ABSTRACT
Background: Polycystic Ovary Syndrome [PCOS] is one of the most common causes of anovulatory infertility. Currently, clomiphene citrate [CC] is considered the first-line therapy for ovulation induction for women with PCOS and infertility. Aromatase inhibitors [AIs] have been introduced as a new treatment option that could challenge CC for ovulation induction
Aim of the Work: The present study was designed to compare the efficacy of combined aromatase inhibitor [Letrozole] with metformin versus CC with metformin in PCOS patients
Patients and Methods: This study was done on 100 documented PCOS cases. They were divided into two groups, The 1st group received CC 50 mg twice daily from the 3rd day of cycle for 5 days and repeated for 3 cycles with metformin 500 mg 3 times daily as an adjunct with CC and continued for 3 cycles. The 2nd group received aromatase inhibitor [Letrozole] 2.5 mg twice daily from 3rd day of cycle for 5 days and repeated for 3 cycles with metformin 500 mg 3 times daily as an adjunct with letrozole and continued for 3 cycles. These cases were followed up for three cycles by transvaginal ultrasound folliculometry to document ovulation [size and number of follicles]
Results: The results of the present study revealed both lines of treatment were effective in treatment of PCOS patients, with slight favorability in letrozole group but without statistically significant difference founded between CC group and letrozole group as regard ovulation rate, number of follicles at the end of first, second or third cycles, or as regard the diameter of follicles, i.e., both regimens showed efficacy to the same extent
Conclusion: both CC and letrozole are equally effective in treatment of infertility in PCOS patients, when combined with metformin treatment
ABSTRACT
Purpose: the present study aimed to evaluate the advantages of external fixation in the management of femoral shaft fractures in. older children [6 years or over]
Patients and methods: between September 200J and September 2005, we treated 14 children with 15 femoral shaft fractures using external fixation. Thirteen of them were available for follow up [14 fractures]. Four fractures were open and ten closed. There were 9 boys and 4 girls. Their average age on the day of injury was 8.4 years [ranged from 6-12 years]. All the patients were managed by closed reduction and application of monoplanner external fixator under control of image intensifier
Results: average follow-up was 12 months [ranged from 6-18 months]. The time to radiological union ranged from 2 to 3 months with an average of 2.5 months. Full range of motion was regained in all patients except two Pin track infection developed in 4 patients. Leg length discrepancy was minimal without any clinical complications and detected in three cases. No significant rotational deviation was seen. Refractor happened in one patient
Conclusion: management of fracture shaft .femur in older children [older than 5 years] by external fixation provides available alternative to conservative treatment
ABSTRACT
Purpose: the aim of this study is to evaluate the results of Coraco-clavicular screw fixation with ligaments suture for the treatment of complete acute acromioclavicular joint [ACJ] dislocation
Material and methods: eighteen patients with complete ACJ dislocation were treated operatively in El-Minia University Hospital. According to the classification of Rockwood and colleague's they had type ill, IV or V lesion. They were operated within three weeks of injury by Coraco-clavicular screw fixation with suture of the Coraco-clavicular ligaments. There was a postoperative immobilization of the injured shoulder for 3 weeks
Results: follow-up period ranged from 6 months to 2 years. Sixteen patients achieved excellent outcome with full range of shoulder movement and pain free. One patient developed chronic shoulder pain [Follow-up X-rays revealed mild subluxation of the acromio-clavicular joint] and one had painful hypertrophic surgical scar
Conclusion: our results indicate that this procedure can be recommended
ABSTRACT
Calculation of anion gap [AG] is an important clinical criterion in establishing the nature of metabolic acidosis [MA]. This study showed that MA as shown by high AG is not uncommon in patients hospitalized with acute exacerbation of asthma. High anion gap was found in 11 out of 20 patients with severe bronchial asthma, whose PaO2 <50 mmHg. Their AG on admission ranged between 20.6 and 39 mEq/L with a mean of 29.50 mEq/L. Fifteen out of 20 patients had absolute and relative hypercapnea, nine of them had high AG. Five patients had hypocapnea, two of them had high AG. Patients with MA ran more aggressive downhill course than those without, six of them needed artificial ventilation. It was concluded that the calculation of AG to recognize MA was not only a kind of diagnosis and evaluating the acid base status, but also it gave a greater insight of the prospect of therapy and follow up of the patients in the quagmire of critical care medicine