Objective: To compare the diagnostic accuracy of Fetal Intelligent Navigation Echocardiography (FINE) method by Five-Dimensional Ultrasound in automated fetal heart examination to conventional fetal heart examination by Two-Dimensional ultrasound in second trimester pregnancy. Methods: 90 normal singleton pregnancies at the second trimester were enrolled in this prospective study. Fetal heart was examined by Two-Dimensional Ultrasound (2D US) and Five-Dimensional Ultrasound (FINE). Paired numerical data were compared using the paired samples t test. Inter-method agreement for the rating of the quality of cardiac views by 2D US or 5D US was assessed by calculation of the prevalence-adjusted and bias-adjusted kappa coefficient (PABAK). Results: There was no statistical significant difference between fetal heart echocardiography assessment using 2DUS or 5DUS(FINE) (p-value > 0.05). The overall inter-method agreement between 2D US and 5D US was 0.92. The difference in % of satisfactory views between 2D and 5D US was 1.73%, (95% CI - 0.5% to 3.33%) (P-value = 0.144). Conclusion: Our findings indicate the accuracy of 5DUS (FINE) echocardiography in evaluation of normal heart in the second trimester of pregnancy.
Background: Endometrial carcinoma ranks second among the most common gynecological malignancy in developing countries. Biomarkers are needed to aid in screening the disease and predicting the clinical as well as the therapeutic outcome. Human Epididymis Protein 4 (HE4) is a protein that was first isolated from human epididymis cells. HE4 levels are elevated in various types of cancers, such as ovarian and gastric cancer. Objectives: We aim to assess the association of serum and tissue, HE4, and endometrial adenocarcinoma in 77 Egyptian patients divided into two groups: 37 patients in the endometrial cancer group and 40 patients in the control group. Results: We found that HE4 levels were significantly increased in both serum and tissue of the endometrial cancer group compared to the negative control group. Moreover, higher expression levels were significantly associated with high-grade tumors. HE4 showed excellent diagnostic and prognostic value with a sensitivity and specificity of over 90 percent. Conclusion: We conclude that both serum and tissue expression of HE4 are sensitive, specific diagnostic and prognostic biomarkers in endometrial adenocarcinoma. In addition, they can predict extra- uterine involvement and staging of the disease. Clinical Trial Registration No:: PRS-NCT03456791.
Objective: This research compared laparoscopic hysterectomy (LH) and vaginal hysterectomy (VH) for operative time, complications, postoperative pain, inflammatory response, hospital stay, and costs. Materials and Methods: A randomized controlled trial compared LH and VH for 80 patients equally allocated to undergo either for benign pathology (Canadian Task Force Classification I). Results: Mean operative time was significantly higher for LH (127.5 ± 25.9 minutes; 95% confidence interval [CI]: 119.2, 135.8) than for VH (104 ± 30.8 minutes; 95% CI: 94.2, 113.9); p = 0.0004. There was no significant difference in median blood loss (LH: 250 mL and VH: 235 mL); p = 0.7983). There was a strong positive correlation between operative time and estimated uterine weight, especially for VH. Adnexal surgery was performed as planned preoperatively in 62.5% of LHs versus 27.5% of VHs; p < 0.0035. Both groups were comparable regarding intra- and postoperative complications (p = 1.0). Median postoperative pain intensity was lower in LH than in VH at 2 hours (51 versus 64.5; p = 0.0038), 6 hours (38.5 versus 46; p = 0.0009), and 24 hours (24.5 versus 36.5; p < 0.0001). Inflammatory response did not differ between the groups, neither as postoperative fever (7.5% of LH versus 2.5% of VH; p = 0.6153) nor as postoperative C-reactive protein rise (median: 57.4 mg/L for LH; 41.6 mg/L for VH; p = 0.1489). There was no difference in hospital stay (LH median: 35.5 hours; VH median: 30 hours; p = 0.6991). Costs for LH were higher (LH median: 5525 Egyptian pounds (EGPs), 335 US dollars (USD); VH median: 3400 EGPs, 207 USD; p < 0.0001). Conclusions: LH has longer operative time, yet better postoperative pain profile, than VH. However, cost considerations make LH fall behind VH as a primary choice for benign hysterectomy, especially in low-resource settings. (J GYNECOL SURG 38:400)
