Role of Gonadotropin-releasing Hormone Stimulation Test in Diagnosing Gonadotropin Deficiency in Both Males and Females with Delayed Puberty

Background:

Delayed puberty can result either from constitutional delay of growth and puberty (CDP) or idiopathic hypogonadotropic hypogonadism (IHH). Gonadotropin-releasing hormone (GnRH) stimulation test has been generally accepted as a current method for diagnosing delayed puberty. The objective of this research was to assess the cut-off values and the efficacy of GnRH stimulation test in the diagnosis of delayed puberty in both males and females.

Methods:

A study of 91 IHH, 27 CDP patients, 6 prepubertal children, and 20 pubertal adults was undertaken. Blood samples were obtained at 0, 30, 60, and 120 min after GnRH administration and the levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) were measured. For each parameter, the sensitivities and specificities were estimated, and the receiver operating characteristic (ROC) curves were constructed.

Results:

The ROC curves indicated that a serum basal LH <0.6 IU/L or peak LH <9.74 IU/L resulted in moderate sensitivity (73.8% or 80.0%) and specificity (90.9% or 86.4%) in the diagnosis of HH in males. Serum basal LH <0.85 IU/L or basal FSH <2.43 IU/L resulted in moderate sensitivity (80.0% or 100.0%) and specificity (75.0% or 50.0%) in the diagnosis of HH in females.

Conclusions:

Our data suggest that isolated use of the gonadorelin stimulation test is almost sufficient to discriminate between HH and CDP in males, but unnecessary in females. The most useful predictor is serum basal or peak LH to differentiate these two disorders in males, but serum basal LH or FSH in females.     

性早熟女童血浆ghrelin水平与腺垂体激素的关系

目的:探讨性早熟女童血浆ghrelin与腺垂体激素的关系.方法:84例年龄在6～9岁的性早熟女童根据第二性征发育情况、骨龄、 子宫、卵巢容积及GnRH激发试验的结果分为特发性中枢性早熟(ICPP)和单纯乳房早发育( PT)组,采用放射免疫法测定性早熟女童空腹血浆ghrelin水平,化学发光法测定ACTH、TSH 、PRL、GH、LH、FSH,并与对照组比较.结果:①ICPP组血浆ghrelin为Log( 2.42±0.26)ng/L,明显低于PT组和对照组[Log(2.62±0.21)ng/L,Log(2.58± 0.44)ng/L,P<0.05];而对照组与PT组两组之间比较差异无显著性(P>0.05 ).②Tanner Ⅲ期的ICPP女童ghrelin为Log(2.31±0.24)ng/L明显低于Tanner Ⅱ期的IC PP女童[Log(2.53±0.24)ng/L,P<0.05].③经双变量相关分析,性早熟女童血浆 ghrelin水平与ACTH、PRL及GnRH激发后的LH15、LH30 、LH60呈负相关 (r分别为-0.248、-0.235、-0.445、0.405、0.398,均P<0.05);而与GH 、GnRH激发后的FSH15及 LH0-2、FSH0-2无相关.结论:ICPP女童血浆ghrelin水平下降,Tanner Ⅲ期女童血浆ghrelin低于Tanner Ⅱ期,GnR H激发后与LH呈负相关.这可能与性启动有关.     

102例性早熟女童性器官发育及血清激素水平分析

目的：分析102例性早熟儿童的临床资料,探讨两种性早熟女童的性器官发育及血清激素水平的临床意义。方法方便选择2012年12月—2013年12月于福建医科大学附属泉州市第一医院儿童内分泌科收治的102例性早熟女童作为临床观察对象,按诊断标准确诊中枢性性早熟(ICPP)52例,单纯性乳房早发育(IPT)50例。对两组患儿的LH、FSH基础值、E2,性器官发育情况进行分析比较,同时对激素水平与性器官发育进行相关性分析,进行LH与FSH、LH/FSH、E2、子宫、卵巢容积的相关性分析,明确两种性早熟临床特征、性器官容积、激素水平的差异性。结果ICPP 组患儿的LH基础值、LH峰值、E2、卵巢容积、子宫容积比IPT组高,组间差异有统计学意义(P﹤0.05)。 CPP组LH基础值(0.380±0.291)mIU/mL。 LH基础值与LH峰值正相关,相关系数0.939, P﹤0.01。卵巢容积与LH峰值正相关,相关系数0.518,P﹤0.01。FSH峰值与LH峰值正相关,相关系数0.826,P﹤0.01。E2与骨龄、子宫容积、卵巢容积正相关。卵巢容积与骨龄、子宫容积、FSH峰值、LH峰值正相关。结论 ICPP组血清激素水平较IPT组高,性器官体积较IPT组大,中枢性性早熟与单纯性乳房可能有延续性进展与转化,血清基础 LH值超过0.38U/L时,建议提前干预,防止其向中枢性性早熟转变。     

