Young indigenous South Asians with PCOS have greater odds of being centrally obese, with a third having the MetS that bears no relationship to the androgenic phenotype. Significant predictors for MetS within the PCOS cohort are advancing age, obesity determined by the Asian cut off (BMI >25 kg/m(2)) and AN, while family history of diabetes, hyperandrogenism and elevated SHBG have no predictive value.

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Background

Background: Statins form the pharmacologic cornerstone of the primary and secondary prevention of atherosclerotic cardiovascular disease. While statins are well-tolerated by most people, the most common adverse effect is the asymptomatic elevation of serum aminotransferase levels. The objective of the study was to determine the incidence of changes in alanine transaminase (ALT) levels in patients who are on statin therapy and to identify cost effectiveness of monitoring of transaminases on a routine basis. Methods:We carried out a retrospective cohort study in patients with Type 2 diabetes mellitus with dyslipidemia at the Diabetes and Endocrinology Unit, Teaching Hospital Kandy, Sri Lanka from August to October 2015. We measured the ALT levels before and after commencing statin therapy.Results: This series comprised of 46 females and 24 males with a mean age of 58.2 years (SD =10.23). Mean total cholesterol, LDL, HDL, triglycerides were 229.94,153.10,46.63 and 146.34 mg/dL, respectively. The mean baseline ALT level was 32.86 U/L. Fifteen patients (21.42%) had baseline ALT levels above the upper limit of normal (>40U/L). Atorvastatin was the most commonly prescribed statin (98.57%). After a mean duration of 12.8 months of statin therapy, no patient had elevated ALT levels more than three times the upper limit of normal. Only two patients (2.86%) had ALT levels greater than twice the upper limit of normal and they remained asymptomatic. Among the fifteen patients who had high baseline ALT, twelve (80%) had normal ALT following statin therapy.Conclusions: Clinically significant increase in liver transaminases following statin therapy is rare. Hence, routine monitoring of transaminases levels may not be cost-effective.

Electronic Patient Records can improve the quality of patient care in psychiatry units. Many patients have long term illnesses and have multiple patient encounters with psychiatric services. Although manual data gathering is available at the moment, data retrieval is time consuming and as files have to be manually searched. Storage of past data is hampered by lack of space. We describe the first electronic patient record system developed for use in a psychiatry unit in Sri Lanka. The system facilitates an electronic storage of data and easy retrieval of information. The system identifies a patient by a unique number and allows different episodes of in-patient and outpatient care to be linked together. The systems' value is enhanced by the generation of reports to assist and improve health administration. Clinical care is enhanced by linking different episodes of care of a patient over time. Discharge reports follow up reports of outpatient attendance and reports of analysis of data are generated by the system. The follow up report identifies outpatients who default treatment enabling community follow up. This would help improve compliance and reduce relapses. This is not currently done as it is not feasible to identify all those who default using a manual record keeping system. Analysis of patients based on different criteria such as diagnosis and treatment will assist in identifying trends of illnesses and also provide a database for research. The system is developed using mysql database and is hosted on apache server. As this uses only open source software this can be deployed in both Linux and windows environment allowing easy, and low cost deployment in other such wards. The system is web based and can be connected to a network expanding the access capabilities.