Assessment of plasma carnitine and acylcarnitine levels in preeclampsia

Objective: carnitine plays a crucial role in fatty acids oxidation. The aim of the study is to assess plasma carnitine and acylcarnitines levels in preeclamptic womedas a measure of abnormal fatty acid oxidation

Methods: the study included 40 women with preeclampsia and 30 normotensive control women in the third trimester of pregnancy. Women with multiple pregnancy, chronic hypertension, diabetes mellitus and renal diseases were excluded. Plasma levels of free carnitine and acylcarnitines were measured with high performance liquid chromatography [HPLC]

results: total and free carnitines and acylcamitines were significantly increased in preeclamptic cases in comparison to the control group. A positive correlation was found between acylcarnitines and diastolic blood pressure [r=0.382, p= 0.018]

Conclusion: the significantly high plasma carnitine concentrations found in this study supports the hypothesis of abnormal fatty acid metabolism in the pathophysiology of preeclampsia. This may contribute to the endothelial cell dysfunction of preeclarnpsia

value of uterine artery doppler in assessment of development of pre-eclampsia in women at risk

To evaluate the role of Doppler study done in the second trimester of pregnancy in the prediction of pre eclampsia. Prospective clinical trial. Department of Obstetrics and Gynecology, Kasr El-Aini Hospital. One hundred pregnant women with singleton gestation, in the second trimester, at risk of pre-eclampsia were subjected to Doppler ultrasound at 18-26 wks to measure S/D ratio, Resistance index RI, Pulsatility index of the uterine artery PI, in addition to the presence or absence of a diastolic notch. All women were followed up till delivery. There were significant differences between patients who developed PIH [eleven cases] and those who didn't develop as regards Doppler parameters at mid trimester including PI. RI, S/D ratio and the presence of diastolic notch. Doppler ultrasound at midtrimester identifies group of women at high risk for the subsequent development of pre-eclampsia for whom we can start preventive regimens

significance of human beta-HCG and vaginal cervicometry in predicting preterm delivery

The aim of the present study was to determine, in addition to endovaginal cervicometry, whether hCG detected in cervicovaginal secretions of patients at 28-34 weeks' gestation with signs and symptoms of preterm labor is a predictor for preterm birth [-37 weeks' gestation]. A prospective observational study of pregnant women with threatened preterm labor between 28 and 34 weeks gestation. The study population consisted of patients admitted to the causality unit in the Department of Obstetrics and Gynecology, Kasr El Aini Faculty of Medicine, Cairo University, Cairo, Egypt between December 2004 to January 2006 with signs and symptoms suggestive of preterm labor and intact membranes. One hundred and three patients satisfied the inclusion criteria and were screened with a bedside qualitative hCG assay and transvaginal cervicometry and subsequently with a quantitative hCG assay. Then, digital examination of the cervix was performed and Bishop scores were assessed. All samples were obtained prior to the administration of tocolytic therapy, refrigerated at -20°C, and assayed within 72 hrs. The primary outcome of the study was the success of stopping labor for at least 72 hours after stopping of tocolytic drug. Qualitative and quantitative hCG results were obtained for all patients enrolled. The mean gestational age at sampling was 31.1 weeks; combined qualitative hCG and cervical length revealed sensitivity and specificity of 91.67%, 84.81% respectively and combined quantitative hCG with cervical length revealed sensitivity and specificity of 91.67%, 86.08% respectively. Qualitative measurements of hCG concentration from cervicovaginal secretions does not require additional instruments and may be easily and cheaply performed at the bedside. Transvaginal ultrasound cervical measurement is a safe and effective technique to predict increased risk of preterm delivery in selected patients and normal results can help avoid unnecessary interventions, Combining the qualitative hCG testing with cervical length will get benefit of the higher sensitivity of the cervical length and the higher specificity of hCG testing in accurately predicting pre-term labor

Subclinical hyperthyroidism as a potential factor for dysfunctional uterine bleeding

To evaluate the functional status of thyroid gland in apparently euthyroid women with dysfunctional uterine bleeding. Forty apparently euthyroid women with menorrhagia and no pathologic lesion in the genital tract were compared to 20 women having normal menstrual cycle as control group. All women were subjected to hormonal assay: total and free T3, T4 and TSH, Serum PRL, P [progesterone], total and free testosterone. A statistically significant difference in the values of TSH, total T3, free T3 and total T4 in the menorrhagia group compared to the control group. Prolactin was decreased significantly in the menorrhagia group. Subclinical hyperthyroidism can be a potential risk factor for dysfunctional uterine bleeding. Other studies are needed to confirm our findings

