Thrombocytosis and CA125 as Predictor of Malignancy in Gynaecological Pelvic Mass

Background: Pelvic masses are common in women & can present at any age of woman life, it could be benign or malignant mass and may originate from gynecological organs like cervix, uterus, uterine adnexia, or from other pelvic organs like intestine, bladder, ureters, skeletal muscle, and bone. Objective: We attempted to determine the increasing of platelet counts(> 450.000 /micro liter) and CA125serum level (> 35 U/mL) as useful tools for predicting and confirming malignancy in gynecological pelvic mass. Patients and methods: A prospective unmatched hospital based case-control study carried out at Baghdad Teaching Hospital, about 126 women were enrolled in our study, divided into two groups 60 women were control group (free of gynecological pelvic mass). The other group includes 66 women above 15 years old with gynecological pelvic mass were all candidate for laparotomy. Results: Serum CA125 and blood platelets count were tested for validity when used as a test to predict a diagnosis of malignancy in gynecological pelvic mass differentiating it from benign gynecological pelvic mass. Both tests showed a very high validity in diagnosis, with serum CA125 showing a marginally higher validity. All studied subjects with a blood platelets count ≥ 385.000 and CA 125≥ 41.7were malignant, while everybody below this cut-off value was benign or healthy. Conclusion: Both blood platelet count (≥385 X 103microlitter) &serum level of CA125 (≥41.7 U/mL) are useful predictor tools to confirm malignancy in gynecological pelvic mass

Umbilical cord drainage versus intraumbilical cord oxytocin injection in management of third stage of labour

Background: Postpartum hemorrhage is an important cause of maternal morbidity and mortality. Considerable difference of opinion exist regarding the optimal approach to the management of the 3rd stage of labour, practice varies between countries &between units. Objectives: To evaluate the effectiveness of intra umbilical vein injection of oxytocin and umbilical cord driange in shortening the duration of third stage of labour. Patient and Methods: In this randomized controlled study, 100 women were enrolled in this study they divided into three groups. (Group 1 ,N =30 )received 20 units of oxytocin diluted in 20 ml 0.9% saline solution injected in the umbilical vein after clamping.(Group 2, N = 34) placental cord drainage.(Group 3, N= 36) with no intervention. The primary outcome was mean duration of third stage of labor. Results: The third stage of labor was significantly shorter in group 1 and 2 as compared to group 3. Groups 1 shorten the duration of third stage of labor by 3 min. and group 2 shorten the duration of third stage of labor by 4.27 min.There were no reports of need for manual removal of placenta or retained placenta. Conclusion: The use of intraumbilical injection of oxytocin and placental cord drainage in the third stage of labor significantly reduced the duration of the third stage

Serum parathyroid hormone and total serum calcium levels in mild & severe preeclampsia versus normal pregnancy

Background: Preeclampsia (PE) is a major cause of maternal morbidity and mortality, complicating 3-14% of all pregnancies. Although the etiology remains unknown, placental hypoperfusion and diffuse endothelial cell injury are considered to be the central pathological process; many endocrinological changes have been linked to the etiology of preeclampsia including parathyroid hormone and calcium level. Objective: to compare serum parathyroid hormone and total serum calcium levels in mild and severe preeclampsia versus normal pregnancy. Patients and methods: Serum parathyroid hormone (PTH) level and total serum calcium level were measured in thirty normotensive pregnant women and thirty women with mild preeclampsia and thirty women with severe preeclampsia using Enzyme Linked Immuno- Sorbent Assay (ELISA) test for parathyroid hormone & colorimetric test for total serum calcium. All pregnant women enrolled in the study had similar demographic background. Patient and control groups were matched for age, and gestational age. Results: Total serum calcium level was decreased and parathyroid hormone level was elevated in preeclamptic women compared to normotensive women with significantly lower total serum calcium (7.43 ± 0.68) and higher level of parathyroid hormone (93.84 ±10.63) in severe preeclampsia compared to mild preeclampsia group where total serum calcium was(8.02±1.02) and parathyroid hormone was (79.34 ±6.04).With p value <0.005 between mild & severe preeclampsia groups. Conclusion: Total serum calcium is significantly decreased & parathyroid hormone is significantly increased in severe preeclampsia in comparison to normal pregnancy

Serum Leptin levels in ovarian polycystic disease and its correlation to body weight

Background: Poly cystic ovary syndrome is a common disorder in women of  reproductive  age,  it  is associated  with  disturbance of  reproductive, endocrine  and  metabolic  functions. The pathophysiology of PCOS appears to be multifactorial and polygenic. Leptin seems to play an important role in pathophysiology of PCOS especially in women with BMI ≥25kg/m2.   J Fac Med Baghdad 2014; Vol.56, No .2 Received Sept .2013 Accepted April. 2014 Objectives:  To assess leptin level in both PCOS and healthy women and explore the relation to their body weight and body mass index. Patient and Methods: A total of 120 women were enrolled in this study, 60 women (50%) had PCOS (study group) and the reminder 60 women (50%) were healthy women and considered as control group. BMI was calculated first. Both groups were further subdivided into two groups; BMI of ≥25kg/m2 and BMI of <25kg/m2. Pelvic U/S scan was done to confirm the diagnosis. Hormonal profile (FSH, LH, LH/FSH, testosterone, TSH, T4 and prolactin) were measured. RBS was measured. Serum  leptin  level was  measured  in patient  with  PCOS  and  the  control   by  Enzyme  linked immunesorbant  assay (ELISA) test. Correlations between leptin levels and age, Wt, Ht, BMI, and serum hormone levels (FSH, LH, testosterone and prolactin) were studied.                Results: Mean serum leptin levels were not significantly higher in patients with PCOS compared to the control group (P =0.052). Leptin levels were found to be higher significantly in the overweight subgroups both in patients with PCOS and in the control women. Leptin levels were found to be higher in over weight patients with PCOS compared to over weight control P value =0.0001. Serum  leptin  levels were  significantly correlated  with  BMI  in  both  patient  with  PCOS  and  control  group (r=0.918 and r=0.846)  respectively. Serum  leptin  concentration  had  a positive  correlation  with  serum  LH  concentration  in  PCOS  group (r=0.327). Leptin levels had strong positive correlation with serum LH, FSH, and testosterone in over weight PCOS subgroup women   and (r=0.592, 0.609 and 0.604) respectively.  Conclusion: Leptin levels are higher in patient with PCOS compared to control groups. Leptin levels were correlated with the amount of fatty tissue not only in PCOS group but also in healthy women. Leptin play an important role in pathophysiology of PCOS of women with BMI ≥25 kg/m2