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Biomedical subjects

R A Vaidya

Publications and source records attributed to R A Vaidya.

17 recordsLinked to original sources

Normalization of visual fields following bromocriptine treatment in hyperprolactinemic patients with visual field constriction.

Two patients with galactorrhea-amenorrhea and bilateral visual field defects were studied. Routine radiologic examination of each patient revealed a normal sella turcica and no demineralization of the posterior clinoid process. Serum prolactin levels were elevated (patient V. G., 80 ng/ml; patient S. R., 204 ng/ml). Within 2 months of bromocriptine therapy, the serum prolactin levels were normal (patient V. G., 12.21 ng/ml; patient S. R., 8.25 ng/ml) and the bilateral visual field defects were corrected. Bromocriptine has been shown to control prolactin secretion in patients with prolactin-secreting pituitary tumors. Normalization of restricted visual fields following bromocriptine therapy indicates the possibility of an anatomical regression of pituitary hyperplasia or an underlying prolactin-producing microadenoma. It is speculated that the modality of functional galactorrhea reflects hyperplasia of the lactotrophs preceding a nodular and ultimately an adenomatous change. The continuous and prolonged administration of bromocriptine may prevent such a progressive sequence. Further experience is required to validate this possibility.

Adult

Laparoscopy for resolving Müllerian abnormalities.

One hundred thirty-five patients with various müllerian abnormalities underwent laparoscopy. At a glance the precise malformation was diagnosed correctly: 44 patients revealed a complete absence of the müllerian system; 35 were found to have a transverse ridge across the pelvis, the lateral ends of which were well developed; 33 patients had rudimentary uteri; 7, a median müllerian nodule; 5 belonged to the group with the testicular feminization syndrome; 4 were classified as having a bicornuate uterus; 3 had unicornuate uteri; and 3, septate uteri. One rare variety of müllerian abnormality is also described. Laparoscopy was found to be invaluable in the diagnosis of müllerian abnormalities.

Abortion, Habitual

Are hormonal contraceptives teratogenic?

The widespread use of hormonal contraceptives for a prolonged time in women during the child-bearing period necessitates that appropriate precautions be taken to ensure safety for the patient as well as for her progeny. Hormonal administration during or prior to pregnancy may be potentially teratogenic. Although there have been many reports during the last decade, it has been very difficult to document conclusively such a relationship. Over-all, it seems that hormonal use prior to pregnancy does not lead to an increase in the frequency of chromosomal aberrations or of congenital malformations. The use of certain hormones during pregnancy, on the other hand, may lead to an increase in the incidence of congenital malformations, probably in the genetically predisposed fetus. In view of this concept hormonal contraceptives should not be used to treat threatened abortion, and their use as a pregnancy test should be abandoned. Since the question of the safety of the inadvertent administration of pills during early pregnancy has not been resolved, the mother should be informed of the potential risks.

Abnormalities, Drug-Induced

The scope and limitations of laparoscopic ovarian biopsy in the diagnosis of secondary amenorrhea.

Laparoscopically directed ovarian biopsy has been evaluated in 39 cases of secondary amenorrhea. The definite diagnosis was achieved in 29 cases. In 10 cases, ovarian histopathology alone was insufficient, and the estimations of gonadotropins were essential for the final diagnosis. The scope and limitations of this procedure for the differential diagnosis of premature ovarian failure and hypothalamic-pituitary lesions are discussed.

Amenorrhea

Premature ovarian failure.

Twelve cases of premature ovarian failure (POF) are described. The clinical, hormonal, histopathologic and cytogenetic studies of each patient have been presented. The scope and the limitations of laparoscopic ovarian biopsy are discussed, as is the importance of radioimmunoassay of follicle-stimulating and luteinizing hormones (FSH/LH) in comparison to ovarian biopsy for the diagnosis of premature ovarian failure. A plea is made for the early diagnosis of POF so that these young women can be spared the expensive and time-consuming treatment for the associated problem of infertility.

Adult

Presence of prolactin in human cervical mucus.

The presence of prolactin in human cervical mucus was demonstrated by radioimmunoassay. The levels of prolactin in cervical mucus were significantly higher (260 ng/ml +/- 47.5 SE) than those in sera of normally menstruating women (30.28 ng/ml +/- 2.0 SE).

Cervix Mucus