Epidermal growth factor [EGF] receptors expression in myometrium and leiomyomas

Fifty patients were included in this work, they all were premenopausal women who underwent hysterectomy at Ain Shams University Maternity Hospital. They were divided into two main groups Group [1] [The study group] : 30 patients who underwent hysterectomy for symptomatic uterine fibroids; Group [2] [The control group] : 20 patients who underwent hysterectomy for other gynecological problems than myoma. After pathological examination, tissue samples of myomas and myometria were collected for immunohisto-chemical study for epidermal growth factor receptors assay. As regards the relation between age of women distributed according to their groups and the EGF receptors expression; it was found that there was no relation between age of women and the expression of EGF receptors. Also for the relation between parity and the expression of EGF receptors; it was found that there was a relation between parity of women in the study group [with leiomyoma] and the expression of EGF receptors [P < 0.01] i.e. highly significant difference, and this may be attributed to the elevated estrogen regulated genes in leiomyomas when the uterus is exposed to circulating levels of estrogen that are many-fold higher through subsequent pregnancies than those seen during menstrual cycle As regards the relation between the receptor level and the phase of menstrual cycle; it was found that there was no cyclic variation of EGF receptors either in the proliferative phase or in the secretory phase and hence estrogen and progesterone play an important equal role in the expression of EGF receptors whether in myometrium or in the growth of leiomyomas. As regards the relation between the receptors level with different pathological subtypes of leiomyomas; it was found that there was no significant difference between these types and the expression of EGF receptors. Concerning the relation between EGF receptors expression in leiomyomas compared to normal myometrium; it was found that although both leiomyomas and myometria showed expression for EGF receptors and may be the expression was slightly elevated in leiomyoma, but we could not find any significant difference [P > 0.05] between EGF receptors expression in leiomyoma compared to myometrium. These findings suggest EGF receptors as a potential regulator for uterine leiomyoma and also suggest that estrogen and progesterone effects on leiomyomas may be partly mediated by EGF receptors

Mycobacterial genital infections and female infertility

Eighty female patients with infertility due to tubal factor [whether primary or secondary] diagnosed on clinical, laboratory, radiological, and laparoscopic bases, were studied for mycobacterial infections of the fallopian tubes and the endometrium using microbiological and histopathological methods. Nine strains of genus mycobacteria were isolated from 9 cases of the studied group [11.25%]. Isolated mycobacterial strains were found to be : 6 Mycobacterium tuberculosis, 2 Mycobacterium bovis and the last one was found to be atypical mycobacterium. The isolated 8 strains of tubercule bacilli were sensitive at least to 3 of the following drugs Rifampicin, isoniazid, ethambutol, streptomycin and paraaminosalysilic acid [PAS] respectively. The atypical strain of the mycobacteria was resistant to the mentioned drugs. From 12 histopathological samples showing granulomas suggestive of tuberculosis; 8 mycobacterial strains were isolated whereas no histopathological findings were detected in the case from whom atypical strain was isolated

Effects of oxytocin and dextrose 5% infusion during labor on neonatal serum sodium, glucose and bilirubin levels

Maternal serum sodium and glucose levels were measured in three groups of laboring women before and after labor. Cord serum samples were also analyzed for the same parameters as well as for bilirubin, and after 72 hours of labor, a neonatal serum sample was analyzed again for bilirubin. The study groups included cases who had full term vaginal delivery and who had no medical or obstetric complication The first group [group A] had neither fluid, nor oxytocin administration during labor. The second group [group B] received 5% glucose in water during labor. The third group [group C] received Oxytocin in 5% glucose infusion [1 unit in 100 ml]. All groups were comparable as regards maternal age, parity and gestational age. Newborns were comparable as regards birth weight and Apgar score, and weight of placenta. Maternal serum sodium [Na] and glucose did not show any significant correlation with cord serum values. Cord serum Na and glucose did not show significant correlation with the 72 hours neonatal serum bilirubin values. A significant increase in neonatal serum bilirubin was found in both groups B and C after 72 hours of birth. On the other hand, mean serum bilirubin [72 hours level] was higher in oxytocin group than in the control group and in the glucose only group. We concluded that the dose range used in this study [less than one litre - IV aqueous glucose solution given during labor] does not induce significant changes in either maternal or cord serum values of Na and glucose. Also oxytocin could be considered responsible of neonatal hyper bilirubinemia without inducing neonatal hyponatremia

Seroprevalence of hepatitis C virus among rural and urban pregnant women

This study focused on seroprevalence of HCV at ceratin urban [El-Mansoura and Benha cities] and rural [Bilqas and Kafr Shokr] areas, and on assessment of risk factors for HCV infection. The study was conducted on 500 pregnant women [as a study group] at their last trimester and 12[non pregnant women [as a reference group]. The overall seroprevalence rate was 20% with more frequency in rural [24.1%]. The work also demonstrated an increase in the incidence of seropositivity to HCV-Ab in multigravida [28.2%] than in primigravida [15.1%]. The correlation between seropositivity and different risk factors show variable degree of incidence listed in the tables. Ortho HCV ELISA second generation test system was used for all cases and some selected cases with elevated ALT level [45 cases], were subjected to polymerase chain reaction [PCR] for detection of the viral genome in the serum. Although HCV antibody test in pregnant group was high [22%], elevated ALT level was found in only 40% of them, despite its use as a surrogate marker for HCV infection. This finding confirms the superiority of specific HCV antibodies tests in demonstrating HCV infection. PCR was positive in 35.6% of HCV antibodies reactive cases and in 3.2% of all tested pregnant cases. This study demonstrated the significance of the parentral route as a main route of HCV infection and stressed on the importance of surgery [gynecological/obstetrical or general] as a risk factor for HCV infection. Also, the study raised the possibility that multiparity and repeated deliveries carry more risk for HCV infection. Because of the high seroprevalence rate of HCV in the present study [overall 20%], we recommend doing routine screening for HCV infection among the pregnant women and to pay more attention for preventive and control measures especially in rural areas, because risk factors such as blood transfusion and increased parity play a more important role in rural area than that in urban ones. Further studies are needed to clarify the true incidence of materno-fetal transmission as this will affect the clinical management of such cases and their neonates