Background Vaginal atrophy is common after menopause and is often linked to sexual dysfunction, p... more Background Vaginal atrophy is common after menopause and is often linked to sexual dysfunction, particularly dyspareunia. Aim The study aimed to investigate the effect of intravaginally applied oxytocin on expressions of vaginal atrophy. Methods Fifty postmenopausal women aged 47 to 66 years with vaginal atrophy participated in this double-blinded placebo-controlled study. The women were randomized to intravaginal treatment with either gel with 600 IU/mL of oxytocin (oxytocin group) or gel alone (control group) once daily for 2 weeks. The gel consisted of hypromellose, pH 3.8 (Vagovital). Outcomes The color of the vaginal mucosa, the vaginal pH, and the cytology of vaginal epithelial cells were investigated before and after treatment. Results The color of the vaginal mucosa shifted from pale to red in all 25 patients treated with oxytocin but only in 4 patients in the control group (P < .001). There was a significant decrease in intravaginal pH in the oxytocin group and the contr...
Background: Remarkably, the current study is one of the first to deploy galectin-1 (Gal-1) in det... more Background: Remarkably, the current study is one of the first to deploy galectin-1 (Gal-1) in determining the degree of impairment of spermatogenesis among cases with non-obstructive azoospermia (NOA) as well as utilizing it as a biomarker to predict the rate of sperm retrieval in these patients. The purpose of the study was to evaluate the seminal plasma and serum levels of Gal-1 in NOA patients as well as their correlations with Johnsen’s tubular biopsy scoring (JTBS). Methods: The current case control study included totally 48 patients with NOA whose ages ranged from 24 to 46 years old and 50 age matched healthy controls. Gal-1 levels were measured in both seminal plasma and serum of all subjects by the enzyme-linked immunosorbent assay (ELISA). Results: A significant negative correlation between seminal plasma levels of Gal-1 and JTBS was detected (r= -0.281, p=0.048) in the NOA cases. Interestingly, the receiver operating characteristic (ROC) curve had demonstrated that the cut...
Objective We aimed to evaluate the hysteroscopic management of first-trimester pregnancy loss com... more Objective We aimed to evaluate the hysteroscopic management of first-trimester pregnancy loss compared to surgical evacuation either blind or under ultrasonographic guidance. Methods This clinical trial included 315 women with first-trimester pregnancy loss, divided equally into three groups. Group 1 underwent traditional blind surgical evacuation, group 2 underwent ultrasound-guided evacuation, and group 3 underwent hysteroscopic management. All women were assessed for retained products, surgical complications, the need for further management, and pregnancy occurrence after evacuation within 2 years of follow up. Results The rate of presence of conception remnants and the need for further treatment was significantly higher in group 1 compared to groups 2 and 3 (4.8% vs. 0% vs. 0%, P = 0.012). The conception rate within 2 years was significantly lower in group 1 compared to groups 2 and 3 (57.4% vs. 73.2% vs. 82.7%, P = 0.002), and the duration needed to conceive was significantl...
Erectile dysfunction (ED) is a common condition with a significant impact on the quality of life.... more Erectile dysfunction (ED) is a common condition with a significant impact on the quality of life. Regenerative medicine maladies are intended to repair or replace damaged tissues and organs through different therapeutic mechanisms. Our aim was to study the effect of intra‐corporeal injection (ICI) of platelet‐rich plasma (PRP) in ED patients. Thirty‐four patients’ erectile function was evaluated by filling up an abridged form of the international index of erectile function (IIEF‐5) before and after PRP therapy. ICI of PRP was done once per week for 2 months. All patients were prescribed PDE5Is for one month after PRP therapy. Penile haemodynamics was assessed using 20 µg of PGE1 before and 3 months after initiating PRP therapy. Interestingly, our study had shown that there was a statistically significant difference in the IIEF‐5 score after ICI of PRP (−5.5, ±5.2, p=<0.001). Furthermore, in multiple logistic regression model for PRP responsiveness, smoking and IIEF score before PRP were the only significant independent variables (p = .040, p = .023 respectively). PRP injection for ED patients may be a promising modality as well as baseline IIEF‐5, and smoking status can be used as predictors for a satisfactory response to PRP in such patients.
