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Article
Study of Occurrence of Polycystic Ovarian Syndrome Among Infertile Women

Authors: Hanaa Rahman Eleawi --- Enas Talib Abdul-Karim**, --- Anam Rasheed AL- Salihi***
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2015 Volume: 14 Issue: 3 Pages: 329-336
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT: BACKGROUND: Most women with polycystic ovary syndrome PCOS don’t even know that they have it ,and do not get a diagnosis until they begin trying to get pregnant.OBJECTIVE:To identify the prevalence of the polycystic ovary syndrome (PCOS) among infertile women attending the Institute of Embryo Research and Infertility Treatment in AL-KadhymiaBaghdad, and to identify some of the common characteristics of infertile women with PCOS and others without PCOS .METHODOLOGY: A cross sectional study was conducted for about four months,during which a review of records of all the women attending the Institute during the year 2010 (six hundred women) . RESULTS: Results showed that the most common factors of infertility in infertile women is the PCOS, PCOS had a higher frequency among women aged 20-29 years, Slightly higher frequency of diabetes mellitus and hypertension among them than other group. higher frequency of acne & hirsutism among the PCOS cases than other causes group, and a higher frequency of increased prolactin level& LH level in the PCOS cases.CONCLUSION: PCOS infertility comprises more than one fourth of causes of infertility and is associated mainly with primary infertility & among younger age group(20-29years) .


Article
Evaluation of serum levels Superoxide dismutase in women with polycystic ovarian syndrome and gingivitis

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Background: Polycystic ovary syndrome (PCOS) is the most common endocrine abnormality in women, there is an increasing evidence for an oxidative stress in PCOS that induce genomic and mitochondrial deoxyribonucleic acid damage that leads directly to reduced fertility. The objectives of this study are to assess and compare the periodontal health status by measuring clinical periodontal parameters (PLI, GI and BOP)as well as serum levels of superoxide dismutase at gingivitis ,gingivitis with PCOS and healthy periodontium groups, then correlate between clinical and biochemical parameters.Materials and Methods: 60 females with an age range between (25-40) years old had been tested and divided into3 groups ,the control group consists of (20) females with healthy periodontium, group of (20) females with gingivitis and group of (20) females with gingivitis and PCOS. After completion of clinical periodontal parameters recording (PLI, GI& BOP), blood samples were collected and biochemical analysis of serum samples were carried out by using [Super oxide dismutase Assay kit] to evaluate serum super oxide dismutase levels.Results: The highest mean values of PLI,GI and BOP score1 were found in gingivitis+PCOS group. Highly significant difference was revealed among the groups regarding mean values of Superoxide dismutase with the highest mean value at gingivitis+ PCOS followed by gingivitis groups. Non-significant correlation were demonstrated between clinical and biochemical parameters except the significant moderate positive correlation of BOP at gingivitis+PCOS group.Conclusion: It could be certified that severity of gingivitis may increase in patients with PCOS. The concentration of serum SOD increased with the severity of gingival inflammation as well as the presence of PCOS. Serum SOD may be useful biochemical marker for early detection of periodontal disease and PCOS


Article
Predictors of Letrezole success in ovulation induction among women with polycystic ovary syndrome resistant to clomiphene citrate
عوامل التنبأ للأستجابة لعقار ليترزول المستعمل لتحفيز التبويض عند النساء المصابات بتكيس المبيض المقاوم لعقار كلومفين سيتريت

Author: Fadia Jassim Al-izzi د.فادية جاسم العزي
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2011 Volume: 24 Issue: 1 Pages: 30-34
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Background: Clomiphen citrate is still the traditional therapy used for inducing ovulation in polycystic ovary syndrome. 20-25% of patients with this syndrome does not respond to clomiphen citrate and fail to develop follicles of desirable size. Letrozol, an aromatase inhibitor, is increasingly used for induction of ovulation in women in whom clomiphen citrate was unsuccessful.Methods: In a prospective study, during the period from October 2008 to the end of December 2009, in infertility clinic in Al-Yarmouk Teaching hospital, fifty one infertile women were diagnosed as having polycystic ovary syndrome according to the Rotterdam criteria; all patients had previously received clomiphene citrate and were diagnosed as having resistance to this drug. Those patients were assigned to receive an aromatase inhibitor, letrizole, in a dose of 2.5 mg, increased to 5 mg in subsequent cycles, given orally from the third day of a spontaneous bleeding or progesterone-induced withdrawal bleeding for 5 days. The primary outcome measures were number of growing and mature follicles and endometrial thickness. Secondary outcome measures were the occurrence of pregnancy and miscarriage.Results: With 51 patients and 122 cycles of letrezole therapy, we had 84 (69.2%) ovulatory cycle and 18 pregnancies (15.4%). This study has showed that the body mass index is significantly different between the two groups and the cut off point for it is equal to or more than 26 (sensitivity 60.71% and specificity 78.26%). The mean cycle day of human chorionic gonadotrophine (h CG) administration was 13.4±1.67.The mean number of mature follicles (more than 18 mm in size) on the day of h CG administration was 1.21(range 1-2) and the mean endometrial thickness on same day was 10.2±1.31mm.Letrezole was well tolerated with no reported side effectsConclusion: Induction of ovulation with letrezole in clomiphene citrate-resistant polycystic ovary syndrome patients is associated with limited number of mature follicles without adverse effect on endometrial thickness. The rates of ovulation and pregnancy are encouraging. One of notable finding is the association of high body mass index with high response rate to letrezole.Keyword: Aromatase inhibitors (letrezole), Polycystic Ovarian Syndrome

