Effect of gonadotrophins, oestradiol and insulin on cumulus expansion of Nili Ravi buffalo oocytes

The objective of the present study was to investigate the cumulus expansions of Nili Ravi buffalo oocytes during cultured in TCM -199 supplemented with 2 micro g/ml oestradiol [E[2]], 0.05 IU/ml recombinant human follicle stimulating hormone [rhFSH], 2IU/ml human chorionic gonadotrophin [hCG], and 0.12 IU/ml insulin [I]. The cumulus oocytes complexes [COCs] were collected from 2-8mm follicles from local abattoir ovaries. Supplementation of medium with single hormones showed significant [P<0.0001] increase in mean diameter of COCs with rhFSH except E[2], hCG and insulin after 24 hours compared to the increase in the mean diameter of COCs matured in TCM-199 without any hormonal supplementation. With rhFSH even at 8th hour, significant increase [P<0.001] in cumulus expansion was observed. In combination of hormones the significant [P<0.0001] cumulus expansion was achieved in E[2]+rhFSH treatment group. The non significant [P>0.05] cumulus expansion was observed in treatment groups viz. E[2]+hCG, E[2]+Insulin, rhFSH+hCG, rhFSH+Insulin, hCG+Insulin, E[2]+rhFSH+hCG and E[2]+rhFSH+hCG+Insulin after 24 hours. In conclusion, supplementation of rhFSH alone and in combination with E2in TCM-199 has highly significant effect on cumulus expansion

Effect of metformin hydrochloride in correcting hyperinsulinemia and high leptin levels in treatment of infertile polycystic patients

Research conducted over PCOS by various groups in the world indicated the effect of Metformin on PCOS. Previous studies suggest that Glucophage by reducing hyper-insulinemia is clinically useful in the treatment of polycystic ovary syndrome [PCOS]. Our Objective was to observe the role of Glucophage in treating infertility of polycystic patients within three months in Group A and six months in Group B patients. Another aim was to assess the decrease in hyper-insulinemia and Leptin levels by Glucophage in our population. This study was carried out at the Department of Obstetrics and Gynaecology, Pakistan Institute of Medical Sciences, and Noor Specialised Clinic Islamabad, from Oct 2004 to Apr 2008. One hundred and seventy women in Group A and 145 in Group B fulfilling the clinical and biochemical criteria for PCOS were enrolled. Glucophage was started at an oral dose of 500 mg/day and maintained at 1500 mg for 3 months or 6 months in both Groups. Besides ultrasonography, serum FSH, LH, fasting insulin, fasting blood sugar, glucose insulin ratio, Quantitative Insulin Sensitivity Check Index [QUICKI] and leptin levels were performed. After three months in Group A and six months in Group B these criteria were again assessed. After 3 and 6 months of Metformin therapy, significant reduction in biochemical parameters was observed such as fasting glucose, insulin and leptin. Data were analysed using SPSS by paired t-test and ANOVA. Six months treatment with Glucophage proved to be better option for infertile PCOS

Association of maternal anthropometry with the neonatal birth weight in 3rd trimester of normal pregnancy

There is scarcity of data from Pakistan, which looks at the relationship of maternal nutritional status with the neonatal birth weight The objective of study was to investigate association of increase in the neonatal birth weight with maternal height and weight, in 3rd trimester in normal pregnancy. The study was conducted between the months of April-November 2007 at Gynecology and Obstetrics Unit of Pakistan Institute of Medical Sciences, Islamabad. This Descriptive case series included a total of 118 patients who were selected by consecutive sampling. Dietary history was taken by a semi structured Food Frequency questionnaire at the time of registration and 24 hours dietary recall was conducted at least three times from time of registration until the last visit before pregnancy and mean dietary intake for third trimester was calculated. Differences between group means were calculated by Student's t-test. Regression analysis was used to examine the trends between neonatal birth weight and the maternal dietary intake including energy, protein, carbohydrates and lipids. Energy consumption of the pregnant women was 2168.89 Kcal/day during the third trimester of pregnancy. Maternal energy intake showed a highly significant [P = 0.007] increase in the birth weight of the neonates. Neonatal birth weight was positively associated with increasing maternal height [p=0.02] as well as increasing maternal weight gain [P=0.008]. No significant difference was observed between the mean maternal energy consumption [kcal/day], maternal weight gain in the last trimester [g/wk], and neonatal birth weight [g] between the pregnant women belonging to the different categories of Body Mass Index and mean upper arm circumference. Maternal nutritional status is positively associated with the neonatal birth weight. Expecting mothers and young girls nutritions must be given special attention to ensure delivery of a healthy and a normal child

Low birth weight and relationship with maternal dietary habits during third trimester of low risk pregnancies in a hospital based study in Pakistan

