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Testosterone- and Cortisol-Secreting Adrenocortical Oncocytoma: An Unusual Cause of Hirsutism
Serap Baydur Sahin,Ahmet Fikret Yucel,Recep Bedir,Sabri Ogullar,Teslime Ayaz,Ekrem Algun
Case Reports in Endocrinology , 2014, DOI: 10.1155/2014/206890
Abstract: Objective. Oncocytomas of the adrenal cortex are usually benign and nonfunctional. They are rarely seen as the cause of hirsutism. Therefore, we aimed to report a case of adrenocortical oncocytoma presenting with hirsutism. Methods. We report a testosterone- and cortisol-secreting adrenal oncocytoma in a 23-year-old female patient presenting with hirsutism. Results. The patient had the complaint of hirsutism for the last year. Laboratory tests revealed total testosterone level of 4.2?ng/mL, free testosterone of >100?pg/mL, and DHEAS level of 574?μg/dL. There was no suppression in cortisol levels with 2?mg dexamethasone suppression test (5.4?μg/dL). Adrenal MRI revealed a ?mm isointense solid mass lesion in the left adrenal gland and the patient underwent laparoscopic left adrenalectomy. Pathological examination confirmed the diagnosis of benign adrenocortical oncoyctoma. Conclusion. This well-characterized case describes a testosterone- and cortisol-secreting adrenocortical oncocytoma as a possible cause of hirsutism. To our knowledge, this is the second report in the literature. Adrenal oncocytomas should always be considered in the differential diagnosis of hirsutism. 1. Introduction Hirsutism, defined as excessive male-pattern hair growth, affects between 5 and 10% of women of reproductive age and most women with hirsutism have polycystic ovary syndrome [1, 2]. Androgen-secreting tumors are rarely seen as the cause of hirsutism. In an epidemiological study, the frequency of androgen-secreting tumors was 0.2% in 950 hirsute women [3]. Most testosterone-secreting tumors arise from the ovary and rarely origins from the adrenal gland. Oncocytic neoplasms or oncocytomas usually arise in the kidneys or thyroid, parathyroid, salivary, or pituitary glands [4]. Oncocytomas of the adrenal cortex are extremely rare and usually detected incidentally [5]. Adrenal oncocytomas are usually benign and nonfunctional in most of cases. Herein, we report a testosterone- and cortisol-secreting adrenal oncocytoma in a 23-year-old female patient presenting with hirsutism. 2. Case Report A 23-year-old female patient admitted to endocrinology outpatient clinic with the complaint of hirsutism for the last year. Excessive hair growth was identified to originate from facial and mandibular areas initially and then to spread to abdominal and thoracic regions. She had regular menstrual cycles since her first period by the age of 12. Medical background and family history were unremarkable. Physical examination revealed that body temperature was 37°C, pulse rate was 80 beats/min,
Routine Screening for Cushing's Syndrome Is Not Required in Patients Presenting with Obesity
Serap Baydur Sahin,Hacer Sezgin,Teslime Ayaz,Emine Uslu Gur,Kadir Ilkkilic
ISRN Endocrinology , 2013, DOI: 10.1155/2013/321063
Abstract: Background. Cushing’s syndrome (CS) is a relatively unusual condition that resembles many of the phenotypic features of obesity. Our aim was to evaluate the frequency of CS in obese patients. Materials and Methods. This study included 354 consecutive patients (87.9% female, age years) who presented with simple obesity. All the patients were evaluated for the clinical signs of CS. Lipid parameters, fasting glucose (FPG) and insulin, 75?gr oral glucose tolerance test, basal cortisol and ACTH were measured. 1?mg overnight DST was performed. Results. The mean weight of the patients was ?kg and BMI ?kg/m2. 34.5% of the patients were hypertensive. 36.2% of the patients had central obesity, 72% dorsocervical fat accumulation, 28.8% abdominal striae and 23.2% acne. 49.4% of the women had hirsutism. 46.5% had prediabetes and 12.0% had type 2 diabetes, 72.6% had dyslipidemia. The mean cortisol and ACTH levels were as follows: ?μg/dL and ?pg/mL. Seven patients failed to suppress plasma cortisol to less than 1.8?μg/dL. Biochemical confirmation tests were performed in these patients and 2 of them were diagnosed glucocorticoid-secreting adrenal adenoma. Conclusions. Routine screening for CS in obese patients is not required. 1. Introduction Cushing’s syndrome (CS) is considered a contributing factor to the development of obesity. On the other hand, obesity itself might share the symptoms and signs of CS such as hirsutism, menstrual abnormalities, acne, dorsocervical fat pad (buffalo hump), supraclavicular fullness, glucose intolerance, and hypertension. Physicians may be called upon to exclude CS in obese patients, who are increasingly present in the general population. Early recognition of CS can reduce the morbidity and mortality [1]. The diagnosis of CS is often a challenge for clinicians due to the variable pattern and the nonspecificity of clinical manifestations. The diagnosis can be difficult particularly in states of mild or cyclical or periodical hypercortisolism [2–4]. The suspicion of CS arises in the presence of concomitant recent weight gain, impaired glucose tolerance, and high blood pressure [3]. Several studies reported a 1–5% prevalence of unsuspected CS in patients with poorly controlled type 2 diabetes and/or hypertension [5–8]. However, there are only few studies on the prevalence of CS in obese patients [9–13]. We therefore aimed to evaluate the frequency of CS in patients who present with obesity. The 1?mg overnight dexamethasone-suppression test (DST) is the most frequently used screening tool for CS [14]. Because it is easy to perform and has