التقديم: يعتبر عقار كلومفين ستريت هو العلاج التقليدي لتحفيز التبويض في النساء اللواتي يعانين من العقم بسبب متلازمة تكيس المبيض،20-25% من النساء لايستجيبن لهذا العقار لذلك برز استعمال مثبطات أنزيم العطرين لتحفيز التبويض عند النساء اللواتي يعانين من العقم بسبب متلازمة تكيس المبيض بعد عدم استجابتهن لعقار كلومفين ستريت.طريقة البحث: دراسة مستقبلية أجريت للنساء العقيمات بسبب متلازمة تكيس المبيض واللواتي لم تظهر عندهن استجابه لعقار كلومفين ستريت وذلك في عيادة العقم في مستشفى اليرموك التعليمي للفترة ما بين تشرين الأول 2008 ولغاية كانون الأول 2009 . احدى وخمسون مريضه يعانين من متلازمة تكيس المبيض ,الجميع استلمن علاج كلومفين ولم تظهر اي استجابة (حالات مقاومة للكلومفين).تم اعطاء هؤلاء المرضى عقار ليتريزول ,احد المثبطات لإنزيم العطرين, وبجرعة 2.5 ملغرام وتصل إلى 5 ملغرام في الدوره العلاجية الثانية او الثالثة وذلك في اليوم الثالث من النزف . نقاط التقويم النهائية الأولية كانت عدد الحويصلات النامية وسمك بطانة الرحم ,بينما كان ظهور الحمل او الاسقاط هما نقاط التقويم النهائية الثانوية.النتائج: مع51 مريض و 122 دورة علاج مع عقار ليتريزول(أحد مثبطات أنزيم العطرين) تم الحصول على 84 (69.2 %) دورة تبويضية وثمانية عشر حمل(15.4 %),لم تسجل فروقات مهمة بين المرضى اللواتي استجبن للعلاج واللواتي لم يستجبن في معظم المتغيرات فيما عدا متغير واحد هو معامل الكتلة الجسدية ,حيث أظهر البحث أن نسبة الاستجابة تزداد كلما أزدادت هذه المعامل,وكانت معامل الكتلة الجسدية ألاكبر من أو تساوي 26 هي نقطة الفارق وبدرجة من الحساسية تبلغ 60.7 % ودرجة من التخصصية تبلغ 78.2 %.الأستنتاج:تحفيز التبويض في مرضى متلازمة تكيس المبيض المعنت لعلاج كلومفين يتضمن عددا محدودا من الحويصلات ولكن بدون أثر سلبي على سمك بطانة الرحم.نسبة الأستجابة وكذلك نسبة الحمل مشجعة.أظهر البحث علاقة ايجابية بين زيادة معامل الكتلة الجسدية ونسبة الاستجابة.


