The relation between serum uric acid and severity of preeclampsia in pregnant women: a cross-sectional study.

Introduction: There are conflicting data regarding the relation between serum uric acid (SUA) and severity of preeclampsia (PE). The aim of the study was to assess the relation between SUA and the severity of PE. Material and methods: A total of 110 pregnant women were studied; 55 with mild PE were compared to 55 women with severe PE in this cross-sectional study, which was conducted in Maternity Hospital. After thorough evaluation and renal function tests, spot urine samples were taken from participants for the protein/creatinine ratio. The urine proteins were measured by the Biuret colorimetric method. The urine creatinine was measured by the modified Jaffe test. The serum uric acid was measured by the enzymatic method. The collected participants' data were statistically analysed, and Pearson's coefficient was used to detect the relation between SUA and severity of PE. Results: The serum uric acid was significantly higher in the severe PE group (7.65 ±0.61 mg/dl) compared to the mild PE group (5.26 ±0.79 mg/dl), (p = 0.04). There were significant positive relations between the SUA and both the systolic and diastolic blood pressures [r = 0.27 (p = 0.045) and r = 0.483 (p < 0.001), respectively] in the severe PE group. There were also significant positive relations between the SUA and both the systolic and diastolic blood pressures [r = 0.359 (p = 0.007) and r = 0.429 (p = 0.001), respectively] in the mild PE group. Conclusions: There were significant positive relations between the SUA and both the systolic and dia-stolic blood pressures in the severe PE group. This study recommends the use of SUA as a reliable marker of the severity of PE.

The relation between primary dysmenorrhea in adolescents and body mass index.

Introduction: The aim was to assess the relation between primary dysmenorrhea in adolescents and body mass index (BMI). Material and methods: Two-hundred and ten adolescents were recruited for this cross-sectional research. After detailed evaluation, pelvic sonography was performed for the studied adolescents to rule out any pelvic abnormalities and/or lesion(s). The severity of the studied adolescents' dysmenorrhea was assessed by the visual analogue scale (VAS). The studied adolescents were divided into underweight, normal-weight, overweight, and obese adolescent groups based on their BMI (kg/m2). Collected data were analyzed using the ANOVA test, and correlation analysis (Pearson's correlation) to assess the relation between primary dysmenorrhea in adolescents and BMI. Results: The visual analogue scale of dysmenorrhea was statistically higher in the underweight adolescent group (8.7 ±0.8) compared to normal-weight (6.5 ±0.5) (p = 0.000001), and overweight (6.3 ±0.6) (p = 0.000001) adolescent groups. The visual analogue scale of dysmenorrhea was also statistically higher in the obese adolescent group (9.4 ±0.6) compared to underweight (8.7 ±0.8) (p = 0.000001), normal-weight (6.5 ±0.5) (p = 0.000001), and overweight (6.3 ±0.6) (p = 0.000001) adolescent groups. Conclusions: The visual analogue scale of dysmenorrhea was statistically higher in the underweight adolescent group compared to normal-weight, and overweight adolescent groups, and there was a strong negative relation between the VAS and BMI in the underweight adolescent group. In addition, the VAS of dysmenorrhea was statistically higher when the obese adolescent group was compared with the overweight, normal-weight and underweight adolescent groups, and there was a moderate positive relation between the VAS and BMI in the obese adolescent group.

The effects of vitamin D and calcium on primary dysmenorrhea: a systematic review.

Dysmenorrhea, affecting approximately 80% of adolescents, significantly impairs quality of life, disrupts sleep patterns, and induces mood changes. Furthermore, its economic impact is substantial, accounting for an estimated $200 billion in the United States and $4.2 million in Japan annually. This review aimed to identify the effects of vitamin D and calcium on primary dysmenorrhea. We conducted a comprehensive literature search across Web of Science, PubMed, Scopus, and Science Direct, focusing on studies published from 2010 to 2020. Keywords included 'primary dysmenorrhea', 'vitamin D', '25-OH vitamin D3', 'cholecalciferol', and 'calcium'. The quality assessment of the articles was done using the Consolidated Standards of Reporting Trials (CONSORT) and the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklists, and the risk bias was assessed using the Cochrane assessment tool. Abnormal low Vit. D levels increased the severity of primary dysmenorrhea through increased prostaglandins and decreased calcium absorption. Vitamin D and calcium supplements could reduce the severity of primary dysmenorrhea and the need for analgesics. This systematic review found an inverse relation between the severity of dysmenorrhea and low serum Vit. D and calcium.. Vitamin D and calcium supplements could reduce the severity of primary dysmenorrhea and the need for analgesics.

