Prevalence and risk factors for female sexual dysfunction in Egyptian married rural women in child bearing period

Sexuality is an important part of health, quality of life and general wellbeing [1]. Sexual dysfunction is characterized by disturbance in sexual desire and psycho physiological changes associated with the sexual response cycle in men and women [2]. Female Sexual dysfunction [FSD] is defined as a disorder of sexual desire, arousal, orgasm, or sexual pain that results in significant personal distress. That might have an impact on the quality of life, interpersonal relationships and self-esteem. Several human studies have documented that, FSD is a progressive, related to hormone-sensitive condition [3]. A woman's sexuality is a complex interplay of physical and emotional response that affects the way she thinks and feels about herself. When a woman has a sexual problem, it can impact many aspects of her life, including her personal relationships. In additional to, causes of sexual dysfunctions can be psychological, physical or related to interpersonal relationships or sociocultural influences [4]. To estimate the prevalence of sexual dysfunction among married rural women in child bearing period. Also to explore possible risk factors that may precipitate to female sexual dysfunction with in marital life. A cross sectional clinic-/hospital based survey. Study was performed in out patient clinics of obstatric and gynacological department of university hospital at Menoufiya Governorate. The subjects of study were 290 married rural women in child bearing age, those were selected from attedences who lived in surrounding villages to the hospital, The study was taken period of time from Jun 2007 to Jun 2008. The researchers utilized structured interviewing questionnaire sheet it was contained the following categories: sociodemographic characteristics, medical, obstetric and gynecological history as well as sexual relation/activity and contraceptive methods which were used. All sample were counseled confidentionially about their dysfunction and their clinically examined Complete assessment was carried out to exclude pathological causes of dysfunction. Subject were diagnosed as FSD by researcher physician. Majority of the sample had sexual dysfunction [86.3%]. Also, third of studied sample were relatives, and beside that relatively all studied sample were circumcised from 8-10 years. FSD is a highly prevalent problem within the scope of this study. The culture, beliefs and educational level of women had a major effect on occurrence of sexual dysfunction

Impact of preoperative clopidogrel on coronary artery bypass

This study was designed to evaluate the effect of preoperative clopidogrel on coronary artery bypass graft surgery [CABG] outcomes. Clopidogrel in combination with aspirin, given before percutaneous coronary intervention, has become the standard for stent thrombosis prevention. Its use in acute coronary syndrome patients and in patients with cerebrovascular strokes and peripheral vascular disease is expanding. Some of these premedicated patients, however, when undergoing coronary angiography, are found to have surgical disease and irreversible platelet inhibition becomes a concern for the upcoming CABG. We retrospectively studied 174 consecutive patients undergoing nonemergent first-time on pump CABG in a tertiary referral center. Patients with concomitant valvular or vascular surgery or preoperative exposure to oral anticoagulants, platelet glycoprotein [GP] IIb/IIIa inhibitors, or thrombolytic therapy were excluded. We compared those with preoperative clopidogrel exposure within five days of the operation [n=54] to those without exposure [n=120]. Patients without clopidogrel exposure were also grouped into those with [n=50] and without [n=70] aspirin exposure within the five days preceding operation, and were compared for post operative bleeding related complications and outcomes in an effort to isolate the effect of aspirin. The two groups with and without preoperative clopidogrel exposure were comparable in age, gender, presence of coronary artery disease risk factors, associated co-morbidities, preoperative electrocardiographic abnormalities, echoc ardiographically estimated left ventricular ejection fraction, and number of diseased coronary arteries. Baseline medications and number of diseased coronary arteries. Baseline medications were similar in the two groups except for a higher prevalence of concomitant aspirin exposure within the 5 days preceding CABG in the clopidogrel group [100%] than the group without clopidogrel exposure [41.7%] [p<0.001]. Whilst awaiting the surgery, both groups had similar complication rates. There were no differences between the two groups regarding operative findings including the number of bypass grafts per patient, the bypass time, and the cross clamp time. Aprotinin was not routinely used [4.6%], but its use was more in the clopidogrel group [11.1% Vs. 1.7%, p<0.006] [Table 2]. The incidence of post operative myocardial infarctions, arrhythmias, chest complications, and strokes were similar in both groups, as was the use of inotropes and peri-operative intro-aortic balloon pump. However total chest tube drainage was significantly higher in the patients with clopidogrel exposure [956.7 +/- 633.5 vs. 539.8 +/- 326.9, p<0.0001], and an increased amout of transfusions with blood and blood products was observed in the clopidogrel group [5.26 +/- 4.1 Vs. 1.98 +/- 1.7, p<0.0001]. Although there was a trend to an increase in re-exploration group, this did not reach statistical significance. the length of stay in the intensive care unit [ICU] was significantly longer in the clopidogrel group [3.04 +/- 0.88 Vs. 2.57 +/- 0.89, p<.001], but the length of hospital stay did not differ between the two groups. In the group with no clopidogrel exposure, the use of aspirin within 5 days of CABG did not affect the 24 hours chest tube output, total number of blood transfusion units, or need for re-exploration for bleeding versus those with no aspirin exposure. Clopidogrel before CABG is associated with higher postoperative bleeding, blood transfusion rates and length of ICU stay. These findings raise concern regarding the routine administration of clopidogrel before coronary angiography