ORIGINAL RESEARCH ARTICLE | Sept. 11, 2023
Sonographic Correlation of Polycystic Ovaries (PCO) with the Fatty Liver
C. A. H. M. Enamullah, Tamanna Jahan, Tahmina Begum, Abid Sikdar, Arzu Manth Ara Begum, Wanaiza Rahman
Page no 345-349 |
DOI: 10.36348/sijog.2023.v06i09.001
Objective: To assess the Sonographic Correlation of polycystic ovaries (PCO) for the fatty liver. Method: This is a study carried out at the Dhaka National Medical Institute Hospital, Johnson Road, Dhaka from June 2022 to November 2022 for a period of 6 months. A total number of 60 female patients with an age range of 18 years to 45 years, who had Sonographic features of polycystic ovaries, were included. Postmenopausal women and patients with a history of HbsAg+ were excluded from this study. Proper history was taken from all patients. Then every patient underwent USG of the Radiology & Imaging department of DNMC. Curvilinear probe 3-5 MHz Samsung HS40 machine was utilized patients with polycystic ovaries and NAFLD (Non-Alcoholic Fatty Livers Disease) are remembered for this examination and patients with some other pelvic pathology are avoided in this investigation. Results: During the study, 40% belonged to 27-35years age group and all patients had bilateral PCOS. Plus, 83.33% had fatty liver. 40% had grade-II fatty liver. Followed by 32% had grade-III fatty liver and only 28% had grade-I fatty liver. Among the 18-26 years group grade-I fatty liver was higher, 70% followed by in 27-35 years group grade-II fatty liver was higher, 52.38%, and the 36-45years years group grade-III fatty liver was higher, 42.85%. Prevalence of Hepatomegaly is typically seen higher in the 36-45years age group, 25%. Conclusion: Based on our study we can conclude that there was a significant correlation between fatty liver and PCOS.
ORIGINAL RESEARCH ARTICLE | Sept. 21, 2023
Effect of Letrozole and Clomiphene Citrate versus Letrozole Alone for Ovulation Induction in Women with Polycystic Ovary Syndrome
Dr. Sohely Nazneen, Prof. Dr. Jesmin Banu, Prof. Dr. Shakeela Ishrat, Dr. Farzana Deeba, Dr. Chalontika Rani, Dr. Shirin Jahan, Dr. Sumaiya Akter, Dr. Mitu Debnath
Page no 350-360 |
DOI: 10.36348/sijog.2023.v06i09.002
Background: Polycystic ovary syndrome (PCOS) is a common endocrinopathy characterized by oligo-ovulation or anovulation signs of androgen excess and multiple small ovarian cysts. It is thought to be one of the leading causes of female sub-fertility. It has been estimated that PCOS affects 5-10% of females in reproductive age. In this study, we used combination of letrozole and clomiphene vs letrozole alone in ovulation induction in infertile PCOS women. Objective: The objective of the study was to compare the effectiveness of the combination of letrozole and clomiphene citrate and letrozole alone in ovulation induction in infertile women with PCOS. Methods: Randomized controlled trial conducted in the Department of Reproductive Endocrinology and Infertility, Bangabandhu Sheikh Mujib Medical University, Dhaka, from July 2020 to June 2021. A total of 50 women 18-40 years of age with a diagnosis of infertility and PCOS as defined by the Rotterdam criteria and no other known cause of infertility were included in this study. Participants were randomly assigned into two groups by using a computer-generated random table to either 5 mg letrozole alone or the combination of 2.5 mg letrozole and 50 mg CC daily on cycle days 3-7 for two treatment cycle. Statistical analysis was performed by the SPSS program for Windows, version 22.0. Main outcome measured by number & size of mature follicles, endometrial thickness, day 21 serum progesterone & ovulation rate in both groups. The secondary outcome includes pregnancy rate and complication of both treatment arms. Results: Regarding demographic criteria, there was no significant difference between two groups. In the current study, clinical characteristics, laboratory parameters and cycle characteristics were also comparable to both groups and showed no significant difference. Dominant follicles were found 24(52.2%) in group A (CC+Letrozole) and 29(63.0%) in group B (Letrozole Alone) without any significant difference. Mono follicular development was found 18(75.0%) in group A and 24(82.8%) in group B which was not statistically significant. Endometrial thickness and serum progesterone level at 1st and 2nd cycle were not statistically significant between two groups (p>0.05). Ovulation rate was higher in group B than group A (76.0% vs 72.0%) with absolute difference 4.0 and relative ratio 0.95. Pregnancy rate was also higher in group B than group A (24.0% vs 16.0%) with absolute difference 8.0 and relative ratio 0.67. Ovulation and pregnancy rate were not statistically significant between two groups. Regarding side effects, no significant difference was found between two groups. Conclusion: Although it was not statistically significant, ovulation and pregnancy rate was a little higher in alone letrozole group than combined group. The results of this preliminary study suggested that letrozole may have a better role as a first-line treatment for anovulatory patients with PCOS.
