This comprehensive review includes large-scale pan-India surveys and regional studies. Every aspect of smokeless tobacco, including variations in social, economic, demographic, gender, and education stratifiers, is presented. This evidence-based presentation thereby provides insight not only to assess the burden but can serve as a base, leading to the development and encouragement of research in closing the existing gaps in knowledge. It can also provide a track to formulate tobacco control strategies as well as to reinforce and potentially guide tobacco control policy aimed at addressing the tailored needs in the Indian context. The recommendations expand the tobacco control spectrum and are the first of their kind in the literature to focus on cessation programs as a paramedical subject to draw the attention of not only policymakers but also to integrate medical and dental educational institutions, health care professionals, and tobacco users to synergistically develop successful tobacco control measures.
{"title":"Oral Tobaccco and Mortality in India","authors":"P. Mohan, H. Lando","doi":"10.4137/IJCM.S25889","DOIUrl":"https://doi.org/10.4137/IJCM.S25889","url":null,"abstract":"This comprehensive review includes large-scale pan-India surveys and regional studies. Every aspect of smokeless tobacco, including variations in social, economic, demographic, gender, and education stratifiers, is presented. This evidence-based presentation thereby provides insight not only to assess the burden but can serve as a base, leading to the development and encouragement of research in closing the existing gaps in knowledge. It can also provide a track to formulate tobacco control strategies as well as to reinforce and potentially guide tobacco control policy aimed at addressing the tailored needs in the Indian context. The recommendations expand the tobacco control spectrum and are the first of their kind in the literature to focus on cessation programs as a paramedical subject to draw the attention of not only policymakers but also to integrate medical and dental educational institutions, health care professionals, and tobacco users to synergistically develop successful tobacco control measures.","PeriodicalId":40062,"journal":{"name":"Journal, Indian Academy of Clinical Medicine","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83914049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This case report describes the presentation of new onset of worsening bilateral proximal and distal upper and lower limb weaknesses for the past three months in a 48-year-old man. His past medical history includes only essential hypertension. He denied any fever, diarrhea, or recent vaccination prior to the onset of his symptoms. He had vague patchy sensory loss in both right upper and lower limbs with no clear dermatomal distribution. The magnetic resonance imaging (MRI) of the cervical spine revealed features consistent of partial transverse myelitis. Cerebrospinal fluid (CSF) analysis showed raised opening pressure with evidence of yeast cells on gram stain examination on three different occasions. His neurological symptoms and signs responded to a two-week course of intravenous amphotericin B and oral flucytosine, but there remained minimal residual neurological deficit.
{"title":"Fungal Partial Transverse Myelitis of the Cervical Spine in an Immunocompetent Individual: A Case Report","authors":"G. Kasinathan","doi":"10.4137/ijcm.s22459","DOIUrl":"https://doi.org/10.4137/ijcm.s22459","url":null,"abstract":"This case report describes the presentation of new onset of worsening bilateral proximal and distal upper and lower limb weaknesses for the past three months in a 48-year-old man. His past medical history includes only essential hypertension. He denied any fever, diarrhea, or recent vaccination prior to the onset of his symptoms. He had vague patchy sensory loss in both right upper and lower limbs with no clear dermatomal distribution. The magnetic resonance imaging (MRI) of the cervical spine revealed features consistent of partial transverse myelitis. Cerebrospinal fluid (CSF) analysis showed raised opening pressure with evidence of yeast cells on gram stain examination on three different occasions. His neurological symptoms and signs responded to a two-week course of intravenous amphotericin B and oral flucytosine, but there remained minimal residual neurological deficit.","PeriodicalId":40062,"journal":{"name":"Journal, Indian Academy of Clinical Medicine","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74738847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Intensive care has become very important in the management of critically ill children who require advanced airway, respiratory, and hemodynamic supports and are usually admitted into the pediatric intensive care unit (PICU) with the aim of achieving an outcome better than if the patients were admitted into other parts of the hospital. It becomes important to audit admissions and their outcome, which may help to modify practices if necessary following thorough introspection, leading to better patient outcomes. Objective To evaluate the morbidity pattern and outcome of admissions into the PICU of a tertiary care center in India. Methods A retrospective study in which records of admissions (from August 2012 to June 2013) were obtained from the PICU records. Information retrieved included age, sex, diagnosis, duration of stay in the unit, and outcome. Results Mean age of the studied 341 patients was 40.01 ± 45.79 months; 50.7% were infants and 59.8% were males. The three most common disease categories admitted were cardiovascular disease (41.1%), neurological disorders (12.0%), and respiratory disease (10.0%). The mean duration of stay in PICU was 3.2 ± 4.5 days. The overall mortality rate was 2.1%. Conclusion Mortality is low in our PICU. We conclude that a well-equipped intensive care unit with modern and innovative intensive care greatly facilitates the care of critically ill patients giving desirable outcome. An expansion of the pediatric wards is advocated to enhance cost–-effective management of patients and avoid unnecessary stretch of the PICU facilities.
