Evaluation of serum adiponectin as a marker of insulin resistance in women with polycystic ovarian syndrome: a comparative cross-sectional study.

BACKGROUND: Insulin resistance (IR) is known to be prevalent amongst women with polycystic ovarian syndrome (PCOS). Its presence has been linked to chronic anovulation and marked long term complications in women. Hence, identification and treatment of IR in women with PCOS is required to prevent the metabolic and reproductive complications of the disease. The aim of this study is to determine if serum adiponectin could be used as a surrogate marker for insulin resistance among women with PCOS. MATERIALS AND METHODS: A total number of 148 consenting women with PCOS diagnosed using the Rotterdam criteria were recruited for this study. Fifty-two of these women had insulin resistance were compared with 96 of the women who did not have insulin resistance. The serum Adiponectin levels, fasting blood glucose and fasting insulin levels were assayed in all study participants. Insulin resistance was assessed in all the study participants using the Homeostasis Model Assessment for Insulin Resistance (HOMA-IR). Data were analyzed using relevant inferential statistics at 95% confidence interval and p value of < 0.05. RESULTS: The prevalence of insulin resistance among the study participants was 35.1%. Majority of the women (83.1%) had a high body mass index (BMI). More than half (68.2%) of the participants were in the age range of 21-30years and 76.4% (113) were nulliparous. There was no statistically significant difference in the median adiponectin level among insulin resistant (3.735 ug/ml) and non-insulin resistant participants vs. (3.705 ug/ml) (p = 0.6762). Both univariate and multivariate regression analysis did not show a statistically significant relationship between adiponectin and insulin resistance in PCOS. CONCLUSION: The prevalence of insulin resistance in women with PCOS is high and serum adiponectin is not a suitable surrogate marker of insulin resistance in women with PCOS.

Bypassing shortages of personal protective equipment in low-income settings using local production and open source tools.

Free and open-source hardware, 3D printing, and the use of locally sourced materials can be valuable tools for local problem solving, as proven by the production of more than 400 reusable face shields and masks in a Nigerian community to bypass PPE shortages during the COVID-19 pandemic.

Trends in Perinatal Health Indices in the Amajuba District; KwaZulu-Natal; South Africa; 1990-2012

Background. In order to address the high perinatal mortality rate; South Africa (SA) commenced a number of interventions from 1995. These included the abolition of user fees; basic antenatal care; on-the-spot diagnosis and treatment of syphilis; and the prevention of mother-to-child transmission of HIV. However; there is a dearth of information on the long-term effect of these programmes on perinatal indicators in district hospitals; where most births and deaths occur.Objective. To determine the levels and trends in maternal and neonatal indicators in Amajuba District; KwaZulu-Natal Province; SA; and to ascertain the dynamics of these indicators vis-a-vis the transformation of healthcare in SA. Methods. The study location was Madadeni Hospital and its nine feeder maternity clinics. Information pertaining to all deliveries and their outcome from these health facilities from 1990 to 2012 was extracted from the clinical registers. Data were analysed using SPSS version 15.0 (IBM; USA). Quantitative variables were summarised as means; while qualitative data were expressed as proportions and percentages. The trends for each outcome variable for the entire study period (1990 - 2012) were analysed and presented as line graphs and tables. Results. There were 154 821 live births and 4 133 stillbirths from 1990 to 2012. The overall mean values for stillbirth rate; perinatal mortality rate; neonatal mortality rate and maternal mortality ratio were 26.3 (standard deviation 5.6); 40.9 (9.6); 16.8 (4.7) and 114 (56.6); respectively. There was a general improvement in all the perinatal health indices in the early 90s; followed by a general worsening until the early 2000s; after which a consistent decline was noted. Conclusion. The perinatal health indices in Amajuba District have followed a pattern similar to that found in the rest of SA: an increase during the late 90s to early 2000s; followed by a decline from the late second half of the first decade of this century