aetiological study of moderate to severe hirsutism

Hirsutism is a common disorder of females. Most cases are idiopathic, however some studies claim polycystic ovarian syndrome to be the commonest cause. The objective of the present study was to evaluate the etiology of moderate to severe hirsutism and to devise a rational diagnostic approach in these patients depending upon age, severity of the problem and other clinical findings. Seventy four consecutive patients with moderate to severe hirsutism [i.e. Ferriman and Gallwey score of 7 and above] were enrolled and recorded on a standard Proforma. All patients were assessed clinically with particular emphasis on signs and symptoms of virilisation. Hormonal investigation as well as abdominal and pelvic ultrasonography for adrenals and ovaries was done in all patients. Of the 74 patients 35 [47.3%] were labeled as idiopathic hirsutism, while 33 [44.6%] were diagnosed as polycystic ovary syndrome. Other causes identified were hypothyroidism [4%], Cushing"s syndrome [2.7%] and congenital adrenal hyperplasia [1.3%]. Majority of patients belonged to the age group 21-25 years. The commonest cause of hirsutism in our study was idiopathic [47.3%]. This was followed by PCOS which accounted for 44.6% of patients

Effect of fluvastatin on dyslipidaemia associated with type 2 diabetes mellitus

Type-2 diabetics suffer from lipid abnormalities. Even though these are mild in most patients, they contribute to the increased cardiovascular morbidity and mortality seen in this disease, especially in South Asians. We report the effect of HMGCoA reductase inhibitor, FLUVASTATIN in lowering lipid levels in type 2 diabetes mellitus in urban Pakistanis from Punjab. Such data does not exist before. Type 2 diabetes with stable disease were entered into the study if the level of lipids remained elevated following period of 8 weeks on diet placebo oral medications. They entered into the next phase [week 0] only if they demonstrated a persistently raised total cholesterol [250 mg/dl] despite the lipid lowering diet. In phase 2, the subjects received FLUVASTATIN 40 mg per day for twelve weeks, lipid levels were estimated at week 0, 6, 12. Monitoring for side effects both clinical and biochemical, was carried out. 50 out of 85 patients were found to have a total cholesterol of less than 250 mg/dl after 8 weeks on a lipid-lowering diet. 35 patients [9 male, 26 female] entered phase two. Their mean age was 46.7 years and mean body mass index 28.6 kg/m[2]. After 12 weeks of treatment with FLUVASTATIN there was no change in fasting blood glucose. However mean total cholesterol was reduced from 313.3 mg/dl to 233 mg/dl [-34.3%]; LDL cholesterol fell from 185.2 mg/dl to 160.6 mg/ dl [-15.4%]. The mean HDL cholesterol level increased from 46.6 mg/dl to 56.1 mg/dl [+17.2%]. Side effects were insignificant. FLUVASTATIN effectively and safely lowers total cholesterol, LDL cholesterol, triglycerides in urban Pakistanis suffering from type 2 diabetes mellitus, presenting at Mayo Hospital, diabetic clinic. It also increases the level of HDL cholesterol