{"title":"Morbidity Pattern and Outcome of Patients Admitted into a Pediatric Intensive Care Unit in India","authors":"B. Abhulimhen-Iyoha, S. Pooboni, N. Vuppali","doi":"10.4137/IJCM.S13902","DOIUrl":"https://doi.org/10.4137/IJCM.S13902","url":null,"abstract":"Background Intensive care has become very important in the management of critically ill children who require advanced airway, respiratory, and hemodynamic supports and are usually admitted into the pediatric intensive care unit (PICU) with the aim of achieving an outcome better than if the patients were admitted into other parts of the hospital. It becomes important to audit admissions and their outcome, which may help to modify practices if necessary following thorough introspection, leading to better patient outcomes. Objective To evaluate the morbidity pattern and outcome of admissions into the PICU of a tertiary care center in India. Methods A retrospective study in which records of admissions (from August 2012 to June 2013) were obtained from the PICU records. Information retrieved included age, sex, diagnosis, duration of stay in the unit, and outcome. Results Mean age of the studied 341 patients was 40.01 ± 45.79 months; 50.7% were infants and 59.8% were males. The three most common disease categories admitted were cardiovascular disease (41.1%), neurological disorders (12.0%), and respiratory disease (10.0%). The mean duration of stay in PICU was 3.2 ± 4.5 days. The overall mortality rate was 2.1%. Conclusion Mortality is low in our PICU. We conclude that a well-equipped intensive care unit with modern and innovative intensive care greatly facilitates the care of critically ill patients giving desirable outcome. An expansion of the pediatric wards is advocated to enhance cost–-effective management of patients and avoid unnecessary stretch of the PICU facilities.","PeriodicalId":40062,"journal":{"name":"Journal, Indian Academy of Clinical Medicine","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87680206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Firyal A Ibrahim, H. Omri, R. Taha, I. A. Hijji, M. Elkhalifa, A. Sabbagh
Mantle cell lymphoma is an aggressive B-cell neoplasm with special clinical and pathological characteristics. As the morphological variants of mantle cell lymphoma are currently acknowledged, a practical challenge for achieving the correct diagnosis is encountered especially when the cytogenetic/molecular data are not widely available. Here we describe a case of mantle cell lymphoma (MCL) presented with a blend of atypical clinical, morphological, and immunophenotypic features that led to an incorrect diagnosis of B-cell prolymphocytic leukemia (B-PLL).
