A study on factors affecting newborn weight and large for gestational age newborns in non-diabetic mothers: The role of maternal serum triglycerides

Introduction: Triglycerides have been shown to be a biochemical predictor of newborn weight and risk of large for gestational age (LGA) in a few previous small studies. The objective of this study is to ascertain whether mid-pregnancy fasting serum triglycerides can predict the risk of developing LGA and newborn weight in non-diabetic pregnant mothers. Methodology Universal sampling of pregnant mothers attending the antenatal clinic at the Hospital Universiti Sains Malaysia (HUSM) and nearby clinics between 24 to 32 weeks gestation was carried out between December 2003 and July 2004. Expectant mothers were screened for exclusion criteria including diabetes, hypertension, preeclampsia, fetal anomaly and multiple gestations. Those who were sure of dates and consented for the study were enrolled. Modified ora.l glucose tolerance test (MOGTT) was performed and fasting serum triglycerides and total cholesterol were analysed. The subjects were followed up at delivery when the period of gestation, the birth weight and the sex of newborn were noted. The correlations of the variables with newborn weight were tested and multiple linear regressions were used to find the associations. Bivariate logistic regression was used to look at the association of LGA newborn and the variables including triglycerides which were divided into two groups. The associations of the two groups of triglycerides and fasting plasma glucose (FPG) with the incidence of LGA were tested in cross tabulations. Results: A total of 310 subjects were enrolled and 267 completed data were analyzed, 246 were normal glucose tolerant (NGT) and 21 impaired glucose tolerant (IGT). The incidence of IGT in this study was 7.9%. In NGT, triglycerides correlated poorly (r-0.14, p=0.03) with newborn weight while maternal body mass index (BMI) (r-0.30, p<0.001) and FPG (r-0.28, p<0.027) were the only two variables moderately correlated with newborn weight after adjustment of the gestation and gender of the newborn. FPG (OR 3, p=0.027), high triglycerides value (>2.78mmoi/L) (p=0.039) and 2 hours postprandial plasma glucose (HPPPG) (p=0.044) were associated with risk of LGA newborn. With high triglycerides (>2.78mmoi/L) and FPG (>4.3mmoi/L), risk of getting LGA was 31.8o/o (p<0.001). Conclusions: In NGT subjects, mid-pregnancy high FPG and high triglycerides value could be used to predict risk of getting LGA newborn

The effect of letrozole (aromatase inhibitorifemara) and clomiphene citrate clomid/serophene) for induction of ovulation in polycystic ovarian syndrome (PCOS)

Women who was diagnosed to have Polycystic Ovarian Syndrome (according to the revised Rotterdam ESHREIASRM criteria, 2003) (2004) attending Infertility Clinic at Hospital Sultanah Bahiyah, Alar Star, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan and Hospital Tengku Ampuan Afzan, Kuantan, Pahang were recruited in this study. They were later randomized into two groups i.e. Letrtozole Group (Letrozole, n=75), Clomiphene Citrate Group (CC n=75). During initial visit, the Body Mass Index and Waist Circuference were measured. Baseline investigations were taken which include Follicular Stimulating Honmone, Luteinising Honmone, Liver Function Test, Renal Function Test and serum prolactin. In Letrozole Group, Letrozole 5.0 mg daily was given from the fifth until the ninth day of menstruation. Clomiphene citrate 100mg daily was given for those patients in CC Group from the fifth until the ninth day of menstruation as well. Serial tranvaginal scan were done to see the dominant follicles, endometrial thickness and number of follicles. Tranvaginal scan were repeated to look for evidence of ovulation. Total of 150 subjects enrolled in this study, completed the ovulation induction cycle and included in data analysis. There were no statistical differences noted in term of sociodemographic, antropometrics and duration of infertility in between these two studied groups suggestive that the subjects were homogenously distributed. The difference between letrozole and CC in tenm of ovulation rate, 59 (78.7%) vs 40 (53.3%); p <0.001 which was statistically significant, and pregnancy rate, 19 (25.3%) versus 12 (16.0%); p 0.22 which was statistically not significant. Letrozole also produce better dominant follicle which is monofollicle compare to CC, 33 (46.5%) versus 20 (26.7%) patients respectively. Endometrial response also yielded similar result. No incidence of adverse pregnancy outcome like Ovarian Hyperstimulation Syndrome (OHSS) observing in this study. Multiple logistic regression (MLR) shows letrozole group had three times more likely having ovulation outcome compare to CC group after controlling other variables of age, duration of infertility, type of infertility, baseline honmonal profile and BMI. Only BMI made significant contribution to predict successful ovulation. If BMI of a patient increases by 1 unit kg/m2 , there is a nine percent of chance of her to have successful ovulation. Letrozole provide a more efficient stimulation to CC in tenm of ovulation induction, thicken the endometrial lining and achieving a successful pregnancy among PCOS women undergoing ovulation induction

