Establishment of age-specific reference intervals for AMH in Indian women and enhancing its use as a diagnostic marker in PCOS

Background: Anti Mullerian hormone (AMH) level is a reliable marker of ovarian reserve. It is known to be influenced by factors like age, ethnicity, and ovarian pathology. Establishment of age-specific reference intervals for AMH, characteristic of different nationalities, is therefore of utmost importance. Serum AMH is known to be elevated in women with polycystic ovarian syndrome (PCOS). It is desirable to determine a population-specific cut-off of AMH, for it to be used as a diagnostic marker for PCOS.Methods: Serum AMH, luteinizing hormone (LH), follicle-stimulating hormone (FSH), Estradiol, Progesterone and Testosterone assays were analyzed in 1978 Indian women, in the age range of 12–50 years. Age-specific reference intervals for AMH were derived for the study population. The cohort of study subjects were then divided into two groups, based on AMH values and clinical history: Control group, and patients with PCOS. The cut-off value of AMH in the study population, corresponding to the diagnosis of PCOS, was also established. Results: Upper 95th percentile limits of reference intervals for the 18-25 26–30, 31–35, and 36–40, 41-45 and >45 age groups were 9.69, 7.60, 6.50, 6.1, 4.80 and 4.5 ng/ml respectively. In the PCOS group the 5th percentile value was 7.80 ng/ml and the upper 95th percentile was 21.81 ng/ml. The median percentile in PCOS group was 10.40 ng/ml. ROC analysis was done to obtain optimal cutoff values for each age group with better discriminative power than the reference limits. The best cut-off point of AMH value for PCOS in our study population was 7.51ng/ml. The sensitivity and specificity were 99.4% and 95.5%, respectively. The calculated area under the Receiver operating characteristic (ROC) curve was 0.988 (95% CI: 0.984-0.991, P <0.001). AMH, LH, and LH/FSH ratio was significantly higher in the PCOS group than in the control group (p < 0.001 for all comparisons). LH/FSH ratio was more than 2 in the PCOS group compared to controls. Serum Testosterone was significantly higher in PCOS.Conclusions: The study aids to establish a biological reference interval for AMH, specific for different age groups in Indian women. 7.51ng/ml has been derived as a diagnostic cut-off of AMH for PCOS in our study population. The establishment of age-specific reference intervals, and syndrome-specific cut-offs in the Indian population will help overcome the influence of variables and broaden the use of AMH in women’s health.

Establishment of age-specific reference intervals for AMH in Indian women and enhancing its use as a diagnostic marker in PCOS

Background: Anti Mullerian hormone (AMH) level is a reliable marker of ovarian reserve. It is known to be influenced by factors like age, ethnicity, and ovarian pathology. Establishment of age-specific reference intervals for AMH, characteristic of different nationalities, is therefore of utmost importance. Serum AMH is known to be elevated in women with polycystic ovarian syndrome (PCOS). It is desirable to determine a population-specific cut-off of AMH, for it to be used as a diagnostic marker for PCOS.Methods: Serum AMH, luteinizing hormone (LH), follicle-stimulating hormone (FSH), Estradiol, Progesterone and Testosterone assays were analyzed in 1978 Indian women, in the age range of 12–50 years. Age-specific reference intervals for AMH were derived for the study population. The cohort of study subjects were then divided into two groups, based on AMH values and clinical history: Control group, and patients with PCOS. The cut-off value of AMH in the study population, corresponding to the diagnosis of PCOS, was also established. Results: Upper 95th percentile limits of reference intervals for the 18-25 26–30, 31–35, and 36–40, 41-45 and >45 age groups were 9.69, 7.60, 6.50, 6.1, 4.80 and 4.5 ng/ml respectively. In the PCOS group the 5th percentile value was 7.80 ng/ml and the upper 95th percentile was 21.81 ng/ml. The median percentile in PCOS group was 10.40 ng/ml. ROC analysis was done to obtain optimal cutoff values for each age group with better discriminative power than the reference limits. The best cut-off point of AMH value for PCOS in our study population was 7.51ng/ml. The sensitivity and specificity were 99.4% and 95.5%, respectively. The calculated area under the Receiver operating characteristic (ROC) curve was 0.988 (95% CI: 0.984-0.991, P <0.001). AMH, LH, and LH/FSH ratio was significantly higher in the PCOS group than in the control group (p < 0.001 for all comparisons). LH/FSH ratio was more than 2 in the PCOS group compared to controls. Serum Testosterone was significantly higher in PCOS.Conclusions: The study aids to establish a biological reference interval for AMH, specific for different age groups in Indian women. 7.51ng/ml has been derived as a diagnostic cut-off of AMH for PCOS in our study population. The establishment of age-specific reference intervals, and syndrome-specific cut-offs in the Indian population will help overcome the influence of variables and broaden the use of AMH in women’s health.

