Role of transdermal testosterone gel pre-treatment on IVF outcome: a prospective randomized controlled trial with active control

Background: Dealing with poor ovarian responders is the newest challenge for the present-day reproductive physicians. Androgens are said to increase pregnancy outcomes due to enhanced oocyte retrieval in poor responders. The aim of the study was to measure the effect of transdermal testosterone gel in women with unexplained poor ovarian response.Methods: It was a prospective randomized controlled trial with active control conducted at ART centre, department of obstetrics and gynaecology, AIIMS, New Delhi from August 2017-August 2018. Seventy women with previously failed IVF/ICSI who had ≤5 oocyte retrieval in previous cycle having normal ovarian reserve with normal or low testosterone levels were randomized. Study arm (N=35) received testosterone gel pre-treatment whereas the control arm (N=35) received standard treatment. GnRH antagonist stimulation protocol was followed. The number of oocytes retrieved and pregnancy outcomes were studied.Results: Of the 70 women in the study, the number of oocytes retrieved was significantly higher (6.5±5.8 vs 3.1±2.1; p=0.002), cycle cancellation rate was lower (8.6% vs 22.9%; p=0.094), implantation rate (8.2% vs 2.6%; p=0.228), clinical pregnancy, ongoing pregnancy, live birth rates (14.7% vs 2.9%; p=0.092) and take home baby rates (17.6% vs 2.9%; p=0.049) were higher in testosterone group compared to controls. One woman in testosterone group developed mild OHSS.Conclusions: The study shows that transdermal testosterone gel is found to improve oocyte retrieval significantly in unexpected poor responders, although there was not a significant improvement in pregnancy outcomes. Hence further studies are of utmost importance to establish the effectiveness of the gel

Bullous Lichen Sclerosus ET Atrophicus in a Child

Lichen Sclerosus Et Atrophicus (LSA) is an enduring atrophic ailment affecting the skin and mucosa. Lesions can encompass genital or superfluous genital skin. Genital LSA is further common in females than males. Girls as young as two years to woman as old as in the seventh decade are affected, having two peak ages of onset, the pre-pubertal and the post-menopausal. Bullous variant of this disease has been testified in extra genital LSA. We report a four year old girl with bullous variant of genital LSA.</jats:p

Comorbid conditions in psoriasis - Higher frequency in females: A prospective study

AIM: To study the association of obesity, diabetes, hypertension, and abnormal lipid profile in women above 40 years of age with psoriasis. MATERIALS AND METHODS: Two hundred consecutive female patients with psoriasis attending private clinics were included. Complete general, systemic, and dermatological examinations were performed. Blood pressure, blood sugar, and lipid profile were recorded in all patients and the findings analyzed. RESULTS: Of 200 patients, 45 were obese. Eighty-eight patients had diabetes mellitus and 29 had dyslipidemia of whom 13 and 18, respectively, were detected at the time of enrolment. All 25 patients with systemic hypertension were on treatment. A total of 177 (88.5%) patients had one or more comorbid conditions. This frequency is much higher when compared to other Indian studies where the sample included patients of both sexes

The scope of teledermatology in India

Telemedicine describes the application of information and communication technologies in the entire range of functions that involve the health sector. Several medical and surgical specialties utilize tele-consultation. Dermatology is the best clinical specialty in the use of communications technology because of its inherently visual nature in both diagnosis and follow-up, which makes it easily applicable to virtual medicine. Teledermatology embraces great potential for revolutionizing the delivery of dermatologic services to remote and distant locations by means of telecommunications and information technology. It encompasses consultations between a patient (and the primary healthcare provider) and a dermatologist for diagnosis and management advice. Teledermatology also covers dermatological education for health professionals and for consumers. Teleconsultations reduce time and increase the chances of access to one or more consultants as the patient or referring doctor desires, irrespective of the distance between the two. Its usefulness in the field of surgery and aesthetic surgery is immeasurable as there are only a few experts in the field of aesthetic surgery available currently in comparison to the dermatology population and the ever growing awareness and demand of the patients towards aesthetics. As the field of teledermatology is advancing in leaps and bounds the day is not far off when an aesthetic surgeon will be able to perform his skill from his own office on a patient in a distant locality with the help of a qualified and trained assistant. By adopting high-tech medical communication, high-performance computers, high-resolution cameras, and fiber-optic equipment′s the entire world shrinks

Trigeminal trophic syndrome

Trigeminal trophic syndrome (TTS) is a rare cause of facial ulceration, consequent to damage to the trigeminal nerve or its central sensory connections. We reporta case of TTS in a 48-year-old woman with Bell′s palsy following herpes zoster infection. The patient was treated and counseled. There hasnot been any recurrence for 1 year and the patient is being followed-up. The diagnosis of TTS should be suspected when there is unilateral facial ulceration, especially involving the ala nasi associated with sensory impairment

Subcutaneous granuloma annulare in a child: A rare presentation

We present a rare case of subcutaneous granuloma annulare (SGA) of the palm in a 3-year-old girl disappearing on removal of a SGA of the dorsum of foot. Though GA is more common in children, subcutaneous type is rare and poses diagnostic difficulty. Very few cases of SGA over the palm have so far been reported. Disappearance of SGA of the palm following removal of a nodule from the foot represents remote reverse Koebner′s phenomenon