RESUMO
Introduction: In the first trimester, almost one in five identified pregnancies end in spontaneous miscarriage, and another 22% result in induced abortion. After a spontaneous and/or induced abortion, there may be retained products of conception (POC). Because of its relatively poor efficacy and the unpredictability of the time interval until spontaneous evacuation, expectant treatment is not often chosen by healthcare professionals. In view of these facts, the current study's objective was to weigh the effectiveness of MVA and oral misoprostol 600 mg in managing incomplete abortion. Materials and Procedures: The investigation was conducted at the tertiary care center in India. The survey was conducted for one year. Subjects were selected from those attending the department for either spontaneous or induced abortions. A total of 230 women were randomly assigned to receive the interventions of a single dose of oral misoprostol 600 mcg or MVA. They were equally distributed to two groups and observed for the various parameters of success, signs and symptoms, satisfaction, and complications. The obtained values were compared statistically for the significance at <0.05 of P values. Results: Of the 200 subjects (30 lost to follow-up), there was no significant variance in the demographics, clinical outcomes, and complications between the groups. However, the pain, fever, shivering, and satisfaction parameters were statistically variant between the groups. Fever, shivering, and pain were lower for the MISO subjects while satisfaction was reported higher from subjects in MISO group. Conclusion: MISO and MVA are acceptable, safe, and efficient therapies for first-trimester un-complicated incomplete abortion. Nonetheless, misoprostol appears to be a marginally superior option to MVA in terms of accessibility, low therapy costs, reduced pain, and reduced demand for specialized personnel or equipment.
RESUMO
Objective: The purpose of this systematic review and meta-analysis was to determine whether there is a connection between polycystic ovarian syndrome (PCOS)-affected women's levels of the anti-Mullerian hormone (AMH) and certain cardiometabolic indicators. Materials and Methods: To find pertinent recent research published between 2017 and 2023, a thorough search was done in PubMed. Studies were included if they looked into the relationship between PCOS-related women's AMH levels and cardiometabolic markers. To determine pooled effect estimates, data from the included studies were examined using random-effects models. Results: Five papers were included in the meta-analysis since they satisfied the inclusion requirements. The meta-analysis found substantial positive relationships between AMH levels and markers of insulin resistance, fasting blood sugar levels, and dyslipidemia measures such as total cholesterol (SMD: 0.68, 95% confidence interval: 0.34-1.00, P < 0.001). Conclusion: This systematic review and meta-analysis show that AMH levels in PCOS-affected women significantly positively correlate with markers of insulin resistance, fasting glucose levels, and dyslipidemia parameters. These findings imply that the pathogenesis of the cardiometabolic abnormalities seen in PCOS may include AMH. AMH may be used as a biomarker to estimate the cardiometabolic risk in PCOS-affected women, but more studies are required to determine its clinical applicability.
RESUMO
The contamination of public water supply and groundwater resources is a major concern in many parts of developing nations. Polluted water poses serious health risks to humans and the environment. This research was conducted to investigate the seasonal variations of the water quality parameters in the public water supply. To assess the supply water quality in different blocks of Ambala District, hydro-chemical analysis was conducted after a series of systematic sampling in various locations. The statistical tools for water quality indexing including water quality indexing (WQI), heavy metal pollution indexing (HMPI), pollution indexing (PI), overall pollution indexing (OPI), metal indexing (MI), and hazard indexing (HI) were used for data as well as the health hazard analysis through water pathway. Overall, 40 water samples were taken from the public water supply systems covering winter and summer seasons, and the levels of pH, total dissolved solids (TDS), EC, F- , Cl- , NO3 - , SO4 2- , HCO3 - , As, B, Cd, Co, Pb, Zn, Cr, Fe, and Mn were investigated. The weight arithmetic index method was used for WQI, and water pollution indices such as HMPI, PI, OPI, and MI were calculated using different models to check the severity of contamination. The mean hazard quotient and hazard index values calculated using the concentration levels of As, B, Cd, Co, Pb, Cr, Fe, Mn, Zn, F- , and NO3 - reveal that supply water may pose a significant health risk to both adults and children that further varies with temporal and spatial changes. During both seasons, a high carcinogenic risk for both adults and children was observed in the studied area because of high levels of As, Pb, Cd, and NO3 - . PRACTITIONER POINTS: The quality of public supply water was assessed at the selected sites of Ambala, India. High levels of NO3 - , As, Cd, and Pb were observed posing a health risk to adults and children via water pathway. 95% of the samples qualified for the excellent water quality category with respect to the levels of F- , Cl- , NO3 - , SO4 2- , HCO3 - , pH, EC, and TDS. Statistical analysis (HMPI, PI, MI, OPI, HI) using different models revealed water contamination with reference to the levels of NO3 - , As, Pb, Cr, Ni, and Cd. Immediate measures are needed to uphold the safety and health of the natives.