The impact of primary dysmenorrhea on adolescents' activities and school attendance.

Primary dysmenorrhea is the most commonly encountered menstrual issue among adolescents, often leading to significant school absenteeism. This study aimed to detect the impact of primary dysmenorrhea on adolescents' activities and school attendance. We conducted a cross-sectional comparative study involving 180 adolescents aged 12 to 18 who experienced primary dysmenorrhea. A comprehensive trans-abdominal pelvic sonography was performed to rule out any underlying pelvic conditions. The severity of dysmenorrhea was evaluated using the visual analog scale (VAS), categorizing adolescents into groups with mild dysmenorrhea (VAS ≥1 to ≤3), moderate dysmenorrhea (VAS >3 to ≤7), and severe dysmenorrhea (VAS >7 to ≤10). Adolescents were surveyed to determine whether the severity of dysmenorrhea had an adverse effect on their physical and social activities as well as their school attendance. We used one-way ANOVA to compare the groups. There was a significant positive relation between the severity of dysmenorrhea and its negative impact on adolescents' physical activities (r=0.395; p<0.00001) and social activities (r=0.658; p<0.00001). Additionally, there was a significant positive relation between the severity of dysmenorrhea and its negative impact on adolescents' school attendance (r=0.416; p<0.00001). The odds of a negative impact on adolescents' physical and social activities and school attendance were significantly higher in adolescents experiencing moderate and severe dysmenorrhea than in adolescents with mild dysmenorrhea.

Relationship between routine urinary catheterization and postoperative urinary symptoms and urinary tract infections in women undergoing elective caesarean section.

Introduction: The aim of the study was to detect the relationship between routine urinary catheterization and postoperative urinary symptoms and urinary tract infections (UTIs) in women undergoing elective caesarean sections (ECSs). Material and methods: One hundred women undergoing ECSs were included in this observational study and randomized into a catheterized (C) group, including women who underwent ECS after insertion of indwelling Foley's catheter, and a non-catheterized (NC) group, including women who underwent ECS without Foley's catheter. The Foley's catheters were removed from all participants in the C group once they were freely ambulant and had recovered from the effect of the spinal anaesthesia. Participants were asked about any abnormal postoperative urinary symptoms (dysuria, frequency, urgency, and/or urinary retention), and to collect urine samples (mid-stream) once they were freely ambulant for urine cultures. Results: The postoperative dysuria, frequency, and urgency were significantly higher in the C group compared to the NC group [36% (18/50), 40% (20/50), and 34% (17/50) vs. 8% (4/50), 6% (3/50), and 6% (3/50), respectively], (p = 0.006, 0.001 and 0.004, respectively). The urinary tract infections and the postoperative antimicrobials used were significantly higher in the C group compared to the NC group [40% (20/50) and 40% (20/50) vs. 6% (3/50) and 6% (3/50), respectively], (p = 0.001 and 0.001, respectively). The postoperative hospital-stay after the ECSs was significantly higher in the C group compared to the NC group (5.4 ±1.8 days vs. 3.8 ±1.15, respectively), (p = 0.001). Conclusions: Routine urinary catheterizations in women undergoing ECS significantly increase the odds of postoperative dysuria, frequency, urgency, UTIs, and the postoperative antimicrobials used.

Relationship between vitamin D and adolescents' hypothyroidism - a cross-sectional study.