Article
Prevalence and Presenting Features of Polycystic Ovarian Syndrome in Iraqi Obese Females

Authors: Faris Abdul Kareem Khazaal --- Abdul Hadi Liebi --- nsaf Jasim Mahmoud
Journal: Iraqi Journal of Embryos and Infertility Researches المجلة العراقية لبحوث الأجنة والعقم ISSN: eISSN: 26166984 / pISSN: 22180265 Year: 2014 Volume: 4 Issue: 2 Pages: 14-18
Publisher: Al-Nahrain University جامعة النهرين

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Background:Polycystic ovarian syndrome (PCOS) constitutes the most common endocrinopathyof women of reproductive age. Women with PCOS manifest hyperandrogenemia,hyperinsulinemia, and hypothalamic-pituitary-ovarian axis aberrations.Objective:The objective of the present study was to find the prevalence and the presentingfeatures of PCO patients and associated manifestations in relation to biochemicaland anthropometric parameters in adult obese women attending obesity research andtherapy unit.Methods:Patients diagnosed as PCOS according to Androgen Excess and PCOS Society/2009criteria were grouped into two groups: those with BMI less than 30kg/m2 and thosewith BMI 30kg/m2 and more. Blood was drawn for biochemical and hormonalassay. Information tabulated, means and percentages used, and the results wereanalyzed.Results: The number of adult females 20-40 years of age attending Obesityresearch and therapy unit (ORTU) during February 2013 to February 2014 was 756,(14.3%) of them had PCOS, (65%) were diagnosed during examination. (94.4%) hadmenstrual disturbances, (63.8%) had hirsutism and (91.7%) had PCOS ultrasoundfindings. Mean BMI of the patients with PCOS was 33.62 (SD 4.21). Mean LHexceeded mean FSH in patients with PCOS and it was more evident with increasingBMI where it was doubled in those with BMI more than 30 kg/m2. LH/FSH ratio forBMI above 30 was 2.1, and although testosterone level was elevated showed nostatistical relation to BMI. The fasting glucose level, cholesterol and triglycerideslevels showed the same pattern of elevation that with increasing BMI.Conclusions:The prevalence of PCOS in females (20-40y) attending ORTU was 14%, of them65% were undiagnosed before, 63% had hirsutism, 94% had menstrual disturbancesand 90% had ultrasonic features of polycystic ovary. These findings suggest the needto stress on diagnosing PCOS in adult female during management of obesity.


Article
Correlation between Homocysteine and Insulin Resistance in women with Polycystic Ovarian Syndrome Referring to AL-Yarmook Teaching Hospital

Authors: Dhilal Q. Mohammed --- Hawaa AL-Dhahir --- Sabah M. Husein
Journal: Iraqi Journal of Embryos and Infertility Researches المجلة العراقية لبحوث الأجنة والعقم ISSN: eISSN: 26166984 / pISSN: 22180265 Year: 2014 Volume: 4 Issue: 2 Pages: 32-39
Publisher: Al-Nahrain University جامعة النهرين

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Background:Polycystic ovarian syndrome (PCOS) is one of the most common endocrinedisorders among females in reproductive age. Women with PCOS have severalcardiovascular disease risk factors. Hyperinsulinemia and insulin resistance (IR)which is a known key factor in the development of type 2 diabetes (T2DM) mayassociate PCOS. Homocysteine, a sulfur-containing amino acid, is toxic to vascularendothelium, leads to early atherosclerosis. PCOS said to be associated with highplasma homocysteine.Objective:To determine the correlation between insulin resistance and homocysteine in PCOSpatients.Methods:Patients diagnosed as PCO according to Androgen Excess and PCOS Society/2009criteria were grouped into two groups: those with BMI less than 30kg/m2 and thosewith BMI 30kg/m2 and more. Blood was drawn for biochemical and hormonalassay. Information tabulated, means and percentages used, and the results wereanalyzed.Results: Homocysteine levels were significantly higher (P value < 0.05) in PCOSgroup (12.28±1.89 μmol/l) as compared to control (9.51±1.92 μmol/l).HOMA-IRwas significantly higher (P value < 0.05) in PCOS (4.15±2.54) as compared tocontrol (1.69±0.54) .There was no correlation between IR and homocysteine withinPCOS group.Conclusions:Polycystic ovarian patients have higher levels of homocysteine and IR compared tocontrol but there is no correlation between IR and homocysteine within PCOS group.


Article
The Effect of Glycemic Control on Menstrual cycle in Iraqi Diabetic Women
بيان تاثير السيطرة الايضية على اضطرابات الدورةالشهريةعند النساء العراقيات المصابات بالسكري

