Discontinuation rates among copper intrauterine device users in primary healthcare unit and university clinic. is there a difference?

Background: in Egypt, despite the high percentage of women using IUD according to Demographic and Health Surveys [DHS] 2014 [52.9%] of total women using contraceptive methods, the discontinuation rates among Cu-IUD users [within 12 months of use] reaches 14.3% in 2014. Aim of the Work: the aim of the study was to compare between primary health care unit and university family planning clinic in discontinuation rate among copper IUD users

Patients and Method: study design: prospective analytical observational study. Study setting: This study was conducted at Family planning Outpatient clinic of Ain Shams Maternity Hospital and El-Zahraa primary health care unit for a year. This study included 260 women whom attending family planning clinic for Cu- IUD insertion. Total 100 subjects was enrolled from each clinic. Rest of subjects was lost on follow up either after 6 months or 12 months. Some others refused to participate or gave wrong personal contacts

Results: preliminary results of the study revealed that there is no statistically significant difference between discontinuation rate among Copper IUD users in university clinic and primary healthcare clinic [p-value = 0.095]

Conclusion: in our Study, analysis of data revealed that age, parity and previous usage of IUD may affect discontinuation rate after 12 months of IUD use. The mean cause of IUD discontinuation was bleeding and Anemia was present in 66.6% of patients complaining from bleeding

Comparative study between the addition of pethidine vs fentanyl to hyperbaric bupivacaine for spinal anesthesia in caesarean section

Background: cesarean section is the most common obstetric surgery in the world. Spinal anesthesia is a preferred technique for cesarean delivery for its distinct advantages over general anesthesia as the simplicity of the technique, reliability, minimal fetal exposure to drugs, patients' awareness and minimization of the hazards of aspiration

Aim of the Work: to define first time require analgesia in postoperative among two groups

Patients and Methods: this prospective comparative study was carried on fifty patients, ASA physical status II, aged from 18 to 45 years. These patients were scheduled for elective caesarean delivery under spinal anesthesia and divided to two groups. This protocol was approved by Research Ethical Committee of Ain Shams University. Written informed and verbal consent was obtained from each patient before being included in this procedure

Results: the addition intrathecal 25mg pethidine make the total duration of analgesia 169.20 +/- 7.59 minute but adding 25Mug fentanyl intrathecal extended the period of effective analgesia up to 178.40 +/- 6.25 min with high significant P-value [0.000]. The rapid onset of sensory and motor blocks in [F] group than [P] group with P value=0.000, also increased duration of sensory and motor blocks in [F] group than [P] group with P value 0.000

Conclusion: intrathecal opioid is a good technique of labor analgesia, although pethidine was the most widely used opioid for obstetric analgesia, it has character of local anesthetics so adding pethidine intrathecal in dose 25mg enhanced effect of local anesthetics but associated with more complications as nausea, vomiting and hypotension

Toxoplasma, Cytomegalovirus and Rubella infections among aborted women attending Sohag University Hospital, Egypt

Background: Undesirable fetal outcomes and reproductive failures mayfollowToxoplasma, Cytomegalovirus [CMV] and Rubella infections

Objective: Detection of Toxoplasma, Rubella and CMV infections among aborted women attending Sohag University Hospital and to determine factors related to these infections

Methodology: Blood samples were gathered from 121 aborted women attended the hospital, from June 2016 to February 2017. Samples were examined for specific IgM and IgG antibodies against Toxoplasma, Rubella, and CMV by ChemiluminescentMicroparticle Immunoassay [CMIA] technology

Results: About two thirds [64.5%] of participants were positive for at least one of the studied infections. The specific IgM antibodies were positive in 1 case for Toxoplasma,3 cases for Rubella, and 5 cases for CMV. Specific IgG antibodies were positive in 45 cases for Toxoplasma, 33 cases for Rubella, and48 cases for CMV. Multiple logistic regression analysis identified that rural residence was significantly linked to Toxoplasma [OR=8.35, p-value <0.001], CMV [OR=2.26, p-value = 0.042], Rubella [OR = 3.7, p-value=0.003] infections. Seropositivity for multiple infections was detected in 33.1% of participants. Rural residence and high parity were significantly connected with multiple infections [p-value <0.001 and 0.045 respectively]

Conclusion: Infection with the studied agents is highly prevalent [64.5%] among the studied women where antibodies againstToxoplasma, Rubella virus and CMV were found in different proportions [38 %, 29.8 %, and 43.8 % respectively]. Rural residence is a strong predictor of these infections. Hence the country's health authorities must be alerted, and preventive measures should be taken

Evaluation of calcium oxalate stones size using kidney, ureters and bladder, fluoroscopy and post lithotripsy procedures

This study aimed to measure renal stone using different modality [kidney, ureters and bladder [K.U.B], fluoroscopy and intravenous urography [I.VU]], to compare these three methods of measurements and to detect the variation of stones size after each lithotripsy shock for the same type of stones. A total of 26 patients males [19] and females [7] their age ranged between 18 and 70 years with renal stones, I.VU, K.U.B were done for all cases. In Al Nelain Medical Centre, The size of renal stone was measured in K.U.B and I.VU by using the Ruler exposure. Staghorn stones which were >4 cm needed >4 times of exposure to. Results: The findings were found to be that stone < 1 cm can be measured but does not disintegrated by lithotripsy and most of the stones that were > 1 cm were properly measured when using the fluoroscopy and were treated effectively after 2[nd] time of the shock waves. This study concluded that the surface area, site, number of stones after extracorporeal shock wave lithotripsy [ESWL] could be detected using K.U.B, I.VU and fluoroscopy, and could help in prospective selection of patients who will respond well to ESWL

Increased cardiac endothelin-1 and nitric oxide in adriamycin-induced acute cardiotoxicity: Protective effect of Ginkgo biloba extract.

Cardiotoxicity and congestive heart failure are the major factors that limit the use of anti-neoplastic drug adriamycin (ADR). There is increasing experimental evidence that endothelin-1 (ET-1) and nitric oxide (NO) are vasoactive mediators that regulate cardiac performance. The present study was undertaken to investigate the role of ET-1 and NO in ADR-induced acute cardiotoxicity and to evaluate the protective effect of Ginkgo biloba extract (EGb761) in rats. A single dose of ADR (20 mg/kg i.p.) caused a significant increase in the cardiac enzyme activities of aspartate transaminases (AST), lactate dehydrogenase (LDH) and creatine phosphokinase isoenzyme (CK-MB) in the serum of animals. This was accompanied by significant increase in cardiac malondialdehyde (MDA), total antioxidant capacity (TAC), tumor necrosis factor-alpha (TNF-α), ET-1 and nitrite/nitrate (NOx) levels. On the other hand, reduced glutathione (GSH) was significantly depressed. Histopathological examination of heart tissues showed hyalinization of the myocardium, with interstitial edema and inflammatory exudates. Pre-treatment of the animals with EGb761 (100 mg/kg, orally) 10 days before and 5 days after ADR treatment reversed the cardiac enzyme levels to normal value, decreased cardiac MDA, TAC, TNF-α, ET-1 and NOx, increased GSH and reversed the histopathological damage induced by ADR. In conclusion, the cardioprotective effects of EGb761 on markers of ADR-induced acute cardiotoxicity appeared to have been mediated by the regulation of inflammatory and vasoactive mediators, as well as the inhibition of membrane lipid peroxidation. Thus, EGb761 may find use as promising adjuvant therapy to ameliorate cardiotoxicity of ADR.