Abstract This randomised controlled trial aimed to compare the effect of early and delayed pushin... more Abstract This randomised controlled trial aimed to compare the effect of early and delayed pushing during the second stage of labour in women with occipitoposterior (OP) malposition. It included 184 nulliparous women with OP position randomised to early pushing in which women were allowed to push within one hour after full cervical dilatation or delayed pushing in which women were asked not to push for maximum of three hours or start pushing when the vertex was visible. The primary outcome was successful vaginal delivery. The rate of spontaneous vaginal delivery was significantly higher in the early pushing group (80.4 vs. 60.9%, p=.004) while the rate of instrumental vaginal delivery (30.4 vs. 15.4%) and CS (8.7 vs. 4.3%) was significantly higher in the delayed pushing group. Women in the delayed pushing group showed a significantly longer duration of the second stage (129.4 ± 7.5 vs. 61.6 ± 15.3 minutes, p<.001) and shorter duration of pushing (219.8 ± 74.8 vs. 693.9 ± 145.2 seconds, p<.001) .The rate of 2nd and 3rd degree perineal lacerations (19.6 and 13% vs. 5.4 and 8.7% respectively, p=.013) and vaginal tears (41.3 vs. 8.7%, p<.001) was significantly higher in the early pushing group. We concluded that early pushing during the second stage of labour is associated with higher rates of spontaneous vaginal delivery and vaginal and perineal lacerations. Clinical trial registration NCT03121274. Impact Statement What is already known on this subject? Occipitoposterior malposition is common during delivery especially in primigravida and is associated with higher rates of instrumental delivery and caesarean section. It can be managed through early or delayed pushing. What the results of this study add? Early pushing is associated with higher rates of spontaneous vaginal delivery, perineal and vaginal tears, shorter duration of second stage of labour, shorter duration of pushing, lower rates of both instrumental vaginal delivery and caesarean section. What the implications are of these findings for clinical practice and/or further research? Early pushing during the second stage of labour is associated with higher rates of spontaneous vaginal delivery and vaginal and perineal lacerations in women with OP malposition and should be tried and not delaying the pushing.
Abstract In this study, the effects of swirling flow and porous media of triple coaxial ports inv... more Abstract In this study, the effects of swirling flow and porous media of triple coaxial ports inverse diffusion flame (TCP-IDF) on the flame shape, temperature and gas emissions are studied. In addition, a comparison between swirling and non-swirling TCP-IDF burner conducted using 5° air swirler. On the other hand, the effect of using a porous screen with 2 mm and 1 mm mesh size including 65°, 45° and 15° flow divergence diffuser on the flame radial and centerline temperatures, and emissions investigated. During all experiments, the air to fuel ratio was constant at 27. The results showed that using swirl reduce CO and UHC emissions and increase the peak temperature and NOx emissions of TCP-IDF. Also increasing the flow divergence angle, all of the CO, UHC, peak temperature and NOx emission decreasing. Concerning the increase in mesh size, it has been noticed that as the mesh size increased, NOx emissions increased while the CO, UHC and peak temperature decreased. Moreover, the combination between the swirl and 65° flow divergence diffuser recorded the lowest value of the CO and UHC emissions. While the combination between the swirl burner with 65° flow divergence diffuser and 1 mm porous screen produced the lowest peak temperature and NOx emissions.
Ultrasonographic assessment of fetal gestational age is very critical for clinical decision makin... more Ultrasonographic assessment of fetal gestational age is very critical for clinical decision making in obstetrics, many fetal biometric parameters are extensively used but in this research study we mainly targeted transcerebellar diameter in second and third trimester among Egyptian population and its accuracy and clinical reliability to calculate fetal gestational age. Aim of the research: The main goal and corner stone purpose of this research was to measure the accuracy of the transcerebellar diameter Transcerebellar diameter in calculating the gestational age of fetuses among Egyptian population and if it is more accurate than other fetal biometric measurements (Biparietal diameter, Head circumference, Abdominal circumference, Femur Length) in gestations with no medical disorders or not and the additional different methodology implemented in this research in comparison to other studies was using the Transcerebellar diameter in diabetic mothers with macrosomic fetuses, in pregnant...