Author: Ghalib A. Al-Sharefi د.غالب عبد زيد الشريفي
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2009 Volume: 22 Issue: 3 Pages: 174-178
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Objective: - The study was designed to evaluate the importance of glycemic control on menstrual cycle disorders in Iraqi diabetic women.Setting: - The study was held at Department of Physiology, Medical College of Al-Mustansiriya University in cooperation with the Iraqi National Diabetes Center (NDC) of Al-Mustansiriya University in Baghdad from November 2004 till November 2005.Outcomes measures: - The glycemic control was assessed by estimation of glycosylated hemoglobin and fasting plasma glucose while the pelvic ultrasound and hormonal measurements were done for detecting menstrual disorders and state of ovarian function. The Follicular Stimulating Hormone FSH, The Lutenizing Hormone LH, Estrogen and progesterone were measured by using Enzyme Linked Fluorescent Assay technique (ELFA). Results: -The present study showed that menstrual disorders disorders are more common in diabetic than non-diabetic females. Diabetics with menstrual disorders (i.e. amenorrhea or oligomenorrhea) had anovulatory cycles with normal or low gonadotrophine and low progesterone levels, and it is more common in poorly controlled diabetics than those with good glycemic control. The polycystic ovarian syndrome was found to be associated with insulin resistance, obesity and glucose intolerance and is more common in diabetics than non-diabetic women.Conclusion: - The study revealed that good glycemic control in diabetic women exerts a positive influence on menstrual cycle regulation and on ovarian and gonadotrophic hormones.Keywords: -Menstrual cycle, ovarian function, glycemic control, polycystic ovarian syndrome.

الاهـــداف : - صممت هذه الدراسه لتقيم اهمية السيطرة الإيضية على اضطرابات الدورة الشهرية عند النســــــــاء العراقيات المصابات بداء السكري .مكان البحث :- اجريت هذه الدراسة بالتعاون بين قسم الفسلجة لكليةالطب/ الجامعة المستنصرية والمركزالوطـــــــني للسكري التابع للجامعة المستنصرية للفترة من تشرين اول 2004لغاية تشرين اول 2005 القياسات : - تم قياس مدى السيطرة الايضية بواسطة حساب خضاب الدم المسكر ونسبة الكلوكوز في بلازما الدم في وهرمــــــونFSH حالة الصيام بينما تم قياس مستوى الهرمونات الانثوية ( الهرمون المحفز للبيوض وهرمون الأستروجين والبروستيرون ) بواسطة المقايسة المناعية الانزيميـــــــــــــة LH الاباضة *. وتم قياس مدى نضوج البيوض داخل المبيض وتحديد وقت الاباضة بواسطة جهاز الامواجEIFA فوق الصوتية **.النتائـــــج :- اظهرت الدراسة بأن اضطرابات الدورة الشهرية تكون أكثر عند النساء المصابات بالسكري مما هي في سائر النساء ، وان النسوة اللواتي يعانين من اضطرابات الدورة الشهرية (غياب الدورة الكامل او الجزئي ) تكون الدورة الشهرية لديهن خالية من الاباضة ((عدم نزول البيضة اثناء الدورة الشهرية )) مـــــــــع مستوى اقل من هرمون البروجستيرون ، وهذة الاضطرابات تكون مصاحبة اكثر لضعف السيطرة الايضية للمصاب بالسكري مقارنة مع المصابات بالسكري ولديهن سيطرة ايضية جيدة . وكذلك وجدنا بأن ظاهرة تكيس المبايض المتعدد تكون مصاحبة اكثر للمصابات بالسكري مصحوبة مع مقاومة الانسولين و السمنة وعدم تحمل فحص تحدي الكلوكوز .الاستنتاجات :- بينت الدراسة بأن السيطرة الايضية الجيدة عند المصابات بالسكري لها تأثير ايجابي على انتظام الدورة الشهرية وكذلك على مستوى الهرمونات الانثوية الصادرة من المبيض او المراكز العليا للدماغ .


Article
Rosuvastatin Add On Metformin In The Treatment Of Polycystic Ovarian Syndrome

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Background:-Polycystic ovary syndrome (PCOS) is common in women of reproductive age and it’s commonly associated with endocrinal and biochemical derangements. Moreover PCOS also associated with increase cardiovascular risks such as adverse lipid profile and endothelial dysfunction. Recently, statins have been shown to improve endocrine and metabolic aspects of PCOS.Aim of the study:-The aim of this study was to evaluate effects of rosuvastatin as adjuvant therapy in treatment of polycystic ovarian syndrome.Materials and methods:-The study was conducted at Al-Kadhemia Teaching Hospital, Department of Obstetrics and Gynecology from February 2014 to December 2015. In this study 96 women with PCOS randomly divided equally to two study groups; Group (A) in which patients were allocated to receive metformin (500 mg three times a day) plus rosuvastatin (10 mg/day) and group (B) in which patients were allocated to receive metformin (500 mg three times a day)plus placebo for 12 weeks. Blood samples were obtained before and after treatment for determination of fasting blood sugar, follicle stimulating hormone, luteinizing hormone, Dehydroepiandrosterone sulfate, serum testosterone and total lipid profile.Results:-At the end of study period, 89 patients complete the study (45 patients in Group A vs 44 patients in Group B). There were a significant decreases observed in both groups with respect to body mass index, fasting blood glucose, testosterones and luteinizing hormone whereas dehydroepiandrosterone sulfate, total cholesterol, low-density lipoprotein cholesterol and triglyceride declined significantly only in Group A.Conclusions:-Rosuvastatin as adjuvant therapy in patients with polycystic ovarian syndrome has many beneficial effects.