ORIGINAL RESEARCH ARTICLE | Sept. 28, 2023
Comparison of Vitamin D Status between Healthy Pregnant Women and Women with Recurrent Early Spontaneous Pregnancy Loss
Morsheda Ferdous, Rezaul Karim Kazal, Farhana lslam, Nishat Anan, Md. Rakib Hossain, Nurjahan Begum, Tripti Sarkar
Page no 361-368 |
DOI: 10.36348/sijog.2023.v06i09.003
Introduction: Recurrent early spontaneous pregnancy loss is the most common negative outcome of pregnancy and identification of modifiable risk factors is potentially of great importance for public health. The immunological factors may play a role in failure of pregnancy in women with recurrent pregnancy loss. The role of this vitamin D has also been proved in the immune system. Aim of the Study: This study aim to determine serum vitamin D status among women with recurrent early spontaneous pregnancy loss and to compare the vitamin D level among them with healthy pregnant women. Methods: This cross sectional comparative study was done at the out patient department of obstetrics and Gynecology in Bangabandhu Sheikh Mujib Medical University during September 2018 to August 2019. The study comprises of 70 women carrying singleton fetus, gestational age between 8 to 12 weeks, in the age range of 18 to 35 years. The respondents were divided into two groups, 35 pregnant women in their early pregnancy loss with previous history of two or more early spontaneous pregnancy loss were considered as group I and 35 women in their early live pregnancy with previous history of one or more successful pregnancy and no history of any pregnancy loss were considered as group II. Fasting serum vitamin D level was measure by CMIA. Results: This study found that most the respondents were vitamin D deficient in both groups. In group I 17(48.6%) and in group II 10(28.6%) were vitamin D severe deficient. Again in group I 18(51.4%) and 24(68.6%) in group II were vitamin D deficient. The mean vitamin D level was 9.90±2.28 ng/ml in group I and 11.43±3.96 ng/ml in group II. The differences was statistically not significant (P>0.05) between two groups. There is a negative correlation (r-0.235; p 0.175) between serum vitamin D level and number of pregnancy loss. Which indicate increase number of pregnancy loss associated with decrease level of vitamin D. Conclusion: Vitamin D deficient in both groups, however the vitamin D level was comparatively low in women with recurrent early spontaneous pregnancy loss but the differences was not significant between two groups.
ORIGINAL RESEARCH ARTICLE | Sept. 28, 2023
Frequency of Hypovitaminosis D in Obese Adolescent with Polycystic Ovary Syndrome
Farhana Islam, Rezwana Kabir, Rezaul Karim Kazal, Morsheda Ferdous, Nishat Anan, Rumnaz Akhanda, Mohammad Shah Jalal Bhuiyan, Erina Tabassum
Page no 369-377 |
DOI: 10.36348/sijog.2023.v06i09.004
Background: Polycystic ovary syndrome (PCOS) is one of the most common female endocrine disorders affecting the reproductive age group and is thought to be one of the leading cause of female infertility. Many patients with polycystic ovary syndrome (PCOS) also have features of the metabolic syndrome, including insulin resistance, obesity, and dyslipidemia. Vitamin D affects insulin and glucose metabolism, and a low vitamin D status maybe a risk factor for PCOS. Aim: To determine vitamin D status among the obese adolescent with Polycystic Ovary Syndrome (PCOS) and to compare the vitamin D level among obese and nonobese adolescent with PCOS. Methods: This cross sectional study was done at the out-patient department of Obstetrics and Gynecology in Bangabandhu Sheikh Mujib Medical University (BSMMU) during November 2017 to October 2018 but the patients enrollment was started after 16 July 2018. The study comprises of 80 adolescent girls diagnosed as PCOS according to Rotterdam criteria, in the age range of 9 to 18 years, out of which 50 obese adolescent girls was considered as group I and 30 non obese adolescent girls was considered as group II. The biochemical parameters measured in the study includes fasting blood sugar, fasting insulin level and serum 25-hydroxy vitamin D level. Serum 25 (OH) D level less than 20 ng/ml was classified as vitamin D deficiency. Results: In this study it was observed that maximum patients were vitamin D deficient in both groups. In group I, 76% and in group II, 60% were vitamin D deficient. Again in group I, 14% and 33.3% in group II were vitamin D insufficient. Only 10% in group I and 6.7% in group II were found to have sufficient level of vitamin D. The mean Vitamin D was found 18.25±5.51 ng/ml in group I and 19.66±5.21 ng/ml in group II. The mean difference of vitamin D level between two groups was statistically not significant. There is a negative significant correlation between vitamin D and BMI which indicates level of vitamin D decreases with increase of BMI of the participants. Conclusion: Vitamin D deficiency was predominant in both groups. Though the difference of vitamin D level was not significant between two groups but the mean level of vitamin D is lower in group I than in group II. There is a negative significant correlation between vitamin D and BMI which indicates that higher BMI levels were associated with lower vitamin D levels.