Morphological characteristics of microfilariae in blood smears of the common treeshrew Tupaia glis (Mammalia: Scandentia) in Gemas, Negeri Sembilan, Malaysia

@#Some filarial nematodes, such as Wuchereria bancrofti, Brugia malayi, and Brugia timori, cause lymphatic diseases in humans in the tropics, whereas other filarial parasites from wild animals cause zoonotic diseases in humans worldwide. To elucidate the prevalence and diversity of filarial parasites in Malaysia, we investigated the filarial parasites from wild animals in Gemas, Negeri Sembilan. To find adult filarial parasites, we dissected 26 animals, which included five frogs, one skink, one snake, two birds, six common treeshrews, and 11 rats. Then, we examined microfilariae in the blood smears and skin snips obtained from each animal. We found two types of microfilariae in the blood smears of common treeshrews: one was very similar to Malayfilaria sofiani and the other closely resembled Brugia tupaiae. These findings indicate an additional distribution of these filarial parasites in Gemas.

Descriptions of the female, male and mature larva of Simulium contractum Takaoka (Diptera: Simuliidae) from Sulawesi, Indonesia

@#Simulium (Simulium) contractum Takaoka from Sulawesi, Indonesia was known only as the pupa. Its female, male and mature larva are described for the first time. The tentative assignment of this species in the Simulium dumogaense species-group is confirmed by the adult characters including the female and male genitalia. The female and male of this species are similar to those of Simulium (Simulium) tumpaense Takaoka & Roberts but are distinguished by the yellowish femora.

Preliminary dengue vector surveillance in the Sunda Islands, Indonesia: Interchange of breeding habitat preferences of Aedes aegypti and Aedes albopictus

@#Ovitrap surveillance was conducted to determine the infestation patterns of dengue vectors in fourteen study sites across eight provinces located in the Sunda Islands, Indonesia. High ovitrap indices up to 70% and 90% were obtained from indoor and outdoor areas, respectively. Mean numbers of Ae. aegypti and Ae. albopictus larvae ranged from 0.13 to 14.50 and 0.10 to 18.60, respectively. Mixed infestation (<10%) and interchange of breeding habitat preferences of Ae. albopictus and Ae. aegypti were also observed in the present study.

Three new species of black flies (Diptera: Simuliidae) from the Lesser Sunda Archipelago, Indonesia

@#Simulium (Gomphostilbia) dhangi sp. nov., S. (G.) sumbaense sp. nov. and S. (Nevermannia) wayani sp. nov. are described from the Lesser Sunda Archipelago, Indonesia. Simulium (G.) sumbaense sp. nov. is placed in the S. varicorne species-group and is characterized by the pupal gill with eight filaments arranged as (1+1+1+1+2)+2 from dorsal to ventral, while S. (G.) dhangi sp. nov., unplaced to group, is characterized by the pupal gill composed of two inflated trunks and four slender filaments all arising basally, and the short larval antenna as long as the stem of the labral fan. Simulium (N.) wayani sp. nov. belongs to the S. ruficorne species-group and is characterized by the female spermatheca with an unsclerotized neck, and pupal gill with four inflated filaments. The number of species of black flies from the archipelago increases from 19 to 22.