The effect of Tualang honey versus Honey Cocktail (HC 124) on safety, physiological and psychosexual changes among postmenopausal women

Introduction: Beehive products such as royal jelly and bee bread have been reported to contain higher minerals. vitamins, free fatty acid and amino acids compared to honey alone. Hence. a combination of beehive products known as Honey Cocktail may provide additional values to Tualang Honey. Objective: To investigate the effects of Tualang Honey (TH) versus Honey Cocktail (HC) (a mixture of honey. bee bread and royal jelly) on safety, physiological (cardiovascular. anthropometric measurements, hormonal profile and bone densitometry) and psychosexual changes (psychosexual and quality of life) among postmenopausal women. Methods: A randomized. double blinded two-armed parallel study involving 100 postmenopausal women aged 45 to 65 was conducted in the ratio of 1 : 1 into either 20 g/day of TH or HC for twelve months duration. Safety profile [(Renal Function Test (RFT) and Liver .Function Test (LFT)J, cardiovascular parameters [(systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL), low density lipoprotein (LDL) and fasting blood sugar (FBS). anthropometric measurements [body mass index (BMI), waist circumference (WC), body fat percentage (Fat%)]. hormonal profile [follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) and testosterone(T)], bone densitometry (T-score), psychosexual changes (self administered FSFI and WHO) were assessed at baseline, six months and 12 months. RM A NOVA and ANCOVA were performed with SPSS version 22.0 was used for data analysis. Duration of menopause was controlled as covariate for hormonal analysis. Meanwhile, for T-score analysis, duration of menopause and E2 level were controlled. Results: There were no significant differences between the groups in serum creatinine, alanine amino transferase and aspartate aminotransferase level at baseline. 6 months and 12 months. However, there were significant improvements in the BMI (p<0.001), WC (p<0.001), Fat% (p<0.001), E2 levels (p=0.043) and T-score (p=0.047) in HC group compared to TH group at 12 months. There were significant improvements in DBP (p=0.014), FBS (p=0.017) and FSH (p=0.006); in TH group compared to HC group at 1 2 months. Other parameters were not significantly different. There was a significant improvement in the overall FSFI scores(p=0.016) in the HC group compared to the TH group at 12 months

A study on common sexually transmitted disease infection in infertile female attended to infertility clinic, HUSM, Kota Bharu, Kelantan.

