Serum AMH, estradiol and progesterone: is there a role in predicting the outcome in IVE?

To evaluate the role of antimullerian hormone and serum Estradiol in predicting the outcome in IVF, Prospective controlled trial. Egyptian Fertility center. 89 patients who suffer from infertility and are candidate for IVF are recruited for the study after consenting. Serum estradiol and progesterone are measured on day 1 of the cycle and on the day of HCG administration; we measure serum antimullerian hormone, estradiol and progesterone. The results are compared with the number of retrieved oocytes, number of tansferred embryos, pregnancy rat and incidence of twin pregnancy. The results are statistically analyzed. The age of the patients ranged from 22-45 years with a mean of 30.68 years. 4 patients of the 89 patients of the study got pregnant. There was significant difference between AMH and number of retrieved oocytes, the number of embryos as well as pregnancy rate. There is no significant correlation between AMH and twining. There is no significant correlation between serum estradiol at day 1 with either number of retrieved ooeytes, the number of embryos, pregnancy rate or twining. When we measure estradiol level at the date of HCG administration, there was a significant correlation with the number of retrieved oocytes and the number of embryos but with no significant correlation with pregnancy rate or twining. As regard to the progesterone level, there was no significant correlation with the number of retrieved oocytes, the number of embryos, pregnancy rate or twining at either progesterone levels at day 1 of the cycle or the day of HCG administration. When the estradiol level is below 50 pg/ml the AMH shows the most significant correlation with the number of retrieved oocytes, the number of embryos and pregnancy rate. The cut-off point or AMH is 0.3028 ng/ml below which we face poor ovarian response whereas that for estradiol at day 1 is 47.32 pg/ml. Both AMH and estradiol level at the day of HCG administration have a role in predicting the outcome of IVF in regard to the number of retrieved oocytes, the number of embryos and pregnancy rates in opposition which shows no actual relation to the IVF outcome parameters. In view of these laboratory investigations mainly AMH, our results do not recommend it as a routine procedure for women undergoing IVF. We can use them in patients whom we anticipate poor response in IVF program

Visceral leishmaniasis in the Syrian Arab Republic: early detection using rK39

Leishmaniasis causes significant morbidity and mortality in areas where it is endemic. A seroprevalence survey was conducted in 2 endemic villages in Daraa, Syrian Arab Republic, where 80 out of 345 children [23.2%] tested positive for visceral leishmaniasis [VL] using rK39 dipstick test. Only 10 cases were symptomatic [12.5%], and 27.5% were positive by ELISA test. All the sera [N = 138] obtained from the control village were negative. Of the rK39 initially positive cases, 52 had seroconverted to negative 9 months later, 55 remained ELISA negative, and none developed the full-blown disease. Being faster and less expensive than other diagnostic tests, rK39 is a rapid, sensitive and specific diagnostic tool for symptomatic cases of VL in remote areas with poor accessibility to health services

Role of ultrasound and doppler flow study in management of malignant gestational trophoblastic neoplasia

Forty four patients with malignant gestational trophoblastic neoplasia [GTN] were enrolled in the study. They were followed up by serum B-HCG and abdomino-pelvic ultrasound during chemotherapy. In addition, the last 6 patients recruited in the study were assessed by doppler flow study. The cure rate was 100% for patients with non metastatic GTN [n = 27] and low risk metastatic GTN [n = 12]. For patients with high risk metastatic GTN [n = 5], the cure rate was only 40%. Ultrasound failed to localize uterine lesions in 4 out of 44 patients [9%] one of them had brain metastatases. Positive findings were found in the other 40 Cases [90%] [e.g. enlarged uterus, focal uterine lesion, ovarian thecalutein cysts liver metastases]. There was also regression of the detected lesions with normalization of B-HCG titre in responding patients [33/38] patients while the lesions persisted in patients with resistance to chemotherapy [5 patients]. Doppler flow study diagnosed 6 out of 6 cases of malignant GTN [100%] and the uterine vasculature decreased in 5 cases who responded to chemotherapy and remained high [Low resistance index and high peak systolic velocity] in one case who was not responding to chemotherapy as indicated by persistently high B-HCG. In conclusion, utrasonography and pulsed doppler flow study of the uterus are complementary tools to serum B-HCG in diagnosis and follow up of malignant GTN during chemotherapy. They can help in selection of patients for more aggressive chemotherapy to minimize relapse rate and hence increase cure rate