Kuwait is a small Arabian Gulf country with a high rate of consanguinity and where a national newborn screening program was expanded in October 2014 to include a wide range of endocrine and metabolic disorders. A retrospective study conducted between January 2015 and December 2020 revealed a total of 304,086 newborns have been screened in Kuwait. Six newborns were diagnosed with classic homocystinuria with an incidence of 1:50,000, which is not as high as in Qatar but higher than the global incidence. Molecular testing for five of them has revealed three previously reported pathogenic variants in the CBS gene, c.969G>A, p.(Trp323Ter); c.982G>A, p.(Asp328Asn); and the Qatari founder variant c.1006C>T, p.(Arg336Cys). This is the first study to review the screening of newborns in Kuwait for classic homocystinuria, starting with the detection of elevated blood methionine and providing a follow-up strategy for positive results, including plasma total homocysteine and amino acid analyses. Further, we have demonstrated an increase in the specificity of the current newborn screening test for classic homocystinuria by including the methionine to phenylalanine ratio along with the elevated methionine blood levels in first-tier testing. Here, we provide evidence that the newborn screening in Kuwait has led to the early detection of classic homocystinuria cases and enabled the affected individuals to lead active and productive lives.
Background: Vitamin D insufficiency is a common health issue widespread throughout the world;however, there are numerous groups that are on the highest risk of insufficiency. The insufficiencyof vitamin D is the grand restrainable and preventable challenge throughout the world. COVID-19outbreak is a significant health issue and has a universal attention with extant the pandemic ofCOVID-19 and the growing cases infected by it. Health care workers' women have the superior riskof exposure for COVID-19 among the population cannot be overlooked. Aim: Assessing knowledgepractices, and attitudes, regarding vitamin D insufficiency amongst health care workers' womenwith COVID-19, in obstetrics and gynecological hospital Ain shams university. Explore the relationbetween serum vitamin D level of health care workers' women and severity of COVID-19symptoms. Methods: A Descriptive-analysis study was proceeded at COVID -19 outpatient clinicat maternity and gynecological hospital, Ain Shams University, from onset of February to theending of April 2021. A purposive sample of 68 health care workers' women with confirmedCOVID-19. Data were gathered through four main tools. The first, structured interviewsquestionnaire which consisted of two parts, the first was to assessing demographic and clinicalfeatures of the studied health care workers' women with COVID-19. The second part was thelaboratory analysis of serum levels of 25-hydroxy vitamin D using the electrochemiluminesenceimmunoassay technique on Cobas e411 immunoassay analyzer-Hitachi Ltd- Japan. The second, aself-administered google form online questionnaire was utilized to evaluate confirmed COVID-19health care workers' women knowledge, regarding vitamin D. The third: A self-reported practicesgoogle form online questionnaire was utilized to evaluate confirmed COVID-19 health careworkers' women practices for vitamin D ingestion and habitual sun exposure, The fourth: A self-administered google form online questionnaire was utilized to assessing confirmed COVID-19health care workers' women attitude on behalf of vitamin D insufficiency. Results: Demonstratedthat the confirmed COVID- 19 health care workers women' mean age' was 40.9± 8.7years.Whereas (7%) of studied participants were had vitamin D sufficiency, (78%) had vitamin Dinsufficiency and (15%) had vitamin D deficiency with total mean ± SD (16.8 ± 8.9). Whilst mean ±SD of the total vitamin D knowledge scores was (49.8 ± 16.1) and (23.5%) of studied participantshad sufficientknowledge and (76.5%) had insufficient knowledge. While (25%) of studiedparticipantshad adequate practice, (75%) had inadequate practice. Moreover (51.5%) of studiedparticipantshad positive attitude, and (48.5%) had negative attitude. A statistically significantrelationship < /div>between majority COVID-19 symptoms inconfirmed COVID-19 health care workers'women and their vitamin D level. Conclusion: Thestudy displayed that mostly of health careworkers' women with COVID-19, had insufficient knowledge regarding to vitamin D, hadinadequate habitual sun exposure practices and vitamin D ingestion, and nearly half of health careworkers' women with COVID-19 had negative attitude toward vitamin D. Virtually, insufficiency ofvitamin D in study participants could be a risk factor of COVID-19 infection.
