Comparative study between measuring FSH, LH and E2 on day two and on any day of the cycle

Background: evaluation of ovarian reserve has become an essential part of the treatment assessment of woman to undergo assisted reproductive technique

Aim of the Work: this work was conducted to measure FSH, LH and E2 at any day of the whole menstrual cycle compared to day2 with measurement and establishing an actual negative correlation between FSH and E2

Patients and methods: observational analytical prospective study on 50 women attending the Gynecology Outpatient Clinics of Maternity Hospital, Ain-Shams University in 2016

Results: there was a significant negative correlation between E2/FSH on the 3[rd], 5[th] and 10[th] days of the cycle. Also there was insignificant negative correlation on day 21

Conclusion: there was negative correlation between basal day2 E2/FSH which was equivalent or similar to that ratio on days [5, 10, 21] so there was no need to wait for hormonal analysis to the next cycle [day 2 or 3] to save time specially in patients >35years; for them there was importance of cycle day3 for evaluation of ovarian reserve and prior ovulation induction and subsequent pregnancy potential during the infertility work up

Recommendations: during the infertility work up, rigid adherence to cycle day3 collection, no longer seems necessary ,no need to wait for hormonal analysis to Estradiol and FSH to the next cycle as there was equivalent negative correlation between E2/FSH on menstrual cycle days [3,5,10,21] aiming for saving time

Comparison of immunochromatographic test and microscopy in the detection of some enteric protozoa in stool samples

Infection with pathogenic intestinal protozoa as Giardia lamblia, Entamoeba histolytica and Cryptosporidium parvum cause considerable gastrointestinal morbidity, malnutrition and mortality worldwide, especially among young children in developing countries. The present study was carried out on 71 cases [44 males and 27 females] chosen from Pediatric and Internal Medicine Inpatient and Outpatient Clinics of Zagazig University Hospitals, complaining of different gastrointestinal troubles with an age range of 6-60 years. Also, 20 apparently healthy individuals [11 males and 9 females] cross matched were considered as a control negative group. All stool samples were examined by direct wet smears, concentration techniques, staining of the smears using trichrome stain and Modified Ziehi-Neelsen method. Copro-antigen detection in faecal sample was by using quick immunochromatographic test. A total of 71 cases suffering from different GIT manifestations showed G. lamblia [30.7%], Cryptosporidium parvum [19.8%], Entamoeba histolytica /E. dispar [11%] and mixed infection of three protozoa [6.6%]. However, by copro-antigen G. lamblia was positive in [31.8%] of C. parvum in [20.9%]; E. hisiolytica/E. dispar in [11%] of cases. lmmunochromatography/copro-antigen test recorded sensitivity and specificity of [100%] and [96.6%] respectively in G. lamblia detection. For C. parvum, sensitivity vas [100%] and specificity was [97.1%] while for E. histolytica/E. dispar sensitivity and specificity were [100%] for both. lmniunochrornatographic assay proved to be simple, easy and useful in confirming absence or the presence of intestinal protozoan infection in clinically suspected cues with negative stool examination

Evaluation of mean platelet volume and platelet distribution width in the diagnosis of Immune Thrombocytopenic Purpura

Objectives: Bone marrow examination is the gold standard test in discriminating between hyper destructive thrombocytopenia and hypo productive thrombocytopenia. However, this procedure is invasive. Mean platelet volume [MPV] and platelet distribution width [PDW] arc simple, inexpensive and noninvasive methods that may be used in discriminating between these two types of thrombocytopenia

Aim of the study: The present study investigated the significance of the platelet indices, mean platelet volume and platelet distribution width in the diagnosis of ITP

Subjects and methods: The present study compared the mean platelet volume and platelet distribution width in 15 patients with hyper destructive thrombocytopenia and 15 patients with hypo productive thrombocytopenia. The sensitivity and specificity of these platelet indices to diagnose ITP were also measured

Results: The MPV showed a sensitivity of 93.3% and a specificity of 66.7% at cut off of 7.7 fL and the PDW showed a sensitivity of 86.7% and specificity of 73.3% at a cut off of 40.6%

Conclusions: The study concluded that although MPV and PDW can be used as an initial hint for predicting the type of thrombocytopenia, it has limited sensitivity and specificity

Is surgical treatment of gingival and palatal cysts of the newborns necessary?

