Epidemiology of high risk pregnancy in Sousse, Tunisia

This descriptive study assessed the frequency of selected risk factors for high risk pregnancy [HRP] among women in Sousse region. All pregnant women [beyond 28 weeks gestation] giving birth in 4 public maternity hospitals between 15 February 2005 and 15 August 2005 and who had at least 1 risk factor were enrolled. Data were collected within 24 hours of birth from obstetric and antenatal records and by interview. Of 4660 pregnant women, 1194 [25.6%] had at least 1 risk factor and were considered at-risk pregnancies. Mean age of the at-risk women was 31.3 [SD 5.4] years, 73% were urban residents, 38% had secondary education or higher and 75% were housewives. The mean number of risk factors was 1.5 per woman. The majority of women [59.3%] had 1 risk factor and 30.4% had 2. The mean number of prenatal visits was 4, 68.6% were seen by an obstetrician and 43% used the private sector. Certain factors were inadequately screened: age > 35 years, parity > 4, previous low birth weight and neonatal death, excessive fundal height and anaemia

Impaction of laparoscopic ovarian electrocautery on doppler indices of stromal blood flow in women with polycystic ovary syndrome

Polycystic ovary syndrom [PCOS] is characterized by infertility, oligomenorrhea, and hyperandrogenism. Clomiphene citrate [CC], an antiestrogen, is first-line treatment for PCOS, if CC fails to induce ovulation, laparascopic electrocautery of the ovaries is offered. In this prospective controlled study, 52 women with clomiphen-resistant PCOS [group 1] and 46 women with regular menstrual cycles as a control group [group 2] were included. Hormonal profile and doppler blood flow changes within the ovarian stroma befor and after laparascopic ovarian electrocautery [LOE] in women with clomiphen- resistant polycystic ovary syndrome assessed and compared between groups. The doppler indices [pulsatility index and resistance index] of ovarian stromal blood flow were significantly lower in group 1 befor LOE than in group 2. The serum levels of testosteron [T] and LH were significantly reduced in group 1 after LOE compared with in group 1 befor LOE [P < 0.05]. Doppler indices [pulsatility index and resistance index] of ovarian stromal blood flow were significantly increased after LOE. Laparascopic electrocautery reduced serum T and LH and reduced ovarian blood flow velocities, which may explain the reduction of ovarian hyperstimulation syndrome in women with PCOS after LOE. Laparascopic electrocautery of the ovaries is now accepted as the preferred first-line treatment of women with PCOS who are resistant to clomiphen citrate. All affected women could be considered for this treatment

Effect of Inferapatellar and Cho-pat straps on knee strength and ROM in patients with anterior knee pain syndrome

Anterior knee pain syndrome is one of the most common problem in knee. Prevalence of this problem on orthopedic center is almost 23-31%. This syndrome happens in athletes, teenagers and specially in females. Trauma, malalignment maltracking of patella and degenerative joint disease or a combination of mentioned disorders seems to be the main cause of the syndrome. The perpose of this study was to identify and compare effects of infera- patella and cho-pat straps on knee strenghs and Rom. 30 patients with Ant pain synd. were evaluated and devided into two groups. Cho-pat strap applied to the first group and infrapottellar strap to the second. Knee extension strength and ROM was evaluated in 3 stages. 1] Before applying the strap 2] Immediately after applying the strap 3] 2week after applying the strap. Dynamometer, goniometer and visual analague scale were used to measare the strengh, Rom and pain respectivly. knee ext. strength increased significantly in the second and third stages of the test for both groups [P<0.05] howerer, there was a decrase in pain and ROM [P<0.05]. In the cho- pat strap group ROM decreased mor than infrapatellar group [P<0.05]. According to our finding reduction of knee pain induce to increasing of knee strength. In addition decreasing of pain results in control of knee ROM and decrease pressure on articular surfaces of patellofemoral joint

[Clinical evaluation of serum CEA and CA15-3 in patients with breast cancer]

Introduction: Tumor markers are useful means for obtaining information about some malignant tumors whilst causing minimal inconvenience and cost

Objective: The purpose of this study was to evaluate the value of CA 15-3 and CEA in patients with breast carcinoma

Materials and Methods: This retrospective study was performed on 604 patients [mean age= 47 years] who were referred for treatment to oncology departments of Ghaem and Omid hospitals of [Mashhad Iran] from 1999 to 2004. CEA [cut off, 5 ng/ml] and CA 15-3 [cut off, 40 U/ml] had been measured with radioimmunoassay method for every patient [1- 10 times]

Results: Stage I to IV were found in 25, 370, 165 and 44 patients respectively at the time of referral. With a mean follow up time of 18 months, from 560 nonmetastatic patients, 76 [13.6%] cases experienced recurrence. The sensitivity of CEA and CA 15-3 measurements in patients with overt metastasis or up to one month before the detection of recurrence were 56.4% and 90% respectively. CEA and CA 15-3 were measured 2 to 8 months before the detection of metastasis in 44 patients from which raising the levels of these markers were found in 7 [15.9%] and 23 [52.2%] cases respectively. Among 249 disease free patients who had been followed for more than 18 months, false positive levels of CEA and CA15-3 were found in 7 [2.8%] and 4 [1.7%] cases respectively

Conclusion: Considering the low number of false positive results in recurrent free patients, both CEA and CA15-3 showed good specificity. The sensitivity of CA15-3 is good for the detection of overt metastasis. However CA15-3 has a modest sensitivity in patients with minimal disease. CEA has a much lower sensitivity compared to CA15-3. However, the positive test can confirm the result of CA15-3 in metastatic setting

Activity of follicular fluid phosphatases and their correlation with levels of serum esteroidal hormones and gonadotropins

The aim of this study was to evaluate the correlation between serum levels of ovarian and gonadotropin hormones, age and number of follicles with follicular alkaline and acid phosphatase activity in infertile women under controlled ovarian hyperstimulation. After collection of follicular fluid and calculation of the number of follicles, the specific activity of alkaline [ALP] and acid phosphatase [ACP] was determined according to the total protein in 19 women at the time of puncture. Also at that time, the levels of progesterone, estradiol, and follicle stimulating hormone [FSH] and leuteinizing hormone [LH] of their sera were measured. The correlation of follicular ALP and ACP with each serum hormone levels, women age and number of follicles was calculated using non-parametric analysis. The ALP has a correlation with progesterone [P=0.01] levels but doesn't have any correlation with the other factors. However, the ACP activity has a correlation not only with follicular number but also with estradiol and progesterone levels [P=0.05]. Thus ACP activity is more affected by ovarian hormone than ALP and it can affect the ovarian microenvironment and oocyte development