Assessment of thyroid function in patients with hyperemesis gravidarum

Pregnancy is accompanied by changes in thyroid function. Human chorionic gonadotropin [hCG] is a glycoprotein hormone that has structural similarity to TSH. Women with hyperemisis gravidarum often have high hCG levels that cause transient hyperthyroidsm. This study was designed to investigate the role played by, Thyroid Stimulating Hormone [TSH], tri-iodothyronine [T[3]] and thyroxin [T[4]], in nausea and vomiting of hyperemesis gravidarum. We studied 90 pregnant patients in their first trimester of pregnancy. Patients were divided into two groups, 60 women in the hyperemesis gravidarum group who came presenting with severe ernesis gravidarum and 30 women as normal controls. There was a significant difference between the two groups as regards gestational age [p=0.003] with the hyperemesis group patients tending to have a higher gestational age [mean=8.3 weeks] than the control group [mean 7.5 weeks], gravidity [p=0.023] with the hyperemesis group having a higher rate than the control group, WBCs [p=0.0001] with the control group [mean 6840] tending to have a higher leucocytic count than the hyperemesis group [mean 6435]. There was a significant difference between the two groups as regards serum Free T level [p=0.001]; Free T[4] level [p=0.001] and TSH level [p=0.001] in 48 out of 60 patients [80%] of the hyperemesis group, ketonuria was present while it was absent in the control group. Positive correlations existed between serum Free T[3], Free T[4], TSH and ketonuria in the hyperemesis group of patients. In conclusion; Thyroid hormone levels [Free T[3], Free T[4] and TSH] are elevated in hyperemesis gravidarum and relate well with the severity of that condition

Assessment of thyroid functions and leptin hormone in pregnant women with hyperemesis gravidarum during the first trimester

Pregnancy is accompanied by changes in thyroid function. Human chorionic gonadotropin [hCG] is a glycoprotein hormone that has structural similarity to TSH. Women with hyperemisis gravidarum often have high hCG levels that cause transient hyperthyroidsm. Leptin is a protein that is structurally similar to cytokine family. Studies have demonstrated that a rapid increase in leptin concentration during the first trimester is associated with hyperemesis gravidarum. This study was designed to investigate the role played by, Thyroid Stimulating Hormone [TSH], free triiodothyronine [FT[3]], free thyroxin [FT[4]] and leptin levels in relation to nausea and vomiting of hyperemesis gravidarum. We studied 90 pregnant patients in their first trimester of pregnancy. Patients were divided into two groups, 60 patients in the hyperemesis gravidarum group who came-presenting with severe emesis gravidarum and 30 patients as normal controls. There was a significant difference between the two groups as regards gestational age [p=0.003] with the hyperemesis group patients tending to have a higher gestational age [mean=8.3 weeks] than the control group [mean 7.5 weeks], gravidity [p=0.023] with the hyperemesis group having a higher rate than the control group, WBCs [p=0.0001] with the control group [mean 6840] tending to have a higher leucocytic count than the hyperemesis group [mean 6435]. There was a significant difference between the two groups as regards free T[3] level [p=0.001]; free T[4] level [p=0.001], TSR level [p=0.001], and leptin level [p=0.0001]. Ketonuria was present in 48 out of 60 patients [80%] in the hyperemesis group, while it was absent in the control group. Correlations existed between Free T[3], Free T[4], TSH and ketonuria in the hyperemesis group of patients. Leptin level correlated with metabolic products [creatinine, urea, and ketone bodies]. It does not correlate with any of the thyroid hormones [FT[3] or FT[4]] or TSR. This demonstrates that both thyroid hormones and leptin are independent factors associated with hyperemesis gravidarum. In conclusion; Thyroid hormone levels [Free T[3], Free T[4] and TSH] in addition to leptin are elevated in hyperemesis gravidarum and relate well with the severity of that condition

IL-6 level as a predictor for diagnosis of pre-eclampsia in the third trimester of pregnancy

Pre-eclampsia is a disease of pregnancy that is associated with increased incidence of maternal and fetal morbidity and mortality. The diagnosis of pre-eclampsia is dependent mainly on the presence of hypertension associated with proteinuria. This work studies serum lL-6 concentration and its association with both the early diagnosis and the prognosis of pre-eclampsia. The population of this study included 90 pregnant women in the third trimester of their pregnancy who were admitted for the Department of Obstetrics and Gynaecology of El-Sahel Teaching Hospital from August 2007 to May 2008. The study population was further subdivided into two groups, pre-eclampsia group [60 patients-67%] and control group [30 patients-33%]. There were no differences in age, gravidity, parity or gestational age between the two groups. The two groups showed significant differences in blood pressure [both systolic and diastolic] with p<0.0001 ; renal function tests [creatinine [p<0.000l], urea concentration [p<0.0001] and uric acid concentration [p<0.0001]]; liver function tests [SGOT [p<0.03], SGPT [p<0.04] and bilibrubin [p<0.001]], blood picture [WBCs [p<0.03], platelets [p<0.01] and hemoglobin [p<0.02]]; IL-6 concentraion [p<0.0001]. IL-6 at a cutoff value of 3.12 pg/mL showed a 100% sensitivity and specificity for pre-eclampsia. IL-6 failed to show a significant correlation with systolic blood pressure in pre-eclampsia group cases [p<0.059] while it showed a significant correlation with the diastolic blood pressure [p<0.015]. The IL-6 serum concentration correlation was significant for platelet levels [p value=0.021] and for white cell count [p value=0.002]. IL-6 serum concentration is a highly sensitive and highly specific markers for the diagnosis of pre-eclampsia and as indicators for the severity of the condition

Breast conservation therapy in treatment of cancer breast

Breast conservation therapy [B.C.T.] comprises local excision, axillary dissection and post operative radiotherapy. Numerous studies have now shown that although local recurrence may be slightly more common after breast conservation than mastectomy, disease-free survival and overall survival are the same. The primary goals of breast conservation therapy are tumour control and acceptable appearance of the breast. Twenty female patients were included in this study. All patients were suitable for B.C.T. Their ages ranged from 25 to 60 years [mean age 41.3 +/- 8.8 years]. All patients were subjected to mammography, fine needle aspiration cytology [FNAC] and metastatic work up [chest x -ray, abdominal ultra sonography and bone scans].The study included 4 patients [20%] in stage I, 14 patients [70%] in stage II and 2 patients [10%] in stage III One patient showed positive safety margin of the lumpectomy specimen and for whom mastectomy was done. The remaining 19 cases were followed up for two years. The study showed an excellent cosmetic appearance however, local recurrence occurred in 3 cases [15.78%]. The higher incidence of total recurrence in the present study may be related to the histopathological nature of the tumour, the biological behavior of breast cancer in Egypt or even the sample is so small in number