Introduction: Thyroid disorders are very common in females and are known to prevent ovulation. Thyroid disorders can impact menstrual cycles and causes menstrual irregularities and infertility in females. Aim: To determine effects of hypothyroidism on menstrual cycle pattern and prevalence of subfertility among women having thyroid dysfunction. Materials and Methods: This cross-sectional study was conducted in Department of Obstetrics and Gynaecology in collaboration with Department of Endocrinology in Government Medical College, Datia Madhya Pradesh, India from July 2019 to June 2021. A total of 205 patients aged 18-45 years were taken. Among them, 116 and 89 patients were of hypothyroid and euthyroid respectively. After properly selecting patients, detailed history of their menstrual cycles was taken and effect of thyroid dysfunction on menstrual irregularities was assessed. The collected data were evaluated and analyzed using Statistical Package of the Social Sciences (SPSS). Results: A total of 205 patients participated in present study. Mean age was 35+/-5 years. Among 205 subjects, 116 were hypothyroid and 89 were euthyroid. Among the hypothyroid subjects, 72 (62.1%) had normal menstrual cycles, 23 (19.8%) had history of oligomenorrhea, 12 (10.3%) had polymenorrhea, and 9 (7.7%) had amenorrhea, while among the thyroid subjects, 76 (85.4%) had normal menstrual cycle, 6 (6.7%) had oligomenorrhea, 5 (5.6%) had polymenorrhea, and 2 (2.2%) had amenorrhea, with statistically significant differences (p<0.001). The proportions of primary 13 (11.2%) and secondary 9 (7.7%) subfertility were significantly higher among hypothyroid subjects compared with thyroid subjects (p<0.05). The prevalence of subfertility was 7 (7.8%), 10 (14.28%), and 12 (26.08%) among the thyroid, overtly hypothyroid, and subclinical hypothyroid subjects, respectively. Conclusion: In this study, effects of thyroid dysfunction were presumably significant on menstrual cycle pattern and fertility; therefore, thyroid status should be assessed in all patients with menstrual disorders and appropriate treatment should be initiated early.

To evaluate safety and efficacy of Gabapentin and Duloxetine in patients with painful diabetic neuropathy.This is a prospective randomized double blinded parallel group study done for a period of 12 weeks. Total of 60 patients were enrolled and randomly allocated to two groups with 30 patients each, group A received Duloxetine 30 mg twice daily and group B received Gabapentin 300mg twice daily and followed every 2 weeks. Patients of age 35 to 60 years with painful diabetic peripheral polyneuropathy are included in the study. Primary objective is improvement in pain assessed by NPRS; Secondary objective is improvement in sleep and clinical condition of the patient, assessed by Sleep Interference Score and Clinical Global Impression of Change (CGIC). Assessment was done at beginning and at four, eight and twelve weeks. Data was analysed using SPSS 12.0 version.Numerical pain rating scores and daily sleep interference scores were reduced significantly with course of treatment within both groups (p = &#60;0.05 in both groups), but there was no significant difference observed between two groups at baseline, 4th week, 8th week and 12th week. There is significant reduction in CGIC severity scores with course of treatment within both groups (p = &#60;0.05 in both groups), but there was no significant difference observed between groups at baseline and at end of treatment. Common adverse events seen are nausea, dry mouth, dizziness, somnolence and constipation in both groups. There is high incidence of nausea and dry mouth with Duloxetine when compared to Gabapentin.Monotherapy with either Duloxetine or Gabapentin was equally effective at 12 weeks treatment with minor side effects. In addition, Gabapentin showed fewer side effects. It can be concluded that for preventing side effects, Gabapentin can be used. Further large head to- head comparator and combination trials are required.