Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Bhanu K Bhakhri

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Super Speciality Paediatric Hospital and Post Graduate Teaching Institute, Noida
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On Sep 2018




Prof. Somashekhar Nimbalkar

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Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
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Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



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Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
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Professor and Head
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Saraswati Dental College
Lucknow
On Sep 2018




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MD, DM (Clinical Pharmacology)
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Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




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Best regards,
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Muzaffarnagar.
On Aug 2018




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"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
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Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011

Important Notice

Original article / research
Year : 2010 | Month : December | Volume : 4 | Issue : 6 | Page : 3410 - 3413

Plasma Protein Oxidation And Total Antioxidant Power In Premenstrual Dysphoric Disorder And Menstruating Young Adult Females

TULADHAR ET*, KAMATH A**, RAO A***

*MD, Department of Biochemistry; **PhD, Department of Biochemistry; ***M Phil, Department of Community Medicine, Kasturba Medical College, Manipal, Karnataka, India

Correspondence Address :
Dr. Anjali Rao, Professor of Biochemistry, Kasturba Medical College, Manipal- 576 104, Karnataka, India, Phone: 918202922326, Fax: 91820 2570062, Email: dranjalirao@hotmail.com

Abstract

Purpose: Oxidative damage has been associated with many human diseases encompassing mood affective disorders. Premenstrual dysphoric disorder (PMDD) has features which are similar to these, along with physical symptoms of stress. The purpose of the present study was, to assess whether oxidative stress has any role in PMDD.
Method: Female subjects suffering from PMDD , in the age group of 20-24 years, were compared to their eumennorhic counterparts and also with those with premenstrual syndrome (PMS), in the follicular phase and in the late luteal phase for the ferric reducing antioxidant power of plasma (FRAP), plasma protein thiol (PPT) and protein carbonyl (PPC) levels.
Results: There were no significant changes in the FRAP and PPC levels in the controls, in the PMS and the PMDD groups, but PPT levels decreased significantly in the luteal phase of the PMS (P=0.015) and the PMDD groups (P= 0.018) when compared to those in the follicular phase. Besides, PPT levels exhibited a significant increase (P=0.015) in the follicular phase of the PMDD subjects.
Conclusion: A marked decrease in PPT levels in the luteal phase of the PMS and the PMDD groups may be due to the pro-oxidant nature of oestrogen - active in this phase of PMS, leading to the consumption of the sacrificial antioxidant – protein thiol. Further, to compensate this loss, a large reserve of PPT gets accumulated in the follicular phase of the PMDD group, thus indicating a dynamic turnover of this antioxidant between the two phases.

Keywords

Ferric reducing antioxidant power of plasma; premenstrual dysphoric disorder; protein thiol; protein carbonyl

Introduction

Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS) that affects 3-8 % of menstruating women. The symptoms of the disorder as categorized by DSM-IV, include marked depression, anxiety, moodiness, irritability, tension, etc. The quality of life of such women is considerably reduced. The pathogenesis of PMDD is not known and the only cure would be menopause (1) or the administration of selective serotonin receptor inhibitors (SSRIs), which is not without the danger of its side effects. Oxidative stress has been associated with many human diseases, including mood affective disorders. Premenstrual dysphoric disorder (PMDD) has features which are similar to these, along with physical symptoms of stress. It is now well documented that oxidative stress may have a role in PMS.(2)(3)(4) However, no such reports are available in its debilitating form, which is called PMDD. Hence, in the present study, the antioxidant status in PMDD, PMS and normal females was studied by using the ferric reducing antioxidant power of plasma (FRAP), plasma protein thiol (PPT) and plasma protein carbonyl (PPC) levels.

Material and Methods

Study Design: Cross sectional study
Study population:Females aged 20-24 years from a University setting
Sample size: By anticipating the prevalence of PMDD among females of 20-24 years as 5%, for a level of significance of 5% and an absolute precision of 3%, 203 women were screened. There was a drop out of 20.1% women in the study. As a result, only 162 females participated in the study.

Sampling: Convenient sampling
The study duration was from June 2005 to July 2006. Inclusion criteria: Females having regular menstrual cycles with no other illness and those who were not on any medications.
Exclusion criteria: No history of polycystic ovarian disease, smoking, alcohol consumption, drug abuse, insulin resistance and the use of contraceptive pills.