生长激素联合醋酸亮丙瑞林治疗特发性中枢性性早熟女童的疗效及安全性分析

目的 探究生长激素联合醋酸亮丙瑞林治疗特发性中枢性性早熟的疗效及安全性。方法 选取2020年1月—2022年1月贵州省安顺市人民医院收治的90例特发性中枢性性早熟女童,采用随机数字表法分为对照组与研究组,每组45例。对照组采用醋酸亮丙瑞林治疗,研究组采用生长激素联合醋酸亮丙瑞林治疗。收集两组患儿的临床资料,比较治疗前后的性激素[黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E₂)]、子宫容积、卵巢容积、血脂[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]及空腹血糖(FPG),观察并记录两组患儿的不良反应情况。结果 研究组患儿治疗前后的LH、FSH、E₂、子宫容积、卵巢容积、TC、TG、HDL-C、LDL-C、FPG比较,差异无统计学意义(P>0.05);研究组女童治疗前后的子宫容积、TC、TG、HDL-C、LDL-C、FPG的差值比较,差异无统计学意义(P>0.05),研究组女童治疗前后的LH、FSH、E₂、卵巢容积的差值高于对照组(P <0...     

简化GnRH激发试验对中枢性性早熟的诊断价值

目的探讨单时相促性腺激素释放（GnRH）激发试验对中枢性性早熟（CPP）的诊断价值.方法应用传统的GnRH激发试验5个时相促性腺激素的值（FSH、LH）、B超检查、骨龄评估等方法对52例CPP女童进行诊断.结果GnRH激发试验5个时相：30 min的LH浓度与峰值相比差异无统计学意义（P＞0.05）,且达到文献推荐的诊断值.结论简化的30 min一次的GnRH激发试验具有可信性.     

血清脱氢表雄酮水平与女性性早熟关系的探讨

目的:探讨血清脱氢表雄酮与女性性早熟之间的关系.方法:60例特发性中枢性早熟(ICPP)女童,62例单纯乳房早发育(PT )女童及31例与年龄匹配的青春前期健康女童,采用ELISA法测定血清脱氢表雄酮(DHEA) 及硫酸脱氢表雄酮(DHEAS)浓度,并对ICPP儿童进行达菲林治疗前、后的对比研究,随访其子宫、卵巢、骨龄及血清DHEA、DHEAS的变化.结果:①ICPP组血清Log(D HEA)、Log(DHEAS)为(0.81±0.36)μg/L,(2.31±0.31)μg/L,PT组为(0.72 ±0.30)μg/L,(2.31±0.28)μg/L,对照组为(0.32±0.26)μg/L(2.16±0.2 7)μg/L,三组比较差异有显著性意义(P<0.05);ICPP组与PT组两组之间比较差异无显著意义(P>0.05);TannerⅢ期的DHEA、DHEAS明显高于TannerⅡ期的DHEA、DHEA S,P<0.0 5.②经双变量相关分析,Log(DHEA)与身高、骨龄、子宫容积、卵巢容积呈正相关,与Lo g(LH峰值)、Log(FSH峰值)、体质指数(BMI)无相关性; Log(DHEAS)与身高、骨龄、卵巢容积呈正相关,与Log(LH峰值)、Log(FSH峰值)、子宫容积、BMI无相关性.③达菲林治疗3个月时,血清Log(DHEA)、Log(DHEAS)较治疗前明显下降 (P<0.05).治疗12个月时,血清Log(DHEA)、Log(DHEAS)与治疗前比较,差异无显著意义(P>0. 05),但子宫容积、卵巢容积、骨龄与年龄的比值治疗前、后比较差异有显著意义(P 均<0.05).结论:①性早熟女童血清DHEA和DHEAS水平增高,并随着Tanne r期的进展而升高;②血清DHEA和DHEAS水平随下丘脑-垂体-性腺轴的抑制,其浓度会有暂时性下降;③血清DHEA与性早熟女童生长加速、骨龄进展有关.     

