Objective:To study the effect of depot-medroxyprogesterone acetate (DMPA) injections on Creactive protein (CRP) and lipid profile and to find the predictors (body weight, body mass index (BMI), blood pressure (BP) and lipid profile) that significantly predict the risk of cardiovascular disease (CVD) among DMPA injections users. Method: A prospective cohort study was performed during the period from March 2009 to March 2010 included thirty apparently healthy married women, their age ranged between 20-35 years, who were attending Al-Batool and Al-Khansa Family Planning Centers in Mosul and started (for the first time) to use DMPA injections (150 mg medroxyprogesterone acetate), called "Depo-Provera" as contraceptive. These (DMPA users group) were compared to another 30 healthy married women who did not use any hormonal contraceptives (non users group). Both groups were followed for one year, during which blood samples were obtained from both groups, before starting to use DMPA, after 6 months and after 12 months. Sera were used for the estimation of the biochemical studied parameters using commercial kits except serum low density lipoprotein (LDL) and atherogenic index (AI) which were calculated by special equations. Results: DMPA injections caused a non significant increase in body weight but a significant increase in BMI after 12 months. There was a significant increase in the mean diastolic blood pressure (DBP) of DMPA users according to the duration of use. The DMPA caused non significant changes in the CRP levels. There was a significant increase in serum triglycerides (TG) after 6 months of DMPA uses with respect to the duration of use. But there were non significant changes in mean serum total cholesterol (TC), high density lipoprotein (HDL), LDL and AI. Among all variables that were studied, only body weight and BMI showed a significant positive correlations with CRP. Using a stepwise multiple regression analysis, it was found that the predictors that significantly predict the risk of CVD among DMPA users were AI, DBP and TG. Conclusion: This study found that there is a significant positive association between CRP and CVD risk factors in DMPA injections users as contraceptive. Furthermore AI, DBP and TG were found to be significant predictors for the risk of CVD among DMPA users. This study confirmed the safety of DMPA use as contraceptive medication, but that special care should be directed for patients with CVD and other patients who were more sensitive to the harmful effects of lipid in the blood.
Objective: To compare the serum level of tissue polypeptide antigen (TPA) and interleukin-6 (IL-6) in women with breast cancer at various stages of the disease and to consider the usefulness of these tumor markers in evaluating the response to chemotherapy. Methods: This case control study included 60 women, from those who were attending the Oncology and Nuclear Hospital in Mosul / Iraq from the period of 1st of March 2012 and 1st of March 2013, complaining of breast cancer of stage 1-4 and receiving chemotherapy after they were operated on. Thirty women age ranged between 29-69 years, were receiving six cycles of chemotherapy after they were operated. This group was compared with the second group of 30 breast cancer women, age ranged between 28-61 years who came for the first time after they were operated on and before receiving chemotherapy. Another 30 apparently healthy, age matched women were included in this study as a healthy control group. The sera obtained from the precipitants used for the estimation of serum TPA and IL-6 level using special commercial kits. Results: The mean serum levels of both TPA and IL-6 were significantly higher in breast cancer patients than healthy control group. The mean serum levels of both TPA and IL-6 in the breast cancer patients who received 6 cycles of chemotherapy were significantly lower than their levels in the breast cancer patients who did not received chemotherapy yet. There was a significant difference among the 4 stages of breast cancer regarding TPA and IL-6 serum levels, the highest value was detected in those with stage IV and the lowest value was detected in those with stage I. The mean serum levels of both TPA and IL-6 were significantly higher in patients with ductal type than those with lobular type in both breast cancer groups. Both TPA and IL-6 are highly sensitive in detecting breast cancer and the combination of the two tumor markers will increase the specificity for detecting breast cancer up to 96.7%. Conclusion: Serum level of TPA and IL-6 discriminates between localized and metastatic breast cancer and their levels are good indicators of disease progression, TPA and IL-6 levels have a good predictive value for response to chemotherapy. The combination of the two tumor markers will increase the specificity for detecting breast cancer up to 96.7%.
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