Impact of Lifestyle Intervention for Management of the Modern Life Scourge of Polycystic Ovarian Syndrome among Girls – A Case Series

Polycystic ovarian syndrome (PCOS) is a complex endocrine, metabolic and reproductive disorder. It affects various body organs. Oligomenorrhea, hirsutism, insulin resistance, obesity and polycystic ovaries are its hallmark features. Usual medicines for PCOS focus on blood glucose and hormonal regulation. Diet, exercise and lifestyle changes for losing weight provide relief from symptoms. We describe here eight PCOS cases enrolled in an RCT. The study aimed to ascertain the impact of the lifestyle intervention for management of polycystic ovarian syndrome among girls. Anthropometric assessments and biochemical parameters, including reproductive hormones and insulin resistance, were performed at baseline and after 6 months of intervention, change in their health profile was noted. After intervention, menstrual regularity was achieved in all cases. The average weight loss was 4.07 kg (range 2.5–14 kg). The average BMI reduced from 26.6 to 25.0 and waist circumference from 94.1 to 86.6. At the end of the intervention, five cases had normal ovarian size, LH:FSH was normal in three cases. Out of six with insulin resistance, only one tested positive after intervention. One of the subjects said “I am very satisfied with the treatment. Almost all of my problems have been resolved – periods are regular, lab reports are normal, mood has improved, weight has reduced; other people ask me how I have lost weight.” Simple changes in lifestyle can easily provide relief in PCOS cases without any medical intervention

Association of the Frequency of Respiratory Illness in Early Childhood with a Change in the Distribution of Blood Lymphocyte Subpopulations

Little is known about the distribution of lymphocyte phenotypes in young children and the association specific phenotypes may have with respiratory illnesses. The objective of this study was to describe lymphocyte distributions in children at approximately 2 years of age and to test for associations with the frequency of respiratory illness during the first 2 years of life. We hypothesized that an increased frequency of illness would be associated with those phenotypes that reflect previous antigen exposure and/or immune activation. Seventy-three children were followed during their first 2 years of life with daily symptom diaries and twice-monthly telephone calls to ascertain the incidence of respiratory illness. After the children reached 2 years of age, the phenotypes of circulating blood lymphocytes were measured by flow cytometry. Associations between illness and phenotypes were adjusted for education level of parents; hours per week in day care; hours per week exposed to environmental tobacco smoke, mould, or water damage in bedroom; and parental history of allergy and asthma. The resulting median lymphocyte count was 4.0 × 109 per litre (standard deviation, 1.3) with a CD4/CD8 count of 2.28, consistent with published values. Illness rates were positively associated with the percentage of CD8+ CD38+ T cells (unadjusted p = .03, adjusted p = .014), CD8+ CD45RO+ T cells (unadjusted p = .06, adjusted p = .036), and CD4+ CD45RO+ T cells (unadjusted p = .01, adjusted p = .005). Our conclusions is that there is an association between the distribution of lymphocyte phenotypes and the incidence of respiratory illness early in life. Future research is recommended to determine the directionality of this association

Assessment of quality of life in patients having Poly-Cystic Ovarian Syndrome: A cross-sectional facility-based study

BACKGROUND: Polycystic ovarian syndrome (PCOS) is a complex and heterogeneous disorder affecting various body organs. Menstrual irregularity, anovulation, and many cosmetic issues faced by PCOS patients endanger the essence of being a woman and may have a deleterious impact on their health-related quality of life (HRQOL). This study aimed to assess HRQOL in patients with PCOS and to identify the clinical and socio-demographic factors that might predict poor HRQOL. MATERIALS AND METHODS: This cross-sectional study was carried out in the tertiary care hospital in India. A total of 275 women visiting the same setting and diagnosed with PCOS were included. The participants' quality of life was studied using a disease-specific HRQOL questionnaire. Information regarding clinical and socio-demographics was collected using the interviewer schedule. For evaluating the predictors of HRQOL in PCOS subjects, analysis of variance and independent t-test was applied. For subgroup analysis, the post hoc (Gabriel) test was applied. RESULTS: The average total score of HRQOL of the study participants was 125.41 ± 29.1. The lowest weighted mean score was for menstrual problems. Among the socio-demographic variables, age and educational level influenced the HRQOL scores. Highly educated women reported the poorest HRQOL. The analysis of variance also indicated a significant variation in HRQOL scores among body mass index categories [F (4,270) = 5.09, P = <.001] and hirsutism status [F (2,272) = 14.222, P =<.001]. CONCLUSIONS: Menstrual irregularity, hirsutism, increased body mass index, educational status, and age are critical in altering HRQOL in PCOS cases. Clinicians should inquire about the HRQOL of patients with severe clinical manifestations and appropriate support must be provided during patient care