Professionalism among nurse practitioners and nurse educators at Tanta University

The aim of the present study was to test the degree of professionalism among nurse practitioners and nurse educators at Tanta University. All clinical nurse instructors working in Higher Institute of Nursing Tanta University were included in the study. Nurse practitioners working in the Teaching Hospital affiliated to Tanta University, were randomly selected and included in the study. The Hall's professionalism scale was translated into arable language and tested on a pilot study, and used for data collection. The components of professionalism scale tested were: the use of professional organization as a major reference, the belief in service to the public, the belief in self regulation, the sense of calling to the field, and autonomy. Results of the study revealed that nurses differ in their degree of professionalism when grouped according to their educational level, occupation and type of working community. They significantly differ in their use of professional organization as a major reference, and in their belief in autonomy. Regarding the rest of components nc significant difference was detected between groups. The nurses professionalism mean scores were significantly higher witi increased level of education. The assistant lecturers scored significantly higher than bedside nurses, while no significani difference was found on total professionalism mean score among clinical instructors, nurse supervisors or head nurses. The nurses working in the educational community scored higher than those working in the practitioner community in their professional attitude. The present study recommends that: 1- Teaching about professionalism in the nursing curriculum is a pressing need for the progress of the nursing profession. 2- Advanced education for nurses at all levels, should be encouraged. 3- Nurses should be encouraged to be active member in the professional nursing organizations and active participant in all nursing issues. 4- Recognition for different types of practitioners with different levels of education

use of collaborative technique for students self-evaluation of clinical performance

The present study aimed to study the relationship between the instructor rating of the student and the student self rating of clinical performance, using the collaborative technique of evaluation. The study included all the fourth year students [73] enrolled in the team leader supervisory role for the clinical experience of nursing service administration course, at the Higher Institute of Nursing, Tanta University [1990]. The evaluation tool consisted of seven main areas of clinical performance; namely: planning of patient care, organization of work assignment, concern for patient medication, ability for teaching, ability for making conferences, use of reporting, and adequacy of recording. The findings of the study showed that most of the students gave greater-scores to themselves as compared to the scores given to them by the instructors, with a significant difference in most of the cases

Developing students leadership style at Tanta Higher Institute of Nursing

The educational outcome of a developed course in nursing service administration was examined on 35 senior students in the Tanta Higher Institute of Nursing. The leadership knowledge questionnaire [80 questions], and Frew [6] test were used. The t-test analysis indicated that the mean score of students leadership knowledge was improved significantly [t = 16.11]. The Z test indicated that the students leadership style changed significantly to become more participative, democratic and less laissez-faire. They preferred more the participative and the democratic kind of bosses after receiving the course

adequacy of recording the assessment data for infants in the MCH centres in Jordan

The aim of the present study was to examine the adequacy of recording the assessment data related to the infant's health in the MCH centres in Jordan. Five MCH centres were selected by systematic random sampling from the total number of MCH centres in Irbid city, Jordan. A sample of 279 family records were selected by systematic random sampling. The records obtained were examined against a check list for adequacy of data recording. Results of the study indicated that the name, address, family members of the child were coerrectly filled in most of the records. The risk factor, family planning advice, the attitude toward family planning the action taken by parents, growth pattern of child, home visits and follow-up visits all give a picture of incomplete medical recording. It is recommended to implement a quality assurance program in the medical record service of MCH centres in Jordan

Risk factors for infant malnourishment and nurses interventions

The purpose of the present study was to investigate the factors which place the infant in high risk group for malnouri-shment and the nurses intervention to lower the risk. A systematic random sample of 204 mothers of children between 6 -12 months of age were selected from Barha MCH Centre in Jordan. An interview schedule was used to collect the data from mothers. The factors which place infants in the high risk group included lost children less than one year of age, those not breast fed for at least 5-6 months of life; infants with birth weight below 2.5 kgm; multiple births; high birth order of the fifth or more; children with older brother/sister died during the first year of life; children infected with measles, whooping cough or repeated diarrhea; children cared for by siblings; and children born with congenital defects. Weaning was another important area included in this study. The nurses interventions investigated were monthly weighing infant, dietary screening, meal planning and discussion of the child growth chart and counselling and educating mothers