特发性中枢性性早熟女孩下丘脑垂体核磁共振和血清胰岛素样生长因子-1检测的临床意义

目的 探讨特发性中枢性性早熟(ICPP)女孩下丘脑垂体核磁共振(MRI)检查和血清胰岛素样生长因子-1(IGF-1)测定的临床诊断意义。方法 选取2007年2月至2009年12月在山东大学附属省立医院儿科内分泌门诊就诊的ICPP女孩患者60例,其中早期ICPP组8例,典型ICPP组36例,ICPP合并生长激素缺乏(GHD)组16例,收集所有患者空腹血清。3组均采用放射免疫法(RIA)测定空腹血清IGF-1和生长激素(GH)水平。免疫化学发光法(ICMA)测定空腹血清促卵泡刺激素(FSH)、促黄体生成素(LH)、 雌二醇(E2)、促性腺激素释放激素类似物(GnRHa)刺激后峰值LH及峰值LH/FSH,ICPP合并GHD组加做生长激素(GH)刺激实验。行下丘脑垂体部位的头颅MRI(测量垂体前叶高度并根据Elster方法将其分级)、妇科B超、骨龄(BA)等检查。另外选取30例青春前期女孩作为正常对照组。对3组的上述指标进行比较,分析所测定的血清IGF-1、E2、基值LH、基值LH/FSH、峰值LH、峰值LH/FSH、骨龄与实足年龄差值(BA-CA)与垂体前叶高度的相关性。结果 早期ICPP组血清E2、峰值LH、峰值LH/FSH、CA、BA-CA均显著低于典型ICPP组(P均＜0.01);早期ICPP组和典型ICPP组的垂体前叶高度及血清IGF-1均显著高于正常对照组(P＜0.01),早期ICPP组及典型ICPP组比较无明显差异(P＞0.05); GnRHa对早期ICPP有显著治疗效果;血清中IGF 1、E2、基值LH、基值LH/FSH、峰值LH、峰值LH/FSH、BA-CA分别与垂体前叶高度之间存在显著的正相关(r=0.65,0.54,0.54,0.45,0.58,0.57,0.45,P均＜0.05);典型ICPP组BA-CA、垂体前叶高度、IGF-1均显著高于ICPP合并GHD组(P＜0.01),峰值LH及峰值LH/FSH显著高于ICPP合并GHD组(P＜0.05);垂体前叶高度及IGF-1在ICPP合并GHD组均显著低于正常对照组(P＜0.01)。结论 下丘脑垂体MRI和血清IGF-1对ICPP女孩的早期和鉴别诊断具有重要临床意义,下丘脑垂体MRI与下丘脑-垂体-靶腺轴联系密切。     

Audit of an urban paediatric emergency department visits

Background:

This study aimed to highlight the health seeking behavior of children in an Emergency Department (ED).

Materials and Methods:

Retrospective files review of ED was done for the month of July, 2008. Data about the children ≤12 years of age was gathered.

Results:

In one month period a total 21000 patients visited our ED, out of them 6120 (29%) were children. Males, Saudis and children of (1-6 years) were more frequent, i.e., 3540 (57.8%), 5760 (94.1%) and 3180 (52%), respectively. Majority of patients visited in shift “2”, i.e., 15:30 hours to 23:30 hours. Among the patients “diseases of respiratory system” were found more frequent 4170 (68.1%) and main diagnosis was “acute upper respiratory tract infection” 3300 (53.9%). Non-urgent cases were 2020 (33%) while 244 (4%) were admitted.

Conclusion:

Young children as well as non-urgent cases were predominant. Evening shift was the busiest one.     

Hospitalised Malaysian children with pandemic (H1N1) 2009 influenza: clinical characteristics,risk factors for severe disease and comparison with the 2002–2007 seasonal influenza

INTRODUCTION

The pandemic caused by the H1N1 influenza virus in 2009 resulted in extensive morbidity and mortality worldwide. As the virus was a novel virus, there was limited data available on the clinical effects of the virus on children in Malaysia. We herein describe the clinical characteristics of children hospitalised with H1N1 influenza at a tertiary care centre. We also attempted to identify the risk factors associated with disease severity.

METHODS

In this retrospective study, we compared the characteristics of the children who were admitted to the University of Malaya Medical Centre, Malaysia, for H1N1 influenza during the pandemic with those who were admitted for seasonal influenza in 2002–2007.

