Evaluation of the level of total nitrate and nitrite concentration in vaginal secretion in cases with preterm labor and if it can be used as a predictor of premature delivery

Vaginal secretions were collected after informed consent from 80 pregnant women with gestational ages from 27 to 32 weeks. Samples were collected by thorough washing of the vagina with 5 ml sterile physiologic sodium chloride solution. Samples were stored at -40C until delivery of all studied pregnant women. The level of total nitrite and nitrate concentration in vaginal secretion of pregnant women who delivered before 37 completed weeks and in those with preterm premature rupture of membranes with subsequent preterm delivery were significantly higher than in those delivered at term

Steroid receptors, carcino embryonic antigen and DNA study in endometrial carcinoma

Thirty cases of endometrial carcinoma and 10 control cases [normal endometrial tissue] were studied in this work. Two years follow-up for patients was performed in order to record the recurrence and metastatic cases. ER immunopositivity were detected in 80% of the carcinoma cases [24 out of the 30 cases] and 20% of the control cases [2 out of the 10 cases]. PR were expressed in 70% of the malignant cases and 10% of the control cases. Both receptors were detected in 68% of the same tumor cells and 10% of the control cells. Both receptors were markedly immunoexpressed in patients below 50 years and in premenopausa1 women. There was inverse relation between both receptors over expression and tumor grade and increased clinical stage, the relation was significant. No recurrence or metastasis was detected in these positive cases, through 2 years follow-up. Carcinoembryonic antigen [CEA] immunopositivity was detected in 63.3% of the carcinoma cases and none of the control cases. No relation was detected between CEA immunopositivity and age, menopausal state, tumor type or tumor differentiation. Marked immunoexpression was seen in stage III tumor. Three cases of recurrence were recorded in immunopositive CEA carcinoma cases. DNA ploidy was studied by image analyzer. Nine carcinoma cases were diploid [DNA index <1] and 21 were aneuploid [DNA index >1]. All control cases were diploid. Tumor aneuploidy was highly recorded in old age group [above 50 years] and in postmenopausal women. There was a direct relation between tumor aneuploidy and increased tumor grade and clinical stage. The relation was significant. No relation was detected between aneuploidy and different histological types

Ultrasonographic and color doppler evaluation of adnexal masses

This is a prospective study conducted on 30 patients with adnexal masses, presented at El-Minia University Hospital at Gynecology department. The aim of this study was how to differentiate between benign and malignant adnexal swellings depending on morphological criteria of the lesion by abdominal and transvaginal gray scale ultrasonography and color Doppler and Pulsed Doppler parameters. The examined females ages ranged between 14 to 70 years with a mean age 42.5 year. Dermoid cyst and infected simple cysts were the most common benign lesions evaluated in our study. Mucinous cystadenocarcinoma was the most common malignant lesion detected. We followed an objective scheme for sonographic assessment of adnexal masses depending on morphological criteria including wall thickness, echogenicity, septations and inner wall structure. Our results revealed that this score is sensitive [100 percent] but less specific [56.3 percent]. As this score is numerical so changing the threshold to 10 instead of 9, the score will be less sensitive but more specific. Color Doppler assessment depends upon vessel location whereas central vessels usually indicate malignant lesions while peripheral detection of vascularity with benign lesions. Diastolic notch was present with benign lesions while absent at malignant lesions as neovascularity have no smooth muscle support. Resistive index [RI] at 0.6 was sensitive in differentiation between benign and malignant lesions [100 percent] but less specific [42.9 percent], changing the parameter to 0.4, the sensitivity become 78.6 percent and specificity 85.6 percent. As regards pulsatility index [PI] a cut off 1 gave sensitivity 100 percent and specificity 92.9 percent and accuracy of 96.4 percent. The combination of ultrasonographic scoring system with Doppler indices was able to discriminate between benign and malignant adnexal masses as this combination correctly identified 13 out of 14 ovarian cancer and rolled out the disease in 14 out of 16 benign cases

Association of bacterial vaginosis with adverse pregnancy outcome

Objective was to examine whether there is a relationship between bacterial vaginosis, premature rupture of membranes [PROM] and preterm labor [PTL]. Two hundred pregnant women at less than 34 weeks gestation were screened for bacterial vaginosis. The diagnosis of bacterial vaginosis [B.V] was based on vaginal pH >/- 4.5 and gram stain of vaginal smears. The occurrence of [PROM] and [PTL] was recorded for each case. Setting: El- Minia University Hospital. The prevalence of [B.V] among healthy pregnant women, women with [PROM] and those delivering prematurely was [13/125 = 10.4 percent], [7/23=30.43 percent] and [14/52= 26.73 percent] respectively. Women with bacterial vaginosis were found to be more likely to develop PROM and preterm labor when compared to healthy pregnant women [P-value = 0.0026 and 0.0030] respectively. Bacterial vaginosis [B.V] occurs in a significantly higher proportion of women with adverse pregnancy outcome compared to those with healthy pregnancy. Bacterial vaginosis should be thought of when dealing with a case of adverse pregnancy outcome especially if it is of unknown origin