Comparative study of anti-mullerian hormone, inhibin-b, and three-dimensional ultrasound determinants of ovarian reserve in patients undergoing icsi

Background: Intracytoplasmic sperm injection [ICSI] is an in vitro fertilization procedure in which a single sperm is injected into an oocyte

Objective: Aim of the Work: Comparing three-dimensional ultrasound parameters, with anti-Mullerian hormone [AMH] and other conventional endocrine markers for the prediction of ovarian response in patients undergoing intracytoplasmic sperm injection cycles

Methods: This observational prospective study was conducted at Alexandria Armed Military Hospital, on a sample of 100 women aged between 25 and 35 years, enrolled for intracytoplasmic sperm injection [ICSI]

Results: a good correlation between inhibin B and other numerical variables. There was strong positive correlation between inhibin B and AMH, strong negative correlation between inhibin B and both FSH and LH. Inhibin B correlated moderately negatively with age and moderately positively with AFC, number of collected oocytes. Inhibin B correlated positively with the number of oocytes and number of grade 1 embryos. As regard pregnancy rate, the good-response group had significantly higher chemical and clinical pregnancy rates, as there was no chemical or clinical pregnancy occurred in poor responders

Conclusion: AFC, AMH and Inhibin B are effective in predicting the ovarian reserve as well as the response to induction, and both AFC and AMH are the most significant predictors of response to ovarian stimulation during ICSI

Recommendations: Larger scale studies including higher number of patients are needed to verify the validity of this parameter as a marker of ovarian reserve in patients undergoing ICSI

Relation of neutrophil-to-lymphocyte, platelet-to-lymphocyte ratio and CRP level with coronary artery disease severity in patients undergoing coronary angiography

Background: coronary artery disease [CAD] is the leading cause of morbidity and mortality throughout the world. It has a complex pathophysiology, and inflammation seems to play an important role in CAD. Previous studies have shown that higher levels of inflammatory markers are associated with the severity of CAD and worse cardiovascular outcome. Although endothelial damage has been known as the triggering factor for the formation of atherosclerotic plagues, inflammatory process is responsible in the initiation and progression of the atherosclerosis. The neutrophil-to-lymphocyte ratio [NLR] and platelet- to-lymphocyte ratio [PLR] have recently been investigated as new predictors for worse cardiovascular outcome. Previous studies have shown that NLR is associated with morbidity and mortality in many cardiovascular diseases such as hypertension, heart failure, infective endocarditis, and acute coronary syndromes [ACS]

Aims: The aim of this study was to explore the relation of NLR , PLR and CRP level with severity of coronary artery disease [CAD] using the Syntax score [Sxscore]

Patients and Methods: This study was conducted to investigate the relationship between the severity of coronary artery disease and inflammatory markers [lymphocyte ratio, lymphocyte platelet, CRP] by sytax score in patients undergoing elective coronary angiography, the active number of 100 patients with a chronic stable was taken Coronary angiography, different markers for coronary assessment, renal function tests, INR, ECG and Echocardiography. A complete clinical evaluation was performed for each of our patients

Results: Coronary lesions were evaluated by the result of camel synthesis and there was a strong relationship between NLR, PLR, CRP level, and coronary heart disease r. 526 p 0.001, r 0.317 p 0.001, r 0.699 p 0.001 However, when we divided the patient for a result Syntax The results show some difference in determining who are drafting the sentence above 21, we found a negative relationship between NLR, PLR and syntax points, while the CRP level was positively correlated at the level of the structure below 31 a significant negative correlation was found with the construct conclusion above 31

Conclusion: Our study concluded that the severity of coronary artery disease is associated with NLR, PLR, CRP levels to some extent in the patient with angina for chronic stable chest

