DERANGED SERUM LIPID LEVELS IN WOMEN WITH PREECLAMPSIA.

Background; Preeclampsia (PE), as a risky pregnancy, is a systemic disease characterized by hypertension, proteinuria and edema, which are thought to be the result of diffuse endothelial activation and dysfunction. About 5% of all pregnant women have PE during the second half of gestation that can cause maternal death throughout the world and is accompanied by substantial perinatal morbidity and mortality. Objective; To determine the frequency of dyslipidemia in women with preeclampsia at a tertiary care hospital.   Material and Methods; A total of 135 women with preeclampsia (Both primigravida and multigravida) aged 20 – 40 years were included in our study.  Patients with twin pregnancy, taking lipid lowering therapy were excluded from our study. Detailed history and physical examination was conducted. Five ml venous blood sample was drawn and sent to central pathology laboratory of Nishtar Hospital, Multan for serum lipid profile estimation. Data was analyzed by using SPSS Version 20. Results; Mean gestational age of our study cases was 33.24 ± 2.77 weeks. Mean age of our study cases was 29.61 ± 3.54 years. Family history was positive in 41 (30.4%) of our study cases. Diabetes was present in 25 (18.5 %) of our study cases. Mean parity was 2.59 ± 1.72 and 77 (57.0%) had parity up to 3. Mean body mass index of our study cases was 25.85 ± 2.54 kg/m2 and obesity was present in 31 (23.0 %) of our study cases. Of these 135 study cases, 104 (77.0 %) were illiterate while 31 (23.0%) were literate. Of these 135 study cases, dyslipidemia was present in 73 (54.1%). Mean Serum Cholesterol level was 223.45 ± 47.21 mg/dl and it was deranged in 71 (52.59 %), mean serum LDL level was 147.15 ± 31.25 mg/dl and it was deranged in 72 (53.33%), mean serum triglyceride level was 154.21 ± 15.29 mg/dl and it was deranged in 70 (51.85%) of our study cases and mean HDL level was 52.42±8.53 mg/dl while it was deranged in 14 (10.37%).   Conclusion; Very high frequency of dyslipidemia was noted in our study in pre-eclamptic women. Dyslipidemia was significantly associated with gestational age, parity and diabetes.  All the preeclamptic women should be screened for serum lipid levels and be managed accordingly to avoid future fetomaternal adverse outcomes. Keywords; Preeclampsia, dyslipidemia, Frequency. DOI: 10.7176/JMPB/52-0

SENSITIVITY AND SPECIFICITY OF VISUAL INSPECTION WITH LUGOL’S IODINE S(VILI) IN CERVICAL CANCER.

Introduction: Cervical cancer is the second most common gynecologic cancer worldwide, accounting for 13% of all female cancer in developing countries. Cervical cancer is a disease that can be prevented through both primary prevention and early detection. Pap smear is a screening method which has been used for so long. Hence, one simple diagnostic test namely visual inspection with Lugol 's iodine (VILI) which is based on the ability of the trained healthcare personnel to detect yellow non iodine uptake areas in the cervical transformation zone are currently being evaluated in the experimental setting as potential alternative to cervical cytology. Objective: To determine diagnostic accuracy of visual inspection with Lugol's iodine (VILI) taking histopathology as gold standard among patients of cervical cancer. Subjects and methods: A total of 285 women with early marriage, history of post-coital bleeding, history of post- menopausal bleeding and history of per vaginal discharge were included in study. Women with obvious cervical growth and diagnosed cervical cancer were excluded. I put each patient in the  lithotomy  position and insert Cusco's speculum to visualize cervix. I cleaned the cervix with cotton soaked with normal saline. Now applied Jugol 's iodine, to the cervix normal squamous epithelium contain glycogen and stain.  Conversely premalignant and malignant squamous tissue contain no glycogen and does not stain with iodine. This was schillers test and non-staining areas were schiller positive. For further confirmation I took biopsy from schillers positive area and sent for histopathology. Results: Age range in this study was from 21 to 60 years with mean age of 39.393± 6.66 years and mean duration of disease was 6.031±2.09 months. 43.9% patients were belong to rural area and 56.1% belongs to urban area. 25.6% patients have Family History of cervical cancer. Visual inspection with Lugol's iodine (VILI) diagnosed 43(15.1%) patients and Histopathology diagnosed 15.8% patients with Cervical cancer. Visual inspection with Lugol's iodine (VILI) has shown sensitivity of 86.6%, specificity 98.3%, diagnostic accuracy by 96%, PPV 90.6%, NPV 97.5%, (p=0.000) in diagnosis of Cervical cancer.  Conclusion: My study showed VILI good sensitivity and it can therefore be a suitable potential alternative/adjunctive screening test not only in resource-poor settings but also in well-equipped centers. Keywords: Cervical cancer, Visual inspection with Lugol's iodine, Diagnostic accuracy DOI: 10.7176/JMPB/52-0