RESUMEN
Polycystic ovary syndrome is a complex disorder defined by the Rotterdam criteria. Insulin resistance is a common factor for the development of type 2 diabetes mellitus among women with PCOS. The SLC2A2 gene has been identified as a T2DM gene by genome-wide association studies in the rs8192675 SNP. This study aimed to investigate the rs8192675 SNP in women diagnosed with PCOS on a molecular level and further for T2DM development in the Saudi women. In this case-control study, 100 PCOS women and 100 healthy controls were selected. Among 100 PCOS women, 28 women showed T2DM development. Genotyping for rs8192675 SNP was performed by PCR-RFLP analysis. Additionally, Sanger sequencing was performed to validate the RFLP analysis. The obtained data were used for a statistical analysis for the genotype and allele frequencies, logistic regression, and ANOVA analysis. The clinical data confirmed the positive association between FBG, FI, FSH, TT, TC, HDLc, LDLc, and family histories (p < 0.05). HWE analysis was associated in both the PCOS cases and the control individuals. Genotype and allele frequencies were associated in PCOS women and strongly associated with women with PCOS who developed T2DM (p < 0.05). No association was found in the logistic regression model or ANOVA analysis studied in women with PCOS (p > 0.05). A strong association was observed between the rs8192675 SNP and women with PCOS who developed T2DM using ANOVA analysis (p < 0.05). This study confirms that the rs8192675 SNP is associated with women with PCOS and strongly associated with women with PCOS with developed T2DM in Saudi Arabia.
RESUMEN
OBJECTIVE: To evaluate the efficacy and costs of chemical (topical glyceryl trinitrate ointment) versus lateral internal sphincterotomy for the treatment of chronic anal fissure. DESIGN: A quasi-experimental study. PLACE AND DURATION OF STUDY: This study was conducted at D.H.Q. /Allied Hospital, Faisalabad from November 2001 to October 2003. PATIENTS AND METHODS: Out of 74 patients, topical treatment was applied to 46. Eighteen patients never followed this modality of treatment so were excluded from the study. The remaining 28 patients applied 0.2% glyceryl trinitrate ointment on their anal verge thrice-a-day for two months. The patients in urgency due to pain or refused topical modality were treated by surgical sphincterotomy. Twenty-eight patients were allocated to undergo surgical sphincterotomy. The patients were followed-up and the extent of improvement in presenting symptoms, side effects, complications and costs of these modalities were noted on the questionnaires. RESULTS: Chemical sphincterotomy relieved symptoms only in 18 (64.3%) patients while surgical sphincterotomy relieved 28 (100%) patients. In the former, recurrence occurred in 6 (33.3%) patients, but in the later group incontinence of flatus/ faeces was present in 18 (64.3%) at first week which resolved by eighth weeks. Wound related complications in 4 (14.2%) cases were noted. Average costs of treatments excluding hospital expenditures were Rs. 164 and Rs. 1244 respectively. CONCLUSION: Topical modality proved to be cost-effective and non-invasive than the surgical modality, but later was superior regarding healing of anal fissures.