comprehensive history were recorded on self-created questionnaire. A comprehensive analysis was conducted. Relevant analyzes were made and metformin was initialized with a dosage of 250 milligram s.i.d. [I/day] in starting then step by step adjusted to 500-milligram t.i.d. [thrice/day] for six months. Weight loss was promoted through exercise and diet. Cases were evaluated later than 6 months to analyze their serum fasting insulin and change in BMI. Statistical analysis was carried out by SPSS V. 17.0. P value less than 0.05 taken significant after applying the paired t test and Chi-square test

Results: Total 335 women were included in the study, but six patients had lost follow-up. Complete data was available for 329 patients, which is evaluated. Most common presentation of these patients with PCOD was oligomenorrhea which is seen in 253 [76.89%] patients. Mean serum fasting insulin before treatment was 23.47 micro U/ ml. After six months treatment with metformin, it decreases to 20.78 micro U/ ml [P=<0.001]

Mean body weight before treatment was 69.4 kg and after treatment, it was 68.8kg [P= 0.6167]

Conclusion: Metformin was a useful treatment in decreasing the level of insulin. Further large sample size studies are required

Triple assessment in the diagnosis of carcinoma breast: mammography along with clinical symptomatology

To determine the clinical symptoms and marnrnographic findings in patients of carcinoma breast. Validation study. Armed Forces Institute of Radiology and Imaging Rawalpindi, from January 2011 to Dec 2011. Women of > 30 years of age including premenopausal and postmenopausal with positive findings on histopathology were included in the study. Pregnant women, breast-feeding women, women younger than 30 years old [in whom only sonography was performed] were excluded from the study. Total 57 female patients were included in the study through non-probability consecutive sampling. Mean age of the patients was 52.8 years [SD = 10.3]. Age range of the patients was between 32-72 years. Maximum patients were in the age group of 40 - 50 years. A total of 42.1% patients reported with complaint of lump and mastalgia while 29.8% with lump alone. As far as mammographic findings are concerned speculated mass with axillary lymphadenopathy was the major finding. Histopathological results showed that most common malignant mass was invasive ductal carcinoma [89.5%]. Mammography is the mainstay for evaluation of breast cancer but only patients with the complaints of lump and mastalgia should be evaluated through mammography to avoid unnecessary evaluation

Surgical site infection; evaluation of causative organisms involved

Wound infection can be defined as invasion of organisms through tissues following a breakdown of local and systemic host defenses. The basic principles of wound care and antisepsis introduced during the past century improved surgery dramatically. Evaluation of causative organisms which evolved in the surgical site infection [elective abdominal surgery] at surgical unit of Liaquat university hospital Jamshoro. This prospective observational study was contains 103 patients undergoing elective, abdominal surgery were included in this study. Surgical wound categories i.e. clean, clean contaminated, were included. Prophylactic antibiotics were given in all cases. Primary closure of wounds was employed in all cases. Follow up period was 30 days postoperatively. All cases were evaluated for postoperative fever, redness and swelling of wound margins, collection and discharge of pus. Cultures were taken from all the cases with any of the above findings. The mean age of the patient was 37 years with male to female ratio of 1:5:1. The overall rate of wound infection was 13.04%. Most frequently involved pathogen was E.col 33.33% followed by Staph Aureus 20%, Klebsiella 20%, proteus 13.33%, Pseudomonas 6.66% and no organism was isolated in 6.66% cases. Most effective antibiotics were cephalosporins, quinolones and aminoglycosides' whereas septran, erythromycin and tetracycline's were ineffective. Surgical wound infections are quite common. Time of postoperative hospital stay was twice longer in infected case. Male sex, old age, anemia, longer duration of operation and wound class were significant risk factors. Most common organims are found in this study E-Coli, Kllebcella and Staph Aureus, these are mostly sensitive to cephalosporins, quinolones and aminoglycosides

To determine the frequency of dyslipidemia in primiparous women, with hypertension

Objective: Objective of this study to determine the abnormalities of lipid profile in primiparous women with hypertension

Study Design: Observational study

Place and Duration of Study: This study was conducted at Gynae Department of MMC and of PUMHSNawabshah from March 2012 to February2014

Materials and Methods: Total 100 primiparous women were chosen in this study after the diagnosis of the gestational hypertension. Cases from second trimester of gestational age were incorporated. Women with systolic blood pressure >130 mmHg, and d blood pressure >90 mm of Hg were considered as hypertensive. Every one of the women with known of fetal abnormalities, DM, abnormalities of the thyroid, ischemic coronary illness, renal failure, liver disease and previous history of lipid profile variations and hypertension before the pregnancy were rejected from the study. Blood tests of all the chose women's were taken in fasting and refer to hospital diagnostic laboratory for lipid profile. After the taking the reports information with respect to lipid profile and hypertension were recorded on the proforma

Results: Total 100 ladies were incorporated, mean age was [mean +SD=28.5 +/- 4.2] years, gestational age was discovered [mean +SD=30.2 +/- 3.1 weeks]. Greater part of the women was found with overweight 68%.Dyslipidemia was found in 59% of the women, while 41% women were noted with ordinary lipid profile. As per the abnormalities of lipid profile, all total cholesterol found up in the 49% of the women, taking after by brought LDL was up in 42.0%, HDL was up in 20%, and TG was noted up in the 53.0% of the women. While in the 45% ladies HDL was noted decreased and 35% women were noted with normalHDL

