Relationship between glucose homeostatic disorders and testosterone in adult Nigerian women with polycystic ovary syndrome

Background: Polycystic ovary syndrome (PCOS) is associated with hyperandrogenemia which is hypothesized to induce glucose homeostastic disorders among women with the syndrome. This study was thereby set to investigate the status of glucose homeostatic disorders and their relationship with testosterone among women with PCOS in Port Harcourt, Nigeria.Methods: This was a retrospective study of 224 women with PCOS who had visited a tertiary hospital in Nigeria over a 10-year period. The laboratory characteristics of these patients were evaluated. Records on age, fasting plasma glucose (FPG) and serum total testosterone (TT) were collected and analyzed using Shapiro-Wilk, descriptive, chi-square, Fisher’s exact, two-way analysis of variance, and Pearson’s tests. A p-value <0.05 was considered significant.Results: Glucose homeostatic disorders were documented in 49.1% of the study population. Impaired fasting glucose (IFG) and diabetes mellitus (DM) was observed among 37.5% and 11.6% of the study population respectively. There was difference in the mean TT levels among those with normal FPG, IFG, and DM (P<0.001). Those with DM had higher TT levels (2.47 ± 0.83 nmol/l) than those with IFG (2.12 ± 0.63 nmol/l) and normal glucose homeostatic status (1.63 ± 0.47 nmol/l). TT correlated positively with FPG among the overall study population (r=0.465; p-value = < 0.001), among those with IFG (r = 0.591; p-value=0.004), and among those with DM (r=0.404; p-value =0.012).Conclusions: Glucose homeostatic disorders are common among PCOS patients in our environment, especially among those with higher testosterone levels. This warrants screening of all PCOS patients for glucose disorders as part of their management strategies

The impact of BMI on the plasma glucose and lipid status of women with polycystic ovary syndrome

Background: BMI status is theorized to impact on the plasma glucose and lipid parameters of women with polycystic ovary syndrome. Hence, this study was instituted to investigate this theory among women with polycystic ovary syndrome in Port Harcourt, Nigeria.Methods: Medical records of 231 women with PCOS visiting a tertiary health center over a consecutive 10-year period were retrospectively acquired and analyzed. The obtained records were age, weight, height, calculated BMI, fasting plasma glucose and lipid profile (total cholesterol, triglycerides, high-density lipoprotein and low-density lipoprotein). The records were analyzed using Shapiro-Wilk, descriptive, chi-square, two-way analysis of variance, and Pearson’s tests. A two-tailed p-value of <0.05 was considered significant.Results: Overweight and obesity was recorded among 33.3% and 45.5% of the study cohorts respectively. The obese cohorts had higher plasma levels and abnormal frequency of fasting glucose (<0.001), total cholesterol (<0.001), triglycerides (<0.001), high-density lipoprotein (<0.001) and low-density lipoprotein (<0.001) status than the normal weight and overweight cohorts. BMI correlated weakly with glucose (r=0.259; p = 0.003), inversely but weakly with high-density lipoprotein (r: -0.373 p<0.001) and weakly with triglycerides (r=0.316; p<0.001) among overweight cohorts. BMI correlated strongly with fasting glucose (r=0.578; p< 0.001), strongly with total cholesterol (r=0.840; p<0.001), moderately but inversely with high-density (r=-0.490; p=0.004), strongly with triglycerides (r=0.753; p<0.001) and strongly with low-density lipoprotein (r=0.759; p<0.001) among the obese cohorts.Conclusions: Abnormal plasma glucose and lipid parameters seem to be prevalent among obese PCOS patients. Therefore, weight reduction should be a therapeutic target during their treatment

Pattern of dyslipidemia among adult women with polycystic ovary syndrome in Port Harcourt, Nigeria

Background: Dyslipidemia is adjudged the most common metabolic disorder observed among women with polycystic ovary syndrome (PCOS). However, there is paucity of data to support this hypothesis in our region. Therefore, this study was structured to evaluate the pattern of dyslipidemia among women with PCOS in Port Harcourt, Nigeria.Methods: This was a retrospective study of 226 adult women with PCOS who had visited the Department of Chemical Pathology and Metabolic Medicine of a tertiary hospital in Nigeria over a 10-year period (1st January 2008 to 31st December 2017), aimed to evaluate the pattern of dyslipidemia in these women. Records on age, total cholesterol (Tc), triglycerides (Tg), high-density lipoprotein (HDL-c), and low-density lipoprotein (LDL-c) were collected and analyzed using Shapiro-Wilk, descriptive, chi-square, and Fisher’s exact statistics. Statistical significance was set at 0.05.Results: The mean age of the study population was 28.40 ± 5.75 and ranged from 18 - 42 years. Most of the study population (55.3%) were within the age group of 20 – 30 years. The most common lipid abnormalities observed among the study population were increased triglycerides (75.7%) and decreased HDL-c (61.1%) concentrations while the least was increased total cholesterol (17.7%) and LDL-c (14.5%). Dyslipidemia was observed in 80.1% of the study population and more frequent (51.9%) within the age group of 20-30 years.Conclusions: Dyslipidemia is common among young adult women with PCOS. Regular assessment for dyslipidemia should be mandatory in PCOS to mitigate the long-term consequences of its complications

Admission cardiotocography versus Doppler auscultation of fetal heart in high risk pregnancies in a tertiary health facility in Nigeria