Role of serum neopterin level in unstable angina

Coronary artery disease is the most common form of heart disease and the important single cause of death. Unstable angina is a life threatening disorder and a major cause of emergency medical care. Disruption of vulnerable atheromatous plaque is the most common pathogenic mechanism in unstable angina. Macrophage and T cell lymphocytes are critical in the growth and changes of plaques through the secretion of growth factors, cytokines and extracellular matrix digesting enzymes, which weaken fibrous cap. Neopterin, which is a byproduct of guanosine triphosphate degradation in macrophages activated by interferon gamma being a marker of macrophage activation, is a more direct measurement of immune system activation. Immune system activation may play a pathogenic role in acute coronary syndrome. Neopterin can be used as a marker for activity of coronary disease. The purpose of this study to evaluate the neopterin level in patients had unstable angina and complex coronary artery disease lesions vs. patient with chronic stable angina. Prospective study was performed in 50 patients divided in three groups. Group1: [30 patients with unstable angina class IIIb according to Braunwald classification. Group2: 10 patients with chronic stable angina. Group3: 10 patients with normal coronary angiography. The neopterin level was high significantly in group 1 in compare to both other two groups. There was correlation between the neoperin level and the number of angiographically complex lesion. Neopterin level was not correlated vessel score or stenosis score

Effect of HCV infection on pathology and pulmonary function tests in COPD patients

The prevalence of HCV infection varies throughout the world, with the highest number of infections reported in Egypt. Chronic HCV infection has been associated with several extrahepatic manifestations and many studies reported that chronic HCV infection might accelerate decline in lung function in patients who already have chronic obstructive pulmonary disease [COPD]. This study aimed to find if there is a specific pathology in the airways of HCV positive patients for the possible contribution of HCV infection to the pathogenesis of COPD. This study was conducted on 40 patients [33 males and 7 females] with COPD that include chronic bronchitis and emphysaema. Another 20 patients [16 males and 4 females] infected with HCV were taken as a control group with no history of respiratory problems. This study showed that 11 out of the 40 cases with COPD were HCV positive by PCR [27.5%], and found a significant statistical differences between HCV positive cases and HCV negative cases as regards the neutrophilic and lymphocytic infiltrations in both the biopsy and the broncho-alvular lavage [BAL]. Also, we found a significant decrease in pulmonary function tests FEY I and peaked expiratory flow rate [PEFR] and a non-significant decrease in forced vital capacity [FVC] and FEV 1/FVC in HCV positive cases in comparison to HCV negative cases. The HCV was detected in the bronchial biopsy of 4 out of these 11 cases, and the BAL of 2 of them

In conclusion: These findings suggest that the HCV infection may affect the pathology and pathogenesis in these patients and may accelerate decline in lung function in patients who already have COPD

Changes in the serum prolactin level in breast cancer patients

A total of 30 female patients [mean age of 48.8 years] with operable breast cancer [14 were premenopausal and 16 were postmenopausal] was studied. Another 10 patients [5 were premenopausal and 5 were postmenopausal] with different types of hernia were taken as a control group. Blood samples for the estimation of serum prolactin level [SPL] were taken from breast cancer and control patients. In conclusion, in breast cancer patients, SPL was higher in advanced staging and in more grading of the tumor

Pathological prediction of post-cesarean endomyometritis

A prospective blinded study was carried out on 80 patients undergoing cesarean delivery and receiving antibiotic prophylaxis. Amniotic fluid samples and decidual-myometrial biopsies were obtained at the time of the operation and examined to identify those incipiently infected patients. 15 patients developed post-cesarean endomyometritis and positive gram stain was detected only in eight of them. Significant histologic differences in decidual inflammation and myometrial polymorphonuclear cell invasion were detected in the group that developed post-cesarean endomyometritis compared with the group without endomyometritis. The patients who subsequently developed post-cesarean endomyometritis demonstrated greater numbers of bacteria in the myometrial biopsy compared with the group without endomyometritis as shown by acridine organ stain. These data showed that the technique of histologic detection of incipient infection and the detection of bacteria within the myometrial tissue provide accurate methods for the identification of the group at risk of development of post-cesarean endometritis