Effect of Berberine Phytosome on reproductive, dermatologic, and metabolic characteristics in women with polycystic ovary syndrome: a controlled, randomized, multi-centric, open-label clinical trial.

Background: Berberine is a poorly absorbed natural alkaloid widely used as nutraceutical to counteract diarrhoea and to lower cholesterol and hyperglycaemia. It has also been reported to reduce signs and symptoms of polycystic ovary syndrome (PCOS). Objective: To explore, through a multi-centric, randomized, controlled and prospective study, the possible role played by a form berberine that is more easily absorbed (Berberine Phytosome®, BP) in 130 Pakistani women with a diagnosis of PCOS and fertility problems due to menstrual and ovary abnormalities. Results: Ninety days of supplementation with BP, administered at 550 mg x2/die, determined (i) resumption of regular menstruation in about 70% of women (versus 16% in the control group; p < 0.0001), (ii) normalization of the ovaries anatomy in more than 60% of women (versus 13% in the control group; p < 0.0001), (iii) acne improvement in 50% of women (versus 16% in the control group; p = 0.0409) and (iv) hirsutism reduction in 14% of women (versus 0% in the control group; p = 0.0152). The metabolic and the hormonal profiles of the women in the two groups did not significantly differentiate at the end of the study. BP was well-tolerated and no specific side-effects were registered. Respectively after one, two and 8 years of trying, three women supplemented with BP became and are currently pregnant. Conclusion: Our study showed the positive effects of BP supplementation in women with PCOS and confirmed the high safety profile of this nutraceutical. Clinical Trial Registration: https://clinicaltrials.gov/, identifier NCT05480670.

Exploring areas of improvement in postnatal care services in a tertiary care hospital in Lahore.

Background and Objective: Poor postnatal care can increase morbidity and mortality. This study assessed the current deficiencies in quality of postnatal care provided to mothers in Lady Aitchison hospital, Lahore when compared to WHO standards and identifies the areas for quality improvement. Methods: It is a descriptive cross-sectional study which employs quantitative method to collect and analyze the data. It was conducted to include ninety-six maternities attending the wards of Lady Aitchison Hospital, Lahore during January 2022 to February 2022. Consenting post-partum mothers were selected by random sampling and interviewed by using a structured proforma. Results: Among 96 mothers, 56% were below 25 years of age, 39% had secondary education, with more than one child (71%) and 57% visited for the first time. Majority of mothers, were given medicine timely (82%) and found the attitude (85%) and information (83%) provided by the healthcare workers helpful. Their subjective satisfaction rate with staff was 90%. The main areas of concern were lack of proper examination guidelines and facilities, limited information to mothers regarding neonatal care and substandard interior of hospitals. The statistics on the detailed maternal and neonatal examination showed that it was left out in 30% to 50% patients. Information regarding the danger signs of mothers and neonates was not given in 69% and information on family planning was provided to only 28%. Contentment with the infrastructure of the hospital was subpar and it was suggested that the sanitary conditions of washrooms and the paraphernalia of the wards i.e., ACs and beds needed improvement. Conclusions: This study suggests that in developing countries like Pakistan, majority of the patients were satisfied by the services of healthcare workers. The prime improvement area is the infra-structure of the hospital which can be upgraded to provide better quality facilities in terms of air-conditioning, washrooms and well-designed areas for extensive examination of breast, pelvis, abdomen and neonates. There is also need for introduction of standard guidelines for postnatal care.

Lactacyd FH as an adjuvant therapy for vulvovaginal infections in Pakistani women: FRESH study, a satisfaction survey.

OBJECTIVE: To demonstrate that adjuvant therapy with lactic acid+lactoserum solution provides satisfactory symptomatic relief and is safe in patients with vulvo-vaginal infections. METHODS: The open-label survey was conducted at 96 private consultation clinics in 14 cities across Pakistan from May to October 2010, and included consecutive patients >18 years of age with first/recurrent episode of vulvo-vaginal infections, having clinical signs and symptoms of such infections, receiving antibiotics for current infections. Data collected included vulvo-vaginal infection symptoms, baseline history of diabetes and hormone replacement therapy, bimanual examination, and current antibiotic treatment. Follow-up was done at 14 days. Compliance and symptomatic relief, safety (solicited reporting) was noted on day 14 or anytime during the study period. RESULTS: Overall, 919 patients were enrolled. Of these, 842(91.6%) patients completed the study. The mean age was 32.6±8.4 years and 295(35%) were diagnosed to have bacterial vaginosis, 278(33%) vaginal candidiasis, and 126(15%) trichomoniasis. The most commonly used antibiotic was metronidazole in 438(52%) cases. Patients used lactic acid+lactoserum for mean duration of 9.7 4.4 days, twice a day, and reported symptomatic relief by fourth day of application, as assessed by reduction in malodour in 681(80.1%) cases, itching 661(78.5%), burning sensation 652(77.4%), and pain 552(65.6%). Lactic acid+lactoserum was reported to be gentle on skin in 769(91.3%) cases, provide feeling of freshness 727(86.3%), and have mild fragrance 724(85.9%). Overall, 746(88.6%) patients reported satisfaction with lactic acid+lactoserum, and 671(79.7%) patients were willing to use it again. No adverse events were reported. CONCLUSIONS: Lactic acid+lactoserum as an adjuvant treatment of vulvo-vaginal infections demonstrated high percentage of satisfaction and safety in Pakistani women.

Frequency of Group B Streptococci in Pregnant Women in a Tertiary Care Hospital.

OBJECTIVE: To determine the frequency and risk factors of Group B Streptococci (GBS) in pregnant patients in third trimester in a tertiary care hospital in Lahore. STUDY DESIGN: Cross-sectional, prospective study. PLACE AND DURATION OF STUDY: Lady Willingdon Hospital, Lahore, from October 2014 to March 2015. METHODOLOGY: Sterile lower vaginal swabs were taken from 200 women aged 20 years and over, in third trimester, with no history of vaginal bleeding, ruptured membrane, recent intake of antibiotics or chronic illness. These swabs were cultured for detection of GBS. The risk factors of GBS and its frequency were noted in the pregnant population. Quantitative and qualitative data was analyzed by SPSS version 20. Chi-square test was applied to see association between diagnosis of GBS and other categorical variables. P-value ≤0.05 was considered as statistically significant. RESULTS: In this study, the mean age of all the females was 26.36 ± 4.32 years and mean duration of pregnancy was 35.54 ± 2.65 weeks. Frequency of GBS in pregnant women was found as 14%. We observed significant association of GBS with parity and previous history of miscarriage (p-value = 0.033 and 0.010 respectively). Moreover, significant association between vaginal discharge and GBS was also found (p = 0.027). CONCLUSION: GBS is present in a small but significant number of pregnant women in our setting and it has association with multiparity, vaginal discharge during pregnancy, and previous history of miscarriage.