Hematological Values in Sheep Fed a Diet Containing Black Cumin (Nigella sativa) Seed Oil.

The aim of this study was to investigate changes in hematological values after feeding diet mixed with oil pressed from seeds of Nigella sativa in sheep. The results indicated that there was no effect on the total Red Blood Cells (RBCs) count due to treatment when compared to the control group, but the treated group showed significant (P≤0.05) increase in the total RBCs count after six weeks compared to the transient decrease at week two. Hemoglobin concentration showed similar pattern to what was observed in the RBC count in both the treated and control groups. Packed Cells Volume (PCV), Mean Carpuscular Volume (MCV), Mean Carpuscular Hemoglobin (MCH) and Mean Carpuscular Hemoglobin Concentration (MCHC) weren’t affected by feeding N. sativa oil to sheep throughout the experiment. However, there were significantly (p≤ 0.05) lower values in total mean of White Blood Cells (WBCs), lymphocytes and granulocytes of the treated group compared to the control. The levels of White Blood Cells in the treated group were not time dependent. The Monocytes total mean was similar in both groups but the cells were significantly (P≤0.05) lower in the N. sativa oil treated group compared to the control at week four. The hematological changes could be due to N. sativa volatile oils incorporated to in the sheep diet. Conclusion: The results revealed that RBCs, Hb, PCV, MCV, MCH and MCHC for treated group are similar to control group but there are significantly increasing in RBCs and HB in 6th week. While WBCs, lymphocytes and granulocytes for treated group are significantly lower than the control group.

Evaluation of potential protective effects of curcumin versus metformin in experimentally-induced metabolic syndrome in rats

Metabolic syndrome [MetSyn] is the clustering of various interrelated risk factors of metabolic origin that increased incidence of cardiovascular diseases and type 2 diabetes. In this study the effectiveness of curcumin was evaluated in comparison with metformin in fructose-induced MetSyn disease in rats. Fructose was fed [10% solution in drinking water] for 8 weeks during which groups of rats were administered once daily vehicle [2% carboxy methyl cellulose], curcumin [40 and 80 mg/kg], metformin [100 and 200 mg/kg], their combinations and compared with group received tap water instead of fructose. The results revealed that induction of MetSyn was associated with glucose intolerance, insulin resistance alongside with increased weights of body and visceral fats. This was accompanied with an elevation of arterial blood pressure. Meanwhile, it caused disturbances in lipid profile [triglyceride, total cholesterol, HDL-C and LDL-C] and both oxidative stress [inalondialdehyde, 8-Iso-PGF[2alpha] and superoxide dismutase] and inflaminatory status [tumor necrosis factor-a, interleukin-6, C- reactive protein and adiponectin] parameters. Each of curcumin and metformin significantly prevents, to variable extents, the progression of most of these signs of MetSyn. Furthermore, the efficacy of each of the two drugs in question was significantly augmented upon their concurrent administration. These protective effects of the two drugs under investigation presumably may be relevant to their ability to reduce the oxidative stress and to ameliorate the inflammatory processes

Evaluation of potential curative effects of curcumin versus metformin in experimentally-induced metabolic syndrome in rats

