use of levonorgestrel-releasing system [metraplant-E] in the treatment of abnormal uterine bleeding

Background: Dysfunctional uterine bleeding [DUB] is one of the commonest condition for which patient seeks out medical consultation. The prevalence increases with the increase of age peaking before menopause

Objective: The aim of this work is to evaluate the effect of this new form of levonorgestrel-releasing IUD on the treatment of patients with abnormal uterine bleeding

Subjects and methods: A prospective age-specific comparative analysis of 61 peri-menopausal women presented with dysfunctional uterine bleeding who constituted the study group. They underwent hysteroscopy and endometrial sampling during an 18 months period from June 2014 to January 2016 at Ain Shams University Materity Hospital. Prior to metraplant-E application, all the patients in this study were in the age of 25-58 years old

Results: The role of Metraplant-E in the treatment of abnormal uterine bleeding [AUB] was evaluated. Sixty-one women with failed attempt[s] of medical treatment unwilling or unfit for hysterectomy were treated with Metaplant-E. Menstrual blood loss was assessed by pictoral bleeding assessment chart [PBAC], bleeding index [B.I] and total bleeding score [T.B.S/month]. The bleeding patterns in the form of the mean menstrual blood loss estimated by bleeding index and the mean menstrual loss estimated by the total bleeding score/month and PBAC decreased significantly [p = 0.001]. The quality of life scale [Likert scale] improved significantly [p = 0.001]. All 15 cases who had endometrial sampling demonstrated progestational effect on histo-pathological examination

Conclusion: Metraplant-E was found to be effective in managing dysfunctional menorrhagia on both clinical and histopathological levels

Two Libyan siblings with beta-ketothiolase deficiency: a case report and review of literature

Beta-ketothiolase [mitochondrial acetoacetyl-CoA thiolase, T2] deficiency is an autosomal recessive disorder characterized by impaired metabolism of ketones and isoleucine. In this study, we report on the first two siblings with T2 deficiency from Libya. Both siblings presented with ketoacidosis, but the severity and outcomes were quite distinctive. T2 deficiency in patient 1, the younger sister, manifested as recurrent severe episodes of ketoacidosis during the first year of life. She unfortunately experienced neu-rodevelopmental complications, and died at 14 months old, after her 5th episode. In contrast, patient 2, the elder brother, experienced only one ketoacidotic episode at the age of 4 years. He recovered uneventfully and has continued to achieve age-appropriate development to date. Upon analysis, the siblings' blood acylcarnitine profiles had shown increased levels of C5:l and C5-OH carnitine. ACAT1 mutational analysis revealed patient 2 is homozygotic for a novel mutation-c.674C > A [p.Ala225Glu]; this mutation was then confirmed by familial analysis. Transient expression analysis of C.674C > A mutant T2 cDNA revealed neither potassium ion-activated acetoacetyl-CoA thiolase activity, which represents T2 activity, nor mutant T2 protein. Therefore, this mutation is truly pathogenic. Interestingly, the incidence of T2 deficiency may be high among the Arab population. This disease should be considered in the differential diagnosis for unexplained ketoacidosis in children. Patients with T2 deficiency could have a favorable outcome if diagnosed and treated early

suggested behavioral cognitive program for limiting problematic behavior of sexually abused children

Objective: Is an attempt to lower severity of the behavior problem of children who suffer exposition to sexual abuse, through using the proposed cognitive behavioral program

Sample: Group consists 13 females children who are exposed to sexual abuse

Problem: The study problem could be crystallized in this following Question: What is the effectiveness of a behavioural cognitive program restricting the behaviour problem of children being exposed to sexual abuse? From this major inquiry, the following minor inquiries are derived What is the effectiveness of the proposed behavioural cognitive program alleviating severity of the behaviour problem of female children being exposed to sexual abuse7, What is the effectiveness of the proposed behavioural cognitive program alleviating severity of the behaviour problem of children being exposed to sexual abuse from a list of problem behavior, What is the effectiveness of the proposed behavioural cognitive program alleviating severity of the behaviour problem of children being exposed to sexual abuse after passing one month of applying the program?

Methodology: The experimental method with one group design technique by applying the pre, post, trace evaluation test

Tools: Behavioral cognitive program, Content Analysis from of files, Behavioral program List

Results: There were statistically significant differences between the average scores of female on the list of problem behavior [Before, After] exposure to the program. There were statistically significant differences between the average scores of female on the list of problem behavior term of abuse for the benefit of the least period, and There are no significant statically differences between average scores of girls suffering sexual abuse on behavior problem scale after being exposed to the program for one whole month at significance