ABSTRACT
Background: Adipocytokines have been recently implicated in the pathogenesis of preeclampsia. Visfatin is one of such adipokines.Objective: To determine the association between serum visfatinlevels and preeclampsia.Methods:A prospective, case-control study was carried out in 160 pregnant womenconsisting of80 pre-eclamptics and 80 normotensive controls, matched for age and parity during the third trimester. Maternal serum visfatinlevels were determined in both groups using a visfatin (Human) enzyme-linked immunosorbent assay. Serum Visfatin levels were compared between the groups and correlated to the blood pressure, proteinuria,fetal birth weight and Apgar scores.Results:The mean serum visfatin level was significantly higher (10.3±6.9ng/ml)in preeclampsia than (7.4±4.4ng/ml) in the control group (p=0.001). The mean serumvisfatin level was higher in severe pre-eclamptics (10.8±8.9ng/ml) compared to (9.6±5.8ng/ml)in mild preeclamptics and this was statistically significant (p=0.021).Visfatin levels showed a negative and non-significant correlation with both systolic (r= -0.011 and p=0.924), diastolic blood pressure(r= -0.012, p=0.913) and body mass index (r= -0.142, p=0.209) in both study and control groups. Mean birth weight was significantly lower in the preeclampsia (2.8±0.25kg) compared to the control group (3.2±0.31kg) P=0.000. The mean birthweight was lower in severe preeclampsia (2.7±0.25kg compared to 2.9±0.39 in mild preeclamsia. There was no significant correlation between the visfatin levels and Apgar score at 5minutes and birth weights in both groups (P=>0.05).Conclusion:This study showed a significant increase in the level of visfatin in preeclampsiacompared to their normo-tensive controls. However, this increased level was not consistent with the severity of the disease.
ABSTRACT
Background: Progesterone only injectable contraceptive provides long acting contraception against unwanted pregnancy. Alterations in menstrual pattern are a well known side effect of this effective contraceptive method. Objective of this study was to compare the weight gain and pattern of menstrual abnormalities in users of Depot Medroxyprogesterone Acetate (DMPA) and Norethisterone Enanthate (Noristerat) in LASUTH.Methods: Retrospective comparative study conducted over a 3year period (January 2013 to December 2015) and involving 237 subjects who used injectable hormonal contraceptive (either DMPA or Noristerat). Case records of all the subjects were retrieved and information obtained on socio-demographic data, parity, previous contraceptive method and reason for discontinuation within one year of usage. Other information including subjects’ weight, menstrual cycle length and pattern, and side effects were collected at 3, 6 and 12 months for DMPA group and 2, 4 and 12 months interval for Noristerat group. Data obtained were analyzed using statistical packages for social sciences (version 19).Results: The combined mean age was 34.15±1.36 years. The mean weight at commencement was 68.16kg for DMPA and 66.61kg for Noristerat users while after a year, it significantly increased to 71.27kg for DMPA and 69.07kg for Noristerat users (P<0.05). No change in menstrual pattern was noted in 10% of DMPA and 7% of Noristerat users while 60% of DMPA and 57% of Noristerat had amenorrhoea by the end one year period. Five percent each of DMPA and Noristerat users perceived weight gain as problem significant enough to discontinue both methods respectively. Overall, 24% of DMPA and 19.1% of Noristerat users discontinued use after one year.Conclusions: There were significant weight gain between users of DMPA and Noristerat which was not considered a problem. Amenorrhoea was the commonest menstrual abnormality responsible for discontinuation of either method.