Oxidant/Anti-oxidant status in pre-eclamptic patients

Pre-eclampsia [PE] is a multi-system disorder characterized by hypertension and proteinuria. There is evidence that pre-eclampsia may be associated with an increase of oxidative stress that leads to cellular damage and endothelial activation. To evaluate whether altered oxidant/antioxidant status was involved in the pathogenesis of pre-eclampsia. Forty pre-eclamptic patients [divided into 2 groups according to severity of the disease], 20 healthy pregnant women of matched gestational age and 20 healthy non-pregnant females [all matched for age and parity] were enrolled in the study. Measuring serum malondialdehyde [MDA] levels were done to detect oxidative damage and five assays were performed: [blood glutathione peroxidase [GPx], blood superoxide dismutase [SOD], serum selenium, serum vitamin A, E and C levels], to evaluate antioxidant capacity. Statistical comparisons and correlations were done using student's t-test, ANOVA test and Spearman correlation coefficient. The mean serum MDA level was significantly higher in pre-eclamptic patients compared to healthy non-pregnant and pregnant control groups [p<0.001]. Significantly higher levels were detected in the severer forms of the disease [p=0.03]. Blood glutathione peroxidase [GPx], blood superoxide dismutase [SOD], serum selenium, serum vitamin A, E and C were all significantly lower in severe than in mild pre-eclampsia [p=0.008; p=0.002; p=0.002 and p=0.007 respectively], but not blood glutathione peroxidase [GPx] levels [p=0.27]. Statistically significant positive correlation was detected between serum MDA level and systolic blood pressure [r=0.422; p=0.007] and diastolic blood pressure [r=0.362; p=0.022] in PE patients. Statistically significant negative correlations were detected between most of studied anti-oxidants and clinical severity of PE [BP and proteinuria]. The oxidative stress associated with the global antioxidant deficiency in pre-eclamptic patients may reflect a physiopathological basis for the development of this disorder. Being higher in the severer forms of the disease, it can be used as a parameter of severity

Color doppler study of the uterine artery in intrauterine contraceptive device users: effect of diclofenac sodium

Copper Intrauterine contraceptive devices [IUCDs] are one of the most widely used contraceptive methods. The most common side effects are menorrhagia and dysmenorrhea. A local inflammatory foreign body reaction leading to increased production of prostaglandins affecting uterine blood flow is blamed. Color pulsed Doppler study of the uterine artery offers a reliable method to evaluate the uterine circulation. Nonsteroidal anti-inflammatory drugs [NSAIDs] are used to control the aforementioned IUCD side effects. To study the uterine artery pulsatility index [PI] in copper T 380-A IUCD users and the diclofenac sodium induced changes in this index. This study included 30 cases divided equally into 3 groups. Group 1 [control group] consisted of 10 healthy women. Croup 2 included 10 copper T 380-A users having IUCD- induced menorrhagia. Group 3 included 10 users of the device without menorrhagia. All participants had a transvaginal color pulsed Doppler study to evaluate the uterine artery PI. Diclofenac sodium was given to cases of groups 2 and 3. Thirty minutes later the same Doppler study was repeated. Higher insignificant uterine artery PI was observed in copper T 380-A users [groups 2 and 3] compared to the control group [group 1]. Cases with IU CD-induced menorrhagia [group 2] showed insignificantly lower PI compared to patients without menorrhagia [group 3]. Diclofenac sodium had insignificantly decreased the uterine artery PI in groups 2 and 3. The use of cooper T 380-A IUCD insignificantly increased the uterine artery PI specially in the absence of of lUCD-induced menorrhagia compared to the control group. Diclofenac sodium insignificantly decreased this index suggesting that this device might induce synthesis of vasoactive substances other than prostaglandins

Opioid antagonists as a sole or adjunctive therapy in ovulation induction in PCOS cases resistant to clomiphene citrate

Patients who have eugonadotrophic hyperandrogenic anovulation with the presence of multiple small ovarian follicles - defined as PCOS - are offered many ovulation induction regimens. Some prove to be clomiphene resistant others develop complications as ovarian hyperstimulation syndrome when treated by gonadotrophins. To evaluate naltrexone - an opioid antagonist - as a simple and safe method for ovarian induction in PCOS patients resistant to clomiphene citrate as a sole or adjunct therapy. Forty PCOS patients resistant to clomiphene citrate were studied. They were randomly divided into 2 groups. Group I [20 cases] who received clomiphene citrate and naltrexone and group II [20 cases] in which naltrexone alone was administered. Estimation of serum level of FSH, LH and prolactin as well as vaginal ultrasonographic follicular tracking was done for all cases. Fifteen cases [75%] of group I achieved ovulation, while none of the patients of group II ovulated even after 21 days of naltrexone treatment. Ovulation can be successfully induced using naltrexone in combination with clomiphene citrate in PCOS cases resistant to clomiphene citrate alone. It is safe simple and inexpensive treatment modality