Study of Association of Global Deoxyribonucleic Acid Methylation in Women with Polycystic Ovary Syndrome.

Background: Polycystic ovary syndrome (PCOS), a common endocrine disorder affecting 5%-10% of reproductive age women worldwide, associated with various metabolic morbidities. One potential molecular mechanism could be epigenetic modifications, such as deoxyribonucleic acid (DNA) methylation. Aims: The aim is to determine the association of global DNA methylation in peripheral blood leucocyte (PBL) cells and PCOS women. Also to assess abnormal lipid profile, insulin resistance, gonadotropins and reproductive markers in them. Settings and Design: The study design involves a hospital-based prospective case-control study. Materials and Methods: Fifty women with PCOS, diagnosed as per Rotterdam criteria and the rest 50 without PCOS or any disease, attending outpatient department were recruited. Serum biochemical markers and Global DNA methylation assay were done by using standardised kit. Statistical Analysis Used: Data were compared using Independent t-test or Mann-Whitney U test using IBM SPSS version 26.0. P < 0.05 was considered statistically significant. Results: Majority, 72% of PCOS and 82% non-PCOS women were between 20 and 25 years. Most common presenting symptom was menstrual irregularity. Women with PCOS have high serum cholesterol and triglyceride level, elevated serum luteinising hormone (LH), follicle-stimulating hormone (FSH), LH/FSH ratio and testosterone but low estradiol levels as compared to non-PCOS. Statistically significant high mean Global DNA methylation percentage was found in PBLs of women with PCOS. Conclusion: Despite study limitations, this study provided insight into Global DNA methylation in PBLs was associated with PCOS. It requires further research to better understand the influence of epigenetic factors including genome-wide DNA methylation profiling in PCOS development.

Seropositivity of Chlamydia trachomatis & Toxoplasma gondii among male partners of infertile couples in Odisha, India: A facility-based exploratory study.

Chlamydia trachomatis (CT) is the most common curable sexually transmitted non-viral infection, which can cause urethritis, prostatitis, orchitis and epididymitis among males. Toxoplasma gondii, a protozoan causes toxoplasmosis among humans. These infections may lead to decreased fertility. Hence, this study was aimed to estimate the seropositivity of CT and T. gondii infection among the male partners of infertile couples in Odisha, India. In this facility-based cross-sectional study, first void urine, seminal fluid and blood sample were collected from 153 males attending infertility clinics including 74 healthy controls. Urine and seminal fluid were tested through polymerase chain reaction (PCR), and enzyme-linked immunosorbent assay was used to detect immunoglobulin (Ig) G, IgA and IgM anti-Chlamydia and IgM anti-Toxoplasma antibodies through serum. The prevalence of CT was 1.26 per cent (95% CI: 0.03-6.85) as estimated from semen samples using PCR. We detected anti-Chlamydia antibodies IgM-four per cent [95% confidence interval (CI): 0.83-11.24]; IgA-28.16 per cent (95% CI: 18.13-40.09) and IgG-12.5 per cent (95% CI: 5.87-22.4) among participants. Anti-Toxoplasma antibodies IgM were observed in 27.63 per cent (95% CI: 17.98-39.08) of participants. None of the control samples were found positive. Overall seropositivity of CT and Toxoplasma infections is comparable, which suggests that greater attention is required for screening these infections at clinics, especially among infertile couples.

Microperforate hymen presenting with incomplete abortion: A case report.

A 20-year-old patient with 3 months of amenorrhea presented in the labor room with bleeding per vaginum and having experienced lower abdominal pain for 2 h. She had a history of difficult intercourse and prolonged menstrual flow. Inspection revealed a bleeding point over an obstructing membrane at the level of the vaginal introitus. Subsequent vaginal examination confirmed the diagnosis of microperforate hymen. Her urine pregnancy test was positive and an ultrasound examination revealed the presence of retained products of conception in the endometrial cavity. Hymenectomy was carried out to evacuate the retained products of conception and the margins of the hymen were sutured to prevent restenosis. The outcome was uneventful. This case study suggests that even though subocclusive hymenal anomalies, such as microperforate hymen, can interfere with normal vaginal intercourse, it does not lead to infertility and can permit pregnancy. Hence, awareness about this rare entity may lead to early detection and improvement in the patient's quality of life.

Effect of metformin in asian Indian women with polycystic ovarian syndrome.

BACKGROUND: This study was conducted to study the therapeutic benefits of metformin and to determine the correction of insulin resistance on 25 patients of polycystic ovarian syndrome (PCOS) attending the Department of Obstetrics and Gynaecology, S.C.B. Medical College and Hospital, Cuttack, India, for varying complaints. METHODS: Twenty-five women diagnosed as having PCOS received metformin in doses of 500 mg every 8 h for 6 months. Periodical evaluation with respect to clinical improvement was done after months 3 and 6, while evaluations of changes in biochemical parameters and hormone levels were done at the end of month 6. RESULTS: Out of 23 cases (92%) women who presented with menstrual disturbances, the cycles were regularized in 21 (91%). Fourteen women complained of infertility, and five (35.7%) of them conceived within the span of treatment. In six (24%) cases with complaints of hirsutism, there was improvement in three cases (50%). Twelve (91.6%) of obese patients with PCOS had weight loss with significant changes in waist-to-hip ratio (WHR) after metformin therapy. Of the three patients with low FSH, the level became normal in two cases. Polycystic changes in ovary regressed in 12 (85.7%) cases. Of the 13 patients with elevated serum testoterone level, normalization of values was seen in 12 cases. Abnormal LH/FSH ratio and impaired glucose tolerance were normalized, and insulin resistance was significantly reduced in all the cases studied, with mean HOMA values decreasing from 3.34 to 1.82. CONCLUSIONS: This study conclusively points out the beneficial effects of metformin in cases of PCOS in Asian women, both in the adolescent and the reproductive age. This mode of treatment is successful and has an etiological rationale behind its use. The additional benefits are a relatively low cost of therapy and diminished hazards associated with surgical intervention.