Seroprevalence of Chlamydia trachomatis among infertile couples in Assiut

The association between Chlamydia trachomatis infection and female and male infertility is scarcely studied in Egypt. Goal of this study immunoglobulin G antibody in the sera of infertile women and men were measured, as an indicator of past Chlamydial infection. 200 women [144 infertile and 56 age-matched pregnant controls] and 160 men [104 infertile and 56 age-matched control] were included in the study. Reproductive and sexual history were recorded, and immunoglobulin G antibody to Chlamydia trachomatis was measured. The seroprevalence of Chlamydia trachomatis among infertile women was 52% versus 10% in the control group [P < 0.001]. Infertile women with tubal factor had a 60% prevalence. though the difference was not statistically significant. Infertile men were not significantly different from the control group in chlamydial seropositivity [24% vs. 14%]. Risk factors for Chlamydia trachomatis infection [early sexual experience, multiple lifetime sexual partners. age under 20 years, being an STD contact, history of therapeutic abortion, previous pelvic inflammatory disease] could not be correlated with seropositivity. Clinical examination was not informative in patients tested seropositive for chlamydial infection. The higher prevalence of Chlamydial seropositivity among infertile women points to its association with infertility, possibly due to tubal factor. In men such a relation was not evident and semen abnormalities were not significantly higher among Chlamydial seropsitive cases

Is endometrial thickness a critical factor for pregnancy in ovulation induction program?

One hundred and thirty patients complaining of infertility due to solely anovulation were included in this study. Induction of ovulation was done using antiestrogens, bromocriptine and HMG/HGG according to baseline hormonal profile. They were monitored through 283 cycles using ultrasonography and hormonal assay. Endometrial thickness increased progressively from day-four to day-zero. Comparing conceptional and non- conceptional cycles showed that endometrial thickness was significantly more in conception than non-conception cycles both in day-zero and mid-luteal, while neither serum E2 level nor follicular diameter showed any difference between the two groups. Multilayered endometrium was detected in all conceptional cycles and in only half of the non-conception cycles. Both endometrial thickness and pattern could predict pregnancy in ovulation induction program. However, the cut- off level of endometrial thickness needed for implantation has to be evaluated in a further study

Management of the third stage of labour with carboprost trometamol in high risk patients for postpartum hemorrhage

This study aimed to compare carboprost treatment with methyl- ergometrine and oxytocin in managing the third stage of labor in parturient mothers had risk factor of PPH. One hundred and six parturient women were randomly assigned to use carboprost trometamol, methyl-ergometrine or oxytocin immediately after delivery of the baby. Both duration of the third stage and the mean blood loss were significantly low in the carboprost group than the other two groups. It was concluded that carboprost trometamol is more potent uterotonic drug than both methyl-ergometrine and oxytocin. It is effective in the presence of risk factor predisposing to PPH. To anticipate the risk of PPH and to use carboprost trometamol early is better than to treat PPH with the possible risks of hemorrhage and treatment. Reducing loss of blood in these women is very important especially in cases where there is the likelihood of anemia

Contraceptive knowledge and use in rural Naga Hammady, Upper Egypt

This study included all currently married women of reproductive age in El-Siad village [8I2] and its two satellites; Naga El-Sheikh [138] and Ezbet El-Bosa [437]; i.e. a total of 1387 women. A house-to-house survey was done using a predesigned questionnaire which was administered to all eligible women to determine the factors affecting knowledge and use of contraceptives in this part of upper Egypt. Results revealed that family planning knowledge is very high [90.0%], while the use is very low [12%]. Oral pills and lUDs are the most commonly used methods of contraception; and the main source for obtaining these methods is the pharmacy and private clinics. The survey showed that wide prevalence of radio and / or T.V. sets, which deliver family planning message regularly, is behind the high percentage of contraceptive knowledge. Illiteracy, early age at marriage and lack of family planning services particularly in rural areas are among the factors contributing to low contraceptive use. Attempts to reduce fertility should be directed towards extending the use of modern methods of contraceptives as a short term policy. But on the long run, raising women status in general is the best way to reduce fertility

Role of vaginal candidosis in abnormal discharge

255 women were recruited in this study; 225 presented with abnormal vaginal discharge and/or pruritis, burning and dysparuenia, the rest were asymptomatic and clinically free. High vaginal swabs taken and streaked immediately on Sabouraud dextrose agar. Vaginal candidosis ascertained by culture morphology and biochemical tests, was detected in 40.8% of symptomatic cases and in 16.6% of asymptomatic cases, the difference was statistically significant [P < 0.01]. The group of vaginal candidosis did not differ significantly from the whole symptomatic group in age or parity distribution. But they presented more in the luteal phase [66.1%] than in the follicular phase [P < 0.05]. The typical picture of candidal vulvo-vaginitis was detected in only 5.22% of patients. Candida albicans was the commonest species isolated from both symptomatic and asymptomatic cases. Torulopsis glabrata was isolated from 4.3% of symptomataic cases but not from asymptomatic cases

Nomograms of cervical dilatation and characteristics of normal labor in Upper Egypt

The pattern of normal cervical dilatation and characteristics of normal labour in 547 parturients have been established following a prospective study of 2112 consecutive labours. The mean duration of the first stage of labour, taken from time of admission, was 5.03 hours in primipara and 4.0 hours in multipara. The mean duration of the second stage of labour was 43.0 minutes in primipara and 28.7 minute in multipara. The mean cervical dilatation rate in the active phase was 1.8 cm/hr in primipara and 1.97 cm/hr and multipara were 3421 and 3464 gm respectively. Cervical dilatation-time curves [nomograms] constructed with references to cervical dilatation found on admission. Post-partum radiological pelvimetry was done in a subgroup of the studied women to determine the diameters of the pelvis in women with spontaneous labour

Role of ultrasonography in managing IUD-related complaints

The study included 211 women who were all using one type of IUDs, Cu-T 330 A. 155 women were presented with complaints related to the IUD use, e.g. abnormal bleeding, pain, missed threads and amenorhoea. The remaining 56 women had no complaints. All women wre examined by real-time ultrasound using abdominal sector and/or vaginal scanners. The parameters that were studied included the top-fundal distance [distance between the device top and the highest point in the uterine cavity], the intercornual and the fundus-is-thmus diameters [of the uterine cavity], and any abnormal finding present. About 50% of complainers had top-fundal distance more than 4 mm, while 28% only of non-complainers did so [P < 0.05]. Too small intercornual diameter [< 30 mm] or too wide [> 38 mm] were detected more frequently in women complaining of bleeding and pain than those without complaint [P < 0.05]. Abnormal findings were diagnosed in 25% of complainers compared to 7% in those without complaint [P < 0.01]. These findings included partial expulsion, picture suggestive of pelvic inflammatory disease, ovarian swellings, perforation and fibroid uterus. Ultrasonography appeared to have a good role in managing IUD-related complaints; its role should start before IUD insertion and extends thereafter