randomized controlled trial of psychosocial counselling for first-time IVF couples

Of this study was to evaluate pre-IVF counselling using self report questionnaire on couples. The acceptability of counselling, perception of help and effects on anxiety and depression were considered. The study included 423 consecutive childless Arabic couples preparing for their first IVF. Randomization was carried out through sealed envelopes attributing participants to counselled and non-counselled groups and was accepted by 300 couples. Another 42 couples refused randomization because they wanted counselling and 81 couples because they did not. Questionnaires including the State-Trait Anxiety Inventory, the Beck Depression Inventory and assessments of help were answered by couples before IVF and counselling, and after the IVF outcome result. Counselling was accepted by 81% [342/423] of couples. There was no significant effect of counselling on anxiety and depression scores which were within normal ranges at both times. Counselling provided help for 86% [225/261] of initially non-demanding subjects and 96% [81/84] of those initially requesting a session. Help was noted in areas of psychological assistance, technical explanations and discussing relationships. This model of routine counselling provides an acceptable form of psychological assistance for pre-IVF couples

Evaluation of risk factors associated with recurrent cesarean section morbidity: a suggested score

This prospective study included 1000 women undergoing cesarean section [CS] under general anesthesia. They were divided into two groups. Group 1 [control group] included 500 patients, who underwent CS for the first time. Group 2 [study group] included 500 patients who had one or more previous CS. Simple scoring system was developed to record the possible risk factors related to CS morbidity. There were six significant preoperative risk factors [high parity, preterm delivery, placenta praevia, antepartum hemorrhage, medical disorders and bad general condition]. There were five highly significant risk factors related to intra-operative morbidity [high parity, placenta praevia, intra-peritoneal adhesions, low experienced surgeon and preterm gestational age] and five risk factors related to previous CS operation [previous three or more CS, previous CS at rural hospital or private clinic, previous upper segment CS, previous complicated CS and tender previous scar]. Eleven factors related to postoperative morbidity were more significant in the repeated CS group. The incidence of overall morbidities was significantly more in the repeated CS group. Total postoperative morbidity was highly significant starting from previous 4 or more CS. Risk factors related to intra-operative morbidity were used to develop a mortality scoring system. Based on a summation of logistic coefficient corresponding to individual risk factors, a scoring system was suggested, which can help in the prediction of CS morbidity. Further prospective evaluation of this scoring system would be helpful to confirm the usefulness and practicality of this system

Laryngoceles associated with laryngeal carcinoma

Laryngoceles and large saccules were found in 3.07% and 5.12% of patients with laryngeal carcinomas. CT proved to be very accurate more than endoscopy in detection of asymptomatic laryngocele associated with cancer larynx. However both endoscopy and CT are recommended in cases presented primarily with laryngoceles to rule out any underlying malignancy. Laryngoceles were bilateral in 50% of cases. Large saccules were ipsilateral in 60% [6/10], bilateral in 10% [1/10], and contralateral in 30% [3/10] of cases. Four patients with supraglottic tumors [4.54%] were associated with two bilateral symptomatic and two asymptomatic ipsilateral laryngoceles. Two patients with transglottic tumors [3.44%] showed asymptomatic ipsilateral internal and bilateral mixed laryngoceles. All asymptomatic laryngoceles were diagnosed by CT and postoperative examination of the specimens as patients presented usually with symptoms related to the tumor. Large saccules were found in 5.68% of supraglottic tumors, 4.76% of glottic tumors, and 5.17% of transglottic tumors. 60% [6/10] of large saccules were ipsilateral, 30% [3/10] were contralateral, and 10% [1/10] was bilateral

Live-donor kidney transplantation: a source for tuberculosis transmission?

Between 1976 and 1994, 700 live-donor kidney transplants were carried out at our center. Among these, 28 recipients [4%] developed Tuberculosis 13-92 months [mean, 22.25] after transplantation. This study was conducted to find out the source[s] of infection entailing retrospective analysis of peri-operative data [for both recipients and their corresponding donors] as well as screening the donors with Ziehl- Neelsen [ZN] staining of their urine concentrate. Ten donated kidneys were found to be the source of infection which resulted in urinary TB in 7 recipients and disseminated infection in the remaining three. Treatment was initiated for both recipients and donors. Eight recipients developed chronic rejection. Ultimately, TB was controlled in 9 recipients while the last patient died of disseminated TB. Among the survivors, 4 had a functioning graft and the remaining 5 finally returned to dialysis, 3 of them died of unrelated causes. In all donors, TB infection was controlled. One donor required ballon dilatation for a stricture in the pelvic ureter of the remaining kidney. Donating a tuberculous kidney is hazardous to the immuno-compromized recipients as well as donors. Being a substantial source for post-transplantation TB, potential donors should be screened with ZN staining and PCR [polymerase chain reaction] of their urine concentrates

profile of retrospective three dimensional CT reconstructed reformat of some congenital paranasal sinus anomalies

Gathered data from spiral axial and coronal computed tomography examination of some congenital paranasal sinus anomalies were constructed to retrospective three dimensional [3D] reconstructions. These data covered congenital anomalies in both the anterior and posterior groups of the paranasal sinuses. The findings were found to be valuable in diagnosing the congenital lesions and its extent, whether hypo-developed or overdeveloped. Moreover, applying this up-to-date technology of three dimensional computed tomography will help in the endoscopic diagnosis and management of sinus lesions, in particular, and in other related diseases in general as well as allocating blood vessels in cases of congenital sinus anomalies