Purpose of this study was to investigate the conservative and or surgical treatment of gingival and palatal cysts of the newborns. A three years prospective study was conducted between 2009 and 2012 at Prince Hashem Ben Al-Hussein Military Hospital/Zarqa-North of Jordan and Prince Zaid Ben Al-Hussein Military Hospital, Atafela-South of Jordan. A total of 5000 newborns were examined. Those newborns who were diagnosed initially to have a single or multiple gingival and or palatal cysts were included in the study, but those with cleft palate and or cleft lip and all with congenital abnormalities were excluded. All infants diagnosed initially by neonatologist as having either gingival or palatal cyst were referred to periodontist for confirmation of the diagnosis. Further evaluations were conducted by neonatologist and periodontist after every two weeks. Over a period of three years, a total of 144 newborns with gingival and or palatal cysts were diagnosed during routine examination of the newborns at Prince Hashem Military Hospital and Prince Zaid Ben Al-Hussein Military Hospital. Patients were followed up for a period of 8 months. Sixty three percent of all cysts were broken by themselves after one week while 8% broke at the age of 3 months, 10% at 6 months of age, 6% at the age of 8 months and only 4% required surgical treatment. The study concluded that the majority of gingival and palatal cysts of the newborns resolved by the age of 8 months by themselves. This emphasizes the need for conservative and regular follow-ups and just reassuring the guardians of the newborns. The minority of them need surgical treatment

Impact of total parenteral nutrition on deciduous tooth eruption of very low birthweight premature infants

Purpose of this study was to investigate the effect of total parenteral nutrition on deciduous teeth eruption of very low birth weight premature infants. It was a prospective study done at Prince Hashim Ben Al-hussein Military Hospital of 85 healthy preterm infants who were born with birthweight of 800-1500grams, and at 27-32 weeks gestational age. They were divided into two main groups Group [40 preterm infants who did not receive total parenteral nutrition] and Group B [45 preterm infants who received total parenteral nutrition [TPN] during stay in the neonatal intensive care unit]. Group B was divided into two subgroups B1 [20 preterm infants who received only 3.5 grams/Kg/day Amino acids] and B2 [25 preterm infants who received amino acids and 3 grams /kg/day intralipids]. A first tooth eruption record was completed by the neonatologist and the parents of the enrolled infants during regular clinic appointments. Normal eruption was seen in subjects with birthweight [1001-1500 grams] than those with birth weight of 800-1000 grams and gestational age [30-32 weeks] than [27-29 weeks]. There were significant differences between groups for total parenteral nutrition, and they were highly significant when amino acids and intralipids were used together. As far as intubation is concerned the difference was not significant when the delayed group compared to the normal group. Neonatal sepsis were significantly increased when the oral intubation was more than 5 days. The study concluded that the introduction of total parenteral nutrition to very low birth weight premature infants resulted with early first tooth eruption. It is concluded that intralipids component of TPN is responsible for this observation, but further studies to evaluate the role of other TPN components are mandatory

Seasonal variation in cardiac conductive disorders in Egyptian patients

To evaluate seasonal variation in cardiac conductive disorders leading to permanent pacemaker implantation. Conductive disorders of all patients who had implanted cardiac pacemakers during the period from January 2007 to end of March 2009 were evaluated. All conduction disorders in atrial and atrio-ventricular node were included. Statistical analysis was done by SPSS version 13. 627 patients, 346 males and 281 females were included in the study divided into multiple age groups. We recorded seasonal variability in the incidence of conductive disorder with two peaks in months march and June i.e. at the end of winter and end of spring. incidence of conduction disorders which lead pacemaker implantation was higher at the end of Winter and the end of Spring than other seasons. This recorded observation opens the discussion about the etiology and provocation in cardiac conductive disorders

Spirometric plus left ventricular and pulmonary blood flow echocardiographic findings in patients with scleroderma before and after sildenafil

Systemic sclerosis [scleroderma] is a chronic debilitating disease that is caused by the occurrence of fibrotic changes and vascular abnormalities at various levels such as: Skin, lungs, kidneys or heart. Lung involvement in scleroderma is one of the leading causes of mortality in this disease. Sildenafil inhibits phosphodiesterase type 5, an enzyme that metabolizes cyclic guanosine monophosphate, thereby enhancing the cyclic guanosine monophosphate-mediated relaxation and growth inhibition of vascular smooth-muscle cells, including those in the lung. We hypothesized that chronic oral administration of the phosphodiesterase-5 inhibitor sildenafil could improve the pulmonary haemodynamics in Systemic sclerosis [Ssc] patients. To investigate the use of sildenafil, detect the effect of sildenafil on the left ventricular function and the pulmonary blood flow echocardiographic parameters and pulmonary functions in a series of SSc patients. Twenty three systemic sclerosis cases were selected for the study. All patients were subjected to clinical evaluation, laboratory investigations, plain chest X-ray, ECG, basal pulmonary function tests and basal echocardiographic assessment. One week of therapy with oral sildenafil 75mg/day in three divided doses was given to the patients, after which they were subjected to a second assessment of respiratory function tests and echocardiography. Sildenafil therapy resulted in the following changes: Mitral E/A was significantly increased [p<0.05]. This was further supported by a significant drop of the pre-ejection period [p<0.001] after using sildenafil. There was a significant rise in acceleration time and the ratio between it and ejection time in both aortic and pulmonary Doppler. Also there was a significant decrease in pulmonary artery diameter [p<0.001], maximal pulmonary flow velocity [p<0.001], pulmonary integral area under the curve [p<0.001] and mean acceleration [p=0.007]. Some ventricular contractility indices as the posterior wall excursion [p=0.001], inter-ventricular septal excursion [p=0.043], velocity of posterior wall excursion [p<0.001], velocity of interventricular septal excursion [p<0.001] showed statistically significant increase. The left ventricular internal dimensions and volume in diastole showed a significant drop [p=0.001, p=0.002 respectively], there was a significant increase in the interventricular septum thickness in systole and diastole [p<0.05] with a borderline significant increase in posterior wall thickness in systole [p=0.05]. Spirometric studies showed a statistically significant increase in FEV[25-75] after the use of sildenafil, [p<0.05] which denotes improvement of airway obstruction. Sildenafil improved left ventricular systolic and diastolic functions and may improve pulmonary blood flow in patients with systemic sclerosis. PDE-5 inhibitors are efficacious in scleroderma-associated pulmonary hypertension

