Role of toxoplasmosis in recurrent abortion

This work was designed to assess the role of toxoplasmosis in recurrent abortion, 771 women attended the obstetrics and gynecology unit at Benha University Hospital were included in this study. 491 of these women had history of sporadic abortions group I; 230 women had history of recurrent successive abortions group II; and 50 women had normal obstetric history group III. The sera of all women were examined for toxoplasma antibodies IgM and IgG using enzyme linked immunosorbent assay [ELISA]. It was found that 213 [43.3%] women were sero positive in group I; 91 [39.5%] woman were sero positive in group II and 8 [16%] women were seropositive in group III. There was a statistically significant difference between group I and III [p < 0.05]. The difference between group II and III was significant [p < 0.05]. The difference between group I and group II was insignificant. Patients with positive sera in group I and II treated by spriramycin antibiotic in one course, 2 grams per day for 3 weeks. Another serological examination was done one week after treatment. The results showed that out of 183 treated women in group I: 124 [67%] women became seronegative and out of 78 treated women in group II: 55 [69%] women converted to seronegative. Repeated abortion in sero negative women was; out of 61 pregnant women in group I; 9 [14.9%] were aborted and out of 40 pregnant women in group II: 7 [17.5%] were aborted, These data confirm that toxoplasma is a definitive cause for recurrent abortion. Serological screening before and during pregnancy for those women who had recurrent abortion can be helpful in reducing the incidence of recurrent abortion

Intrauterine insemination [IUI] using swim-up technique or percoll gradient technique versus timed intercourse in the management of unexplained infertility

Forty-eight patients with unexplained infertility were subjected to 3 treatment protocols. They were randomly divided into 3 groups. Group I comprised 13 patients who were treated by induction of superovulation and timed intercourse through 17 treatment cycles. Group II included 16 patients who were treated by induction of superovulation and IUI using husbands washed sperm prepared by the swim-up technique through 19 treatment cycles. Group III. on the other hand, included 19 patients who were similarly treated but with IUI utilizing Percoll gradient technique, through 23 treatment cycles. The clinical pregnancy rates/treated cycles were 5.9% in the first group, 10.5% in the second group and 13% in the third group. Induction of superovulation and IUI with husbands capacitated sperm especially using Percoll gradient technique may he beneficial for treatment of patients with unexplained infertility

Predictors of lithium therapeutic response in mania

Fourty patients diagnosed as Mania according to the criteria of ICD-10 were subjected to full Clinical psychiatric examination and psychometric assessment using Manic Rating Scale and Scale for Affective Disorder [SAD] derived from schedule for affective disorder and schizophrenia [SADS]. Investigations were done at the Start of lithium therapy and every week for one month, the dose of lithium was adjusted according to plasma level using flame emission photometer positive family history of affective .disorders was found to predict good outcome, while older age, previous depression, younger age of onset, paranoid features and formal thought disorders were found to predict poor outcome

Carbamazepine in the treatment of mania

This study was conducted on 44 manic patients diagnosed according to the criteria of ICD 10 and randomly assigned into two groups, carbamazepine treated group [N=24] and Haloperidol treated group [N = 20]. Treatment response was measured objectively by using Beigel Manic Rating Scale and Scale for Affective Disorders [SAD]. Beck depression inventory was used to evaluate outcome and detect development of depression after therapy. Carbamazepine has demonestrated substantial effectiveness in 50% of manic patients. Therapeutic remission occured mostly within 8 weeks after initiation of therapy. If after 3-4 weeks in the high therapeutic range a patient fails to respond, alternative therapeutic measures should be considered. Carbamazepjne induced therapeutic response rates nearly comparable to those induced by haloperidol, however, it showed rather more rapid action, better tolerability, less side effects and less risk for development of depression