Single intrauterine insemination versus double intrauterine inseminations at differnt timing in controlled ovarian hyperstimulation cycles

The use of controlled ovarian hyperstimulation[COH] in combination with intrauterine insemination [IUI] has gained acceptance as a valuable method of infertility treatment. This study was done to compare the effectiveness of a single periovulatory IUI with double IUI and to determine the optimal timing of double IUI in relation to human chorionic gonadotropin [hCG] administration in COH cycles. Thirty infertile couples with unexplained infertility were enrolled in our study and were classified into three groups, ten couples in each group. After COH with clomiphene citrate and gonadotropins, patients in group A received a single IUI performed 34 hours after hCG administration, patients in group B received double IUI performed 34 hours and 60 hours after hCG administration and patients in group C received double IUI performed 18 hours and 42 hours after hCG administration. Each regimen was tried in patients for three successive COH cycles. The pregnancy rate in group A, group B and group C were 20%, 20% and 40% respectively in relation to number of patients, and 7.7%, 7.4% and 16.7% respectively in relation to number of treatment cycles. This means that double IUI performed at 18 hours and 42 hours after hCG administration in COH cycles is the most cost- effective regimen for patients with unexplained infertility

Serum prolactin and cortisol in children with epilepsy and febrile convulsions

Serum prolactin and cortisol levels were estimated in 67 children having either febrile convulsions [group 1 of 24 cases], epilepsy [group 2 of 20 cases] and non-specific fever with no seizures [group 3 of 23 cases]. Their ages ranged from 1 to 8 years. These studied groups were matched with a control group [4] of 20 healthy children of same ages with no fever and non-epileptic. Blood samples were taken as soon as possible postictial [within 2 hours from the fit]. All serum levels were compared between the different studied groups. Mean serum prolactin levels [32.9 SD13.9 ng/ml] were significantly higher [P>0.001] in epileptic group than in the group with febrile convulsions [14.2 SD 6.4 ng/ml], group of non-specific febrile illness [13.7 SD 6.0 ng/ml]and normal controls [12.8 SD 6.l ng/ml]. It was thus also evident that postictial mean serum prolactin level was slightly higher in febrile convulsions than the non-specific febrile group and the control group,this increase was within the normal ranges for their ages and was thus statistically insignificant [P<0.05]. Mean serum cortisol levels were non-specifically elevated in children with epilepsy [13.1 SD 7.6 ug/dl], febrile convulsions [36.4 SD 8.9 ug/dl] and non-specific febrile illness [30.2SD9.0 ug/dl]. The mean of these three groups was highly statistically significantly increased than the control group [m=11.9 SD 4.7 ug/ml and P> 0.001]. Our observations suggests that elevated serum prolactin levels associated with afebrile true epileptic seizures may help in differentiating epilepsy from febrile seizures. But cortisol levels appear to be non -specifically elevated in all stressful conditions. Thus, we recommend the utility of diagnostic capillary blood collection kits to assist the diagnosis of febrile convulsions even in the out-patient clinic

Haemostatic profile in patients with congenital cyanotic and acyanotic heart disease

Among the studied coagulation parameters, there was only a significant prolongation of prothrombin time, in both heart disease groups in comparison with the control group. Furthermore, cyanotic patients revealed, among the tested parameters a significant elevation of hemoglobin and hematocrit levles and of red cell count as well as a significant defect of clot retraction and ADP-induced platelet aggregation, as compared to acyanotic patients. Only defective clot retraction could be significantly correlated with blood hematocrit in the former group. Some derangement of hemostasis was thus observed in congenital heart disease, especially in cyanotic patients. Assessment, and if possible correction of such abnormalities is advised prior to surgery in such patients

Study of factor VIII in haemophilia:[A] patients with a trial of carrier detection

This study was carried out on 48 subjects from about 18 haemophilia A families attending the haematology clinic at New Children Hospital, Cairo University. They were Classified into 24 haemophilic male patients, 13 potential and 11 obligatory carriers. Fifteen healthy controls of the same age group were included in this work. Patients, carriers and controls were subjected to full clinical examination and laboratory studies. F VIII coagulant activity [F VIII C] was markedly reduced in all patients and even absent in two of them. It was also reduced in 8 of the obligatory carriers, decreased in five of the potential carriers and was increased in two pregnant obligatory carriers. F VIII related antigenic [F VIII Ag] was normal or increased in haemophiliacs, minimally decreased in carriers, 90+ACU- in obligatory and 79+ACU- in potential carriers. F VIII C/F VIII Ag ratio was one in normal controls, 0.5 in obligatory carriers, 0.8 in potential carriers and 0.02 in haemophiliacs