These results suggest an association between the use of VPA and PCO, hyperandrogenism, obesity and menstrual abnormalities. For women receiving VPA therapy, clinicians should consider performing an assessment of ovarian structure and function, especially if these patients develop menstrual cycle disturbances during treatment.

Background: Overweight in infancy could increase the risk of cardiovascular disease (CVD) and diabetes mellitus (DM) in later life, however the mechanisms are need to be investigated. Aim: To assess the relationship between overweight and right ventricular function during infancy in relation to the mode of feeding. Methods: A cross-sectional study was conducted for 76 healthy infants aged 3 to 12 months of life (38 breastfed (BF) and 38 milk formula fed (MFF). Anthropometric measurements were done for weight, supine length and body mass index (BMI). The right ventricular functions (RV) were assessed by two dimensional (2D) echocardiography and Tissue Doppler Imaging (TDI). Results: BMI percentiles were significantly higher in MFF infants compared to BF infants (P<0.05). BMI was positively correlated with structural dimensions in MFF but not BF. BMI correlated with RV function in BF but not MFF.     Conclusion: Overweight in MFF increases right sided cardiac dimensions but in BF the functional component of the RV is increased.

Background: Second hand smoke (SHS) exposes infants and young children to many short and long term hazards. In adults PS was found to result in left sided diastolic dysfunction. Aim: To identify changes in the structure and function of the right side of the heart that can be influenced by exposure of infants to SHS. Methods: Echocardiographic evaluation of the right side of the heart was carried out for 75 infants aged 3 to 12 months of age; 39 were formula milk fed (FF) from birth and an age matched control of 36 breastfed  (BF) infants. A sub-analysis was done for each group in relation to exposure to PS. Measurements included Tricuspid annular plane excursion (TAPSE) and S’ wave for peak systolic annular velocity for right systolic function, E wave (early passive ventricular filling) and E/A ratio, tissue Doppler imaging (TDI) for E’ and A’ and E/E’ prime ratio for assessing ventricular filling pressure for diastolic dysfunction. Findings:  TDI in FF showed significantly higher values for E prime and E/E’ ratio in infants not exposed to SHS vs. those exposed to SHS (12.5±0.96 cm vs. 11.1±1.1 cm at P=0.000) and E/E’ (6.65±0.9 vs. 7.7±0.9 at P=0.003) respectively. There were no significant differences in systolic function (TAPSE) and S’ wave. However RV diameter was significantly higher in those exposed to SHS (1.3±0.09 cm) vs. no exposure (1.2±0.07 cm) at P<0.05. In the BF there were no significant differences in all dimensions examined for SHS exposures and no exposures. Conclusions: SHS in FF infants are at risk of right sided diastolic dysfunction while early breastfeeding seems to protect the heart from the hazards of SHS.