Objectives The aim of this study was to determine day 3 Serum AMH, FSH, LH, Estradiol (E 2 ), Inhibin B levels, ovarian volume, and antral follicular count to assess ovarian function. LH (p [ 0.05), and E 2 (p \ 0.05) were increased. Serum AMH level was 4-6.8 ng/ml with optimal fertility in 26.15 % cases and 2.2-4.0 ng/ml with satisfactory fertility in 53.85 % cases. Serum AMH levels were more strongly correlated with AFC (p \ 0.0001) and ovarian volume (p \ 0.0001). Conclusion Serum AMH levels were more robustly correlated with AFC than FSH, LH, E 2 , and Inhibin B on day 3 of the cycle. This suggested that serum AMH might be taken as single test to reflect ovarian reserve.
INTRODUCTIONNationally unplanned pregnancy rate is 21% of all pregnancies.1 In India 65% of women in the first year postpartum have an unmet need for family planning, out of which only 26% of woman are using any method of contraception. Hence, contraceptive counselling has become an integral part of antenatal and postpartum programme as pregnant and postpartum women are generally highly motivated towards controlling the fertility, either in spacing out there children or stopping their fertility altogether. Postpartum period is one of the sensitive time of woman's life when she is in contact with health care facility known as crisis oriented and when both mother and newborn need a special care. Postpartum contraceptive options are limited. Barrier contraceptives and progesterone only pills, both are user and compliance dependent methods and therefore have high failure rates. Traditionally, Cu T insertion was limited to interval period. But now, recent studies on postpartum contraceptive methods have suggested the use of Cu T in postpartum period which can provide long term and effective contraception with failure rate of <1%.Percentage of institutional deliveries in India is 41%.2 As the number of institutional deliveries is increasing, postpartum Cu T insertion can provide a unique opportunity to increase the contraceptive prevalence ABSTRACT Background: The use of Cu T in postpartum period can provide long term and effective contraception and this study compares PPIUCD versus interval IUCD. Methods: 300 women enrolled in the study were divided into two groups. Postpartum group-150; Postplacental or within 10 minutes/intracaesarean/within 48 hrs of delivery. Interval Group 150; after 6 weeks of delivery / postmenstrual. Cu T 380A was used in the study. Contraindication for PPIUCD were between 48 hrs and 6 wks postpartum, chorioaminionitis, PROM >18 hrs, unresolved PPH and puerperal sepsis. All were followed up for 6 months.
Results:The continuation rate at 6 months was 81.81% in interval group and 88.23% in postpartum group. Complications occurred in 15.33% cases after PPIUCD and in 19.33% cases after interval IUCD. Expulsion rate was significantly higher in PPIUCD as compared to interval insertions (6.96% v/s 2.2%; p value <0.05). Removal rate of IUCD was almost similar in both the groups (4% in PPIUCD v/s 6.0% in interval). Conclusions: PPIUCD is an effective, safe, convenient, low cost and long term method of postpartum contraception irrespective of the mode of delivery.
Background: Polycystic ovarian syndrome (PCOS) is characterized by the combination of hyperandrogenism, chronic anovulation and polycystic ovaries. Objective of present study was to compare the effects of N-acetyl cysteine, metformin and vitamin D3 with calcium on clinical and metabolic profile in PCOS.Methods: 66 women were randomly assigned into three equal treatment groups. Group 1 received N-acetyl cysteine, 600 mg three times a day. Group 2 metformin hydrochloride, 500 mg two times a day for 1 week, then three times a day for rest of the study and Group 3 Vit-D3 60,000 IU weekly with calcium 1500mg daily. Clinical and metabolic assessment was done at baseline and after three months of treatment.Results: After 12 weeks of treatment improvement of symptoms was seen in all the three groups, however better improvement in oligomenorrhea and hirsutism was seen in metformin group than others two groups. The clinical parameters like weight, BMI, waist hip ratio, biochemical markers of insulin resistance, fasting glucose, fasting insulin, fasting glucose/insulin ratio were significantly decreased in N-acetyl cysteine group than others two groups.Conclusions: N-acetyl cysteine had better improvement in clinical, and metabolic profile than metformin and vitamin D3 with Calcium group in PCOS patients. It can be used as a substitute for insulin reducing medications in treatment of PCOS patients, considering its limited adverse effects.
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