Metabolic syndrome [MetSyn] is an important public health concern that predisposes individuals to the development of cardiovascular diseases and/or type 2 diabetes [T2D]. In the present study the curative effect of curcumin, the active ingredient of spice turmeric, was assessed in comparison with metformin, the antidiabetic agent, against fructose-fed rats [FFR] model of MetSyn. Seven groups of rats were fed with 10% fructose solution in drinking water for 8 weeks. At the beginning of 9[th] week, the groups of rats received respectively once daily the vehicle [2% carboxy methyl cellulose, CMC], curcumin [40 and 80 mg/kg], metformin [100 and 200 mg/kg] and their combinations for additional 2 weeks. Moreover, another group received plain tap water instead of fructose [normal control group]. The results of this study demonstrated that fructose-feeding was coupled with insulin resistance [IR], impaired glucose tolerance [IGT] together with elevation in body and visceral fat weights. This was associated with elevation of arterial blood pressure [ABP]. Meanwhile, fructose-feeding produced alterations in lipid profile [triglyceride [TG], total cholesterol [TC], High-density lipoprotein-cholesterol [HDL-C] and low-density lipoprotein-cholesterol [LDL-C]] and both oxidative stress [malondialdehyde [MDA], 8-iso-prostaglandin F[2 alpha] [8-iso-PGF[2 alpha]] and superoxide dismutase [SOD]] and inflammatory status [tumor necrosis factor-alpha [TNF-alpha] interleukin- 6 [IL-6], C-reactive protein [CRP] and adiponectin] parameters. Administration of curcumin and metformin significantly ameliorated, to variable extents, the development of most signs of MetSyn. Furthermore, the effectiveness of the two drugs was augmented upon their coadministration. These curative effects of curcumin and metformin may probably be relevant to their antioxidant and anti-inflammatory activities

Effect of plastic mulch on growth and yield of chilli (Capsicum annuum L.)

In this work a field study was conducted to evaluate the effect of coloured plastic mulch on growth and yield of chilli from October 2005 to April 2006. The plastic mulches were transparent, blue, and black and bare soil was the control. Different mulches generated higher soil temperature and soil moisture under mulch over the control. Transparent and blue plastic mulches encouraged weed population which were suppressed under black plastic. Plant height, number of primary branches, stem base diameter, number of leaves and yield were better for the plants on plastic. At the mature green stage, fruits had the highest vitamin-C content on the black plastic. Mulching produced the fruits with the highest chlorophyll-a, chlorophyll-b and total chlorophyll contents and also increased the number of fruits per plant and yield. However, mulching did not affect the length and diameter of the fruits and number of seeds per fruit. Plants on black plastic mulch had the maximum number of fruits and highest yield. Thus, mulching appears to be a viable tool to increase the chilli production under tropical conditions.

Value of serum nitric oxide in patients with coronary artery disease before and after percutaneous transluminal coronary angioplasty with or without stent

Our study was planned to assess the value of plasma NO as an early marker for endothelial injury and to detect its relation to the severity of coronary artery disease and its relation to restenosis after PCI. This study included [51] patients; [14] were normal control group [Group I]; and [37] patients were diseased [Group II], whom classified into three subgroups; subgroup [A] patients with single vessel disease [15 patients], subgroup [B] patients with two vessels disease [15 patients], subgroup [C] multi-vessels disease included [7 patients]. All patients subjected to coronary angiography with or without intervention [PTCA only, PTCA + stent or without stent]. [21] Patients accepted and respected follow-up by coronary angiography after 4 months. NO serum level was done before PCI and after 4 months in those accepted follow-up. Mean NO serum level on control group was 83 micro mol/L, while mean plasma NO serum level in subgroup [A] [34.8 +/- 10.3 micro mol/L], [17.5 +/- 3.5 micro mol/L] in subgroup [B]; and [8.9 +/- 2.2 micro mol/L in subgroup [C]. This revealed a highly significant decrease than control group, with P-value <0.05, <0.0005 and <0.0005 respectively when compared mean NO serum level in control group with each subgroup. On comparing the mean values of plasma NO level of subgroups [A, B, C]; to each other there was more or less gradual mathematical decrease in NO serum level between the subgroups, with highly significant P-values. Comparing the mean level of plasma NO of restenosis cases before and after PCI in each subgroup [A, B and C], we found a significant decrease in plasma NO level after PCI than before PCI. Endothelial dysfunction is an important contributing factor in CAD and it is associated with NO deficiency which can be considered as one of the endothelial markers for CAD. The more the degree of endothelial dysfunction, the more the deficiency of NO, the more the severity of CAD. Restenosis is a multi-factorial subject requiring a lot of work and lack of NO is related at least in part to the development of restenosis after angioplasty. We can suggest that if plasma NO level after PCI is reduced at least 30% of its initial level before PCI, most probably restenosis has occurred

