Objective:Women with polycystic ovary syndrome (PCOS) may represent a large underappreciated segment of female population who is at increased cardiovascular risk because of the presence of cluster of metabolic abnormalities. The aim of our study was to assess atherosclerotic risk factors in women with PCOS.Materials and Methods:In a cross-sectional study, 50 women with PCOS and 50 age and weight-matched healthy controls were enrolled. Endothelial dysfunction by flow-mediated dilatation (FMD) of brachial artery, highly sensitive C-reactive protein (hs CRP), and carotid intima media thickness (CIMT) were measured in both cases and control groups.Results:The mean age of women with PCOS was 26.82 ± 3.26 years and Body-mass index (BMI) of 26.2 ± 4.8 kg/ m2. Thirty-six (72%) patients were overweight or obese,54% had central obesity and 12% had impaired glucose tolerance. Among the markers of atherosclerosis, hsCRP levels were nonsignificantly higher in patients with PCOS than in controls. The FMD was 12.18 ± 2.3% vs 8.3 ± 2.23% in patients with PCOS and controls respectively (P=0.01). CIMT was significantly different in two study groups (0.68 ± 0.11 in PCOS vs 0.52 ± 0.02 in normal subjects, (P=0.01). FMD had significant negative correlation with homeostasis model assessment (HOMA) index (r = −0.32, P=0.02) and hs CRP (r = −0.37, P=0.04) while hs CRP was correlated with BMI (r = 0.54, P=0.005), HOMA (r = 0.38, P=0.02) and FMD (r = -0.33, P=0.01). CIMT was significantly different in women with PCOS and control subjects, and it had significant correlation with age (r = 0.42, P=0.03), BMI (r = 0.36, P=0.01), waist circumference (r = 0.52, P=0.001) and HOMA (r = 0.31, P=0.04).Conclusion:Women with PCOS definitely have increased risk for future cardiovascular events. Clinicians should consider early cardiovascular screening and interventions to control all modifiable cardiovascular risk factors.
Ectopic spinal localization of Fasciola may occur during the transmigration path of the parasite through peritoneum or from the liver through portal venous system.
Aim: To document our experience regarding the management of ureteric injury following gynecologic surgery. Material and Methods: Between January 2004 and December 2008, 24 patients with ureteric injury were referred to our institute. A retrospective review of the hospital charts, clinical notes and the operation theatre register was carried out. Unilateral ureteric injury was observed in 18 patients and bilateral ureteric injury (BUI) in 6 patients. The clinical presentation was urinary incontinence with normal voiding (ureterovaginal fistula) in 12 patients, recurrent flank pain (due to lower ureteric stricture) in 6 patients and anuria (due to BUI) in 6 patients. Patients were managed by urinary diversion or double J stent insertion followed by delayed ureteric repair or by immediate abdominal exploration and ureteric repair. Results: One patient suffering from BUI died of septicemia, uremia and electrolyte imbalance. All the other patients were doing well as per their last follow-up. Conclusion: Timely detection and proper referral of ureteric injury followed by judicious and expeditious management can reduce morbidity and help save lives.
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