Objective: The aim was to assess the effect of chronic kidney disease (CKD) on erectile function.... more Objective: The aim was to assess the effect of chronic kidney disease (CKD) on erectile function. Patients and Methods: This study included 40 patients on hemodialysis (HD), 40 patients on medical treatment [predialysis (PD)], and 20 controls. They were assessed using international index of erectile function questionnaire andlaboratory investigations (blood urea, serum creatinine, and both total and free testosterone). Results: The mean age in HD patients was 42.20±5.08 years, in PD patients was 43.83±6.59 years,and in control group, it was 42.10±5.66 years, with no significant difference among the three groups (P=0.383). Overall, 10% of HD patients had severe degree of erectile dysfunction (ED) in comparison with only 2.5% of PD patients, with no patient experiencing severe ED in the control group. There was a significant difference among the three groups regarding the grade of ED (P<0.001). The mean free testosterone levels in HD, PD,and control groups were 3.78±2.09, 3.84±1.36...
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, Jan 31, 2018
To assess the sensitivity of a urine test for high-risk HPV DNA genotypes in the detection of hig... more To assess the sensitivity of a urine test for high-risk HPV DNA genotypes in the detection of high-grade squamous intra-epithelial lesion (HSIL) and its correlation with pathologic precancerous lesions. The present prospective cross-sectional study included women referred to Kasr AlAiny Medical School, Cairo, Egypt, for cervical smear anomalies, a history of cervical smear anomalies, or for suspicious cervix between May 1, 2015, and April 30, 2017. Paired urine tests and cervical smears were performed. HPV DNA was detected in urine using polymerase chain reaction and cervical smears were performed with a cervical spatula and a cytobrush. Agreement between urine test results and pathology was examined. In total, 1375 women were included. Urine test for high-risk HPV DNA demonstrated 97.8% (95% confidence interval [CI] 92.1%-99.7%) sensitivity and 100% (95% CI 99.7%-100.0%) specificity for HSIL. Overall, 87 women had a positive urine test for high-risk HPV; of these, 82 (94.3%, 95% CI...
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, Jan 7, 2018
Subcutaneous tissue closure technique is a wide area of interest for obstetricians who perform ce... more Subcutaneous tissue closure technique is a wide area of interest for obstetricians who perform cesarean section especially on obese women while many observers studied in an extensive manner postoperative pain and wound cosmetic results.
To study the effect of intramural fibroids on uterine and endometrial vascularity in infertile wo... more To study the effect of intramural fibroids on uterine and endometrial vascularity in infertile women scheduled for in-vitro fertilization (IVF). 3D power Doppler was used to measure the endometrial volume and blood flow indices in 182 women with intramural fibroids not affecting the uterine cavity and compared them to a matched control group without fibroids. There was significantly increased vascularity in the endometrium of the fibroid group as denoted by higher endometrial VI (p = 0.018), FI (p = 0.027) and Endometrial VFI. No significant difference in mean uterine artery RI (p = 0.277) or PI (p = 0.187). Among the fibroid group 62.6% had a fibroid > 4 cm. Women with fibroids > 4 cm had a significantly higher Endometrial FI (p = 0.037), and VFI (p = 0.02). Uterine artery blood flow was not affected, as uterine RI (p = 0.369) and PI (p = 0.321) were not statistically different. Compared with the control group (non fibroid), women with fibroids > 4 cm had significantly hig...
