Day 1 change in maternal serum ß-HCG levels as an early predictor of successful medical therapy in ectopic pregnancies.

Objective: To evaluate the role of ß-HCG level changes between days 0 and 1 as an early predictor of methotrexate success in cases of tubal ectopic pregnancy.Methods: A retrospective study included 86 tubal ectopic pregnancies treated with a single-dose methotrexate protocol of 50 mg/m2 of body surface. ß-HCG measurements were taken on days 0, 1, 4 and 7 where day 0 is the day of methotrexate injection. Day 0 ß-HCG and the percentage change in ß-HCG level between days 0 and 1 (HCG index) were calculated and compared between patients who were successfully or unsuccessfully treated. Receiver operator characteristics (ROC) curves were plotted to identify the best cutoff levels.Results: The average level of ß-HCG (1416.8 versus 2502.5 IU/L, p=.001) and its increment after 24 hours (12.9 versus 27.1%, p=.001) were significantly lower in the successful treatment group. ROC curves for ß-HCG level and its relative increment revealed that cutoff values of ≤1550 IU/L and ≤13% increment showed a sensitivity of 90 and 70% respectively for successful methotrexate treatment.Conclusion: Day 0 ß-HCG level ≤1550 IU/L and an increment of ≤13% after 24 hours are early predictors of successful methotrexate treatment for tubal ectopic pregnancy.

Prevalence and differences between type 1 and type 2 diabetes mellitus regarding female sexual dysfunction: a cross-sectional Egyptian study.

OBJECTIVE: To evaluate the female sexual dysfunction in both type 1 and type 2 diabetes mellitus (DM). METHODS: This cross-sectional study was carried out at Suez Canal University Hospitals from the start of February 2015 to the end of May 2016 among 189 married premenopausal women attending endocrinology and diabetology outpatient clinic for regular follow-up; 25 of whom refused to participate and 18 more were excluded due to incomplete data sets resulting in a final sample of 146 diabetic females. Ninety healthy women were recruited from the administrative staff at the hospital as a control group. Sexual dysfunction was assessed using female sexual function index (FSFI), a validated 19-item, self-administered, screening questionnaire comprising the six major sexual domains: desire, arousal, lubrication, orgasm, satisfaction and pain. Responses to each question were reported and scored on 0-5 scale with 0 representing no sexual activity and 5 suggestive of normal sexual activity. RESULTS: Prevalence of sexual dysfunction was significantly higher in both type 1 and 2 DM groups (44 and 25%, respectively) than in the control group (9%). FSFI mean total score was significantly lower in type 1 DM (21.1 ± 3.9) than type 2 DM (26.4 ± 4.2) and both were significantly lower than the control group (31.5 ± 5.8). With regard to FSFI domains, mean values for desire, arousal, lubrication, orgasm, satisfaction and pain were significantly lower in both type 1 and type 2 DM groups when compared with the controls. CONCLUSION: FSD is a significant health problem among premenopausal diabetic Egyptian women. Type 1 DM women were more affected than type 2 DM that in turn was more affected than healthy control females.

Psychological impact of female genital mutilation among adolescent Egyptian girls: a cross-sectional study.

OBJECTIVES: Worldwide, at least 200 million women and girls have undergone female genital mutilation (FGM). The medical and sexual consequences have been documented, but the psychological impact has not been studied to the same extent. The aim of this study was to explore the relationship between FGM and psychiatric problems among adolescent girls. METHODS: A total of 204 girls, aged 14-19 years, were included in a cross-sectional study conducted at Suez Canal University Hospitals. All participants completed an Arabic-validated, structured questionnaire covering nine symptom scales. Sociodemographic data were also collected. Main outcome measures were the prevalence of psychiatric problems among adolescent girls who had undergone FGM. RESULTS: Overall, 66.2% of girls had undergone FGM. The percentage in rural areas was 91.8%, compared with 43.0% in urban areas. There were no significant differences between the FGM and non-FGM groups as regards religion, educational and socioeconomic levels. FGM girls had a significantly higher level of psychological problems with regard to somatisation, depression, anxiety, phobic anxiety and hostility compared with non-FGM girls (p < .0001). CONCLUSIONS: FGM is a traumatic experience that may leave a lasting psychological mark and a negative impact on the psychological status of affected girls.