Insight on the relation between maternal derangement of homocysteine metabolism and their offsprings with contruncal heart defects

This study was performed to evaluate the effect of maternal derangement of homocysteine [Hcys] metabolism and their children with contruncal heart diseases. The fasting plasma levels of Hcys, folic acid and vitamin B12 were measured by radioassay techinque. The study consisted of 22 mothers of 22 off springs having contruncal heart defects [Pre-treatment group] and 22 healthy mothers having healthy offsprings as administrated a commercially avaliable multivitamin supplementation, and plasma Hcys level, in pre-treatment group. The study revealed a mean fasting plasma Hcys level, in pre-treatment group, of 13.17 +/- 2.63 micro mol/l, and 11 +/- 1.81micro mol/l in post-treatment group and 9.71 +/- 1.63 micro mol/l in control group, there was a statistically significant difference between all studied groups. Also, there was a positive significant correlation between maternal age and Hcys plasma level, and a negative significant correlation between fasting plasma levels of Hcys, folate, and vitamin B12. In conclusion, this study showed a significant increase of fasting plasma Hcys level in mothers having offersprings with contruncal heart defects and that multivitamin supplementation would decrease this level

Unilateral versus bilateral laparoscopic ovarian electrocautery in patients with polycystic ovarian syndrome: a prospective hormonal and clinical study

The aim of this work was to assess the efficacy of unilateral and bilateral laparoscopic ovarian electrocautery in correcting the endocrine abnormalities and inducing ovulation in infertile patients with clomiphene citrate resistant PCOS. Fifty patients were included in this study. They were randomly allocated to either unilateral [25 cases] or bilateral [25 cases] laparoscopic ovarian electrocautery. Serum LH FSH and testosterone [T] levels were estimated in the early follicular phase before and after the operation. The cases were followed postoperatively for 6 months to detect, the occurrence of ovulation and pregnancy. A highly significant postoperative fall of serum LH and LH/FSH ratio [P<0.0001] was detected following either unilateral or bilateral ovarian electrocautery. Also serum FSH increased significantly [P<0.05] and serum T decreased significantly [P<0.05]. Ovulation occurred in 72% of the patients following unilateral ovarian electrocautery and in 76% following bilateral ovarian electrocautery. It was found that neither the preoperative LH, FSH nor T level could be used to predict the occurrence of postoperative response. Unilateral ovarian electrncautery resulted in bilateral ovarian activity in all responders. Pregnancy occurred in 48% of the patients of unilateral ovarian electrocautery and in 56% of the patients of bilateral ovarian electrocautery. The less traumatizing technique of unilateral laparcscopic ovarian electrocautery resulted in endocrine and clinical effects nearly similar to that produced by bilateral ovarian elctrocautery with no statistically significant difference. It has the advantage of preserving one side of the pelvis away from possible postoperative adhesions

Prophylactic transcervical amino-infusion during labour complicated by meconium

A prospective randomized trial of saline amnioinfusion through a transcervical Foley's catheter included 64 term and postterm patients in labour complicated by meconium; 32 of them had amnioinfusion and the others had standard obstetric care without amnioinfusion. Amnioinfusion was found to be significantly effective in the dilution of meconium stained amniotic fluid as detected by spectrophotometry. The incidence of thick meconium was significantly lower after amnioinfusion compared with the control group P< 0.005]. The incidence of 1-minute Apgar scores < 4 and 5 -minutes Apgar scores < 7, meconium more than trace below vocal cords and meconium aspiration syndrome were significantly reduced in the infants of the amnioinfusion group [P< 0.05]. No complications related to the amnioinfusion procedure were observed. We concluded that, prophylactic transcervical saline amnioinfusion in labour complicated by meconium is a safe procedure that significantly improves neonatal outcome