effect of hysterectomy on psychiatric morbidity [anxiety and depression]

To evaluate the psychiatric morbidity [anxiety and depression] in women underwent an abdominal and vaginal hysterectomy of a benign indication. This is a prospective observational study which was done in the Obstetric and Gynecology and Neuropsychiatry Departments, Sohag University Hospital. One hundred and two women were scheduled for undergoing hysterectomy after fulfilling the inclusion criteria. All women underwent a thorough history taking, clinical examination and complete psychiatric history. General health questionnaire [GHQ-28] was used to assess women with psychiatric co-morbidity before and after the operation. All women with psychiatric co-morbidity were re-evaluated by Beck depression inventory [BDI] and Hamilton anxiety scale [HAMA] before and after hysterectomy. On screening for psychiatric co-morbidity using the GHQ-28 for the 96 women who completed the follow up protocol of the study 35 [36.46%] scored >/= 4 [Group I] with psychiatric co-morbidity, and 61 [63.54%] scored <4 [Group II] without psychiatric co-morbidity. GHQ-28 was reapplied to all women in group II [post-operatively] where 48 [78.69%] scored >/= 4 [group IIa] and 13 [21.31%] scored <4 [group IIb. Severe anxiety and depressive symptomes were the most common presentation after the operation and represented 8 [40%] and 8 [53.3%], of patients of group I, respectively. In patient, of group II [without psychiatric morbidity] after hysterectomy, depressive and anxiety symptoms was the most common presentation in nulliparous women and was found in 7 [63.64%] and 3 [27.27%], respectively. However, the least depressive and anxiety symptoms was observed in women with parity >/= 5 and was found in 12 [38.7%] and 9 [29.03%], respectively. It is not worthy that the majority of women free from psychiatric co-morbidity was observed in women with parity >/= 5 and represented 10 [32.5%] of patients. It was clear that there was a definite significant relation between hysterectomized women and psychiatric morbidity of a depressive and anxiety nature. So we recommend that before hysterectomy in benign conditions, gynecologists should exhaust great effort of using the available recent less invasive modalities of treatment as first option

comparative study between serological and molecular identification of cytomegalovirus infection

Cytomegalovirus [CMV] is a common virus that infects most people worldwide. Aim of this study is to compare between serological identification and molecular detection of CMV by PCR technique. The samples consisted of 120 pregnant women [complaining from repeated abortion], prospectively screened for CMV by serology. The women were presenting for routine antenatal care. CMV IgG and IgM were detected in patient serum by using a commercial microparticle enzyme immunoassay, and determination of the presence of CMV genome by PCR. All neonates were diagnosed after one month of birth by serological and clinical signs. The age range of the pregnant women was 18 to 46 years, with no significant difference seen between the mean age of seropositive and seronegative women. The CMV seropositivity rate for the pregnant women showed that, overall, 76.8% women were CMV IgG positive at pregnancy. Pregnant women were considered in high risk due to [i] documented seroconversion to positively for CMV [ii] presence of CMV immunoglobulin M [IgM] [iii] intrauterine growth retardation as detected by ultrasound or CMV symptoms [increase in liver enzyme levels and/or fever]. No. of all of them was 30. After birth it was found that 6 neonates [+ve] by serological tests and clinical signs of them. But, it was found that also one case false +ve from PCR group, and one case false -ve from the rest. So, determination of the presence of CMV genome by PCR can be considered as a rapid and accurate tool for detection of CMV infection but negative results cannot rule out of infection, so that diagnosis of this infection should be based on correlation between serological and PCR Identification

Chlamydia trachomatis antigen detection in female infertility

Chlamydia trachomatis is a well recognized sexually transmitted pathogen. Besides its potential to produce genital tract infection, C. trachomatis is increasingly being associated with long-term complications like infertility. The present study was undertaken to assess the role of C. trachomatis in female infertility. Women of primary and secondary infertility [n= 150] and 20 healthy term pregnant women as control group were enrolled in the study. Detailed clinical history of each patient was recorded. Hysterosalpingography was performed in all patients. Endocervical swabs were collected for culture on cycloheximide treated McCoy cell line and for antigen detection by Blocking assay antibody technique. C. trachomatis was detected in 48 [32%] of the 150 infertile women while 3 [15%] in control group was positive for C. trachomatis. Among the total 48 [32%] infertile Chlamydia positive cases, C, trachomatis was detected by both cell culture and EIA, in 22 [45.8%], 14 cases [29.5%] were positive for C. trachomatis by cell culture alone and in 12 [25%] only antigen could be detected. Chlamydial positivity was seen in 22 [24.2%] women- with primary infertility and in 26 [44.l%] with secondary infertility. A significantly high rate of C. trachomatis infection was found in infertile women and more so in asymptomatic females and in secondary infertility cases. Lack of symptoms make clinical diagnosis of chlamydial infection difficult. Screening of infertile women for C. trachomatis is therefore recommended so far early therapeutic interventions

Vaginal misoprostal: comparison of two regimens for termination of early pregnancy failure

Two hundred patients were included in this trial. They had data of diffuse peritonitis proved surgically. Information specific to peritonitis and variables necessary for the calculation of APACHE II, MPI and PIAII scores were recorded. The three scoring systems were compared as regards the discriminatory ability, sharpness and reliability. It was found that APACHE II score is more superior than both MPI and PIA II as it produces reliable predications and can define more precisely the risk groups. Additional antibiotic trial was performed using APACHE II score to look for the impact on wound sepsis, augmenting which proved to be the best, followed by unasyn and lastly zinnat