RESULTS

Among the 77 children (aged ≤ 12 years) admitted to the centre due to H1N1 influenza from 1 July 2009–30 June 2010, nearly 60.0% were aged < 6 years and 40.3% had an underlying medical condition. The top three underlying medical conditions were bronchial asthma (14.3%), cardiac disease (10.4%) and neurological disorders (11.7%). The risk factors for severe disease were age ≤ 2 years, underlying bronchial asthma and chronic lung disease. Two of the three patients who died had an underlying medical condition. The underlying causes of the deaths were acute respiratory distress syndrome and brain stem encephalitis.

CONCLUSION

The clinical presentation of the children infected with pandemic (H1N1) 2009 influenza virus did not differ significantly from that of children with seasonal influenza. However, there were more complaints of fever, cough and vomiting in the former group.     

Risk factors for under-nutrition among children aged one to five years in Udupi taluk of Karnataka,India: A case control study

Background

Despite her apparent economic success, India is plagued by a high burden of under-nutrition among children under five. This study was aimed at understanding some of the risk factors for under-nutrition in a region with favourable maternal and child health indicators.

Method

A case control study was carried out among children aged one to five years attending the paediatric outpatient department in six rural health care centres in Udupi taluk of Karnataka in Southern India. A total of 162 children were included in the study, of which 56 were cases. A semi-structured questionnaire was used to interview the caregivers of the children and the nutritional status was graded according to the Indian Academy of Paediatrics (IAP) grading of protein-energy malnutrition.

Results

Under-nutrition was associated with illness in the last one month [OR– 4.78 (CI: 1.83 –12.45)], feeding diluted milk [OR–14.26 (CI: 4.65 – 43.68)] and having more than two children with a birth interval ≤2 years [OR– 4.93 (CI: 1.78 – 13.61)]. Lack of exclusive breast feeding, level of education of the caregiver and environmental factors like source of water did not have an association.

Conclusion

Childhood illness, short birth interval and consumption of diluted milk were some of the significant contributory factors noted among this population. Information, Education, Communication (IEC) campaigns alleviating food fads and promoting birth spacing is needed.     

Efficacy and Safety of Avandamet or Uptitrated Metformin Treatment in Patients with Type 2 Diabetes Inadequately Controlled with Metformin Alone: A Multicenter,Randomized, Controlled Trial

Background:

At present, China has listed the compound tablet containing a fixed dose of rosiglitazone and metformin, Avandamet, which may improve patient compliance. The aim of this study was to evaluate the efficacy and safety of Avandamet or uptitrated metformin treatment in patients with type 2 diabetes inadequately controlled with metformin alone.

Methods:

This study was a 48-week, multicenter, randomized, open-labeled, active-controlled trial. Patients with inadequate glycaemic control (glycated hemoglobin [HbA1c] 7.5–9.5%) receiving a stable dose of metformin (≥1500 mg) were recruited from 21 centers in China (from 19 November, 2009 to 15 March, 2011). The primary objective was to compare the proportion of patients who reached the target of HbA1c ≤7% between Avandamet and metformin treatment.

Results:

At week 48, 83.33% of patients reached the target of HbA1c ≤7% in Avandamet treatment and 70.00% in uptitrated metformin treatment, with significantly difference between groups. The target of HbA1c ≤6.5% was reached in 66.03% of patients in Avandamet treatment and 46.88% in uptitrated metformin treatment. The target of fasting plasma glucose (FPG) ≤6.1 mmol/L was reached in 26.97% of patients in Avandamet treatment and 19.33% in uptitrated metformin treatment. The target of FPG ≤7.0 mmol/L was reached in 63.16% of patients in Avandamet treatment and 43.33% in uptitrated metformin treatment. Fasting insulin decreased 3.24 ± 0.98 μU/ml from baseline in Avandamet treatment and 0.72 ± 1.10 μU/ml in uptitrated metformin treatment. Overall adverse event (AE) rates and serious AE rates were similar between groups. Hypoglycaemia occurred rarely in both groups.

Conclusions:

Compared with uptitrated metformin, Avandamet treatment provided significant improvements in key parameters of glycemic control and was generally well tolerated. Registration number: ChiCTR-TRC-13003776.     

