Purpose Adult ADHD is one of the most undiagnosed diseases mainly because of the misperception that ADHD is a childhood disease. In this study, we assess the characteristic features of adult ADHD using clinical assessment and structural Magnetic resonance imaging (sMRI) Methods We obtained structural MRI data from the UCLA Consortium for Neuropsychiatric Phenomics for 21 untreated adult ADHD patients and 21 age and gender propensity-matched control patients. For clinical assessment, we compared the scores of Barrat's impulsivity score, Dickman impulsivity inventory II, and Eysenck's Impulsivity Inventory. We then compared grey matter volume (GMV) between ADHD and control patients using a two-sample t-test. We also assessed the correlation between different clinical assessments and GMV. Results Based on our results, adult ADHD showed significantly higher impulsivity scores, however, no significant difference in functional impulsivity scores or empathy summary scores. For sMRI, there was a significant decrease of GMV of the left cuneus in female ADHD patients. For clinical assessment scales, only the motor impulsiveness subdomain showed a significant positive correlation with the GMV of the left precuneus. Conclusions In this study, we assessed the characteristic sMRI features and clinical assessment scores for untreated adult ADHD. Our results show that a study with a bigger sample size can identify diagnostic features for adult ADHD.

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Background: Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder among women in the reproductive period. It is one of the leading causes of infertility. The manifestations of PCOS include irregular or no menstrual periods, excess body weight and facial hair, acne, heavy periods and pelvic pain. The aim of this study is to determine the efficacy of stair step protocol compared to traditional protocol in ovulation induction of polycystic ovarian syndrome (PCOS) patients in terms of increasing rate of ovulation and pregnancy. Methods: This study is non-blinded, multicenter, randomized controlled study and was carried out on infertile women attending the Fertility Clinic of Tanta University Hospital and Hurghada General Hospital. Two Hundred infertile patients with PCOS criteria and no other causes of infertility were enrolled according to inclusion and exclusion criteria. Results: Student t test was used for the continuous variables (FSH, LH, Prolactin, AMH, TSH, Free testosterone). Student t test was used for the continuous variables (Endometrial thickness, Time to ovulate (d)). Chi-square analysis was used for the categorical variables (Ovulation rate, Pregnancy rate). Chi-square analysis was used for the categorical variables (Ovulation rate per cycle). There was no significant difference between two groups as regards mild and severe side effects. Conclusions: This study concluded that stair step regimen improves the ovulation rate and pregnancy rate without any detrimental side effects compared to traditional regimen. It helps to know the sensitivity and resistance of an individual to clomiphene citrate much earlier and helps to plan ahead with alternative treatment for desired outcome. The advantage of shorter treatment period with similar side effects makes the stair step protocol suitable for use in routine clinical practice.