خلفية: تعتبر متلازمة المبيض المتعدد الكيسات من الحالات الشائعه لدى النساء في سن الإنجاب وانها ترتبط عادة مع اضطرابات في الغدد الصماء .وعلاوة على ذلك فان متلازمة تكيس المبايض ترتبط أيضا مع زيادة مخاطر القلب والأوعية الدموية كزياده الدهون الضاره و خلل وظائف الخلايا البطانية للاوعيه الدمويه. الهدف من هذه الدراسة: لتقييم آثار رسيوفاستاتين كعلاج مساعد في علاج متلازمة المبيض المتعدد الكيسات المواد وطرائق البحث: أجريت الدراسة في مستشفى الكاظمية التعليمي، قسم أمراض النساء والتوليد من فبراير 2014 وحتى ديسمبر عام 2015 حيث شملت هذه الدراسة 96 امرأة مع متلازمة تكيس المبايض قسمت عشوائيا بالتساوي على مجموعتي الدراسة. المجموعة (أ) والتي تم تخصيص المرضى فيها لتلقي الميتفورمين (500 ملغ ثلاث مرات يوميا)، بالإضافة إلى رسيوفاستاتين (10 ملغ / يوم) والمجموعة (ب) والتي تم تخصيص المرضى فيها لتلقي الميتفورمين (500 ملغ ثلاث مرات يوميا)، بالإضافة إلى عقار وهمي لمدة 12 أسبوعا. وقد تم الحصول على عينات من الدم قبل وبعد العلاج لتحديد نسبه الجلوكوز الصومي, هرمون منشط للحوصلة، هرمون منشط للجسم الأصفر ، ديهيدرو إيبي أندروستيرون ,التستوستيرون , ومجموع الدهون في الدم.النتائج: -في نهاية فترة الدراسة لوحظ ان 89 مريضا إكملوا الدراسة (45 مريضا في المجموعة الأولى مقابل 44 مريضا في المجموعة الثانية). بينت نتائج الدراسه ان هناك انخفاض كبير في كلا المجموعتين فيما يتعلق بمؤشر كتلة الجسم، والجلوكوز الصومي,هرمون منشط للجسم الأصفر و التسيتيرون في الدم في حين ان ديهيدرو إيبي أندروستيرون ، كوليسترول الدم، البروتين الدهني المنخفض الكثافه والدهون الثلاثية قد انخفضت احصائيا بشكل كبير فقط في المجموعة الاولى.الاستنتاجات: - يعتبر استخدام الرسيوفاستاتين كعلاج مساعد في المرضى الذين يعانون من متلازمة المبيض المتعدد الكيسات علاجا له العديد من الآثار المفيدة.


Article
Evaluation of Serum Homocysteine and Nitric Oxide Levels in Women with Polycystic Ovarian Syndrome and Periodontal Diseases

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ovary syndrome (PCOS) and periodontal diseases arecommon chronic inflammatory disorders. PCOS is a complicatedcondition affects overall health and causes broad spectrumchanges that affect periodontal health status. Available evidencesuggests that oxidative stress might comprise a link for theassociation between periodontal diseases and components of themetabolic syndrome. Both homocysteine (Hcy) and nitric oxide(NO) are considered to reflect the strength of oxidative stress. Theaims of the study were to compare the periodontal health conditionamong the study groups (gingivitis, gingivitis +PCOS, chronicperiodontitis (CP) and CP + PCOS group) by measuring theclinical periodontal parameters (Plaque Index (PLI), GingivalIndex (GI), Bleeding on Probing (BOP), Probing Pocket Depth(PPD) and Clinical Attachment Level (CAL), and measure serum(Hcy) and (NO) and compare their levels between study groups ,then correlate between these parameters with each other and withclinical periodontal parameters in order to determine the effect ofPCOS on periodontal health status and levels of serumHcy and NO.