Taiwanese journal of obstetrics & gynecology, 2017
To detect the effect of combined oral contraceptive pills (COC) on dynamic postural balance in he... more To detect the effect of combined oral contraceptive pills (COC) on dynamic postural balance in healthy middle aged women. A prospective randomized controlled study included 200 patients classified into two groups. Group I received COC containing 30 μg of EE and 3 mg of drospirenone for 12 consecutive cycles and Group II received no treatment. Overall, medio-lateral and antero-posterior stability were measured using Biodex system after 12 months. There was a highly statistically significant difference between the 2 study groups regarding estradiol level (12.84 ± 1.96 vs. 38.86 ± 3.99, P value < 0.001) and progesterone level (0.52 ± 0.25 vs. 11.64 ± 4.53, P value < 0.001). There was a highly statistically significant difference between the 2 study groups regarding mediolateral stability (1.84 ± 0.23 vs. 2.40 ± 0.56, P value < 0.001), antereoposterior stability (1.91 ± 0.29 vs. 2.33 ± 0.61, P value < 0.001) or overall stability (2.42 ± 0.29 vs. 2.95 ± 0.53, P value < 0.0...
Archives of gynecology and obstetrics, Jan 8, 2017
The aim of this study was to evaluate the role of maternal serum total Homocysteine (tHcy) and ut... more The aim of this study was to evaluate the role of maternal serum total Homocysteine (tHcy) and uterine artery (Ut-A) Doppler as predictors of preeclampsia (PE), intrauterine growth restriction (IUGR), and other complications related to poor placentation. A prospective cohort study was conducted on 500 women with spontaneous pregnancies. tHcy was measured at 15-19 weeks, and then, Ut-A Doppler was performed at 18-22 weeks of pregnancy. 453 pregnant women completed the follow-up of the study. The tHcy and Ut-A resistance index were significantly higher in women who developed PE, IUGR, and other complications when compared to controls (tHcy: 7.033 ± 2.744, 6.321 ± 3.645, and 6.602 ± 2.469 vs 4.701 ± 2.082 μmol/L, respectively, p value <0.001 and Ut-A resistance index: 0.587 ± 0.072, 0.587 ± 0.053, and 0.597 ± 0.069 vs 0.524 ± 0.025, respectively, p value <0.001). The use of both tHcy assessment and Ut-A Doppler improved the sensitivity of prediction of PE relative to the use of e...
Background Vaginal atrophy is common after menopause and is often linked to sexual dysfunction, p... more Background Vaginal atrophy is common after menopause and is often linked to sexual dysfunction, particularly dyspareunia. Aim The study aimed to investigate the effect of intravaginally applied oxytocin on expressions of vaginal atrophy. Methods Fifty postmenopausal women aged 47 to 66 years with vaginal atrophy participated in this double-blinded placebo-controlled study. The women were randomized to intravaginal treatment with either gel with 600 IU/mL of oxytocin (oxytocin group) or gel alone (control group) once daily for 2 weeks. The gel consisted of hypromellose, pH 3.8 (Vagovital). Outcomes The color of the vaginal mucosa, the vaginal pH, and the cytology of vaginal epithelial cells were investigated before and after treatment. Results The color of the vaginal mucosa shifted from pale to red in all 25 patients treated with oxytocin but only in 4 patients in the control group (P < .001). There was a significant decrease in intravaginal pH in the oxytocin group and the contr...
Background: Remarkably, the current study is one of the first to deploy galectin-1 (Gal-1) in det... more Background: Remarkably, the current study is one of the first to deploy galectin-1 (Gal-1) in determining the degree of impairment of spermatogenesis among cases with non-obstructive azoospermia (NOA) as well as utilizing it as a biomarker to predict the rate of sperm retrieval in these patients. The purpose of the study was to evaluate the seminal plasma and serum levels of Gal-1 in NOA patients as well as their correlations with Johnsen’s tubular biopsy scoring (JTBS). Methods: The current case control study included totally 48 patients with NOA whose ages ranged from 24 to 46 years old and 50 age matched healthy controls. Gal-1 levels were measured in both seminal plasma and serum of all subjects by the enzyme-linked immunosorbent assay (ELISA). Results: A significant negative correlation between seminal plasma levels of Gal-1 and JTBS was detected (r= -0.281, p=0.048) in the NOA cases. Interestingly, the receiver operating characteristic (ROC) curve had demonstrated that the cut...