Conclusion: Variations in the lipid profile are the major reason for hypertension inprimiparous women. Therefore it is very important that serum lipid profiles should be constantly observed all through the entire pregnancy period from ahead of diagnosis of hypertension to reduce the maternal morbidity and mortality in youngwomen

Effects of simvastatin and alpha-tochopherol on disturbed nerve conduction in obese sprague dawley rats

Background: The incidence of obesity is increasing worldwide. The neuropathy associated with obesity, that is evident from disturbed nerve conduction, is one of the complications for which a number of treatment options are being considered. In this study, Simvastatin, a hydroxyl methyl glutaryl coenzyme A reductase inhibitor and alpha-tocopherol, a dietary antioxidant are compared for their effects on sciatic nerve conduction velocity. Objectives: To compare the effects of Simvastatin and alpha-tocopherol on sciatic nerve conduction velocity in obese rats. Methods: The study was a Randomised control trial conducted from December 2008 to November 2009. One hundred and twenty adult male Sprague Dawley rats were divided into four groups with 30 rats in each group. One group of rats was taken as control with normal diet while other three groups were given high fat diet [HFD] for the whole study period. Along with the high fat diet, group III and group IV were given Simvastatin and alpha-tocopherol supplemented diet respectively. At the end of study, conduction velocity of sciatic nerve was determined with the help of PowerLab® data acquisition system. Results: The three groups with HFD showed more than 25% increase in weight at the end of study compared to control group. The control group with high fat diet [Group II] showed decreased sciatic nerve conduction velocity when compared with control [Group I]. Both the groups that were given Simvastatin and alpha-tocopherol each showed improvement in sciatic nerve conduction velocity [p<0.001] after four weeks when compared with the group that was given HFD without any supplementation. However with alphatocopherol, the nerve conduction velocity was improved more significantly. Conclusions: Simvastatin and alpha-tocopherol both are effective for improving sciatic nerve conduction velocity in HFD induced obesity. Keywords: Obesity, Simvastatin, nerve conduction velocity, alpha-tocopherol, High Fat Diet

Effects of simvastatin on lipid profile and nerve conduction velocity in obese sprague dawley rats

Background: The incidence of obesity is increasing worldwide. The lipid derangements and decrease in nerve conduction velocity are important complications for which a number of treatment options are being considered. In this study, Simvastatin, a hydroxyl methyl glutaryl coenzyme A reductase inhibitor is studied for its effects on these complications of obesity. Methods: The study was a randomised control trial conducted at Islamic International Medical College, Rawalpindi in collaboration with Railway General Hospital, Rawalpindi, and National Institute of Health, Islamabad. Ninety adult male Sprague Dawley rats were divided into three groups with thirty rats in each group. One group of rats was taken as control with normal diet while other two groups were given High Fat Diet [HFD] for the whole study period, i.e., 10 weeks. One of the HFD group was given Simvastatin along with high fat diet for four weeks. Lipid profile was done by enzymatic colorimetric method. Conduction velocity of sciatic nerve was determined with the help of PowerLab® data acquisition system. Results: The two groups with HFD showed more than 25% increase in weight at the end of study as compared to control group. HFD group showed significantly higher lipid profile and decreased sciatic nerve conduction velocity when compared with control. The group that was given Simvastatin showed significant improvement in lipid profile and increased sciatic nerve conduction velocity after 4 weeks when compared with the group that was given HFD without any intervention. Conclusions: Simvastatin is effective for improving the lipid profile and sciatic nerve conduction velocity in HFD induced obesity. Keywords: Obesity, Simvastatin, nerve conduction velocity

Effects of alpha-tocopherol on lipid profile and nerve conduction velocity in obese sprague dawley rats

Objectives: to study the effects of alpha-tocopherol in high fat diet induced obese Sprague Dawley rats on lipid profile including serum total cholesterol, triglycerides, low density lipoproteins, high density lipoproteins and the sciatic nerve conduction velocity

Methods: the study was a randomized control trial conducted from December 2008 to November 2009. A total of ninety adult male Sprague Dawley rats were divided into three groups, each group having thirty rats. One group of rats was taken as control with normal diet while other two groups were given high fat diet [HFD] for the whole study period i.e. ten weeks. One of the HFD group was given alpha-tocopherol supplementation along with high fat diet for last four weeks. Lipid profile was done after intracardiac blood sampling by total enzymatic colorimetric method. Conduction velocity of sciatic nerve was determined with the help of Power lab data acquisition system

Results: the two groups with HFD showed more than 60% increase in weight at the end of study as compared to control group. HFD group showed significantly higher lipid profile and decreased sciatic nerve conduction velocity when compared with control. The group that was given alpha-tocopherol showed improvement in lipid profile [p-value < 0.001] and increased sciatic nerve conduction velocity [p-value < 0.001] after four weeks when compared with the group that was given HFD without any supplementation

Conclusions: alpha-tocopherol is effective for improving the deranged lipid levels and sciatic nerve conduction velocity in obesity