A Study of Endometrial Pathology by Transvaginal Color Doppler Ultrasonography and its Correlation with Histopathology in Post-menopausal Women.

Objective: Endometrial carcinoma is the most common gynaecological malignancy. Approximately 80% of endomentrial carcinoma occur in post-menopausal women. Present study aimed to evaluate the role of transvaginal ultrasonography and colour flow imaging in diagnosing endometrial pathologies especially endometrial carcinoma and later its confirmation by histopathology. Methods: 38 women presenting with history of at least 6 months amenorrhoea followed by bleeding per vaginum were included in the study. Transvaginal colour Doppler (TVS) followed by fractional curettage was done in all cases and cervical biopsy was done in selected cases. Uterine size, endometrial thickness and blood flow indices (RI, PI) were measured. Analysis of data was done using ‘z’ test and ‘t’ test. Results: Out of 38 women maximum number of cases (39.47%) were between 50 – 55 years. Using 4 mm of endometrial thickness as cut off value for discriminating normal and abnormal endometrium, sensitivity, specificity, PPV and NPV were 94.12%, 50%, 95.12% and 50% respectively (p < 0.05). No case of endometrial carcinoma was detected when the endometrium was <4 mm, making the sensitivity as 100%, NPV 100%, specificity 13.33% and PPV 23.53%. Using RI = 0.81 as cut off value for discriminating benign and malignant endometrium, sensitivity was 62.5%, specificity 53.33%, PPV – 26.3% and NPV as 84.2%. Conclusion: Transvaginal sonographic (TVS) evaluation of endometrial thickness (ET) is a reliable method of screening women with post-menopausal bleeding. Conservative approach may be offered to women showing ET of less than 4 mm and high impedance to flow in uterine and endometrial vessels.

Study of serum lipid and lipoprotein in pre-eclampsia with special reference to parity.

A cross sectional study was done to determine serum lipid and lipoprotein cholesterol in pre-eclamptic women in their third trimester, taking normal pregnant women in third trimester as controls. The values were compared in patients of different parity. It was observed that serum triglycerides (TG), cholesterol (Chol), LDL-c, VLDL-c, phospholipids (PL) and total lipids (TL) were significantly raised, while HDL-c, was significantly lower in pre-eclampsia compared to normal pregnancy. TG and VLDL-c were found to be increased significantly with parity.

Thyroid functions in pre-eclampsia and its correlation with maternal age, parity, severity of blood pressure and serum albumin.

Maternal thyroid function was investigated in 32 pre-eclamptic women and 10 normal pregnant women in their third trimester. Serum total tri-iodothyronine (TT3) and total thyroxine (TT4) were decreased significantly (P < 0.001) and TSH was increased significantly (P < .001) in pre-eclampsia as compared to normal pregnancy. There was no influence of parity and maternal age on thyroid functions. TT3 and TT4 decreased significantly (P < .001) with increase of serum albumin, while there was no correlation of TT4 with serum albumin.

Effect of oral zinc supplementation on copper and haemoglobin levels in pregnant women.

In the present study, pregnant women in different trimesters of pregnancy were randomly allocated to untreated control group (Gp A; n = 58), and zinc treated group (Gp B; n = 104). Both groups were administered ferrous sulphate 60 mg, and folic acid 5 mg, twice daily throughout the period of study. Gp B subjects were also administered 45 mg elemental zinc, in a single daily post lunch dose. Maternal blood and urine samples collected in each trimester, and at the time of delivery, and blood taken from the umbilical cord were tested for Cu levels. Maternal Hb was also estimated. In Gp A, mean serum Cu increased significantly from 117.15 +/- 2.12 micrograms/dl in I trimester to 138.57 +/- 0.92 micrograms/dl in III trimester (P < 0.001). In Gp B, serum Cu declined significantly from 115.64 +/- 1.12 micrograms/dl in I trimester to 111.10 +/- 0.99 micrograms/dl in III trimester (P < 0.001). Urinary Cu declined significantly from 47.24 +/- 2.31 micrograms/24 hrs in I trimester to 37.43 +/- 2.06 micrograms/24 hrs in III trimester (P < 0.01). Zn treatment did not alter differentially the serum Cu levels in anaemic and normohaemic subjects. Gp B cord blood serum Cu was significantly lower as compared to respective controls, significance being proportional to duration of zinc administration. Hb levels increased significantly in all subjects. Increase in Hb in Gp B was significantly higher in comparison to that in Gp A (P < 0.05). Elemental zinc when administered to pregnant women in a dose of 20-45 mg/day, causes improvement in Hb level, without leading to hypocupremia.

Zinc taste test in pregnant women and its correlation with serum zinc level.

Pregnant women in different trimesters of pregnancy were divided into control (n = 58) and study (n = 104) groups. Study group subjects were given 45 mg zinc/p.o./day as 200 mg 'zinc sulphate tablets from the day of reporting till term. Body zinc status was clinically assessed by 'zinc taste test'. Blood samples were drawn at the same time and serum zinc levels measured. Zinc taste test scores decreased with advancement of pregnancy (P < 0.05) and increased significantly following zinc administration (P < 0.05). Serum zinc level declined significantly with advancement of pregnancy (P < 0.001). Following zinc administration, serum zinc level increased significantly (P < 0.001). Accuracy of zinc taste test in individual cases ranged between 70 and 100 percent. On the whole, zinc taste test was well correlated with serum zinc level, and provides a fair idea of zinc deficiency.

A study of the effect of oral zinc supplementation during pregnancy on pregnancy outcome.

Women in different trimesters of pregnancy (Group B; n = 106) were administered 200 mg zinc sulphate (elemental Zn 45 mg) orally/day from the day of reporting till delivery. Untreated group of 62 served as control. Levels of zinc in maternal serum, umbilical cord blood serum, and urine were estimated. Pregnancy outcome was assessed in terms of incidence of prematurity, IUGR, birth weight; apgar score and gestational age. Serum zinc levels in Gp. A declined significantly from 113.00 +/- 2.80 ug/dl in I trimester to 83.78 +/- 2.20 ug/dl in III (P < 0.001). Following zinc supplementation (Gp. B) serum zinc levels increased significantly from 109.70 + 3.23 micrograms/dl to 205.40 +/- 4.47 micrograms/dl (P < 0.001). Urinary excretion of zinc in Gp. A declined significantly with increase in the period of gestation. However in Gp. B, elimination of Zn increased significantly in proportion with the serum levels (P < 0.001) cord blood serum zinc level was normal irrespective of maternal serum Zn levels. Following oral Zn supplementation, levels increased significantly from below 127.0 micrograms/dl to above 158.0 micrograms/dl in Gp. B (P < 0.001). Maternal serum and cord blood serum zinc ratios were fairly constant in Gp. A as well as in Gp. B. Birth weight of babies born with Zn supplementation was significantly higher than control and was related to duration of oral zinc supplementation (P < 0.001). Gestational age of babies in Gp. B was significantly higher than respective controls when Zn supplementation was given for more than 3 months (P < 0.01), and was related to duration of zinc therapy (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)