Comparative study of cardiovascular effects of losartan and captopril in rabbits

Drugs that interfere with renin - angiotensin system [RAS] play a prominent role in treatment of cardiovascular diseases. These drugs include two groups, angiotensin converting enzyme inhibitors e.g. captopril and angiotensin II receptor blockers e.g. losartan. This work was performed to investigate the effects of chronic administration [60 days] of each of losartan and captopril on the progression of atherosclerosis, serum lipids, glutathione peroxidase activity and on arterial blood pressure in rabbits fed with 1% cholesterol enriched diet. Specimens from different levels of aorta, heart, liver and kidneys of each rabbit were formalin-fixed, paraffin-embedded and stained with haematoxylin and eosin and Verhoff's stains. The serum lipids were estimated by enzymatic colorimetric tests. The glutathione peroxidase activity in the aortic tissues was determined by a modified spectrophotometric method. Our results showed that administration of each of losartan and captopril had the ability to attenuate the progression of atherosclerosis in hypercholesterolemic rabbits. The antiatherogenic effect of losartan was more pronounced than that of captopril. Both drugs also prevented the effect of hypercholesterolemia on the heart and liver compared to the non-medicated hypercholesterolemia rabbits. On the other hand, cholesterol-fed rabbits treated with each of losartan and captopril demonstrated significant decrease in total cholesterol, triglycerides and low density lipoprotein with an insignificant increase in high density lipoprotein compared to untreated hypercholesterolemia rabbits. However, the intensity of changes produced by losartan was of greater extent than that produced by captopril. This study revealed an increase in the glutathione peroxidase activity in aortic tissues of groups of atherosclerotic animals treated with either losartan or captopril in comparison with the non-mediated atherosclerotic rabbits. Moreover, a lowering in the blood pressure was recorded in cholesterol-fed rabbits treated with either losartan or captopril. In conclusion, these results are encouraging and the beneficial antiatherosclerotic effects of both drugs are presumably attributed to then ability to interrupt influences on the RAS. In addition, their contributory role of the possible antioxidant properties of these drugs must not be ruled out. Besides, the documented ability of these drugs to accumulate kinins and nitric oxide as well as prevention of the vascular endothelial dysfunction can not be neglected

Serum level monitoring of digoxin in cardiac patients attending Assiut University Hospitals: utility in therapy optimizations.

This study addressed the utility of digoxin level monitoring in the optimization of drug therapy. The results revealed toxic serum levels [> ng/ml] only in 91 of the 147 suspected cases. Among 61 patients with inadequate response, low concentrations [<0.7 ng/ml] were noticed. Similarly, in ten patients with non-compliance, very low subtherapeutic levels were observed even to the nil level in 50% of the cases. Accordingly, therapeutic failure of digoxin resulting from under dosage or non-compliance could be detected by TDM that helped in appropriate intervention and in the achievement of optimum clinical outcome. On the other hand, the TDM in clinically controlled cardiac patients indicated that the target concentration of digoxin required to the control heart failure and/or supraventricular arrhythmias could range from 0.7 ng/ml to 2.0 ng/ml. These data indicated that the international therapeutic range [0.7-2.0 ng/ml] of digoxin could be also applied to Upper Egypt cardiac patients. In addition, this study demonstrated the importance of proper sampling time and measurement of serum potassium and creatinine in the interpretation of digoxin level data