Effect of GnRH antagonists on clinical pregnancy rates in ovulation induction protocols with gonadotropins and intrauterine insemination

INTRODUCTION

Intrauterine insemination (IUI) after controlled ovarian hyperstimulation (COH) was applied to selected infertile patients to determine the effect of gonadotropin-releasing hormone (GnRH) antagonists in IUI cycles, in which recombinant follicle-stimulating hormone (rFSH) had been used for COH.

METHODS

This study was conducted between April 1, 2009 and June 10, 2009, and involved a total of 108 patients. These patients had primary or secondary infertility, which resulted in an indication for IUI, and they each received two cycles of ovarian stimulation treatment with clomiphene citrate. The patients were randomised into two groups – patients in group A received rFSH + GnRH antagonist (n = 45), while those in group B received only rFSH (n = 63).

RESULTS

The mean age of the patients was 31.84 ± 3.73 years and the mean body mass index (BMI) was 24.40 ± 1.88 kg/m². The mean age and BMI of the patients in groups A and B were not significantly different. There was no significant difference in the mean total rFSH dose administered (988.33 IU in group A and 871.83 IU in group B). When compared to group B, the mean number of follicles that were > 16 mm on the human chorionic gonadotropin (HCG) trigger day was significantly higher in group A (1.58 and 1.86, respectively; p < 0.05). When the two groups were compared, there were no statistically significant differences in the number of cancelled cycles due to premature luteinisation (none in group A vs. two in group B) and the rate of clinical pregnancy (8.9% in group A vs. 7.9% in group B).

CONCLUSION

No significant improvement in the clinical pregnancy rates was observed when GnRH antagonists were used in COH + IUI cycles, despite the significant increase in the number of follicles that were > 16 mm on HCG trigger day.     

特发性中枢性性早熟女童GnRHa治疗前后心理行为的变化

目的：了解特发性中枢性性早熟（ICPP）女童心理行为改变与血清脱氢表雄酮（DHEA）、硫酸脱氢表雄酮（DHEAS）的关系，探讨长效促性腺激素类似物（GnRHa）在逆转或阻断ICPP女童不良心理行为中的作用。方法：由专人采用瑞文标准推理测验、艾氏儿童行为量表、自尊量表（SES）、躯体自信量表（BES）等对确诊ICPP女童和对照组女童进行心理行为的评估，用ELISA法检测DHEA、DHEAS水平，并对GnRHa治疗的ICPP女童进行DHEA、DHEAS及心理行为的随访。结果：①ICPP女童SES、BES的评分明显低于对照组（P〈0．05）；而艾氏儿童行为量表的抑郁、退缩、攻击性、体诉这4个因子的评分，ICPP组女童明显高于对照组（P〈0．05）；②ICPP组女童经GnRHa治疗12个月后，SES、BES得分有改善，治疗前、后比较差异有显著意义（P〈0．05）。ICPP组女童GnRHa治疗前血清DHEA为Log（0．77＋0．36）μg／L，明显高于对照组Log（0．28&#177;0．22）μg／L（P〈0．01）；GnRHa治疗后3个月，DHEA和DHEAS浓度明显下降；而治疗12个月时，DHEA和DHEAS与治疗前比较差异无显著意义（P〉0．05）。③ICPP女童SES的分值和BES中的体重关注、身体耐力2个分值与DHEA呈负相关（r分别为-0．492、-0．356、-0．202和-0．216，P均〈0．05）；而艾氏儿童行为量表的9个因子与DHEA无相关关系。结论：ICPP女童存在自尊程度低，自信心不足，且这种自尊程度和自信心不足随体内DHEA水平的增高而更加明显；性早熟女童更容易表现为抑郁、退缩、攻击性和好抱怨，但与体内DHEA水平变化无关；GnRHa治疗能不同程度地逆转ICPP女童的自尊程度低和自信心不足。     

Surgical Indications of Exploring Optic Canal and Visual Prognostic Factors in Neurosurgical Treatment of Tuberculum Sellae Meningiomas

Background:

Tuberculum sellae meningiomas (TSMs) present a special symptom because of the adherence and compression to the optic nerve, optic artery, and the chiasm. A significant number of patients with TSMs appear visual deficits. This study aimed to investigate the surgical indications of exploring the optic canal and visual prognostic factors in the neurosurgical treatment of TSMs.