Background: Admission cardiotocography (CTG) and intermittent auscultation (IA) of the fetal heart  might help to identify those foetuses that could not withstand the stress of labour and also predict neonatal outcome. The aim was to compare the associations of admission CTG findings and those of IA of the fetal heart with labour and neonatal outcome.Methods: It was a prospective COHORT study. 30 minutes admission CTG for each of the 387 participants was interpreted, using the FIGO 2015 guideline and physiological interpretation. Admission IA was also performed on the same patients. Women whose CTG showed chronic hypoxia had caesarean section while those with either suspicious or pathological CTG, had intrapartum fetal resuscitation. Those that responded proceeded to labour during which fetal condition was monitored with IA. Data was analysed using a statistical package for social science (SPSS) software, version 19.Results: 108 (28.57%) and 57 (15.08%) of the 378 participants had abnormal admission CTG and admission IA findings respectively. The sensitivity of abnormal admission CTG and IA to predict abnormal IA findings in labour were 70.59% and 41.18% respectively. Compared with admission IA, admission CTG was more likely to predict the following labour and neonatal outcomes: caesarean section rates 72 (70.59%) and 42 (41.18%) for admission CTG versus IA groups respectively; relative risk RR=1.714; 95% CI 1.317-2.231, 1 min Apgar score less than 7, 78 (89.66%) and 36 (41.38%); RR=2.167; 95% CI 1.670-2.810, 5 min Apgar score less than 7, 57 (90.48%) and 33 (52.38%); RR=1.727; 95% CI 1.347-2.215, admission to SCBU 51 (68%) and 30 (40%); RR=1.700; 95% CI 1.237-2.336, intrauterine fetal deaths and early neonatal death.Conclusions: Admission CTG was a better predictor of labour and neonatal outcome than admission IA. CTG was therefore highly recommended as an integral tool in the management of labour

Risk assessment and thromboprophylaxis for venous thromboembolism in the puerperium in a tertiary health facility in Nigeria

Background: Venous thromboembolism (VTE) is a leading cause of maternal morbidity and mortality in the puerperium. Unfortunately in Nigerian tertiary institutions, there is paucity of information about its risk factors, screening for it, and its prophylaxis. The aim of the study therefore was to review the VTE risk and thromboprophylaxis in the puerperium at the University of Port Harcourt Teaching Hospital (UPTH), Nigeria.Methods: A retrospective cross-sectional study carried out at the University of Port Harcourt Teaching Hospital (UPTH). The following data were extracted from the notes of 424 consecutive inpatients postnatal women who delivered from the 1st of January to the 30th of April 2020: history/demographic characteristics, risk factors for VTE using the RCOG Green top guideline No. 37a.of 2015 as a benchmark, thromboprophylaxis, diagnosis and treatment of VTE. Women with a VTE event in the preceding 4 months before pregnancy were excluded. Data was analysed using a statistical package for social science (SPSS) software, version 18.Results: Risk assessment for VTE and its prophylaxis in the puerperium were not routine practice at the UPTH. 420 (99.06%) out of the total 424 postpartum women that were assessed were at significant risk of developing VTE and therefore needed to be on thromboprophylaxis with low molecular weight heparin. Irrespective of the high prevalence of risk factors and the fact that 100 (23.58%) of the patients had symptoms and signs of VTE, no case of VTE was recorded in the study population. Paucity of information and lack of knowledge about the diseases may be responsible for that.Conclusions: 420 (99.06%) out of the total 424 puerperal women were at significant risk of developing VTE and therefore needed to be on thromboprophylaxis in the puerperium. It was therefore recommended that a national guideline on VTE in the puerperium be written, taking into consideration local disease topography, ethnic diversity and the level of economic development in Nigeria

Evaluation of reproductive profile in male albino rats following varied duration of administration with Revive capsule

Background: Revive capsule is a polyherbal formulation commonly used to treat erectile dysfunction or enhance libido in men. Some of the individual herbs used in the formulation of this drug have been known scientifically to affect various biochemical components of the human body; hence this study was aimed at evaluating the reproductive profile in male albino rats following varied duration of administration with Revive capsule.  Methods: A total of 42 male albino rats were used for the study, and were divided into six (6) groups of seven (7) rats each. They were allowed to acclimatize for two (2) weeks by maintaining 12-hour light and dark cycles daily, with access to standard feed and water ad libitum. Group A (negative control) rats were administered with distilled water once daily, while groups B, C, D, E and F were administered once daily with 72 mg/kg of Revive capsule for 1 week, 2 weeks, 3 weeks, 4 weeks and 6 weeks respectively. The rat dose administered was extrapolated from the human dose using the formula by Paget and Barnes. At the end of each treatment week, the rats were allowed to fast overnight, followed by their anaesthetization using chloroform, and blood sample collection via jugular vein puncture. Also, the testes were excised; the epididymis were also excised from the testes and used immediately for semen analysis, while the epididymis-free testes were examined histologically. Rat-specific test kits with ELISA method were used to analyze serum LH, FSH and testosterone.Results: The results showed a significant increase (p<0.05) in serum LH, FSH and testosterone levels, and a significant increase in sperm count and sperm quality parameters in the treatment groups compared to the negative control, with the maximum levels attained after 6 weeks of treatment (group F). Also, photomicrographs of histologically examined testes of the treatment groups appeared indifferent from those of the negative control.Conclusions: These findings may suggest that in using a rat model, treatment with Revive capsule at the appropriate dosage for 6 weeks is safe, and that, besides its acclaimed use in enhancing libido or treating erectile dysfunction, it may also be effective in promoting male fertility.