{"title":"Mantle Cell Lymphoma: A Report of a Case with a Blend of Atypical Features","authors":"Firyal A Ibrahim, H. Omri, R. Taha, I. A. Hijji, M. Elkhalifa, A. Sabbagh","doi":"10.4137/IJCM.S10608","DOIUrl":"https://doi.org/10.4137/IJCM.S10608","url":null,"abstract":"Mantle cell lymphoma is an aggressive B-cell neoplasm with special clinical and pathological characteristics. As the morphological variants of mantle cell lymphoma are currently acknowledged, a practical challenge for achieving the correct diagnosis is encountered especially when the cytogenetic/molecular data are not widely available. Here we describe a case of mantle cell lymphoma (MCL) presented with a blend of atypical clinical, morphological, and immunophenotypic features that led to an incorrect diagnosis of B-cell prolymphocytic leukemia (B-PLL).","PeriodicalId":40062,"journal":{"name":"Journal, Indian Academy of Clinical Medicine","volume":"162 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84934666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Monoclonal antibodies (MAbs) are an old immunological tool with applications in the fields of immunology, biotechnology, biochemistry, and applied biology. Production of monoclonal antibodies using hybridoma technology was discovered in 1975 by Georges Kohler of West Germany and Cesar Milstein of Argentina. Modern-day research on MAbs from laboratories worldwide is revealing additional applications in diverse branches of sciences. Recently, MAbs have been widely applied in the field of clinical medicine. Currently, MAbs account for one-third of all the new therapeutic treatments for breast cancer, leukemia, arthritis, transplant rejection, asthma, and psoriasis, with many more late-stage clinical trials being conducted. In this review, we outline the (i) production of MAbs, (ii) application of MAbs, (iii) antibody engineering, and (iv) pharmaceutical application of MAbs. The future prospect of this review lies in the applicability of monoclonal antibodies as a molecule for understanding and monitoring the biology of disease and its role in research, clinical, diagnostic, analytical, and pharmaceutical applications.
{"title":"Monoclonal Antibodies: A Tool in Clinical Research","authors":"Waliza Ansar, Shyamasree Ghosh","doi":"10.4137/IJCM.S11968","DOIUrl":"https://doi.org/10.4137/IJCM.S11968","url":null,"abstract":"Monoclonal antibodies (MAbs) are an old immunological tool with applications in the fields of immunology, biotechnology, biochemistry, and applied biology. Production of monoclonal antibodies using hybridoma technology was discovered in 1975 by Georges Kohler of West Germany and Cesar Milstein of Argentina. Modern-day research on MAbs from laboratories worldwide is revealing additional applications in diverse branches of sciences. Recently, MAbs have been widely applied in the field of clinical medicine. Currently, MAbs account for one-third of all the new therapeutic treatments for breast cancer, leukemia, arthritis, transplant rejection, asthma, and psoriasis, with many more late-stage clinical trials being conducted. In this review, we outline the (i) production of MAbs, (ii) application of MAbs, (iii) antibody engineering, and (iv) pharmaceutical application of MAbs. The future prospect of this review lies in the applicability of monoclonal antibodies as a molecule for understanding and monitoring the biology of disease and its role in research, clinical, diagnostic, analytical, and pharmaceutical applications.","PeriodicalId":40062,"journal":{"name":"Journal, Indian Academy of Clinical Medicine","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80146465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dengue hemorrhagic fever (DHF) is a spectrum of disease ranging from uncomplicated febrile illness to various devastating hemorrhagic manifestation and refractory shock. Cardiac complication in dengue fever (DF) is not common. Myocarditis has been a known complication of dengue fever. We report the case of myocarditis complicating DHF in a 34 years old female at 36 weeks of gestation with probable fetal myopericarditis.
{"title":"Myocarditis Complicating Pregnancy in Dengue Hemorrhagic Fever","authors":"J. Koshy, M. John","doi":"10.4137/IJCM.S10425","DOIUrl":"https://doi.org/10.4137/IJCM.S10425","url":null,"abstract":"Dengue hemorrhagic fever (DHF) is a spectrum of disease ranging from uncomplicated febrile illness to various devastating hemorrhagic manifestation and refractory shock. Cardiac complication in dengue fever (DF) is not common. Myocarditis has been a known complication of dengue fever. We report the case of myocarditis complicating DHF in a 34 years old female at 36 weeks of gestation with probable fetal myopericarditis.","PeriodicalId":40062,"journal":{"name":"Journal, Indian Academy of Clinical Medicine","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75664252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Need to Increase Awareness among Urologists regarding the Possible Association between Pioglitazone and Bladder Cancer","authors":"S. Chandru, V. Janarthanan, V. Mohan","doi":"10.4137/IJCM.S10505","DOIUrl":"https://doi.org/10.4137/IJCM.S10505","url":null,"abstract":"No abstract supplied.","PeriodicalId":40062,"journal":{"name":"Journal, Indian Academy of Clinical Medicine","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86011597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We assessed the applicability of the Glasgow Coma Scale (GCS) and the QT interval (QTc) to predicting outcomes in patients with organophosphate (OP) poisoning. In the hospital setting, QTc and GCS were monitored in each patient at admission. Patients with respiratory failure were compared to patients without these complications, and mortality was compared between groups. We found that the group with complications had a significantly longer QTc and a lower GCS score, a higher number of intubations, and worse outcomes (P < 0.05). GCS score and QTc have been shown to be equally good in predicting respiratory failure and hospital mortality in patients with OP poisoning. These results suggest that during initial out-of-hospital care of patients with OP poisoning, it is essential to monitor the QTc and the GCS score. The simplicity and promptness of these methods will allow providers to perform early and effective triage.
