Insulin plays a major role in polycystic ovary syndrome (PCOS). Insulin resistance and resultant hyperinsulinemia stimulate both the ovary and adrenal to produce androgens. Oral antidiabetic agents have been used to alleviate the symptoms and to induce ovulation in women with PCOS. This review focuses on the relation between insulin and PCOS and discusses the use of oral antidiabetic agents.
This prospective study was conducted at Dhaka Medical College and Hospital, Bangladesh. The objective was to identify the time required to control high blood pressure levels in obstetric patients by injection of hydralazine in a bolus intravenous dose vs continuous drip. Seventy-seven patients with eclampsia and hypertensive emergencies comprised the target population. Patients were managed either by hydralazine drip in normal saline (existing official protocol, n = 33) or hydralazine bolus injection (as experiment, n = 44) until diastolic blood pressure fell to 90-95 mmHg. Results were compared. Student's t-test was done for statistical significance, and a P value of <.05 was considered as significant. The groups were similar with respect to maternal age and their mean systolic and diastolic blood pressure at the time of enrollment. Patients who received bolus injection required less time to achieve the therapeutic goal (65.23 +/- 23.38 minutes) than continuous drip (186.36 +/- 79.77 minutes; P <.001). The experimental group also required significantly lower doses (6.68 +/- 1.66 mg) in comparison to that required by control group (20.07 +/- 11.38 mg; P <.001). There was no overshoot hypotension in either group. The data suggest that hydralazine bolus dose is equally safe and more effective than continuous drip in the management of hypertensive emergencies in pregnancy.
Background: Most psychiatric services (eg, inpatient units, day therapy centers, outpatient clinics, and community clinics) are not currently segregated by sex, but recent developments--such as increasing psychiatric acuity and increasing numbers of comorbidities--have raised the level of violence and perceived threat in psychiatric facilities and have made a proportion of the more vulnerable patients feel unsafe.
Aim: The purpose of this review is to examine the concept of vulnerability as it applies to female psychiatric patients and to review the literature on the determinants of violence in psychiatric facilities and on preferences among psychiatric patients with respect to same-sex vs mixed-sex psychiatric services.
Results: Literature from Great Britain and from disability organizations supports same-sex facilities as options for women who feel unsafe in mixed-sex facilities. Outcomes with respect to violent incidents have not been evaluated.
Conclusions: Same-sex psychiatric facilities need to be implemented in a variety of communities and careful research conducted to examine potential benefits in specific populations.
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