Endometrial response to ethinyl estradiol and sildenafil as adjuvant therapy with clomiphene citrate in unexplained infertility patients

Adverse effects of clomiphene citrate [C C] on the endometrium are likely to be the primary cause of the suboptimal pregnancy rates in ovulation induction with clomiphene citrate. The aim of this study was to examine the effect of adjuvant ethinyl estradiol [E E] or sildenafil citrate with clomiphene citrate to oppose this effect and improve thickness, morphology of endometrium and uterine resistance [R I] and pulsatity indices [R I]. One hundred and twenty patients of unexplained infertility were divided into four groups, the first is the control group who received no medications, the second group received clomiphene citrate for induction of ovulation, the third group received clomiphene citrate with ethinyl estradiol, the fourth group received C C with sildenafil citrate. For each patient serial vaginal ultrasound folliculometry was done with evaluation of endometrium at time of dominant follicle detection and color doppler study of the uterine artery on either side. Endometrial thickness and morphology were significantly affected in group 2 [C C] compared to control group [9.6 +/- 1.4] and 10% compared to[10.7 +/- 1.6] and 43% respectively. This was not significant comparing group 3 [E E] and group 4 [sildenafil] with control group [10.8 +/- 1.2] and 47% and [10.6 +/- 1.3] and 57% respectively. Also, uterine P I was significantly increased in group 2 [2.87 +/- 0.05] compared to other groups, while R I of uterine artery was not significantly different between any of the groups. Endometrial thickness and pattern were adversely affected with the use of clomiphene citrate alone, an effect which was corrected by adding ethinyl estradiol or sildenafil as adjuvant therapy to clomiphene citrate more with sildenafil than ethinyl estradiol

Immunohistochemical study of stromal fibronectin in mammary cystic hyperplasia and various breast neoplasms

The stromal fibronectin has been studied by indirect immunoperoxidase in benign and malignant human breast lesions. Fibronectin [FN] appeared as fibrils, streaks and granules in the stroma of different breast lesions. The normal breast tissue contained scanty amount of FN which was present at the stromo-epithelial junction of the ductules and lobules. FN was also observed as diffuse fibrils in the stroma and in the waIls of blood vessels, while benign tumours showed only minor difference from normal mammary tissue, malignant mammary neoplasm displayed a different stromal pattern. Moderate and abundant amount of stromal FN were present in 40% of cases of fibrocystic disease, in 40% of benign breast neoplasm and in 80% of the mammary carcinomas. The malignant breast neoplasms contained greater amount of stromal FN .than benign mammary lesions. Scanty amount of stromal FN was noticed in 12% of infiltrating duct carcinomas and in none of the medullary carcinomas. The lobular carcinomas expressed less amount of stromal FN if compared to the infiltrating ductal and medullary types. The grade III duct carcinomas contained plentiful stromal FN .than those of grade II. These findings support the previous studies which suggested that the intense stromal reaction in malignant neoplasms could be attributed to the increasing injury inflicted on connective tissue by infiltrating cancer cells

Histochemical study of epithelial mucin in endometrial hyperplasia and adenocarcinomas

The pattern and type of mucin were studied on 37 curettage specimens. These cases were formed of 25 endometria showing normal proliferative and secretory phase and 12 endometria showing hyperplastic changes. Fifteen hysterectomy specimens from cases of endometrial adenocarcinoma were also examined in this work. All cases were stained by Hematoxylin and Eosin, periodic acid-schiff [P.A.S.] and alcian blue. The cases of endometrial hyperplasia showed the same distribution of both types of mucin secreted by the normal endometrial glands, although increased in quantity. Most of endometrial adenocarcinomas contained different quantities of cellular mucin, which was found to be more abundant and widely distributed in the well differentiated than in the moderately or poorly differentiated ones. It was observed that the histochemical properties, site and pattern of mucin secretion in these cases strongly resembled that seen in the normal endometrium. This may play a role in differentiating adenocarcinoma of endometrial origin from other carcinomas in the female genital tract like that of endocervical origin