{"title":"Study of Glasgow Coma Scale Score and QTc Interval in Prognosis of Organophosphate Compound Poisoning","authors":"A. Deshpande, N. Gaikwad, S. Deshpande","doi":"10.4137/IJCM.S9807","DOIUrl":"https://doi.org/10.4137/IJCM.S9807","url":null,"abstract":"We assessed the applicability of the Glasgow Coma Scale (GCS) and the QT interval (QTc) to predicting outcomes in patients with organophosphate (OP) poisoning. In the hospital setting, QTc and GCS were monitored in each patient at admission. Patients with respiratory failure were compared to patients without these complications, and mortality was compared between groups. We found that the group with complications had a significantly longer QTc and a lower GCS score, a higher number of intubations, and worse outcomes (P < 0.05). GCS score and QTc have been shown to be equally good in predicting respiratory failure and hospital mortality in patients with OP poisoning. These results suggest that during initial out-of-hospital care of patients with OP poisoning, it is essential to monitor the QTc and the GCS score. The simplicity and promptness of these methods will allow providers to perform early and effective triage.","PeriodicalId":40062,"journal":{"name":"Journal, Indian Academy of Clinical Medicine","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90689200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hypertension is an important medical and public health issue all over the world. It is one of the most prevalent conditions seen today by clinicians in both developed and developing countries. Depending upon progression of systolic and diastolic blood pressure it is classified into stage 1, 2 and 3 hypertension. Life style modifications may be helpful in initial stage but pharmacological treatment is necessary when it become difficult to control it. In routine practice, pharmacological treatment is being selected from diuretics, β-blockers, calcium channel blockers and renin angiotensin system inhibitors either alone or in combination for both initial and maintenance therapy. Choice of drug depends upon favourable effects in specific clinical setting. Thiazide type diuretics are being preferred for most patients with uncomplicated hypertension whereas β-blockers show strong benefits in patients with a variety of cardiovascular complications. ACE-Inhibitors and ARBs are superior to other class in patients with multiple risk factors like obesity, insulin resistance or diabetes. CCBs compared with other class of hypertensive drugs demonstrate similar blood pressure lowering effects and similar reductions in cardiovascular morbidity and mortality but higher incidence of heart failure and fatal myocardial infarction in some patients. Despite the continued decrease in mortality and morbidity rate by these antihypertensive drugs, some documented increasing prevalence of cardiac failure and end stage renal disease remains to be explained.
