ABSTRACT
Aim of the work: this study aimed to evaluate the effect of laparoscopic ovarian drilling [LOD] on plasma levels of anti-Mullerian hormone [AMH] and ovarian stromal blood flow changes, by using 2D power Doppler ultrasonography, in polycystic ovary syndrome [PCOS], previously described as being clomiphene citrate resistant and to evaluate the value of these parameters in predicting the clinical outcome of this line of treatment
Patients and methods: this prospective controlled was conducted in Al-Hussien University Hospital, Al-Azhar University and Police Authority Hospitals. This study was included twenty-three anovulatory clomiphene citrate [CC]-resistant women with PCOS and 20 fertile women as a control group. Laparoscopic ovarian drilling was done. Serum levels of hormonal profile were measured [AMH, LH, FSH, LH/FSH ratio and total testosterone], ovarian stromal blood flow Doppler indices [RI and PI] and occurrence of ovulation or pregnancy
Result: in this study we reported our findings regarding the effects of LOD on AMH, hormonal profile and ovarian stromal blood flow in women with PCOS with Clomiphene resistance. These results suggested that the measurement of AMH, LH, LH/FSH ratio, total testosterone, ovarian volume and ovarian stromal blood flow by color Doppler were in discrimination of PCOS from potentially normal women. The data in our study also suggested that there were no significant differences as regard AMH, hormonal profile except total testosterone, ultrasound ovarian findings and ovarian stromal blood flow before and after LOD, but there were significant differences as regard total testosterone before and after LOD. Also, there was good predictive value for AMH after LOD for ovulation and clinical pregnancy
Conclusion: measuring AMH for women with anovulatory PCOS undergoing LOD may provide a useful tool in evaluating the outcome of LOD, but ovarian stromal blood flow 2D Doppler indices did not show significant changes predicting ovulation or pregnancy rate after LOD
ABSTRACT
In this study 46 patients' suffering from SLE and 39 control groups the patients divided into disease with remission [11] and in active state [35] with age below 20 year or above all patients had complete clinical examination together with laboratory investigation. In this study females [41] more affected than male [5] in a ratio 8.1 and at age onset from [9:35] with malar rash [38]' photosensitivity [29], alopecia [31], mucosal ulcers [I I], arthritis [3 I], sororities [lo], renal disease [25] hepatic disease [18] and CNS [6], for the haemogram findings, anemias [35], leucopenia [24], lymphopenia [22] and thrombocytopenia [8]. Auto antibodies showed ANA in [43], anti-ds DNA [dl], anti-RO [28] and antism [23] Patients. The value of anti-ds DNA, anti-RO and anti-SM were significantly higher in patients with activity than control and remission. Peripheral pattern of ANA by IF was found in activity while homogenous in remission. In this study there was a significantly increased frequency of HLA -DRBl*03 and significantly decrease frequency of HLA-DRBI *7 in SLE patients than control. The frequency of HLA-DRBI * 11, I3 increased in SLE patients than control also HLA-DRBI *3, 11 with age onset less than 20 year while HLA-DRBI* 13 in age more than 20 years old. Regarding HLA-DRBI gene association with different clinical and laboratory findings, positive association of different clinical signs, also between certain clinical signs of SLE and auto antibodies. This study suggested that the presence of HLA-DRBl*03 may predispose to SLE or its clinical manifestation, while the presence of HLA DRBI *07 may have a protective effect from SLE. Also the presence of HLA-DRBI *03 or 11 predispose to early SLE in age less than 20 year while HLA-DRBI *I3 to late SLE development at age more than 20 years old
ABSTRACT
Acinetobacter baumannii [A. baumannii] is a rapidly emerging pathogen in the healthcare settings. It usually causes different nosocomial infections, which are usually resistant to several antibiotics. Rapid identification of A. baumannii among hospital patients and the hospital environment is very important to control its spread. Very limited data are available about the prevalence of A. baumannii in Egyptian hospitals particularly at Minia University Hospital [MUH]. In this study, a total of 264 and 109 pus samples were collected from patients suffering from wound and burn infections, respectively. In addition, a total of 549 environmental samples were collected from the environment of MUH Herellea agar was used for isolation of A. baumannii. Identification of the isolates was carried out using culture characteristics, biochemical, staining properties and detection of bla [oxa-51-like] gene; which is intrinsic to A. baumannii; by polymerase chain reaction. A total of 20 [5.4%] and 32 [5.8%] A. baumannii isolates were identified and confirmed by PCR in pus and environmental samples, respectively. While A. baumannii represented the least commonly isolated organism, Klebsiella species [14.5%] and P. aeruginosa [10.4%] were the most frequently isolated aerobic Gram-negative organisms from pus and environmental samples; respectively. Bla axa-51-like gene expression was examined by PCR directly on 48 pus samples after DNA extraction. A. baumannii was identified in 4 pus samples [8.3%] that were negative for culture on here/lea agar and in 8 pus samples [16.7%] that were positive for culture on here/lea agar. So, PCR is a more sensitive and rapid technique for identification of A. baumannii than microbial culture. In conclusion, although A. baumannii does not represent a current major health hazard at MUH, it could lead to significant problems in the future