Article
Measurement of serum Superoxide dismutase levels in women with polycystic ovarian syndrome and chronic periodontitis

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Background: Polycystic ovarian syndrome (PCOS) is one of the most important reproductive and endocrine disorders in women at reproductive age. It's associated with metabolic disorder, obesity, insulin resistance and oxidative stress chronic periodontitis and PCOS both of them associated with low chronic grade of inflammation. The prevalence of periodontal disease seems to be higher in women with PCOS. Superoxide dismutase enzyme (SOD) is an important circulating marker and protecting enzyme helping the body tissues to get rid of reactive oxygen species (ROS) that damage the tissue. Aim of the study: The aim of this study was to measure and compare the levels of (SOD) among group of chronic periodontitis patients with PCOS, group of chronic periodontitis without PCOS and a third group who were systemically and periodontally healthy. Material and Method: This study consist of (60) women at reproductive age ranged between (25-40) years old. They divided into three groups Group I consist of 20 women systemically healthy and with healthy periodontium, group II consist of 20 women with chronic periodontitis and systemically healthy and Group III consist of 20 women with chronic periodontitis and (PCOS). We evaluated the periodontal health of the groups through measuring these important indices: Plaque index, gingival index, bleeding on probing, probing pocket depth and clinical attachment loss. SOD antioxidant marker was measured colormeterically for the three groups. Results: this study showed higher means of periodontal parameters (plaque index, gingival index, bleeding on probing, probing pocket depth and clinical attachment loss (1.275±0.246, 1.295±0.239, 0.24±0.16, 6.47±0.345, 4.125±0.328 respectively). Highly significant differences were found using t-test in inter group comparison. (P≤0.001) regarding pocket depth and clinical attachment loss .Higher mean of (SOD) level was found for G3 (137.72±29.769) U/mL . F-test was used for intragroup comparison and highly significant difference was found (P≤0.001). Positive but weak correlation where found among (SOD) level, bleeding on probing in Group I and Group II , also among (SOD) level, probing pocket depth and clinical attachment loss. Conclusion: (PCOS) associated with oxidative stress and more prone to periodontal diseases with high level of antioxidant agent like (SOD) level to compensate the high level of (ROS)


Article
The Early Detection of Subclinical Left Ventricular Diastolic Dysfunction in Iraqi Women with Polycystic Ovarian Syndrome

Author: Ismail Ibrahim Hussain*, Henan Dh. Skheel**, Suaad Muhssen Ghazi ***
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2018 Volume: 17 Issue: 1 Pages: 49-57
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: The left ventricular diastolic dysfunction (LVDD) in asymptomatic patients with polycystic ovarian syndrome (PCOS) has been documented by both pulsed wave Doppler and tissue Doppler echocardiography.OBJECTIVE: The aim of this study was to identify the earliest asymptomatic impairment of the left ventricular diastolic dysfunction in polycystic ovarian syndrome women.PATIENTS AND METHODS: This study is conducted by the Department of Physiology, College of Medicine, Al-Mustansiriya University in cooperation with the unit of Infertility and unit of Echocardiography at Al-Yarmook teaching hospital in Baghdad during the period from December 2015 to April 2017. A total number of 150 subjects were included in this study, 50 healthy subjects (control group) and 100 patients with polycystic ovarian syndrome with (mean age and standard deviation of 28.27 ± 7.27 years). Pulsed wave blood flow Doppler and tissue Doppler imaging were used for estimating left ventricular diastolic dysfunction.RESULTS: 11% of the 100 PCOS women showed evidence of left ventricular diastolic dysfunction through impairment of mitral valve annular velocities and in the filling velocities of the left ventricle by pulsed wave Doppler, the ratio of peak early (E) filling velocity to the late (A) filling velocity (E/A ratio) was significantly lower in polycystic ovarian syndrome women with left ventricular diastolic dysfunction (0.780.17). By TDI the ratio of early (e՛) mitral annular velocity to the late (a՛) mitral annular velocity (e՛/a՛ ratio) was significantly reduced in polycystic ovarian syndrome women with the left ventricular diastolic dysfunction. Body mass index, waist circumference, waist-to-hip ratio, fasting blood sugar, fasting insulin, serum cholesterol, serum triglycerides, low density lipoprotein, very low density lipoprotein and homeostasis model assessment of insulin resistance were higher in polycystic ovarian syndrome group with left ventricular diastolic dysfunction.CONCLUSION: Diastolic dysfunction can develop early in patient with PCOS, and might be an early signal for cardiac involvement in this patient population..

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