The nutritional difference was insignificant, as they belonged to the same socioeconomic strata. The body mass index (BMI) for all the subjects was well within the normal range (22- 24 kg/m2). A Calendar of Premenstrual Experiences (COPE) questionnaire was used to identify the females who experienced PMS and PMDD. (5)

The screen positive PMDD females were considered as cases. The rest of the group comprised of PMS cases and the normals. The questionnaire screening identified eight females who experienced PMDD. Thus, 24 each of the normal and PMS females were randomly selected from the rest of the group to form the group of Controls and the PMS subjects.

Blood sample collection:
Under aseptic conditions, 1.5 ml of venous blood was collected in EDTA containing vacutainers. The blood samples were collected from each volunteer at two time points, namely, the follicular phase sample (seven day period following menstruation) and the luteal phase sample (seven day period before menstruation). The plasma was separated immediately after the collection of the sample by centrifuging at 4000 rpm for two minutes. The separated plasma was transferred and stored (if needed) at -20ºC. The parameters were assayed immediately or within the next two days of the collection of the samples. The plasma samples were allowed to thaw to room temperature before the assay was carried out.

This study was carried out after clearance from the institutional ethical committee. The samples were obtained from the volunteers after their written consent was taken. FRAP was measured according to the spectrophotometric method of Benzie et al. (6) At low pH, reduction of a ferric tripyridyltriazine (FeIII-TPTZ) complex to the ferrous form, which has an intense blue colour, can be monitored by measuring the change in absorption at 593 nm. The change in absorbance is directly related to the combined or “total” reducing power of the electron donating antioxidants which are present in the reaction mixture. PPT was measured in plasma by a spectrophotometric method by using di thionitrobenzene (DTNB)-Ellman’s method. (7),(8) Ellman's reagent or 5,5'-dithiobis (2-nitrobenzoate, DTNB) is a symmetrical aryl disulfide which readily undergoes the thiol-disulfide interchange reaction in the presence of a free thiol. The TNB dianion has a relatively intense absorbance at 412 nm as compared to both the disulfides. The protein thiol concentration in plasma was determined by using the molar extinction coefficient of the TNB complex in the assay mixture at 412 nm which was obtained after using known standard concentrations and their absorbance values.

PPC was analyzed by treating the plasma with 2,4- dinitrophenylhydrazine (DNPH) (9) and the absorbance peak was measured at 355 nm. The assay was based on the fact that several reactive oxygen species (ROS) can attack amino acid residues in proteins (particularly histidine, arginine, lysine and proline) to produce carbonyl functions that can react with DNPH to generate chromophobic dinitrophenylhydrazone, which can be measured spectrophotometrically.

Statistical analysis was carried out by using the SPSS package (version 11.0). Continuous data was summarized by using median and interquartile ranges, as the data was skewed. Comparison of the median between the three groups was done by using the Kruskal Wallis test, followed by a pair wise comparison of the groups by using the Mann Whitney test with Bonferroni correction for the type I error.

Results

There was no significant difference in the FRAP and PPC levels between the control subjects and the PMS and PMDD groups at both the time points ie. the follicular as well as the luteal phases (Table/Fig 1).

(Table/Fig 1): FRAP and plasma protein oxidative markers in controls, PMS and PMDD, Median (IQR)*

*Values are expressed as median (Interquartile Range), nonparametric Mann Whitney test.
aP=0.015 when two phases of PMS were compared, Wilcoxon’s Signed Rank test
b P=0.015 between the groups, Kruskal Wallis test (Anova)
c P=0.018 when two phases of PMDD were compared, Wilcoxon’s Signed Rank test

Further, an intra group comparison of these levels in the follicular and the luteal phases in the controls and PMS subjects also showed no significant changes. However, a comparison of the PPT levels between the follicular and luteal phases of the PMS and the PMDD groups indicated a significant decrease (P=0.015 and P= 0.018, respectively) in PPT in the luteal phase (Table/Fig 1), the FRAP and PPC levels remaining unchanged. Moreover, an inter group comparison exhibited a markedly significant (P=0.015) PPT reserve in the follicular phase of the PMDD group (Table/Fig 1).