value of pulsed tissue doppler study in the early diagnosis of diastolic dysfunction in type 2 diabetes mellitus

Cardiovascular disease is the most important cause of mortality and morbidity among patients with type 2 diabetes. Diastolic dysfunction represents the earliest preclinical manifiestataion of diabetic cardiomyopatahy that can progress to sympotomatic heart failure. Transmitral flow Doppler echocardiography is widely used to non-invasively evaluate diastolic function in type 2 diabetic patients, however, this method may give misleading results. Recently, Pulsed Tissue Doppler Imaging [TDIK] has emerged as a new non invasive imaging modality that allows direct online measurement of myocardial velocities throughout the cardiac cycle. The aim of this work is to evaluate the usefulness of pulsed tissue Doppler study of mitral annulus versus transmitral flow Doppler in assessing the diastolic function in type 2 diabetic patients. This study included 4 subjects divided into: 15 patients with type 2 DM having diastolic dysfunction diagnosed by conventional Doppler [group I], and another 15 diabetic patients with normal diastolic function by conventional Doppler [group II], in addition to 10 normal controls [GROUP III]. All patients were subjected to clinical evaluation, laboratory investigations, ECG, echocardiographic assessment and Pulsed Tissue Doppler Imaging of the mitral inflow and mitral annulus with assessment of the transmitral flow veloctities. All partients with diastolic dysfunction diagnosed by conventiaonal Deoppler showed the same abnormality on using TDI, moreover the use of the ratio E[TDI]/A[TDI] by TDI diagnosed 33.33% of group 2 patients to have diastolic dysfunction while they were having normal patterns by conventional Doppler. There were no values in the control group of E[TDI]/A[TDI]<1. Higher values of FBS, PP, HbA1c and triglycerides were associated with impaired LV diastolic performance. Diastolic dysfunction is common in type 2 DM patients specially those with worse glycaemic control. Pulsed TDI of the mitral annulus is more sensitive than conventional Doppler in identifying early LV diastolic dysfunction in type 2 DM patients

Interfacial micro-morphology and shear bond strength of two resin adhesives bonded to human enamel compromised by bleaching or micro-abrasion therapy

Bleaching and enamel microabrasion are considered less destructive alternatives to the mechan-ical removal of discolored enamel. The aim of the present study was to investigate the effect of in-office bleaching or micro-abrasion on the bond strength of two dental adhesives bonded to surface enamel. The interfacial micro-morphology of the involved surfaces was also studied by using SEM. Materials and methods: A total of 26 extracted human premolars were used to prepare 52 samples exposing enamel surfaces. Samples were randomly assigned to two groups to test the bonding with two dental adhesives. Each group was further subdivided into 2 subgroups of 13 each. The first subgroup of samples was bleached using Luma-white TM bleaching system whereas the second was treated with microabrasion. Five samples from each subgroup were processed for SEM to study the interfacial micro morphology.

Results: statistical analysis revealed that enamel surfaces treated with microabrasion showed significantly higher bond strength with Excite than with Rely -a light bond. , While by bleaching there was no significant difference between the mean bond strengths of the two adhesives. Moreover, bleaching therapy reduced the shear bond strength significantly than micro-abrasion. SEM of the interface of bleached enamel revealed the presence of tinny micro-gaps alternating with discrete areas of irregular resin tags when enamel was bonded using Rely-a bond. While with Excite bonding system relatively larger micro-gaps were detected. On the other hand, microabraded enamel showed almost gap-free interface with the two adhesive systems used

Conclusions: [1] Bleaching with LumaWhite bleaching system adversely affects the shear bond strength to human enamel. [2] Pretreatment of enamel with micro-abrasion enhanced the bond strength particularly with alcohol-based adhesives. [3] Fluoride releasing adhesive systems could enhance the bond strength with enamel compromised by bleaching and hence could be recommended for bonding of orthodontic brackets

Cytochemical localization of Ca2 - Mg2 ATPase in the growing end of rat incisor

Ca[2]-Mg[2] ATPase activities were detected in the growing end of the rat incisor as esrly as the undifferentiated cells. These activities varied with the differentiation state of the inner enamel epithelium cells. The enzyme reaches maximum activity during secretory stage