Exploring Serum Vitamin D, Sex Hormones, and Lipid Profile Disparities in Women With and Without Polycystic Ovarian Syndrome: A Case-Control Study.

Background Polycystic ovarian syndrome (PCOS) is a common endocrine disorder affecting women of reproductive age. It is characterized by dyslipidemia, hormonal imbalances, and metabolic dysfunctions. Vitamin D deficiency may be implicated in the pathogenesis of PCOS, potentially exacerbating its metabolic syndrome. However, the exact interplay between these factors remains underexplored. Aim This study aimed to evaluate serum levels of vitamin D and its association with modalities of PCOS among women with PCOS and healthy controls.  Methods This was a hospital-based case-control study where 60 women newly diagnosed with PCOS and 56 non-PCOS controls were consecutively recruited within a 10-month period. The women aged 20-40 were recruited at the gynecology clinics of Lagos State University Teaching Hospital and Lagos Island Maternity Hospital. PCOS was diagnosed using the Rotterdam's criteria. The biodata, anthropometry, clinical features, serum vitamin D, cortisol, progesterone, testosterone, estradiol, prolactin, anti-Mullerian hormone (AMH), thyroid-stimulating hormone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), insulin, fasting blood glucose (FBG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), and very-low-density lipoprotein cholesterol (VLDL-C) levels of PCOS-diagnosed women were assessed and compared with those of women without PCOS. The exclusion criteria comprised known diabetics, women with gynecological pathologies such as fibroids, and women on medications affecting the study analytes or hormones. Statistical analyses included chi-square or Fisher's exact tests for categorical variables, student t-test for continuous variables, and Pearson's correlation for assessing relationships between continuous variables. The significance level was set at p<0.05 and a confidence interval of 95%. Results Individuals with PCOS exhibited a younger mean age (26.90±3.73 versus 29.95±5.00 years, p=0.001) and a higher prevalence of irregular menstrual patterns (46.7% versus 14.3%, p=0.0001) and acne (58.3% versus 37.5%, p=0.025). Moreover, PCOS was associated with elevated levels of TC (p = 0.03), TG (p = 0.03), LDL-C (p = 0.014), FBG (p = 0.001), LH:FSH ratio (p = 0.002), AMH (p = 0.0001), and testosterone (p = 0.003), but low progesterone (p = 0.001) and vitamin D (p = 0.033), alongside a higher incidence of vitamin D deficiency (33.3% versus 26.1%) and insufficiency (66.7% versus 56.5%). Additionally, significant but weak correlations were observed between serum vitamin D levels and waist-hip ratio (r = 0.4, p = 0.016) and FBG (r = -0.4, p = 0.036) in the PCOS group, suggesting potential metabolic implications. Conclusion The PCOS subjects in this study had decreased vitamin D and progesterone levels, with elevated concentrations of testosterone, AMH, lipid profile (TC, LDL, and TG), FBG, and LH:FSH ratio. Studies on the therapeutic effect of vitamin D administration in managing PCOS will need to be further evaluated.

Non puerperal uterine inversion due to submucous fibroid: a case report.

An unusual case of non-puerperal uterine inversion is presented. The patient, a 37 year old multipara who had been earlier diagnosed with uterine fibroids, subsequently developed a protrusion from the vagina having declined surgery. The mass had become necrotic and infected at the time of presentation. Uterine inversion was diagnosed clinically and further confirmed at surgery where a vaginal hysterectomy was carried out. Uterine inversion is a rare condition not encountered by most gynaecologists. Diagnosis and treatment could thus be challenging. The literature on non-puerperal uterine inversion regarding the evaluation and management is reviewed.

The evolving roles of hospitals in health systems: the Lagos-Nigeria example.

With the revision of the definitions of health systems and the expectations of the public there is a need to reassess the roles of hospitals. Hospitals remain the centre of health care services and they face lots of challenges in service delivery. Lagos State in Nigeria has analyzed her perculiar circumstances and formulated a Health Service Reform law. This law seeks to restructure the State's health system with an emphasis on improving the functioning of the hospitals. This article highlights the roles of hospitals in general with an insight into how the Health Service Reforms seek to improve Lagos hospitals and health system.

Risk factors for hepatitis B virus infection among pregnant women in Lagos, Nigeria.

OBJECTIVES: To determine the risk factors for hepatitis B virus infection among pregnant women in Lagos, Nigeria, and the possible implications for hepatitis B prevention in the country. DESIGN: Prospective case control study. SETTING: Lagos Island Maternity Hospital. METHODS: Between 1 August 2006 and 31 January 2007, risk factors for hepatitis B infection were determined amongst pregnant women using a structured questionnaire. The women were tested for hepatitis B surface antigen (HBsAg) as part of routine antenatal care. Univariate and multivariate analyses were carried out using logistic regression. MAIN OUTCOME MEASURES: Risk factors for hepatitis B virus infection among pregnant women. RESULTS: Of the 1,052 women attending the antenatal clinic, 6.08% (n = 64) were positive for HBsAg. A total of 61 HBsAg positive and 183 negative controls were interviewed. The significant risk factors for HBV infection were an early age of sexual debut below 19 years (adjusted OR = 2.79; 95% CI = 1.44-5.40; p = 0.0023); history of multiple sexual partners (adjusted OR = 2.02; 95% CI = 1.02-3.98; p = 0.0427); and past history of sexually transmitted infection (adjusted OR = 2.61; 95% CI = 1.15-5.90; p = 0.0214). Of the HBsAg positive women, 45 (73.77%) had at least one of these risk factors while 91 (49.73%) of the controls had at least one risk factor. CONCLUSION: Screening pregnant for hepatitis B infection on the basis of risk factors may not be effective. Education on modification of lifestyle and sexual behavior as well as non-selective screening of pregnant women for HBV infection is recommended.