Spinal bone density in women using Depot Medroxy progesterone acetate, Norplant implants or oral contraceptives

The objective of this study was to evaluate and compare bone mineral density [BMD] in long term users of depot medroxy progesterone acetate [DMPA], norplant implants or combined oral contraceptive pills [COCs]. One hundred women aged 30-39 years who are currently using different contraceptives for two to three years were recruited in the present study in four groups, twenty five women in each group. Group I included women who are using DMPA, group II included women who are using norplant implant, group III included women who are using COCs and group IV included women who are using intrauterine contraceptive device as control group. They were recruited between September 1998 till October 1999. Quantitative computed tomography [QCT] was used for measurement of BMD of the lumber spine for each woman in the study. The demographic and clinical characteristics of women were similar in all groups except that 44% of the women in the DMPA group were amenorrheic and this was significantly higher than the control. The mean bone mineral density [BMD] was slightly lower [153.2 mg/cc] in the DMPA group than the control group [166.9 mg/cc] but the difference was not significant in the norplant group The mean BMD [165.3 mg/cc] was more or less similar to that of the control group. The highest mean BMD was in women using COCs [188.3 mg/cc] but this was not significantly higher either in the control group or the other two studied groups

Surgical and computed tomography evaluation of soft tissur sarcomas

The current trend towards limb-sparing surgery in patients with soft tissue sarcomas increased the need for accurate preoperative assessment of the primary tumor. Tumor site, extent and relationship to the adjacent bone and neurovascular structures were evaluated to determine whether adequate radical surgery is feasible or more limited excision as a part of multimodality treatment is appropriate. Preoperative computed tomography [CT] was compared with operative findings in 18 patients with soft tissue sarcomas. CT prediction of muscle group involvement by the tumor was correct in 88.9% and that of major artery or vein invasion was correct in 83.3% and 94%, respectively. Assessment of the tumor relationship to major peripheral nerve was accurate for thigh sarcomas but was not possible in upper limb tumors. Although CT confirmed frank bony involvement in two patients, it failed to distinguish between tumors closely adjacent to periosteal and those with periosteal invasion. Detection of residual or recurrent tumor nodules by CT is less reliable. CT is the most useful and accurate method before surgical intervention