Objective We aimed to evaluate the hysteroscopic management of first-trimester pregnancy loss com... more Objective We aimed to evaluate the hysteroscopic management of first-trimester pregnancy loss compared to surgical evacuation either blind or under ultrasonographic guidance. Methods This clinical trial included 315 women with first-trimester pregnancy loss, divided equally into three groups. Group 1 underwent traditional blind surgical evacuation, group 2 underwent ultrasound-guided evacuation, and group 3 underwent hysteroscopic management. All women were assessed for retained products, surgical complications, the need for further management, and pregnancy occurrence after evacuation within 2 years of follow up. Results The rate of presence of conception remnants and the need for further treatment was significantly higher in group 1 compared to groups 2 and 3 (4.8% vs. 0% vs. 0%, P = 0.012). The conception rate within 2 years was significantly lower in group 1 compared to groups 2 and 3 (57.4% vs. 73.2% vs. 82.7%, P = 0.002), and the duration needed to conceive was significantl...
Erectile dysfunction (ED) is a common condition with a significant impact on the quality of life.... more Erectile dysfunction (ED) is a common condition with a significant impact on the quality of life. Regenerative medicine maladies are intended to repair or replace damaged tissues and organs through different therapeutic mechanisms. Our aim was to study the effect of intra‐corporeal injection (ICI) of platelet‐rich plasma (PRP) in ED patients. Thirty‐four patients’ erectile function was evaluated by filling up an abridged form of the international index of erectile function (IIEF‐5) before and after PRP therapy. ICI of PRP was done once per week for 2 months. All patients were prescribed PDE5Is for one month after PRP therapy. Penile haemodynamics was assessed using 20 µg of PGE1 before and 3 months after initiating PRP therapy. Interestingly, our study had shown that there was a statistically significant difference in the IIEF‐5 score after ICI of PRP (−5.5, ±5.2, p=<0.001). Furthermore, in multiple logistic regression model for PRP responsiveness, smoking and IIEF score before PRP were the only significant independent variables (p = .040, p = .023 respectively). PRP injection for ED patients may be a promising modality as well as baseline IIEF‐5, and smoking status can be used as predictors for a satisfactory response to PRP in such patients.
Abstract This randomised controlled trial aimed to compare the effect of early and delayed pushin... more Abstract This randomised controlled trial aimed to compare the effect of early and delayed pushing during the second stage of labour in women with occipitoposterior (OP) malposition. It included 184 nulliparous women with OP position randomised to early pushing in which women were allowed to push within one hour after full cervical dilatation or delayed pushing in which women were asked not to push for maximum of three hours or start pushing when the vertex was visible. The primary outcome was successful vaginal delivery. The rate of spontaneous vaginal delivery was significantly higher in the early pushing group (80.4 vs. 60.9%, p=.004) while the rate of instrumental vaginal delivery (30.4 vs. 15.4%) and CS (8.7 vs. 4.3%) was significantly higher in the delayed pushing group. Women in the delayed pushing group showed a significantly longer duration of the second stage (129.4 ± 7.5 vs. 61.6 ± 15.3 minutes, p<.001) and shorter duration of pushing (219.8 ± 74.8 vs. 693.9 ± 145.2 seconds, p<.001) .The rate of 2nd and 3rd degree perineal lacerations (19.6 and 13% vs. 5.4 and 8.7% respectively, p=.013) and vaginal tears (41.3 vs. 8.7%, p<.001) was significantly higher in the early pushing group. We concluded that early pushing during the second stage of labour is associated with higher rates of spontaneous vaginal delivery and vaginal and perineal lacerations. Clinical trial registration NCT03121274. Impact Statement What is already known on this subject? Occipitoposterior malposition is common during delivery especially in primigravida and is associated with higher rates of instrumental delivery and caesarean section. It can be managed through early or delayed pushing. What the results of this study add? Early pushing is associated with higher rates of spontaneous vaginal delivery, perineal and vaginal tears, shorter duration of second stage of labour, shorter duration of pushing, lower rates of both instrumental vaginal delivery and caesarean section. What the implications are of these findings for clinical practice and/or further research? Early pushing during the second stage of labour is associated with higher rates of spontaneous vaginal delivery and vaginal and perineal lacerations in women with OP malposition and should be tried and not delaying the pushing.
