Clinical Efficacy of Low Dose Flutamide plus Diane-35 in the Treatment of Idiopathic Hirsutism and Polycystic Ovary Syndrome

Objective: Idiopathic hirsutism (IH) or polycystic ovary syndrome (PCOS) are the most common causes of hirsutism which affects 5–10 % of all women. The aim of this study was to evaluate the efficacy of flutamide plus diane 35 in the treatment of idiopathic hirsutism and polycystic ovary syndrome. Materials and Methods: 26 polycystic ovary syndrome and 24 idiopathic hirsutism patients were evaluated. Fifty patients were divided into two groups according to their diagnosis: idiopathic hirsutism or polycystic ovary syndrome. All patients received 125mg Flutamide once a day and Diane 35 tablets for 21 days of each month, for 12 months. We measured hirsutism scores and hormonal levels of all patients. Evaluations were done before treatment, in the 6th and 12th months of therapy. Results: There were no significant differences in Ferriman-Gallwey scores at the beginning and at the end of the therapy between the IH and PCOS groups. The decreases in Ferriman-Gallwey scores were significant in both groups in the 6th and 12th month of therapy. Combined treatment significantly decreased total and free testosterone, DHEAS and significantly increased SHBG levels in both groups and additionally decreased levels of LH, androstenodione and LH/FSH ratio in the polycystic ovary syndrome group. Conclusion: Combined treatment was effective and safe in the treatment of hirsutism. Combined regimens have additional effects on the treatment of hirsutism

Poziom surowiczego czynnika wzrostu związanego z angiopoetyną (AGF) jest podwyższony w cukrzycy ciążowej i związany z insulinoopornością

Objective: Angiopoietin-related growth factor (AGF) is associated with angiogenesis but it can also affect glucose and energy metabolism. The aim of the study was to determine AGF levels in gestational diabetes mellitus (GDM). Materials and Methods: The study included 44 patients with GDM (GDM group) and 33 non-diabetic, healthy, women in the third trimester of pregnancy (control group). We analyzed serum levels of AGF and other biochemical and anthropometric markers in all subjects. Results: The study revealed that serum AGF levels were significantly higher in patients with GDM (113.30+/-69.92 ng/ml) than in controls (52.30+/-35.59 ng/ml), (p-valueCel: Czynnik wzrostu związany z angiopoetyną (AGF) jest odpowiedzialny za angiogenezy ale może też wpływać na metabolizm glukozy i energii. Celem tego badania była ocena poziomu AGF w cukrzycy ciążowej (GDM). Materiał i metoda: Do badania włączono 44 pacjentki z GDM (tzw. grupa GDM) i 33 zdrowe ciężarne w trzecim trymestrze ciąży (grupa kontrolna). Zbadano poziom surowiczego AGF oraz inne biochemiczne i antropometryczne markery u wszystkich pacjentek. Wyniki: Wykazano, że poziom surowiczego AGF był istotnie wyższy u pacjentek z cukrzycą ciążową (113,3+/-69,92 ng/ml) niż w grupie kontrolnej (52,3+/-35,59 ng/ml), (

İlk trimester spontan uterus rüptürü: Olgu sunumu

Gebelikte uterus rüptürü maternal morbitide ve mortalite riskini arttıran nadir fakat acil bir durumdur. Gebeliğe bağlı ilk trimester uterin rüptürler ise son derece nadirdir. Kliniğimize kasık ağrısı nedeni ile başvuran hastada, 10 haftalık canlı gebelik, akut batın bulguları ve batın içerisinde serbest sıvı tespit edildi. Hastanın tıbbi kayıtlarından önceki gebeliğinin sezaryan ile sonlandırıldığı ve bu esnada uterus fundusunda perforasyon geliştiği öğrenildi. Eksploratif laparotomide bu perforasyon bölgesine uyan alandan uterus rüptürü olduğu görüldü. Akut karın bulguları olan ve batın içerisinde sıvı koleksiyonu tespit edilen gebe hastalarda uterus rüptürü, düşünülmesi gereken bir ön tanı olmalıdı