Treatment seeking behavior among patients with polycystic ovarian syndrome (PCOS)—A cross-sectional study from Northern India

BACKGROUND: Polycystic ovarian syndrome (PCOS) has now become a common problem among adolescent girls and young women in India. However, little is known about the treatment and satisfaction incurred from it. Our study aimed to assess the treatment-seeking behaviour among patients with PCOS. MATERIALS AND METHODS: The cross-sectional study was carried out in gynecology OPD of PGIMER, Chandigarh. Women with PCOS, 275, visiting the gynecology OPD were included. The treatment-seeking behavior for PCOS was elucidated among cases using a questionnaire. This included parameters like healthcare consulted, preferred system of medicine, referral pattern, treatment efficacy, and expenses incurred. Univariate descriptive analysis was used to present the results. RESULTS: The majority (68%) of the study participants were less than 25 years of age. The average weight was 66.78 (±13.0) Kg. Half of the participants were students. More than 70% belonged to the upper or upper-middle class. The study participants were diagnosed with PCOS at an average age of 21.4 (±4.7) years. The minimum age reported at diagnosis was 11 years, and the maximum age of diagnosis was 36 years. Most respondents preferred Allopathic treatment followed by homeopathy and Ayurveda. Few also opted for other treatment choices like diet therapy, yoga & meditation, weight loss supplements, and home remedies. Treatment efficacy ranged between 17.3%-34.2%. The majority of respondents reported the treatment to be moderately expensive. Most respondents (58.91%) were hardly influenced, while 16% were quite influenced by PCOS medicine or treatment advertisements. CONCLUSION: PCOS patients opt for different treatment options but generally find the treatment less effective and expensive

Using OPD-Based Counselling Room Approach to Inculcate a Feel Good Factor among Girls Tormented by Polycystic Ovary Syndrome (PCOS) Symptoms

Background: Polycystic ovarian syndrome (PCOS) prevalence is steeply rising. The reported prevalence among adolescents ranges from 9.13% to 36%. PCOS affects various body organs. The features of PCOS include oligomenorrhea/amenorrhea, hirsutism, alopecia, anovulation and polycystic ovaries. If not treated, it can increase the risk of infertility, diabetes, metabolic syndrome and cardiovascular disease. Obesity and overweight worsen the symptoms of PCOS women. Among PCOS women, obesity and overweight is reported to be 50%–70%. Research shows that physical health consequences of PCOS may result in psychological distress among women affected by the condition. It seriously compromises health-related quality of life of girls. The anxiety in life of PCOS women is mostly attributed to irregular menses, hirsutism and infertility. The influence of PCOS on quality of life is an issue that needs to be taken seriously. The psychological implications of this condition are underestimated and largely ignored.

Association of the Frequency of Respiratory Illness in Early Childhood with a Change in the Distribution of Blood Lymphocyte Subpopulations

Abstract Little is known about the distribution of lymphocyte phenotypes in young children and the association specific phenotypes may have with respiratory illnesses. The objective of this study was to describe lymphocyte distributions in children at approximately 2 years of age and to test for associations with the frequency of respiratory illness during the first 2 years of life. We hypothesized that an increased frequency of illness would be associated with those phenotypes that reflect previous antigen exposure and/or immune activation. Seventy-three children were followed during their first 2 years of life with daily symptom diaries and twice-monthly telephone calls to ascertain the incidence of respiratory illness. After the children reached 2 years of age, the phenotypes of circulating blood lymphocytes were measured by flow cytometry. Associations between illness and phenotypes were adjusted for education level of parents; hours per week in day care; hours per week exposed to environmental tobacco smoke, mould, or water damage in bedroom; and parental history of allergy and asthma. The resulting median lymphocyte count was 4.0 × 109 per litre (standard deviation, 1.3) with a CD4/CD8 count of 2.28, consistent with published values. Illness rates were positively associated with the percentage of CD8+ CD38+ T cells (unadjusted p = .03, adjusted p = .014), CD8+ CD45RO+ T cells (unadjusted p = .06, adjusted p = .036), and CD4+ CD45RO+ T cells (unadjusted p = .01, adjusted p = .005). Our conclusions is that there is an association between the distribution of lymphocyte phenotypes and the incidence of respiratory illness early in life. Future research is recommended to determine the directionality of this association.</p