Methods:

Totally 21 patients with TSM, who were operated from September 2007 to August 2011 in the Department of Neurosurgery, Tongren Hospital were enrolled in this study. Results of orbital computed tomography (CT) and magnetic resonance imaging (MRI), visual acuity, Goldmann visual field test, orbital color Doppler flow imaging (CDI) test in these patients were retrospectively analyzed.

Results:

Visual deficit and optic canal involvement (OCI) were detected in all the 21 patients. Fourteen patients had bone proliferation within the area of the optic canal. After the operation, visual outcomes were improved in 13 patients, unchanged in 7 patients, and deteriorated in 1 patient. All the 21 patients performed orbital CDI test preoperatively, the results showed that if the peak systolic velocity (PSV) of central retinal artery (CRA) value was ≤8 cm/s, the visual outcome would be better.

Conclusions:

The surgical indications of exploring optic canal in TSM cases included: (1) The neuroimaging evidences of OCI (CT and/or MRI); (2) PSV of CRA in orbital CDI test was ≤8 cm/s; (3) visual acuity was below 0.1; (4) visual field deficit. The PSV of CRA in CDI test could be a prognostic factor for visual outcomes of TSMs.     

Efficacy and Safety Investigation of Kuntai Capsule for the Add-back Therapy of Gonadotropin Releasing Hormone Agonist Administration to Endometriosis Patients: A Randomized,Double-blind,Blank- and Tibolone-controlled Study

Background:

As a Chinese Traditional Medicine product, Kuntai capsule could improve the peri-menopausal symptoms in postmenopausal women. But it is still not clear whether Kuntai capsule has a good effect on alleviating peri-menopausal symptoms induced by gonadotropin releasing hormone agonist (GnRH-a) treatment. The purpose of this study was to investigate the clinical effectiveness and safety of Kuntai capsule, on peri-menopausal symptoms in endometriosis (EMS) patients, with postoperative GnRH-a treatment.

Methods:

Ninety EMS ovarian cyst women with postoperative GnRH-a administration were enrolled in the study, and were randomly divided into Kuntai group, Tibolone group, or blank Control group. The therapeutic strategy in Kuntai group was 4 Kuntai capsules tid,po for 12 weeks after the first GnRH-a injection, while Tibolone 2.5 mg qd, po for 12 weeks in Tibolone group. There was no drug addition in Control group. Climacteric complaints were evaluated by Kupperman menopausal index (KMI) and hot flash/sweating score. Liver and renal functions, lipid profile, serum sex hormone levels and endometrial thickness were measured, and the frequency of adverse events in Kuntai and Tibolone groups was recorded.

Results:

(1) Before GnRH-a therapy, the baseline parameter results were comparable in the three groups (P > 0.05). (2) After GnRH-a therapy, KMI and hot flash/sweating scores in all the three groups increased significantly (P < 0.05). At the 4^th week after GnRH-a therapy, KMI and hot flash/sweating score results were as follows: Control group > Kuntai group > Tibolone group (P < 0.05); at the 8^th and 12^th week after GnRH-a therapy, KMI and hot flash/sweating score in Control group were significantly higher than the other two groups (P < 0.05), and no significant difference was identified between Kuntai and Tibolone group (P > 0.05). (3) No statistical change took place in the liver and renal functions and lipid profile in all the three groups after the treatment (P > 0.05). (4) The posttherapeutic serum follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2) level and endometrial thickness decreased significantly in all the three groups (P < 0.05). After therapy, serum E2 level in Tibolone group was obviously higher than the other two groups (P < 0.05), while FSH and LH levels were obviously lower (P < 0.05). (5) The incidence of vaginal bleeding, breast distending pain in Tibolne group was obviously higher than Kuntai group (P < 0. 05).

Conclusions:

Kuntai capsule is effective on the peri-menopausal symptoms induced by postoperative GnRH-a administration to EMS patients, although its clinical effect might be a few weeks later than Tibolone. Kuntai capsule might be a little safer than Tibolone tablet.     

Correlation between blood lead concentration and iron deficiency in Iranian children

Background:

Iron deficiency anaemia is the most common nutritional anaemia among children. Lead toxicity is a serious health threat, especially in developing countries due to environmental pollution. It was thus aimed to investigate correlation between blood lead concentration and iron deficiency in children of Mashhad, Iran.