Effect of thyroid hormone replacement therapy on ovarian volume and androgen hormones in patients with untreated primary hypothyroidism

Background and Objectives: Primary hypothyroidism may be associated with ovarian enlargement and/ or cyst formation. We evaluated the effect of thyroid hormone replacement therapy on hormonal changes, ovarian volume and sonographic appearance. Design and Setting: Open, prospective study of women admitted to university gynecology clinic. Patients and Methods: The study included 26 patients with untreated hypothyroidism who had polycystic (n=10) or normal-appearing (n=16) ovaries and 20 euthyroidic controls. Basal serum total testosterone, free testosterone, androstenedione, dehydroepiandosterone-sulfate, prolactin, estradiol, luteinizing hormone, follicle-stimulating hormone, free T3, free T4 and thyroid-stimulating horone, together with ovarian volumes, were determined and repeated after euthyroidism was achieved. Results: Ovarian volumes of patients with hypothyroidism were significantly greater compared with controls, and their magnitudes diminished significantly during thyroid hormone replacement therapy. Hypothyroidic patients with polycystic ovaries had significantly higher serum free testosterone and dehydroepiandosterone-sulfate, but lower androstenodione levels compared with those who had normal-appearing ovaries. Serum total testosterone concentrations were significantly higher in hypothyroidic patients without polycystic ovaries, and thyroid hormone replacement therapy achieved a significant reduction in total as well as free testosterone. Conclusion: Severe longstanding hypothyroidism leads to increased ovarian volume and/or cyst formation. A decrease in ovarian volume, resolution of ovarian cysts and reversal of the polycystic ovary syndrome-like appearance, together with improvement in serum hormone levels, occurred after euthyroidism was achieved

A new method used in laparoscopic hysterectomy for uterine manipulation: uterine rein technique

The aim of this study is to define a new method of manipulating the uterus during laparoscopic hysterectomy. A total laparoscopic hysterectomy (TLH) with the newly defined technique was performed in 29 patients between July 2016 and July 2017. In this new technique, the uterus was bound from uterine corpus and fundus like a bridle with polyester tape, to allow abdominal manipulation. The technique was successfully performed at the first attempt in 93.1% of cases. It was repeated in two cases (6.9%) since the polyester tape departed away from the uterus at the first attempt. The mean application time was 11.2 min. The vaginal manipulator was not required in any of the cases. There were no intraoperative complications. In conclusion, this method has the advantages of not requiring any vaginal manipulator, reducing the number of people required during operation, permitting a near maximum manipulation of the uterus in all three dimensions, and giving the control of these manipulations directly to the surgeon. On the other hand, the technique also has some inadequacies which should be discussed and improved on in the future.Impact of statement What is already known on this subject? In a laparoscopic hysterectomy, manipulation of the uterus is essential for anatomical dissection of the regions and completion of the operation without complications. An ideal uterine manipulator is defined as inexpensive, as convenient, fast and suitable for injecting solutions, removing the need for an assistant and most importantly offering the most suitable range of motion. In this study, we describe a new and different technique (rein technique) allowing the abdominal manipulation of the uterus in a laparoscopic hysterectomy and discuss the advantages and disadvantages of this method. What do the results of this study add? The procedure was easily accomplished in most patients. We did not need to use an extra uterine manipulator in any of the cases. What are the implications of these findings for clinical practice and/or further research? In conclusion, the rein technique of uterine manipulation is effective and safe

Clinical Efficacy of Low Dose Flutamide plus Diane-35 in the Treatment of Idiopathic Hirsutism and Polycystic Ovary Syndrome

Objective: Idiopathic hirsutism (IH) or polycystic ovary syndrome (PCOS) are the most common causes of hirsutism which affects 5-10 % of all women. The aim of this study was to evaluate the efficacy of flutamide plus diane 35 in the treatment of idiopathic hirsutism and polycystic ovary syndrome