Role of vitamin D and leptin levels in PCOS in young women: A family medicine perspective.

Introduction: Adolescent girls and young women of childbearing age are the main populations affected by endocrinopathy known as polycystic ovarian syndrome (PCOS). It is especially important to take into account whether clinical and biochemical signs of hyperandrogenism are present in female patients. In maintaining metabolic homeostasis, leptin is crucial. According to research, vitamin D deficiency may play a role in the pathophysiology of PCOS by contributing to insulin resistance, inflammation, dyslipidaemia, and obesity, which are all conditions linked to the syndrome. In this study, leptin and vitamin D3 levels will be measured in order to determine how each relates to the aetiology of PCOS. Materials and Methods: Hundred young women were allocated into two groups, 50 women with PCOS (diagnosed on the basis of revised Rotterdam criteria for PCOS), taken as a study group, and 50 healthy women with no PCOS as control group. Blood samples were collected and tested for hormonal parameters. Results: Between the two groups, there were no appreciable variations in demographic traits. Study groups were found to have considerably higher serum leptin levels than control groups. The study group's vitamin D3 levels were found to be lower than those of the control group. Conclusion: Patients with PCOS are a special population with distinctive hormonal profiles that differ from typical profiles in healthy populations. Comparing PCOS to healthy individuals, leptin levels were higher while vitamin D3 levels were lower. It is necessary to conduct more extensive research on the involvement of leptin and vitamin D3 in the aetiology of PCOS.

A Cross-Sectional Study of Acute Coronary Syndrome and Thyroid Profile: Dissecting the Relationship to Improve Patient Care.

INTRODUCTION: Thyroid-releasing hormones are pivotal in regulating cardiovascular (CVS) function and maintaining its hemodynamics and homeostasis. Even a minor alteration in thyroid function has an enormous implication on CVS morbidity and mortality. Moreover, hypothyroidism was found to be a potential menace for coronary artery disease (CAD). The objective of this study was to determine the role of thyroid-releasing hormones in patients suffering from acute coronary syndrome (ACS). METHODOLOGY: Among a cohort of 100 patients suffering with ACS, a complete history and clinical information followed by physical examination and electrocardiography were recorded. Blood samples were also collected to record the blood sugar levels i.e., fasting blood sugar (FBS), postprandial blood sugar (PPBS), and thyroid profile, including free thyroid stimulating hormone (TSH), free thyroxine (fT4), free triiodothyronine (fT3), and reverse triiodothyronine (rT3). The data was analyzed using SPSS version 26 software (IBM Corp., Armonk, NY, USA). RESULT: The study identified alterations in the thyroid hormone levels in 27% of patients suffering from ACS. The prevalence of euthyroid sick syndrome was found to be 59.3%, while subclinical hypothyroidism and subclinical hyperthyroidism were reported among 18.5% and 14.8% of patients respectively. There was no significant difference found between males and females. The study illustrated a greater occurrence of aberrant thyroid hormone profiles among those aged 40-60 years. The ST-elevated myocardial infarction (STEMI) group had a statistically significant higher prevalence of an aberrant thyroid hormone profile compared to the non-ST-elevated myocardial infarction (NSTEMI) and unstable angina (UA) groups (p=0.02). A total of nine patients died with ACS and all of those had statistically significant low fT3 and TSH values while higher rT3 values (p<0.05). CONCLUSION: An atypical thyroid status has been found to elevate the likelihood of developing CAD and experiencing CVS mortality. This condition can impact ventricular function and serum cholesterol levels as well as heart rate and rhythm. Therefore, understanding this relationship could potentially lead to improved treatment strategies for individuals with ACS which will further prevent major CVS complications.

Clinical and Etiological Profile of Acute Undifferentiated Fever With Thrombocytopenia in an Emergency Department.

INTRODUCTION: Acute undifferentiated fever with thrombocytopenia is a common and challenging clinical presentation encountered in the emergency departments of tertiary care centers, particularly in tropical regions, often requiring prompt evaluation and management. The study aimed to explore the clinical and etiological profile of acute undifferentiated fever with thrombocytopenia in the Emergency Department of Indira Gandhi Institute of Medical Sciences, Patna. It investigates factors associated with patient outcomes and compares platelet transfusion requirements among different etiological groups. METHODS: In this cross-sectional observational study, 350 patients with acute undifferentiated fever with thrombocytopenia were analyzed for one year from October '21 to September '22. Pre-existing chronic infectious diseases, liver cirrhosis, and autoimmune conditions were excluded. RESULTS: Thrombocytopenia was observed in all patients, with 65% having platelet counts below 50,000/µL. Associations were found between the degree of thrombocytopenia and organ dysfunction, shock, and third space loss. Logistic regression analysis identified thrombocytopenia, organ dysfunction, and platelet transfusion requirement as significant predictors of the overall outcome. Etiological group comparisons revealed higher platelet transfusion requirements in the bacterial group. CONCLUSION: Prompt recognition and management of thrombocytopenia in acute undifferentiated fever are vital. Thrombocytopenia, along with organ dysfunction and shock, significantly influence patient outcomes. Tailored interventions based on etiological factors are crucial. Further research should focus on specific viral aetiologies in acute undifferentiated fever with thrombocytopenia.