Background:The strength of the muscles of the pelvic floor and other supporting structures of the pelvic organs are affected by various events that occur during a woman's lifetime.Pregnancy and childbirth have a pronounced influence on maternal anatomy and physiology.Aim of the Work: The aim of the study was to investigate the impact of the mode of delivery on the sexual function (arousal-pleasure-orgasm-desire)among a representative sample of Egyptian primiparae.Subjects and Methods: This cross-sectional observational comparative study was conducted at Ain Shams University Maternity Hospital during the period between November 2017and July 2018 on 260 women who had single uncomplicated delivery within a duration of not less than 6 months and not more than 2 years from recruitment of the study.Results: Pain was significantly positively correlated to the age [r=0.319,p=0.013] and social class [r=0.276,p=0.028].Both satisfaction and the overall sexual function score was also significantly positively correlated to social class[r=0.275, p=0.032; r=0.237, p=0.048; respectively].Pelvic floor muscle strength was poorly correlated to sexual function.Conclusions: The study revealed a significant difference in pelvic floor muscle strength between women who delivered vaginally and those who delivered by Cesarean section.However, there was no significant difference in sexual function between women who delivered vaginally and those who delivered by Cesarean section.Pelvic floor muscle strength was poorly correlated to sexual function.Recommendations: Cesarean section on demand should not be considered as prophylaxis against sexual dysfunction.A larger, nation-wide based study should be performed for assessment of sexual dysfunction among women of different age groups and parities.
Objective: To compare the efficacy and compliance of the conventional therapy of iron deficiency anemia (ferrous sulfate) with the new forms of therapy chewable iron tablets: (iron polymaltose complex) in the treatment of iron deficiency anemia in pregnant women. Methods: This Randomized Control Trial study included 290 pregnant women with iron deficiency anemia, and they were randomly allocated to a control group who received ferrous sulfate capsules for two months and study group who received iron polymaltose complex chewable tablets for two months. Complete Blood Picture (hemoglobin level and hematocrit level) and Serum ferritin level were done after four and eight weeks to determine the efficacy. In addition, any complains or side effects had been reported to assess the tolerability of the drugs. Two-factor repeated-measures analysis of variance (ANOVA) was used to compare the change in hemoglobin and serum ferritin levels in both groups. Results: There was no statistical significant difference between the two research groups as regards baseline hemoglobin, and at week 4 from onset of treatment (p values = 0.990, 0.112, consecutively). However, there was statistical significant difference on week 8 of continuous drug intake in both groups in which the iron poly maltose complex research group had significantly higher hemoglobin levels (p value = 0.006). Conclusion: The results of the study showed oral iron polymaltose complex increases Hemoglobin and serum ferritin levels more than oral ferrous sulfate and produces less adverse effects than ferrous sulfate.
Abstract Background Placenta accreta spectrum is a serious obstetric disorder that is characterized by deeply penetrating villi which are abnormally attached to the myometrium of the uterus. This prevents its complete dissociation during the third stage of labor that may cause severe bleeding, with its marked risk on the mother life. All recent studies confirm that the occurrence of placenta accreta increased dramatically in the recent years with the increasing number of caesarean sections. The number of previous caesarean deliveries accompanied by placenta previa markedly increase the risk for placenta accreta. There is a continued need to study risk factors of abnormally adherent placenta to improve the antenatal diagnosis . Objective The current study aims to evaluate the effect of the short duration between the perior caesarean delivery and the current pregnancy on the occurence of placenta accreta spectrum. Patients and Methods a case control study which was performed in the Maternity Hospital of Ain Shams University. It compare the duration between the perior caesarean section and the current pregnancy in the placenta accreta cases and the matched controls to determine if it increases the occurrences of placenta accreta or not. It include all pregnant ladies with placenta accreta spectrum diagnosed radiologically or surgically in the period of the beginning of June 2019 to the beginning of December 2019 with in the inclusion criteria, also the matched controls. Results there was no difference with a statistical significance between control group and patients group regarding inter pregnancy interval. Conclusion this study reveals that there was no effect of the short duration between the previous caesarean delivery and the current pregnancy on the occurence of placenta accreta spectrum.
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