{"title":"Clinical Perspective on the Management of Hypertension","authors":"M. Iqbal","doi":"10.4137/IJCM.S5475","DOIUrl":"https://doi.org/10.4137/IJCM.S5475","url":null,"abstract":"Hypertension is an important medical and public health issue all over the world. It is one of the most prevalent conditions seen today by clinicians in both developed and developing countries. Depending upon progression of systolic and diastolic blood pressure it is classified into stage 1, 2 and 3 hypertension. Life style modifications may be helpful in initial stage but pharmacological treatment is necessary when it become difficult to control it. In routine practice, pharmacological treatment is being selected from diuretics, β-blockers, calcium channel blockers and renin angiotensin system inhibitors either alone or in combination for both initial and maintenance therapy. Choice of drug depends upon favourable effects in specific clinical setting. Thiazide type diuretics are being preferred for most patients with uncomplicated hypertension whereas β-blockers show strong benefits in patients with a variety of cardiovascular complications. ACE-Inhibitors and ARBs are superior to other class in patients with multiple risk factors like obesity, insulin resistance or diabetes. CCBs compared with other class of hypertensive drugs demonstrate similar blood pressure lowering effects and similar reductions in cardiovascular morbidity and mortality but higher incidence of heart failure and fatal myocardial infarction in some patients. Despite the continued decrease in mortality and morbidity rate by these antihypertensive drugs, some documented increasing prevalence of cardiac failure and end stage renal disease remains to be explained.","PeriodicalId":40062,"journal":{"name":"Journal, Indian Academy of Clinical Medicine","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82889583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-01-01DOI: 10.1177/117739361000100002
K. Gayatri, J. Kumar, B. B. Kumar
Objective To compare the effects of Metformin with N-acetyl cysteine in polycystic ovarian syndrome (PCOS). Methods A prospective, randomised controlled study was conducted in the Department of Obstetrics and Gynaecology in a Medical College and General Hospital. Total 115 cases of polycystic ovarian syndrome presenting with different complaints were selected for the study. Fifty nine cases were treated with Metformin (Group-M) and other 56 with N-acetyl cysteine (Group-N). Primary outcome measures are improvement in clinical features and biochemical profile, where as secondary outcome measures are improvement in hormonal profile and ultrasonographic findings. Statistical analysis was done by Z test and Chi square test. Results From each group, 50 patients were ultimately evaluated. There was significant improvement in some of the clinical features like weight gain, acne and hirsutism in group-N (P < 0.05), but there was no significant change in other features like oligomenorrhea, amenorrhoea and infertility. The biochemical markers of insulin resistance like fasting insulin, fasting glucose/insulin ratio and HOMA-IR were significantly reduced in group-N. Hormone levels like serum LH, FSH, TT and LH/FSH ratio was significantly decreased in group-N, but FT, FT/TT ratio and SHBG were similar in both the groups. Ultrasonographic findings were similar in both the groups. Conclusion N-acetyl Cysteine had better improvement in clinical, biochemical and hormonal profile than Metformin in PCOS patients. It can be used as a substitute for insulin reducing medications in treatment of PCOS patients, considering its limited adverse effects.
{"title":"Metformin and N-acetyl Cysteine in Polycystic Ovarian Syndrome–-A Comparative Study","authors":"K. Gayatri, J. Kumar, B. B. Kumar","doi":"10.1177/117739361000100002","DOIUrl":"https://doi.org/10.1177/117739361000100002","url":null,"abstract":"Objective To compare the effects of Metformin with N-acetyl cysteine in polycystic ovarian syndrome (PCOS). Methods A prospective, randomised controlled study was conducted in the Department of Obstetrics and Gynaecology in a Medical College and General Hospital. Total 115 cases of polycystic ovarian syndrome presenting with different complaints were selected for the study. Fifty nine cases were treated with Metformin (Group-M) and other 56 with N-acetyl cysteine (Group-N). Primary outcome measures are improvement in clinical features and biochemical profile, where as secondary outcome measures are improvement in hormonal profile and ultrasonographic findings. Statistical analysis was done by Z test and Chi square test. Results From each group, 50 patients were ultimately evaluated. There was significant improvement in some of the clinical features like weight gain, acne and hirsutism in group-N (P < 0.05), but there was no significant change in other features like oligomenorrhea, amenorrhoea and infertility. The biochemical markers of insulin resistance like fasting insulin, fasting glucose/insulin ratio and HOMA-IR were significantly reduced in group-N. Hormone levels like serum LH, FSH, TT and LH/FSH ratio was significantly decreased in group-N, but FT, FT/TT ratio and SHBG were similar in both the groups. Ultrasonographic findings were similar in both the groups. Conclusion N-acetyl Cysteine had better improvement in clinical, biochemical and hormonal profile than Metformin in PCOS patients. It can be used as a substitute for insulin reducing medications in treatment of PCOS patients, considering its limited adverse effects.","PeriodicalId":40062,"journal":{"name":"Journal, Indian Academy of Clinical Medicine","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84564498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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