Materials and Methods:

This cross sectional study was performed on children between 1 year and 10 years, in Imam Reza teaching hospital of Mashhad, Iran, in 2010. Indeed during complete blood count (CBC), we measured iron and total iron binding capacity (TIBC) by colorimetric methods, ferritin by radioimmune assay and blood lead concentration by atomic absorption method. Results were analysed by Statistical Package for Social Sciences (SPSS) (version 11.5), using statistical tests including independent sample t-test, Mann-Whitney U test, Spearman''s test and analysis of variance (ANOVA) and Pearson''s or Spearman''s correlation coefficient. P value ≤ 0.05 was considered as a significant level.

Results:

We studied 223 cases including 98 control children and 125 patients. All children had lead intoxication. Mean (±SD) blood lead concentration in the control group was 57.1 ± 25.3 (ranged 20-212) μg/dl and in the patient group was 57 ± 20.4 (ranged 10.9-159) μg/dl with no significant difference (P value = 0.713). We also did not find any correlation between blood lead concentration and haemoglobin, ferritin, iron, TIBC, mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC), white blood cells (WBC) and platelets.

Conclusion:

Based on these results, no correlation was found between blood lead concentration and iron deficiency in the children. Because all children had lead intoxication, further studies in highly polluted and a comparison with a low polluted area are necessary to make a general conclusion.     

Aqueous seed extract of Cola nitida rubra reduces serum reproductive hormone concentrations and sperm count in adult male albino Wistar rats

Background:

Following the high rate of consumption of Cola nitida (cola nut) among the male population in Nigeria, this study seeks to determine the effects of consumption of Cola nitida on serum reproductive hormones and sperm count, which are major determinants of male fertility.

Materials and Methods:

Thirty-two male albino wistar rats weighing 180-220 g were used for this study and were divided into 4 groups of eight animals each. Group 1 served as control, group 2 received 2 mg/kg Cola nitida extract (Test 1), group 3 received 6 mg/kg Cola nitida extract (Test 2) and group 4 received 10 mg/kg Cola nitida extract (Test 3). After 6 weeks of treatment, reproductive hormonal assay was carried out using the rat serum. Epididymal spermatozoa were collected and sperm count determined.

Results:

Serum concentrations of luteinizing hormone (LH) and testosterone were significantly (P < 0.05) reduced in test 2 and 3, compared with control. Sperm count was significantly lower in test group 1 (P < 0.05), 2 (P < 0.001) and 3 (P < 0.001) compared with control, with test 3 significantly (P < 0.05) lower compared with test 1. There was no significant difference in testicular and epididymis weight in the different experimental groups studied.

Conclusion:

Aqueous seed extract of Cola nitida rubra resulted in reduced serum reproductive hormone concentrations and sperm count in male wistar rats, and may therefore be detrimental to reproductive health, hence the need for regulation of its consumption.     

Vitamin D deficiency remains prevalent despite increased laboratory testing in New South Wales,Australia

INTRODUCTION

The aim of the present study was to assess the prevalence of vitamin D deficiency and toxicity, the frequency of 25-hydroxyvitamin D (25[OH]D) testing, and 25(OH)D variations with respect to patient gender, patient age and season in New South Wales, Australia.

METHODS

A retrospective analysis of pathology records was performed to ascertain patient age, patient gender, sample collection date, plasma or serum 25(OH)D levels, calcium and parathyroid hormone (PTH) levels, and test numbers between 2001 and 2010. Linear regression with Bonferroni correction was used to calculate and compare age- adjusted mean 25(OH)D levels. Relationships of 25(OH)D with PTH and calcium were tested using Spearman’s rank correlation.

RESULTS

25(OH)D testing increased by 730% over the ten-year study period. In 2010, many men (33%) and women (40%) were, to some degree, vitamin D deficient (≤ 50 nmol/L). Vitamin D toxicity was rare, with only one instance noted. 25(OH)D levels correlated positively with calcium and negatively with PTH levels. 25(OH)D levels decreased with age. In 2010, 25(OH)D levels were highest in February and lowest in September/October. Cyclical variation was observed for 25(OH)D levels between 2006 and 2010.

CONCLUSION

We found that vitamin D deficiency was prevalent in both men and women, with a higher prevalence in the latter, despite the substantial increased demand for 25(OH)D testing in our population over the decade. Vitamin D deficiency was associated with elevated PTH levels. Vitamin D toxicity was rare and only observed once during our study period. 25(OH)D levels decreased with age and varied with season, with the highest levels observed in late summer and the lowest in early spring.