Relation of serum estrogen level to endometrial abnormalities and uterine blood flow in cases of post menopausal bleeding

Post menopausal women are subject to various endometrial changes, this study was done to determine the relation between endometrial thickness, abnormalities and uterine blood flow, to the serum estrogen level in cases of postmenopausal bleeding. The study was carried out for Two years period May 2005-Apr 2007 including 50 patients with postmenopausal uterine bleeding, examined by transvaginal ultrasound to assess the endometrial thickness and echogenicity; Color Doppler imaging was used to evaluate blood flow velocity through both uterine arteries and Pulsatility Index [PI] to analyze the waveform; Serum estrogen level was measured to all cases using the Radio-immunoassay [RIA] technique, The normal value of serum estrogen in postmenopausal women is 5-25 pg/ml. Dilatation and curettage was done to study the endometrial and endocervical histopathological feature. TVS and measurement of serum E2 were used as a screening tests for the detection of postmenopausal endometrial hyperplasia and/or malignancy. Doppler flow mapping for the uterine arteries and histopathological evaluation further added as complementary parameters. Endometrial hyperplasia was reported in 22 cases [44%] and endometrial cancer in 12 cases [24%]. The hyperplasia group further classified into simple, complex and atypical. Simple hyperplasia recorded in 12 cases [24%], complex in 7 cases [14%], and atypical in 3 cases [6%]. Endometrial polyp was seen in 5 cases [10%], Endometrial atrophy was seen in 7 cases [14%], while fibroid was seen in 4 patients [8%]. Assessment of the endometrium by TVS and measurement of serum E2 should be used as a primary diagnostic simple screening tests for the detection of postmenopausal endometrial hyperplasia and/or malignancy; But they must be supplemented by Doppler sonography of the uterine arteries whenever the serum E2 level is above normal or endometrial thickness is more than 5 mm in order to detect cancer at an early stage

Role of transvaginal ultrasound in diagnosis of stress incontinence in females

Incontinence of urine is one of the most common health problems in women, especially in the elderly. The aim of this study was to evaluate the role of vaginal ultrasonography in diagnosing the type of stress incontinence whether genuine stress incontinence [GSI[or detruser overactivity [DOA], Fifty women divided into two groups: 40 with stress incontinence and 10 control cases at Al-Azhar University Hospitals and national institute of urology and nephrology. Vaginal ultrasonography measuring average bladder wall thickness, urethral angulation and bladder neck mobility was done for the fifty cases as well as urodynamic evaluation. DOA cases showed thicker bladder wall with preserved urethral angulation and normal bladder neck position and mobility. On the other hand, cases with GSI showed no significant differences as regard to average bladder wall thickness. However, urethral angulation was diminished and bladder neck was hypermobile. Although a variety of methods have been advanced to objectively demonstrate stress incontinence and its type, ultrasonography as a practical, economic, convenient and patient accepted method can also diagnose type of stress incontinence. It is recommended that ultrasound should be implemented in diagnosing type of stress incontinence in females

Effect of corticosteroid therapy on doppler study of umbilical and middle cerebral arteries and fetal outcome in woman at risk of preterm labour

To investigate the effects of maternal steroid administration on umbilical and fetal middle cerebral artery flow velocity waveforms and fetal out-come. Sixty Pregnant Women with singleton healthy fetuses "without fetoplacental insufficiency" complaining from threatened preterm delivery at 30-36Wks were treated using steroid therapy. There was a significant decrease in umbilical artery and foetal middle cerebral artery pulsatility indices with decrease in UA/MCA P.I ratio at day 3, day 5 after treatment, with no changes at day 7 after steroid administration and also, no significant changes in foetal heart rate. Betamethasone therapy given to the mother to avoid complications of premature fetus e.g. R.D.S., there was transient significant effect on foetal middle cerebral artery and umbilical artery "decreased PI at day 3 and day 5" after steroid administration; The effects were disappeared or declined at day 7, with no significant changes in foetal heart rate during the courses of therapy

Serum apolipoproteins in ischemic heart disease correlated with the extent and severity of CAD

Serum apolipoportein A-1 [apo A-1] and apolipoprotein B [apo B] in 42 patients [28 males and 14 females] undergoing elective coronary angiography were correlated with the number of stenosed major coronary arteries and with extent and severity of coronary artery disease [CAD]. Fasting serum levels of total cholesterol [TC], triglycerides [TG], high density lipoprotein cholesterol [HDL-C], low density lipoprotein cholesterol [LDL-C] were also correlated. Simple linear regression analysis, unpaired student t-test, and analysis of valiance [ANOVA] were used to compare the means. Twenty eight patients had CAD [group I] while, 14 subjects had angiographically normal coronaries [group II]. In group I, as a whole, the patients with 3 vessel disease [3VD] had a significantly lower level of apo A-1 than those with single vessel disease [single VD] while, the HDL-C level showed nonsignificant [NS] difference. In males with 3VD both apo A-1 and HDL-C levels were significantly lower [P <0.01, P <0.01] than in those with single VD. In group I, as a whole, significant correlations were proved between the extent and the angioscore for severity of CAD and LDL-C [P <0.05], the ratios TC/HDL-C [P <0.01] and LDL/HDL-C [P <0.01], apo A-1 [P <0.05], apo B [P <0.01] and the ratio apo B/apo A-1 [P <0.01]. HDL-C showed NS correlation

Bilharzial oval patterns in rectal and colonic mucosa for patients with urinary bilharziasis

Mucosal biopsies from the rectum and colon of 25 males of pure urinary bilharziasis and negative stools were examined directly in the fresh state for bilharzial oval pattern by a slide compression technique. The method proved valuable in the diagnosis of bilharzial nature of the disease as a supplement to routine urine and stool examination. It has the additional balue of indentifying the species of bilharzia in the different levels of rectum and colon. This showed that the bilharzial oval pattern in patients with pure urinary bilharziasis is dominatly that of pure haematobium and dominant haematobium at 10 cm level as compared to a dominant pattern of pure mansoni and dominant mansoni at cm level irrespective of the presence of recent or past history of anti-bilharzial therapy and finally we can conclude that occuld mansoniasis is common in our locality and is discovered only by mucosal biopsy particularly colonic biopsy