Effect of metformin alone compared with metformin plus simvastatin on polycystic ovarian syndrome in Pakistani women

Objective: To determine the efficacy of metformin alone versus metformin plus simvastatin for treatment of polycystic ovarian syndrome [PCOS]

Study Design: Randomized controlled trial

Place and Duration of Study: Maternal and Child Health Centre, Unit II, Pakistan Institute of Medical Sciences [PIMS], from November 2014 to April 2015

Methodology: One hundred and eight patients [108] were randomly divided into metformin group [n=54] and metformin plus simvastatin group [n=54], detailed clinical history, including menstrual details, was taken with thorough examination performed. Baseline ultrasound was performed to evaluate ovarian size and these were considered enlarged with volume >10cc or with >12 follicles in any one ovary. Blood samples were taken at baseline and after three months of therapy to determine the LH/FSH ratio and lipid profile. Efficacy was defined as >15% decrease in the baseline values

Results: The mean age of patients was 28.82 +/- 7.18 years. Mean BMI of the patients was 22.41 +/- 1.55 Kg/m[2]. Efficacy was achieved in 66.7% patients with metformin alone, while in 92.6% with combination medication [p=0.001]

Conclusion: The combination of metformin plus simvastatin is more efficacious as compared to metformin alone for management of females with PCOS

Use of internet by medical students in their basic and clinical skills

The potential of using internet for medical education is widely accepted in enhancing their knowledge, skill and attitude. To assess the ability, accessibility and attitudes of medical students about use of information technology for e-learning in improving their basic and clinical skills. A qualitative descriptive study carried out at Gynae Unit II and ENT Unit I, Allama Iqbal Medical College/Jinnah Hospital, Lahore from January 2007 to April 2007. One hundred and fifty medical students each from last three years of MBBS were included in the study. A self-administered questionnaire was applied to them which included their demographic details and perceived level of IT [information technology] ability and accessibility. Four hundred fifty undergraduate students participated in the survey. There were 49% females and 51% males with similar average age. Among students 88.5% were using internet for educational purposes either at home or in college computer lab. However, the average use per week was 3.4 hours. Google, Yahoo and Ask were three most commonly used search engines. Majority [90%] of the students said that they are not getting input from their teachers on e-medicine should be the part of education from first year onwards. Undergraduate medical students have a reasonable access and perception for internet based learning and this should become a part of medical curriculum from the first year of MBBS. Medical teachers should facilitate the use of internet as an important tool of learning. Internet facilities should made widely available in the medical colleges to help them in enhancing their skills

Carcinoid tumor of small intestine; a radiological diagnosis

Carcinoid tumors are most common primary tumors of small-bowel and appendix. These are characteristically slowly growing tumors that may go unrecognized for many years. The diagnosis is typically not made until the patient undergoes imaging and exploratory surgery. We reported the CT findings of a carcinoid tumor of small intestine [ileum] in our patient. CT showed focal non-calcified mesenteric mass surrounded by thickened mesentery with stellate radiating pattern [desmoplastic reaction]; retraction/ shortening of small bowel mesentery was also noted resulting into the kinking of ileal loops with segmental thickening of adjacent loops. A low density lymphadenopathy was also noted; however no liver metastases were seen. These findings were classically suggestive of carcinoid tumor of the ileal loops