Introduction: To detect the relationship between 25(OH)D and hypothyroidism in adolescents. Material and methods: A total of 180 adolescents were included in the current study, which was conducted in West Kazakhstan (Aktobe) over 2 years. After thorough evaluation, blood samples were collected from the studied participants to measure the thyroid stimulating hormone (TSH), free thyroxine (T4), prolactin, glycosylated haemoglobin, and 25(OH)D. Participants were classified into a 25(OH)D-deficient group (study group) and controls. MedCalc and correlation analysis (Pearson's correlation) were used to detect the odds of hypothyroidism and the relationship between 25(OH)D and adolescents' hypothyroidism, respectively. Results: Thyroid-stimulating hormone was statistically higher in the 25(OH)D-deficient group than in the normal controls (3.71 ±1.4 mIU/ml vs. 2.67 ±0.99) (p = 0.0006), and the free T4 was statistically lower in the 25(OH)D-deficient group than in normal controls (1.4 ±0.56 ng/ml vs. 1.5 ±0.4) (p = 0.0008). The 25(OH)D deficient group had higher odds of subclinical (OR 4.89; p = 0.016), and clinical hypothyroidism (OR 4.3; p = 0.013) compared to controls. A significant negative correlation between the 25(OH)D and TSH (r = -0.793; p < 0.00001), and a significant positive correlation between the 25(OH)D and free T4 (r 0.55; p < 0.00001) were detected in this study. Conclusions: The thyroid-stimulating hormone was statistically higher and the free T4 was statistically lower in the 25(OH)D-deficient group than in normal controls. The 25(OH)D-deficient group had higher odds of both subclinical and clinical hypothyroidism compared to controls. A significant negative correlation between the 25(OH)D and TSH, and a significant positive correlation between the 25(OH)D and the free T4 were detected in this study.

Relation between vitamin D and adolescents' serum prolactin.

Introduction: To detect whether there is a relation between vitamin D (Vit. D) and adolescents' serum prolactin (PRL) or not. Material and methods: Hundred and seventy-six adolescent girls were recruited for the current study, which was conducted in West Kazakhstan (Aktobe) over two years. After thorough evaluation, blood samples were taken from adolescents to measure thyroid stimulating hormone (TSH), free thyroxine (T4), PRL, glycosylated hemoglobin and 25(OH)D. The studied adolescents were classified into study group [25(OH)D deficient] and controls [normal 25(OH)D]. The acquired adolescents' variables were analyzed using the Student t-test and Pearson's correlation. Results: The serum TSH and PRL were statistically higher in the study group than normal controls (3.73 ±1.45 mIU/ml and 47.5 ±7.6 ng/ml vs. 2.67 ±1.0 and 10.8 ±5.1, respectively), (p = 0.0003 and p = 0.0001, respectively). The free T4 was statistically lower in the study group than normal controls (1.4 ±0.6 ng/ml vs. 1.5 ±0.4), (p = 0.0001). Strong negative associations between the serum PRL and 25(OH)D [r = -0.803 (p < 0.00001)], and between the serum PRL and free T4 [r = -0.6959 (p < 0.00001)] were detected in this study. Additionally, there was a strong positive association between the serum PRL and TSH [r = 0.8137 (p < 0.00001)]. Conclusions: A strong negative association between the serum PRL and 25(OH)D and a strong positive association between the serum PRL and TSH were detected in this study. This study recommends further studies to confirm the relation between Vit. D and PRL and screening Vit. D deficient adolescents for PRL and thyroid disorders.

The effect of vitamin D on adolescents' primary dysmenorrhea.

Vitamin D receptor (VDR) expression in the female reproductive tract explains the regulatory role of vitamin D on inflammatory cytokine and prostaglandin (PGD) synthesis. This study aimed to evaluate the effect of vitamin D on adolescents' primary dysmenorrhea and the relationship between Vit. D and adolescents' primary dysmenorrhea. Eighty-five adolescents were included in the current study. After a detailed evaluation, pelvic sonography was performed for all participants to rule out any pelvic pathology. Blood samples were collected to measure thyroid stimulating hormone (TSH), prolactin, glycosylated hemoglobin (HbA1C), and 25-hydroxyvitamin D (25[OH]D). Participants were administered vitamin D (50,000 IU weekly for five months), and their dysmenorrhea symptoms were evaluated before and after this period using the Visual Analog Scale (VAS) and the Verbal Multidimensional Scoring (VMS). The mean VAS and VMS scores of dysmenorrhea statistically decreased from 8.7±0.91 and 2.65±0.93 to 4.8±0.75 and 0.80±0.75, respectively, after vitamin D intake (p=0.03 and 0.025, respectively). Significant negative associations between 25(OH)D and VAS (R = -0.886; p<0.00001) and VMS of dysmenorrhea (R = -0.885; p<0.00001) were detected in this study. Vit. D could be a useful therapeutic option to reduce the severity of primary dysmenorrhea and could limit the use of non-steroidal anti-inflammatory drugs.