The study is conducted to observe the relationship of maternal diet in third trimester of pregnancy with the neonatal birth weight, in the women at a low risk of delivering low birth-weight neonates. This hospital based follow up study was conducted during the months of April-November 2007 at the Gynaecology and Obstetrics Unit of Pakistan Institute of Medical Sciences, Islamabad. Pregnant women with low risk of delivering low birth weight neonates were registered at 26 weeks of pregnancy, by employing consecutive [non-probability] sampling technique. Dietary history was taken by a semi structured Food Frequency questionnaire and 24 hours dietary recall at the time of registration. Written informed consent was obtained. Thirteen percent of women with normal pregnancies delivered low birth weight neonates weighing <2500 grams [including preterm and full term neonates]. The women delivering low birth weight neonates had significantly lower consumption of calories [P= 0.0002], carbohydrate [P=0.008], and lipid [P=0.00005] during the third trimester. In addition the mean maternal weekly weight gain and maternal hemoglobin concentration was also significantly lower in the women who delivered LBW neonates. The frequency of total protein, meat, carbohydrates and fruits consumption per week, calculated from food frequency questionnaire conducted at the start of third trimester was also lower in the women who delivered LBW neonates. The consumption of soft drinks and tea per week was higher in the women who delivered LBW neonates, although this finding was not statistically significant. This study suggests the importance of good maternal nutrition during pregnancy for the optimal newborn weight

Localization of DFNB28 locus in a Pakistani consanguineous kindred

To determine the disease locus involved in autosomal recessive nonsyndromic deafness. Five generations of a Pakistani sheikh consanguineous family suffering from nonsyndromic deafness was ascertained from the Punjab province. The molecular studies were carried out at Biomedical and Genetic Engineering Division, KRL, Islamabad. Fifteen family members [five affected and ten normal] were processed for molecular studies. All marriages were consanguineous. Linkage analysis for known loci of autosomal recessive non-syndromic deafness was carried out. Two point lod score analysis resulted in maximum lod score [Z max] 4.35 for marker D22S445 at 6 = 0. Significant linkage was found with DPNB28 locus at chromosome 22 [22ql3]

Identification of LCA 4 locus in a Pakistani consanguineous kindred suffering from Leber's congenital amaurosis

To determine the disease locus involved in autosomal recessive Leber's Congenital Amaurosis. Biomedical and Genetic Engineering Division, KRL, Islamabad. Five generations of a Pakistani consanguineous family suffering from congenital blindness [Leber's Congenital Amaurosis] was studied. Genomic DNA was amplified across the polymorphic micro satellite markers. Polymerase chain reaction [PCR] products were separated by non-denaturing polyacrylamide gel electrophoresis. Alleles were assigned to individuals. LOD score calculations were done using the Cryllic and MLINK software program. Molecular studies were done in 29 individuals of the family of whom 11 were blind and 18 were normal. Of eleven blind individuals six were males and five females. Linkage analysis for known loci of autosomal recessive LCA loci was carried out. Two point LOD score analysis with LCA 4 locus [17p13.1] resulted in maximum lod score [Z max] of 4.75 for marker D17S796 at q=0. Significant linkage was found with LCA4 locus [17p13.1]

Role of hyperprolactinemia in fertility

Role of Hyperprolactinemia in fertility was studied. A total of 100 hyperprolactinemic women [16 to 40 years of age] were studied at Salma and Kafeel Medical Center, Islamabad.Of these patients 18 were normoprolactinemic [control] and were taken as control.Fertile hyperprolactinemic were 25 [30.49%] and infertile were 57 [69.51%]. In this retrospective study the patients were interviewed to record the marital status, hormonal levels, type of infertility and duration of infertility. The results show that fertile hyperprolactinemic women had significantly [P<0.001] increased prolactin level, decreased LH and E2 [P<0.01] level during follicular phase compared with normoprolactinemic group. During ovulatory phase, fertile hyperprolactinemic women had significantly [P<0.001] increased prolactin level, decreased FSH and progesterone [P<0.05] level compared with normoprolactinemic group.In luteal phase these women had significantly increased prolactin level [P<0.001], decreased LH [P<0.01], FSH and E2 [P<0.05] levels compared with normoprolactinemic group. Hyperprolactinemic women with primary infertility [37; 64.91%] had significantly increased prolactin level [P<0.001], decreased LH and E2 [P<0.01] levels during follicular phase compared with control group. During ovulatory phase these women had significantly increased prolactin level [P<0.001], decreased LH, FSH levels and significantly [P<0.05] decreased progesterone level compared with normoprolactinemic group. In luteal phase these women had significantly increased prolactin level [P<0.001], decreased LH [P<0.02] and progesterone [P<0.01] levels compared with control group. Infertile [20;35.09%] hyperprolactinemic women with secondary infertility had significantly [P<0.001] increased prolactin level and significantly decreased LH level [P<0.01] during follicular phase compared with normoprolactinemic group. During ovulatory phase these women had significantly increased prolactin level [P<0.001], decreased LH [P<0.02] and E2 levels [P<0.05] compared with control group. During luteal phase these women had significantly increased prolactin level [P<0.001], decreased LH [P<0.02], FSH and progesterone [P<0.05] levels compared with normoprolactinemic group. It is concluded that hyperprolactinemia leads to infertility and its prevalence is higher in infertile women as compared to fertile women