Discussion

Stress is one of the most common symptoms which are experienced during PMS and more so, in PMDD. (1),(10) Now, there are also reports on the involvement of oxidative stress in the pathophysiology of both PMS and PMDD.(2) Thus, in the present study, a significant depletion of PPT, a sensitive antioxidant in the luteal phase, both in the PMS and the PMDD groups over that in the follicular phase as compared to the controls, indicated that this sacrificial antioxidant was being consumed to probably counteract the oxidative challenge which was thrust at that period of time. Further, the increased levels of PPT in the follicular phase of the PMDD subjects only, could be used to neutralize the free radical toxicity which was generated during the luteal phase of these subjects. This fact could be explained on the basis of previous observations (11) on the prooxidant and antioxidant effects of oestrogens. The excessive activity of oestrogen in the luteal phase of the PMS/PMDD groups may stimulate its prooxidant nature. Oestrogens can get converted to catecholoestrogens which act as oxidants and in turn, significantly lower the PPT levels.(12) However, in the present study, the hormonal status of all the subjects was found to be well within the normal limits. Furthermore, the antioxidant activity of oxytocin, enkephalin and endorphin was influenced by oestrogens. (13)(14)(15) Moreover, dietary influence on the antioxidants and the hormone levels may also play a role in PMDD.(16) Thus, such a confluence of hormone action involving oestrogens (17) also may lead to oxidative stress in PMDD, as observed in this study.

Key Message

PMS/PMDD involve oxidative stress.
The body tries to adapt to this stress by utilizing endogenous antioxidants.
Plasma protein thiols appear to be more sensitive antioxidants.

References

1.
Steiner M, Born L . Diagnosis and treatment of premenstrual dysphoric disorder : an update. Int Clin Psychopharmacol 2000 ; 15 : S5-S17.
2.
Duvan CI, Nilgun AC, Turhan O, Karasu C, Kafali H. Oxidant/antioxidant status in premenstrual syndrome. Arch Gynecol Obstet DOI 2010;10.1007/s00404-009-1347-y.
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Kalia G, Sudheendran S, Rao A. Antioxidant status and lipid peroxidation in premenstrual syndrome: a preliminary study. Clin Chim Acta 2001; 309 : 97- 99.
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Tuladhar ET, Rao A. Plasma protein oxidation and total antioxidant power in premenstrual syndrome. Asia Pacific J Trop Med 2010; 3 : 237-240.
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Ling FW. Recognizing and treating premenstrual dysphoric disorder in the obstetrics, gynecologic and primary care practices. J Clin Psychiatry 2000; 61(suppl): 9-16.
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Benzie IFF, Strain JJ. Ferric reducing /antioxidant power of biological fluids and modified version for simultaneous measurement of total antioxidant power and ascorbic acid concentration. Methods Enzymol 1999; 299: 15-27.
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Hu ML. Measurement of protein thiol groups and glutathione in plasma. Methods Enzymol 1994; 233:380-385.
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Motichnik PA, Frei B, Ames BN. Measurement of antioxidants in human blood plasma. Methods Enzymol 1994; 234:269-279.
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Reznnick AZ, Packer L. Oxidative Damage to proteins: spectrophotometric method for carbonyl assay. Methods Enzymol 1994;233:357-363.
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Kaur G, Gonsalves L, Thacker HL. Premenstrual dysphoric disorder: a review for the treating practitioner. Cleve Clin J Med 2004; 71: 303-318. Review.
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Natan L, Chaudhari G. Antioxidant and prooxidant action of estrogens: potential physiological and clinical implications. Semi Reprod Endocrinol 1998; 16: 309-1314.
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Beral V, Banks E, Reeves G. Evidence from randomized trials on the long term effects of hormone replacement therapy. Lancet 2002; 360 : 942-944.
13.
. Reed SC, Levin FR, Evans SM. Changes in mood, cognitive performance and appetite in the late luteal and follicular phases of the menstrual cycle in women with and without PMDD (premenstrual dysphoric disorder). Horm Behav 2008; 54 : 185-193.
14.
Straneva PA, Maixner W, Light KC, Pedersen CA, Costello NL, Girdler SS. Menstrual cycle, beta-endorphins, and pain sensitivity in premenstrual dysphoric disorder. Health Psychol 2002; 21 : 358-367.
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Moosmann B, Behl C. Secretory peptides hormones are biochemical antioxidants: structure activity relationship. Mol Pharmacol 2002; 61:260-268.
16.
Bloomer RJ, Fisher-Wellman KH. Lower postprandial oxidative stress in women compared with men. Gender Medicine 2010; 7 :340-349.
17.
Karowicz-Bilinska A, Plodzidym M, Krol J, Lewinska A, Bartosz G Changes of markers of oxidative stress during menstrual cycle. Redox Rep. 2008;13:237-240.

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