Real-Time Implementation of Solar Inverter with Novel MPPT Control Algorithm for Residential Applications  [PDF]
Ayaz Ahmad, Rajaji Loganathan
Energy and Power Engineering (EPE) , 2013, DOI: 10.4236/epe.2013.56046
Abstract: Solar energy is a fast growing energy resource among the renewable energy resources in the market and potential for solar power is huge to contribute towards the power demand almost in all the countries. To capture the maximum power from the sun light in order to generate maximum power from the inverter, control system must be an equally efficient with the well designed power electronic circuits. Maximum power point tracking (MPPT) control system in general is taking care of extraction of maximum power from the sun light whereas current controller is mainly designed to optimize the inverter power to feed to power grid. In this paper, a novel MPPT algorithm using neuro fuzzy system is presented to ensure the maximum MPPT efficiency in order to ensure the maximum power across the inverter terminals. Simulation and experimental results for residential solar system with power electronic converters and analysis have been presented in this paper in order to prove the proposed algorithm.
The Professional Medical Journal , 2006,
Abstract: Objective: To ascertain the role of Exercise Tolerance Test as ascreening tool for coronary artery disease, in asymptomatic men who had one or more risk factors for developingischemic heart disease. Design: A descriptive study. Place and Time Period: Department of Medicine PAF HospitalMushaf Sarghoda from March 2004 to March 2005. Patients and Methods: A total no of 100 asymptomatic men age25-50 years with mean age of 38 years were included in the study. They were divided in to five groups according tonumber of risk factors they had for developing CAD. Following risk factors were included in the study (hypertension,diabetes ,smoking, obesity, hyper-lipidemia, family history of CAD.). All of them underwent E.T.T over treadmill usingmodified Bruce protocol. Test was considered positive if 2mm or more ST segment depression was noted .those testedpositive had coronary angiogram done to confirmed IHD. Results: Seven out of 100 tested positive for IHD on E.T.T.Those tested positive underwent coronary angiography 6 out of seven showed significant narrowing of coronaryarteries and 1 had normal angiogram. These results showed that E.T.T has a 76% sensitivity and 87% Specificity.Conclusion: E.T.T is an important, reliable and cost effective test to detect latent CAD in asymptomatic persons whohad multiple risk factors for developing CAD.
Automated Determination of a Package's Center of Mass
Ayaz Hemani
Undergraduate Journal of Mathematical Modeling : One + Two , 2010, DOI: 10.5038/2326-3652.3.1.15
Abstract: In order to address the issue of increased efficiency and better planning for parcel shipments, an automated computer program was developed in Microsoft Excel that calculates center of mass and moments of mass with greater speed and reliability than currently implemented systems. This simple program requires only a variable density function and limits of integration for a given object as input within the spreadsheet system. Once the required input has been provided, a series of chain calculations, with the help of a Visual Basic for Applications (VBA) script, is able to process the input, which is done through integration and a Riemann sum. Furthermore, the foundation of the program can also be used for calculating other physical quantities of interest such as the moment of inertia or surface area of an object.
An Assessment of the EU`s Role in the Developing World in Relation to Migration
Esengul Ayaz
Journal of Global Analysis , 2010,
Abstract: The aim of this article is to analyse the EU`s role in the developing world in relation to migration. To achieve that reasons behind the migration from developing countries to EU countries are discussed and the impact of migration on the development of poor countries is analysed. Thecommon migration policy of the EU is introduced and EU`s policies to manage the migration flows are presented. The main argument of this article is that despite some attempts of the EU to manage migration relations between developing countries and the EU in favour of both sides, the Union still has a long way to go.
