Background: Endometriosis has a complex multifactorial pathophysiology and is a leading cause of female infertility. Emerging evidence suggests the role of endocrine disrupting chemicals and environmental factors such as Diethyl phthalate (DEP) in the pathophysiology of the disease. Aim: To investigate the serum DEP levels in females with infertility having endometriosis and normal healthy counter parts. Methods: Married females (n=50) age 20-40 years, diagnosed with endometriosis and having history of >1 year of infertility, were selected as cases. Age matched women (n=50) with proven fertility and screened negative for endometriosis were included as controls. Females on any medicine, having co morbid conditions were also excluded from the study. DEP concentration in serum was determined by using High performance liquid chromatography (HPLC). Results: Significantly higher levels (p=0.003) of DEP were seen in endometriosis females (3.76± 1.28 ng/ml) as compared to controls (2.61± 1.72 ng/ml). The comparison of DEP levels between different stages of endometriosis revealed an increasing, but no significant trend with advancement of the disease. Conclusion: High serum DEP levels in patients substantiate their role in disease pathophysiology. Therefore, it may be advisable to pay attention while using such compounds. There is an increased need to regulate the levels of such industrial compounds manufactured for daily use of human beings by efficient and judicious quality assurance plastics and by using the standards set by WHO and/or FDA. Keywords: Phthalate, Endometriosis, Diethyl phthalate, plasticizers, Infertility
Background: Folate and Vitamin B12 are important micronutrients necessary for fetal growth and development. Deficiencies of these vitamins in women of reproductive age results in adverse pregnancy outcome. Objective: To determine red blood cell folate and serum Vitamin B12 levels in apparently healthy women of reproductive age group. Methodology: The study was conducted in Baqai medical university, Karachi. Apparently healthy volunteer women (N=196) between ages of 15 and 49 years residing in different areas of Karachi were selected after fulfilling the inclusion and exclusion criteria. The cut off values for defining Vitamin B12 deficiency, marginal insufficiency and folate insufficiency were <203 pg/mL, 203-299 pg/mL, and <400 ng/mL, respectively. Analysis of red blood cell folate and serum vitamin B12 levels was done after complete blood count and peripheral smear morphology. Results: The mean serum vitamin B12 and red blood cell folate levels were 233.69 ± 54.10 pg/mL and 540.34 ± 54.04 ng/mL. Percent values of Vitamin B12 deficiency and marginal insufficiency were 42% and 46%. All of the study participants had red blood cell folate levels >400 pg/mL. A significant negative association was present between age and serum vitamin B12 levels. Conclusion: Low serum levels of vitamin B12 in women of reproductive age group can be considered an important etiologic factor for adverse pregnancy outcomes especially neural tube defects. The need is to asses pre-conceptional level of vitamin B12 and to implement public health program especially food fortification to improve vitamin B12 status.
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