Résumé
Background: brain-derived neurotrophic factor [BDNF] is a27-kDa polypeptide that belongs to the neurotrophin family binding with high-affinity protein kinase receptors [Trk] and the unselective p75NGFR receptor. The BDNF gene has a complex structure with multiple regulatory elements and four promoters that are differentially expressed in the central or peripheral tissue
Aim of the Work: this study aimed to detect affection of follicular fluid neurotrophin level in different types of infirtility and its using as peredictor for ovarian reserve
Patients and Methods: this crosssectional study was carried out in Ain Shams University, Maternity Hospitals Assisted Reproductive Technology Unit [ART unit] in the period from Septemper2016 to June 2017
Results: the present study showed a cut-off value of BDNF for the patients who underwent this study was 2.7 pg/ml with sensitivity of 74.2%, specificity 95.5%, PPV 85.2% and NPV 91.4%
Conclusion: FF-BDNF measurement on the d-OPU in women with different types of infertility underwent COH for IVF-ET, had positive correlation with ovarian reserve and positive predictor of pregnancy which occurred in 25.8% of cases
Recommendations: BDNF has positive correlation with ovarian reserve and positive correlation with pregnancy outcome so we recommend to measure serum BDNF before starting IVF cycle as predictive factore and cost effective
Résumé
Background: adenomyosis is a common benign gynecological affecting premenopausal woman, in which there is increased overgrowth of the endometrium with invasion of the underlying myometrium. The precise pathogenesis of adenomyosis remains unknown with many theories being proposed that consider it to be a pathology that initially affects the endomyometrial junctional zone [JZ]
Aim of the Work: the study aims to compare 3D transvaginal ultrasound with MRI in diagnosing adenomyosis in comparison with the gold standard histopathology
Patients and Methods: this cross-sectional study was carried out on 77 patients who were recruited from women presenting to the outpatient clinic at Ain Shams University Maternity Hospital planned to undergo hysterectomy [abdominal, vaginal or laparoscopic assisted hysterectomy] for adenomyosis according to the inclusion/ exclusion criteria
Results: out of 77 patients included in the study, 67[87%] were +ve for adenomyosis by 3D TVUS, confirmed in 46[59.74%] by histopathology, while 52[67.53%] were +ve by MRI, confirmed in 39[50.64%] by histopathology.3D transvaginal US was able to diagnose adenomyosis in 67[87%] patients and fibroid in 23[29.9%] patients, while MRI was able to diagnose adenomyosis in 52[67.5%] and fibroid in 36 [46.8%]
Conclusion: our study results indicated that, 3D transvaginal ultrasound is highly accurate as MRI in diagnosing adenomyosis and leiomyoma as a preoperative diagnostic tool
Recommendations: as the 3D ultrasonography is more available, cheaper, less time consuming and easier technique, it is recommended to be used in every day clinical practice, helping the clinicians to reach an accurate diagnosis, select an appropriate treatment, and individualize management for each patient to reach the best outcome therapeutic rates
Résumé
Introduction: The normal microbial flora of the vagina plays an important role in preventing genital and urinary tract infections in women. Thus an accurate understanding of the composition and ecology of the ecosystem is important to understand the aetiology of these diseases. In addition, microorganisms possibly those associated with bacterial vaginosis may inhabit the uterine cavity [bacteria endometrialis] where they are responsible for some common gynecological and obstetric enigmas. The aim of the present work was to study vaginal and uterine ecosystem in some gynecologic disorders aiming at reconsidering the place of appropriate antibiotic regimens
Subjects and Methods: The present study was conducted on 100 patients admitted to Obstetrics and Gynecology Department, Ain Shams University Hospital. Their ages ranged from 36-60 years and they were all indicated for hysterectomy. Informed consent was obtained from each patient. They were subjected to history taking, general and local examinations and vaginal PH measurement before taking the specimens. The specimens included three swabs taken from cervical os and the posterior fornix of vagina immediately before the operation and three endometrial swabs taken immediately after hysterectomy and incising the uterine wall using full aseptic technique. Swabs were used for preparation of direct Gram stained smear, Isolation of aerobic and anaerobic bacteria. Results in the present study showed that metrorrhgia and uterine fibromyomas were the most common indications for hysterectomy and Lactobacilli were the most commonly isolated organism, followed by coagulase negative Staph, Diphtheroids, Peptococci, anaerobic Gram -ve bacilli and Gardnerella vaginalis [G Vaginalis]. However, there was no statistically significant association between any of the isolated organisms and the indications for hysterectomy. In premenopausal patients, Lactobacilli were the most commonly isolated organism while coagulase negative Staph was the most commonly isolated organism from postmenopausal patients. With exception of Lactobacilli, the difference between premenopausal and postmenopausal women regarding isolated organisms was statistically none significant. Organisms were isolated from the uterine cavity in 11 patients and the most commonly isolated organisms were G vaginalis and Staph aureus. Each organism was isolated from four cases, anaerobic Gram -ve bacilli was isolated from two cases and Peptococci was isolated only in one case. It could be concluded that presence of bacteria in the endometrial cavity could be implicated as a significant previously unrecognized; cause of obstetrics and gynecologic diseases, as in recent years, an unexpected infectious aetiology has been found for a variety of clinical conditions. Thus, the place of appropriate antibiotic regimens would need careful consideration. However, further studies are needed to confirm these results
Résumé
The goal of this study was to test the influence of two widespread techniques of general anaesthesia on motor evoked potentials [MEP] in response to transcranial and cortical high frequency repetitive electrical stimulation. Total intravenous anaesthesia [TIVA] based on propofol and alfentanil was studied in 17 patients [Group A] and balanced anaesthesia [BA] based on nitrous oxide, isoflurane and alfentanil was studied in 13 patients [Group B]. Distinct motor responses were available in 15 of 17 patients [88%]] of [Group A] and in one of 13 patients [8%] of [Group B]. Amplitudes increased significantly with increasing stimulus intensity and number of pulses under conditions of TIVA. At the same time, latencies decreased significantly with increasing stimulus intensity and decreasing inter-stimulus intensity interval, but not with increasing number of pulses. It is hypothesized that propofol suppresses corticospinal I-waves at the cortical level resulting in a conduction block at the level of the alpha-motor neuron; this effect may be overcome by high frequency repetitive stimulation. In contrast, nitrous oxide and isoflurane seem to have an additional suppressive effect on corticospinal D-waves which may be overcome by higher stimulation intensity. It was concluded that transcranial high frequency repetitive stimulation and TIVA provide a feasible setting for intraoperative MEP monitoring, while higher doses of nitrous oxide and isoflurane are not compatible with recording of muscular activity elicited by the stimulation technique as described