Keywords : pre

The Value of Free Thyroid Hormones and Aspartate Aminotransferase in Vaginal Washing Fluid for Detection of Preterm Pre-Labor Rupture of Membrane

Iraqi Postgraduate Medical Journal, 2019, Volume 18, Issue 1, Pages 52-58

Preterm pre-labor rupture of membrane occurs in about 2% of all pregnancies. The most frequent
consequences of preterm pre-labor rupture of membrane is preterm delivery, sepsis and pulmonary
hypoplasia. The correct diagnosis of preterm pre-labor rupture of membrane is crucial and successful
management will be based upon it.
To determine whether measurement of vaginal washing fluid aspartate aminotransferase(AST) ,
free triiodothyronine (free T3) and thyroxin(free T4) were useful tests for the diagnosis of preterm
pre-labor rupture of membrane.
STUDY DESIGN: A case - control study.
SETTING: :This study was conducted at department of Obstetrics and Gynecology of AL-Yarmouk
teaching Hospital and National center for Diabetes
It included hundred pregnant women with a gestational age ranging between 24 - 36+6 weeks. They
were divided into two groups, the study group which included fifty pregnant women presented with
preterm pre-labor rupture of membrane and the control group which includes fifty pregnant women
without any complaint, matched for gestational age. All women underwent sterile speculum vaginal
examination. Free triiodothyronine and free thyroxin levels were measured by using Enzyme immune
assay method, and aspartate aminotransferase level was measured by using colorimetric method, in
vaginal washing fluid.
Vaginal washing fluid free T3, free T4 and AST levels were significantly higher in the study group
(1.15), (0.071), (4.9) respectively compared with the control group (0.93), (0.048), (4.5) respectively.
Vaginal washing fluid free T4 having the largest area under the curve on receiver operating
characteristic curve (ROC) analysis (P<0.001). ROC curve analysis showed that free T3 validity
results in predicting preterm pre labor rupture of membrane among pregnant women were (cut-off
1.07pg/ml, sensitivity 88%, specificity 76% and accuracy 82%), free T4 validity results were (cutoff
0.055pg/ml, sensitivity 84%, specificity 80% and accuracy 82%) and AST validity results
were (cut-off 4.9IU/L, sensitivity 52%, specificity 80% and accuracy 66%).
Measurement of aspartate aminotransferase free triiodothyronine , and thyroxin in vaginal washing
fluid of suspected and diagnosed patient presented with preterm pre labor rupture of membrane
found to be a useful markers for the diagnosis of preterm pre labor rupture of membrane.

Serum Her-2/Neu a Potential Biomarker in Breast Cancer Patients: Correlation with the Clinico-Pathological Parameters

Iraqi Postgraduate Medical Journal, 2015, Volume 14, Issue 4, Pages 555-563

Breast cancer is the most common malignancy in women, and a major cause of mortality and morbidity despite the advances in diagnosis and treatment. There is evidence that changes in HER2 protein expressions are associated with breast cancer progression.
To investigate whether measuring this tumour marker in serum of breast cancer patients before and after treatment might also be useful markers in the diagnosis, screening and monitoring the malignant tumour progression and response to therapy.
Serum samples were obtained from (28) apparently healthy women (Control Group) with a mean age of 40.9 ± 7.6 years and (60) female patients complaining from primary breast cancer (Patients Group) with a mean age of 48.3 ± 8.9 years. They were divided according to their clinical end point into: Pre-Surgical Group, Post-Surgical Group and post- chemotherapy Group. Serum Her-2/nue level was measured using ELISA kits.
Level of Her2/neu (3130.4 pg/ml) was significantly higher in after 6 cycles of chemotherapy group than each of control (1400.8 pg/ml), before surgery (1597 pg/ml) and after surgery (1487.4 pg/ml) (P < 0.05). Her2/neu is effective test only after 6 cycle chemotherapy with an accuracy of 95.2%. The best performance for Her2neu was observed at values ≥ 1464 pg/ml (sensitivity = 95% and specificity = 61%). There were significant influences of the studied personal and the pathological characteristics of the tumour upon the biomarker levels where the levels were significantly higher with the increase of tumour pathological stage and in the presence of positive status for Her2neu receptors (P < 0.05).
In this study there was a statistically significant association between tissue HER-2/neu and serum HER-2 /neu levels in the extracellular domain. It could be concluded that using serum Her-2/neu in patients after six cycles chemotherapy could predict response to therapy.