Retention of pressure sore knowledge at Tanta HIN

The purpose of the present study was to determine if lectures supplemented with audio-visual aids would significantly increase acquisition and retention of knowledge related to "pressure sore", compared to formal lecture. 94 junior students in the fundamentals of nursing course participated in the study. They were randomly divided into control group [48 students] attending a formal lecture on "pressure sore" subject, and an experimental group [46 students] attending a lecture supplemented with audio-visual aids about the same content material. A pre test was given to evaluate knowledge base prior to lecture. A post test was given immediately after the lecture to evaluate initial knowledge acquisition. Retention test was given three weeks later to evaluate the amount of knowledge retained. Analysis of covariance showed that students attending the lectures supplemented with audio-visual aids demonstrated significantly higher retention test score, although they did not demonstrate a significantly higher score from pre test to post test. In conclusion the "pressure sore" subject material was better taught using lecture supplemented with audio-visual aids because it increases the retention of knowledge

Role expectations in AIDS control among HIN undergraduates and their clinical instructors

The present study was conducted to examine the knowledge of HIN participants about AIDS by testing their expectations about aspects the nurse might through which play a role to share in AIDS control. The sample involved participants from clinical instructors, interns, and students from the four scholastic undergraduate classes. A questionnaire particularly designed to the purposes of the study was used. Findings of the study revealed the lack of participants knowledge about AIDS. Their expectations about nurses role in AIDS control were affected by their misinformation about aspects of AIDS control and the lack of their knowledge about AIDS. This necessitates the corporation of AIDS related informations into teaching curricula of HIN undergraduates. Socialization of students on nurses role in AIDS control and reinforcing expectations associated with that role through the educational process are recommended. Training programmes and research studies about AIDS are recommended for clinical instructors and interns to improve their level of knowledge about the subject

Variables that induce hospital nurses to leave their jobs

The present study was conducted to identify variables that induce nurses to leave their job. The sample was limited to nurses working in two public general hospitals in two areas Kasr Elany Hospital in Cairo and Tanta General Hospital in Tanta. A questionnaire was designed to collect data on demographic variables, degree of satisfaction, a part for ranking 15 variables according to their priority in inducing nurses to leave job, and a question to know if the nurse wanted to leave job or not was included. Findings of the study revealed that nurses desire to leave job was induced by their dissatisfaction and unmet needs. As well as the contradiction of family responsibilities with some aspects of the job. The logical conclusion that nursing department requires an administrative philosophy and manpower management that pay attention to personal and professional development as well as job enlargement

Job satisfaction among nurse's educators at the university level [comparative study]

This study was done to compare nurse educators at both Alexandria and Cairo Higher Institute of Nursing, as regards their perception of the importance of given job characteristics to job satisfaction, the extent of their satisfaction and the predictors of their job satisfaction. A two parts questionnaire was used to collect the data. The first part collects demographic data, while the second part respondent rated the importance of job- characteristics to job satisfaction and indicated her satisfaction with each. Analysis of the data revealed, that the nurse educators at both institutes showed low degree of satisfaction. Educators ranked extrinsic factors in the importance index as more important than intrinsic factors. There was negative correlation between importance and satisfaction with some items. For Alexandria educators the intrinsic factors are the best predictor for job satisfaction, while age, years of experience, work group and self-actualization were best predictors for Cairo educators job satisfaction

perceived benefits of breast feeding among students of Tanta higher institute of nursing Part I: relation to clinical practice

The present study was conducted to examine the relationship between H.I.N. undergraduate students perceived benefits of breast feeding and their practice in the clinical area. All the students were included in the study. The theoretical framework used in this study was the Health Belief Model. The personal data sheet, the perceived benefits, and the practice questionnaire were used to collect data. Findings of the study revealed that third and fourth year students reported better scores on perceived benefits of breast feeding, and on practice. This necessitates the integration of breast feeding subject in first and second year courses

perceived benefits of breast feeding among students of Tanta Higher Institute of nursing: Part II curriculum development

The study was carried out to develop a module for integrating breast feeding subject in the curriculum of first and second academic years in Tanta Higher Institute of Nursing. Data were collected by analyzing the curriculum of Higher Institute of Nursing, and reviewing the content of the various courses. The analysis revealed that no breast feeding material was offered in the first two years. Thus, a module for integrating breast feeding subject was designed based on students needs, principles derived from education and nursing literature, and opinions of selected experts in the nursing and medical fields