Higher clinical pregnancy rate with in-vitro fertilization versus intracytoplasmic sperm injection in treatment of non-male factor infertility: Systematic review and meta-analysis.

OBJECTIVE: To evaluate the evidence about in-vitro fertilization (IVF) versus intracytoplasmic sperm injection (ICSI) for the treatment of non-male factor infertility. DATA SOURCES: Electronic databases searched using the following MeSH terms (Sperm Injection, Intracytoplasmic) AND (in Vitro Fertilisation) AND (Infertility). METHODS OF STUDY SELECTION: All RCTs included infertile patients due to non-male factors underwent IVF or ICSI were considered for this meta-analysis. One-thousand twenty-two studies were identified of which 20 studies deemed eligible for this review. DATA EXTRACTION: Three independent authors extracted the relevant data from included studies. The study outcomes were pooled in the form of relative risk (RR) and 95 % confidence interval (CI) using Mantel-Hansel method. The main outcome measures are the fertilization rate, the implantation rate, the clinical pregnancy rate (CPR), the total fertilization failure and the live birth rate. RESULTS: Regarding the fertilization rate, the pooled estimate did not favour either IVF or ICSI group (RR = 0.94; 95 %CI [0.82, 1.07]; p = 0.34). However, IVF significantly increased the CPR than ICSI (RR = 1.28, 95 %CI [1.11, 1.49]; p = 0.001). The overall effect estimate did not favor either of two groups regarding the implantation rate (RR = 1.25, 95 % CI [0.92, 1.68], p = 0.15). Similarly, no difference between both groups regarding the live birth rate (RR = 1.08, 95 % CI [0.79, 1.49]; p = 0.62). CONCLUSIONS: No difference between ICSI and IVF regarding fertilization rate per oocytes, implantation rate and live birth rate in the treatment of non-male factor infertility, while IVF has significantly higher clinical pregnancy rate and higher risk of total fertilization failure.

Sacrospinous colpopexy using Masson luethy needle holder.

OBJECTIVE: Sacrospinous colpopexy (SSC) is a well-known surgical technique to correct apical support defect, however its approach is still challenging. The current study describes an alternative and economic approach for suture placement in the sacrospinous ligament during SSC using Masson luethy needle holder. STUDY DESIGN: A prospective study was conducted in a tertiary care center. The study recruited women with uterovaginal prolapse or post hysterectomy vaginal vault prolapse scheduled for SSC as a constructive surgery for vaginal superior segment defect. Eligible women were assigned to have SSC using Masson luethy needle holder (Group I) for suture placement in the sacrospinous ligament. The control group (Group II) consisted of a group of patients who had SSC using Deschamps ligature carrier. RESULTS: By the end of the study, 104 women underwent SSC. (Group I) included 55 women while (Group II) included 49 women. The mean SSC operative time was significantly shorter in (Group I) [109±33min versus 206±67min in (Group II), p<0001], with a mean difference of 10.5min [95% CI, 74-136]. This difference in SSC operative time was due to faster suture placement in (Group I) [47±14min versus 153±46min in (Group II), p<0001]. The mean SSC related operative blood loss was significantly less in (Group I) [582±349ml versus 985±463ml in (Group II), p<0001]. The perioperative complications, recurrence and cure rates were similar in both groups. CONCLUSION: Using Masson luethy needle holder reduced the difficulty associated with suture placement during SSC and allowed the completion of the procedure within a significantly shorter time.