Introduction: Sexually tramsmittcd disease (STDs), once call ed venereal disease, are among the most common infectious diseases in the world. In Western countries, there has been a dramatic increase in the reported incidence 0f sexually transmitted diseases (STD) during the past 25 years. It is tragic irony that despite medical efforts against sexually transmitted di seases and the existence, since the 1 9~0 s, of powerrul treatments for them, !he~e di se~ses ~,,crs ist; eVC:il il11 ive in the twenty first century. This trend was augmented by ea rlier sexual maturity in girls and earlier age of onset of sexual activity in both sexes. Other sociological changes which contribute to the increased incidence of STD include urbani7.ation, increased mobility among the young, and the greater ease of world-wide tra vel. Sexual tourism is increasingly common. This last factor has also promoted the importation of unusual tropical STDs and antibioticresistant infections. Traditionally, five diseases ha ve been class ified as sexually transmitted diseases which are syphilis, gonorrhoea, lyphogranuloma venereum, chancroid, and granuloma inguinale. Lyphogranuloma venereum is one of disease caused by Chlamydia thrachomatis. To d~t e more than 20 distinct sex ually transmitted or transmissible pathogens were identified which may have different clinical lllanifestations. Ilowever in this study we are only concentrate on three common sexually tran smitted diseases which are chlamydia! infection, gonorrhoea and syphilis. Chlamydia! inti!ction and gonorrhoea are wdl known to cause pelvic inflammatory disease (PID) and their sequelae; infertility, chronic pehic pain and ectopic pregnancy, whereas syphilis affect the outco1ne of the baby before and after the pregnancy. Another important issue is that, the genital chlarnydial int'tction is mcreasing in trend worldwide. Objectives: To determine the local prevalence of common organism m Sexually Traus1niued Diseases (STDs) infections (C 'hlun~vdia lracbrnuatis, gonorrhoea and syphilis) in intertHe len1ales attended to Jntertihty Clinic Hospital Universiti Sains Malaysia, Kubang Kerian, Kota Bhant, Kelantau. And to dctennine the clearance rate of ('h/anzydia trachoJJzalis and gonorrhoea infection after a course of azithromycin I gram single dosage. Methodology: This 1s a prospective study involving 150 intertile females under fOllow up at infertility clinic Department of Obstetrics and Gynaecology, Hospital Universiti Sa ins tvtalaysia between I st of March 2002 lill 281h of February 2003 . Endocervical saruples were obtained to detect ( 'hla11~~·dia trachotnatis by direct immunofluorescence, Nei.1·seria gonorrhoea by Gram smear and culture & sensitivity. Blood sa1nples vverc also obtained tbr Venereal Disease Research Laboratory (VDRL) testing and tor lg f\·1 antibody toward chla1nydia. For VORL testing positive patient another blood san1plc tor 'lieponetna pallidun Conclusion: The prevalence of sexually transtnitted diseases (Chlarnydia trachomatis, gonorrhoea and syphilis) infection in infertile female is lo\v in our studied g~oup. The 8 clearance rate of Chlanzydia trachrnnatis infection by azithrotnycin is good. There is statistically significant correlation behveen the incidences of tubal factor causing infertility \vith Chlamydia trachontatis infection arnong thern. The prevalence is not a true representation of Malaysian populations as it is a hospital-based study. A larger scale study involving a few centers i~ needed in order to obtain a better representation of Malaysian populations

Immediate and long-term relationship between severe maternal morbidity and health-related quality of life: a prospective double cohort comparison study

Abstract Background Given the growing interest in severe maternal morbidity (SMM), the need to assess its effects on quality of life is pressing. The objective of this study was to compare the quality of life scores between women with and without SMM at 1-month and 6-month postpartum in Kelantan, Malaysia. Methods A prospective double cohort study design was applied at two tertiary referral hospitals over a 6-month period. The study population included all postpartum women who delivered in 2014. Postpartum women with and without SMM were selected as the exposed and non-exposed groups, respectively. For each exposed case identified, a non-exposed case with a similar mode of delivery was selected. The main outcome measures used were scores from the Short Form-12 Health Survey (SF-12). Results The study measured 145 exposed and 187 non-exposed women. The group-time interaction of the repeated measure analysis of variance (RM ANOVA) showed no significant difference in the mean overall SF-12 physical component summary score changes (P = 0.534) between women with and without SMM. Similarly, the group-time interaction of the RM ANOVA showed no significant difference in the mean overall SF-12 mental component summary score changes (P = 0.674) between women with and without SMM. However, women with SMM scored significantly lower on a general health perceptions subscale at 1-month (P = 0.031), role limitations due to physical health subscale at 6-month (P = 0.019), vitality subscale at 1-month (P = 0.007) and 6-month (P = 0.008), and role limitations due to emotional problems subscales at 6-month (P = 0.008). Conclusions Women with severe maternal morbidity demonstrated comparable quality of life during the 6-month postpartum period compared to women without severe maternal morbidity