Abstract In this study, the effects of swirling flow and porous media of triple coaxial ports inv... more Abstract In this study, the effects of swirling flow and porous media of triple coaxial ports inverse diffusion flame (TCP-IDF) on the flame shape, temperature and gas emissions are studied. In addition, a comparison between swirling and non-swirling TCP-IDF burner conducted using 5° air swirler. On the other hand, the effect of using a porous screen with 2 mm and 1 mm mesh size including 65°, 45° and 15° flow divergence diffuser on the flame radial and centerline temperatures, and emissions investigated. During all experiments, the air to fuel ratio was constant at 27. The results showed that using swirl reduce CO and UHC emissions and increase the peak temperature and NOx emissions of TCP-IDF. Also increasing the flow divergence angle, all of the CO, UHC, peak temperature and NOx emission decreasing. Concerning the increase in mesh size, it has been noticed that as the mesh size increased, NOx emissions increased while the CO, UHC and peak temperature decreased. Moreover, the combination between the swirl and 65° flow divergence diffuser recorded the lowest value of the CO and UHC emissions. While the combination between the swirl burner with 65° flow divergence diffuser and 1 mm porous screen produced the lowest peak temperature and NOx emissions.
Ultrasonographic assessment of fetal gestational age is very critical for clinical decision makin... more Ultrasonographic assessment of fetal gestational age is very critical for clinical decision making in obstetrics, many fetal biometric parameters are extensively used but in this research study we mainly targeted transcerebellar diameter in second and third trimester among Egyptian population and its accuracy and clinical reliability to calculate fetal gestational age. Aim of the research: The main goal and corner stone purpose of this research was to measure the accuracy of the transcerebellar diameter Transcerebellar diameter in calculating the gestational age of fetuses among Egyptian population and if it is more accurate than other fetal biometric measurements (Biparietal diameter, Head circumference, Abdominal circumference, Femur Length) in gestations with no medical disorders or not and the additional different methodology implemented in this research in comparison to other studies was using the Transcerebellar diameter in diabetic mothers with macrosomic fetuses, in pregnant...
Objective: The aim was to assess the effect of chronic kidney disease (CKD) on erectile function.... more Objective: The aim was to assess the effect of chronic kidney disease (CKD) on erectile function. Patients and Methods: This study included 40 patients on hemodialysis (HD), 40 patients on medical treatment [predialysis (PD)], and 20 controls. They were assessed using international index of erectile function questionnaire andlaboratory investigations (blood urea, serum creatinine, and both total and free testosterone). Results: The mean age in HD patients was 42.20±5.08 years, in PD patients was 43.83±6.59 years,and in control group, it was 42.10±5.66 years, with no significant difference among the three groups (P=0.383). Overall, 10% of HD patients had severe degree of erectile dysfunction (ED) in comparison with only 2.5% of PD patients, with no patient experiencing severe ED in the control group. There was a significant difference among the three groups regarding the grade of ED (P<0.001). The mean free testosterone levels in HD, PD,and control groups were 3.78±2.09, 3.84±1.36...
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, Jan 31, 2018
To assess the sensitivity of a urine test for high-risk HPV DNA genotypes in the detection of hig... more To assess the sensitivity of a urine test for high-risk HPV DNA genotypes in the detection of high-grade squamous intra-epithelial lesion (HSIL) and its correlation with pathologic precancerous lesions. The present prospective cross-sectional study included women referred to Kasr AlAiny Medical School, Cairo, Egypt, for cervical smear anomalies, a history of cervical smear anomalies, or for suspicious cervix between May 1, 2015, and April 30, 2017. Paired urine tests and cervical smears were performed. HPV DNA was detected in urine using polymerase chain reaction and cervical smears were performed with a cervical spatula and a cytobrush. Agreement between urine test results and pathology was examined. In total, 1375 women were included. Urine test for high-risk HPV DNA demonstrated 97.8% (95% confidence interval [CI] 92.1%-99.7%) sensitivity and 100% (95% CI 99.7%-100.0%) specificity for HSIL. Overall, 87 women had a positive urine test for high-risk HPV; of these, 82 (94.3%, 95% CI...