Cadmium (Cd) Removal from Saline Water by Veronica anagallis and Epilobium laxum Plants in Hydroponic System  [PDF]
Fazal Hadi, Ayaz Ahmad, Nasir Ali
Agricultural Sciences (AS) , 2014, DOI: 10.4236/as.2014.511101
Abstract: Present study was conducted to investigate the Cadmium (Cd) phytoextraction potential of two plants (Veronica anagallis-aquatic and Epilobium laxum Royle) for Cd removal from induced saline water. In hydroponic system, various concentrations of the Cd (50, 100, and 150 ppm) and NaCl salt (1000, 3000, and 6000 ppm) were used alone and in various combinations to evaluate the effect of salt (NaCl) concentrations on Cd absorption and accumulation in Veronica anagallis and Epilobium plants. The Cd at higher concentrations (100 and 150 ppm) significantly reduced the growth and biomass of both plants and addition of salt (NaCl) to growth media (Hoagland solution) further reduced the growth. The Cadmium (Cd) translocation factor (TF) of Epilobium plant was more than one (1), while the Veronica plant showed translocation factor less than 0.5. Veronica plant showed higher Bio-concentration factor (BCF) as more than 3.5 and Epilobium plant demonstrated Bio-concentration factor less than 1 (BCF 1 is a threshold limit for a plant to be hyper-accumulator of Cd). Conclusively, the Veronica anagallis plant is reported as Cd hyper-accumulator, while Epilobium
Neonatal Mortality and Prevalence of Practices for Newborn Care in a Squatter Settlement of Karachi, Pakistan: A Cross-Sectional Study
Afsheen Ayaz,Sarah Saleem
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0013783
Abstract: During the past two decades there has been a sustained decline in child and infant mortality, however neonatal mortality has remained relatively unchanged. Almost all neonatal deaths (99%) occur in developing countries, where the majority are delivered at homes. Evidence suggests that these deaths could be prevented by simple, inexpensive practices and interventions during the pregnancy, delivery and postnatal period. In Pakistan over the last decade extensive efforts have been made by the international donors and government to implement these practices. However, limited attempts have been made to explore if these efforts have made a difference at the grass root level. This study assessed the burden of neonatal mortality and prevalence of practices for newborn care in a squatter settlement of Karachi, Pakistan.
Influence of different cytokinins used in in vitro culture on the stoma morphology of pistachio (Pistacia vera L. cv. Siirt)
S Namli, E Ayaz
African Journal of Biotechnology , 2007,
Abstract: Three different cytokinins (BA, kinetin and TDZ at 1 mg/l) were tested in order to study their effects on pistachio stoma morphology. Additional BA concentrations of 0.25, 0.625 and 2 mg/l were also tested. The stoma morphology of pistachio leaves in vitro was affected by cytokinins. Stomas obtained from 1 mg/l BA medium were similar to those developed in vivo. TDZ, kinetin and other BA concentrations resulted in abnormal stoma development.
Antimicrobial Effect of Garlic (Allium sativum) and Traditional Medicine
Gulsen Goncagul,Erol Ayaz
Journal of Animal and Veterinary Advances , 2012, DOI: 10.3923/javaa.2010.1.4
Abstract: Medicinal plants like pumpkin seed, thyme, onion, nigella sativa, lemon balm, stinging nettle are used extensively today. One of these plants used most intensively and widespread is garlic. In this context, fresh shape, powder state and oil of garlic have been used all around the world especially in Far East for centuries. In conclusion it is observed that the information transferred between generations and studies made scientifically that garlic is effectively used in cardiovascular diseases as regulator of blood pressure and with dropper effects of it on glycaemia and cholesterol, against bacterial, viral, mycosis and parasitic infections. It s also known that garlic is a wonderful plant having the properties of empowering immune system, anti-tumour and antioxidant. Garlic shows its this effect thanks to >200 components it involves. Garlic includes to >200 components such as volatile oils (allicin, alliin and ajoene) consisting of sulphur, enzymes (alliinase, peroxidase and miracynase), carbohydrates (sucrose, glucose), minerals (germanium, selenium, zinc), amino acids like cysteine, glutamine, isoleucine and methionine, bioflavonoids like quercetin and cyanidin and allistatin I and allistatin II, C, E and A vitamins and niacin, B1, B2 vitamins and beta carotene. In this study, it will be given a summary about properties of garlic and its areas of use against bacterial diseases.
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