Association of oxidative stress and memory performance in postmenopausal women receiving estrogen-progestin therapy

Objective: The aim of this study was to examine the association between changes in blood oxidative stress level/ activity and changes in memory performance among postmenopausal women. Methods: This study involved 39 postmenopausal women who received estrogen-progestin therapy (EPT) for 16 weeks. Verbal learning and memory performance were assessed using the Malay Version of Auditory Verbal Learning Test before and after 16 weeks of EPT. Oxidative stress levels/activities before and after 16 weeks of EPT were determined using commercially available kits. Data were analyzed using paired t test and r. P G 0.05 was considered significant. Results: The activities of glutathione peroxidase and catalase were considerably increased (P G 0.05), but the level of 4-hydroxynonenal was notably decreased (P G 0.05), after 16 weeks of EPT. There were positive correlations between changes in plasma superoxide dismutase and changes in trial A2 scores (r = 0.36, P G 0.05), and between changes in the ratio of blood reduced glutathione to oxidized glutathione and changes in trial A2 scores (r = 0.34, P G 0.05). Conclusions: Sixteen weeks of EPT increase blood antioxidant capacity. However, most of the changes in oxidative stress level/activity are not significantly associated with changes in the memory performance of postmenopausal women

Improved blood oxidative status is not associated with better memory performance in postmenopausal women receiving Tualang honey supplementation

We examined association between the changes in blood oxidative stress level/activity and the changes in memory performance in postmenopausal women receiving Tualang honey (TH). The verbal learning and memory performances of thirty nine postmenopausal women were assessed using the Malay version of the Auditory Verbal Learning Test (MVAVLT) and their oxidative stress levels/activities were determined using commercially available kits before and 16 weeks after TH supplementation. The plasma glutathione peroxidase (GPx) and catalase (CAT) activities were considerably increased but the 4-hydroxynonenal (4-HNE) level was notably decreased after 16 weeks of TH supplementation. There were positive correlations between the changes in plasma GPx and the changes in trial A6 scores (r = 0.48, P < 0.05) and between the changes in plasma CAT and the changes in recognition score (r = 0.32, P < 0.05). TH supplementation for 16 weeks reduced blood oxidative stress but most of the changes in blood oxidative stress level/activity were not significantly correlated with the changes in memory performance

Tualang Honey Supplementation Reduces Blood Oxidative Stress Levels/Activities in Postmenopausal Women

his study aimed to investigate the ability of Tualang honey (TH), a phytoestrogen, to reduce blood oxidative stress levels/activities in postmenopausal women and compared the efects with the standard estrogen progestin therapy (EPT). A total of 78 healthy postmenopausal women were randomly assigned to one of two groups; EPT group received Femoston conti 1/5 (1mg 17�- estradiol and 5mg dydrogesterone), and TH group, received 20 g of TH supplement daily for 16 weeks. he reduced glutathione to oxidized glutathione ratio (GSH:GSSG), plasma glutathione peroxidase (GPx), catalase (CAT), superoxide dismutase (SOD), and �-hydroxynonenal (�-HNE) levels/activities were measured at pre- and postinterventions using commercially available kits. he plasma GPx and CAT activities were notably increased, and plasma �-HNE level was signiicantly decreased in postmenopausal women who received EPT and TH supplementation. TH supplementation for 16 weeks was able to reduce blood oxidative stress levels/activities of postmenopausal women comparable to those who received EPT. hus, TH has a potential to be used as antioxidant therapy to combat oxidative stress-induced neurodegenerative diseases.his trial is registered with NCT01300676