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, Jan 7, 2018
Subcutaneous tissue closure technique is a wide area of interest for obstetricians who perform ce... more Subcutaneous tissue closure technique is a wide area of interest for obstetricians who perform cesarean section especially on obese women while many observers studied in an extensive manner postoperative pain and wound cosmetic results.
To study the effect of intramural fibroids on uterine and endometrial vascularity in infertile wo... more To study the effect of intramural fibroids on uterine and endometrial vascularity in infertile women scheduled for in-vitro fertilization (IVF). 3D power Doppler was used to measure the endometrial volume and blood flow indices in 182 women with intramural fibroids not affecting the uterine cavity and compared them to a matched control group without fibroids. There was significantly increased vascularity in the endometrium of the fibroid group as denoted by higher endometrial VI (p = 0.018), FI (p = 0.027) and Endometrial VFI. No significant difference in mean uterine artery RI (p = 0.277) or PI (p = 0.187). Among the fibroid group 62.6% had a fibroid > 4 cm. Women with fibroids > 4 cm had a significantly higher Endometrial FI (p = 0.037), and VFI (p = 0.02). Uterine artery blood flow was not affected, as uterine RI (p = 0.369) and PI (p = 0.321) were not statistically different. Compared with the control group (non fibroid), women with fibroids > 4 cm had significantly hig...
Taiwanese journal of obstetrics & gynecology, 2017
To detect the effect of combined oral contraceptive pills (COC) on dynamic postural balance in he... more To detect the effect of combined oral contraceptive pills (COC) on dynamic postural balance in healthy middle aged women. A prospective randomized controlled study included 200 patients classified into two groups. Group I received COC containing 30 μg of EE and 3 mg of drospirenone for 12 consecutive cycles and Group II received no treatment. Overall, medio-lateral and antero-posterior stability were measured using Biodex system after 12 months. There was a highly statistically significant difference between the 2 study groups regarding estradiol level (12.84 ± 1.96 vs. 38.86 ± 3.99, P value < 0.001) and progesterone level (0.52 ± 0.25 vs. 11.64 ± 4.53, P value < 0.001). There was a highly statistically significant difference between the 2 study groups regarding mediolateral stability (1.84 ± 0.23 vs. 2.40 ± 0.56, P value < 0.001), antereoposterior stability (1.91 ± 0.29 vs. 2.33 ± 0.61, P value < 0.001) or overall stability (2.42 ± 0.29 vs. 2.95 ± 0.53, P value < 0.0...
Archives of gynecology and obstetrics, Jan 8, 2017
The aim of this study was to evaluate the role of maternal serum total Homocysteine (tHcy) and ut... more The aim of this study was to evaluate the role of maternal serum total Homocysteine (tHcy) and uterine artery (Ut-A) Doppler as predictors of preeclampsia (PE), intrauterine growth restriction (IUGR), and other complications related to poor placentation. A prospective cohort study was conducted on 500 women with spontaneous pregnancies. tHcy was measured at 15-19 weeks, and then, Ut-A Doppler was performed at 18-22 weeks of pregnancy. 453 pregnant women completed the follow-up of the study. The tHcy and Ut-A resistance index were significantly higher in women who developed PE, IUGR, and other complications when compared to controls (tHcy: 7.033 ± 2.744, 6.321 ± 3.645, and 6.602 ± 2.469 vs 4.701 ± 2.082 μmol/L, respectively, p value <0.001 and Ut-A resistance index: 0.587 ± 0.072, 0.587 ± 0.053, and 0.597 ± 0.069 vs 0.524 ± 0.025, respectively, p value <0.001). The use of both tHcy assessment and Ut-A Doppler improved the sensitivity of prediction of PE relative to the use of e...
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