Significance of assay of nucleated RBCs in umbilical cord blood in neonates with meconium-stained amniotic fluid.

BACKGROUND: Approximately 8-15% of all infants are born with evidence of meconium-stained amniotic fluid (MSAF). MSAF is a potentially serious sign of fetal compromise and may indicate fetal hypoxia Objectives and aim of the work: The present study was designed to evaluate the relationship between meconium stained amniotic fluid and fetal nucleated red blood cell counts. As well, we aim to evaluate the relationship between the presence of meconium in amniotic fluid and Apgar scores in neonates. SUBJECTS AND METHODS: A prospectively case-controlled study was performed on 40 women with clear amniotic fluid as control and 40 women with meconium-stained amniotic fluid as the study group. At delivery, 2 ml of umbilical cord blood was collected and analyzed for nucleated red blood cell (NRBC). RESULTS: The mean NRBC counts in meconium-stained amniotic fluid was significantly higher than the control group (18.35 ± 7.7 and 9.6 ± 4.96), respectively (p < .001). There were statistically significant differences concerning 1- and 5-min Apgar scores with lower values in the MSAF group (p < .001 and .001, respectively). CONCLUSION: Our results support previous studies which indicate the presence of meconium can be associated with chronic fetal hypoxia as demonstrated by elevated fetal NRBC levels.

The reproducibility of the novel utilization of five-dimensional ultrasound and power Doppler in the prediction of endometrial receptivity in intracytoplasmic sperm-injected women: a pilot prospective clinical study.

OBJECTIVE: The ultimate goal of this study is to reassess the five-dimensional implantation markers and pregnancy predictors on the day of human chorionic gonadotropin injection in the intracytoplasmic sperm injection and embryo transfer programs. DESIGN: A pilot prospective clinical trial. SETTING: The Assisted Reproductive Technology Unit of Ain Shams Maternity Teaching Hospital during the period from April 2014 to December 2017. PATIENTS AND METHODS: The study was conducted on 400 women undergoing intracytoplasmic sperm injection (ICSI). Those women were not older than 40 years, with normal uterine cavity and with no previous uterine scars. INTERVENTION: The ovarian stimulation protocol, used in this study for all patients, was the long protocol, before ovarian stimulation therapy, patients were instructed to use oral contraceptive pills from day 2 starting in the preceding cycle, then the standard regimen. On the day of hCG administration, 5D transvaginal ultrasound measurements were performed by the same observer after the patients had emptied their bladders. Measurements included endometrial volume and 3D power Doppler parameters, endometrial vascularization index, flow index, and vascularization flow index. RESULTS: The present study shows that endometrial volume ≥ 5 in the prediction of endometrial receptivity in ICSI patients had good sensitivity and low specificity in a group application; in an individual application it had good predictive negative value and bad predictive positive value. So it could be used as a good test to exclude success. Overall pregnancy rate was 40.5%; endometrial volume, flow index, vascularization index, and vascularization flow index were significantly lower in the nonpregnant group than those of the pregnant group. The area under curve in the receiver operating characteristic for three-dimensional ultrasound and power Doppler angiography parameters was statistically significant, but their values were suggestive but not conclusive in the prediction of endometrial receptivity in ICSI patients, no cutoff points with good diagnostic characteristics could be obtained. CONCLUSION: Five-dimensional ultrasound and power Doppler angiography is a useful exam to assess the endometrial receptivity in IVF/ICSI and embryo transfer cycles.

Assessment of hysteroscopic role in management of women with recurrent pregnancy loss.

OBJECTIVES: To assess the hysteroscopic value in the management of intrauterine lesion in women with recurrent pregnancy loss. METHODS: This study was done in Ain Shams Maternity Hospital after the approval of the research Ethics Committee, during the period between August 2014 and December 2015 where 200 nonpregnant women with a history of three or more consecutive unexplained first and second trimester miscarriages before 20 weeks were recruited from recurrent miscarriage clinic. A written informed consent was obtained from all women before participation. RESULTS: This current study was conducted in Ain Shams University Maternity Hospital during the period between August 2014 to May 2015 a total of 200 women with history of recurrent miscarriage were included in the study. Regarding the results of this study the mean age was 30.5(5.7), the mean number of previous abortion 3(3-5) the mean number of the first trimesteric abortion was 2 with range (2-2) the mean number of second trimesteric abortion was 2 with range (1-2). In this study, 88% of patients were nullipara. It was also found that hysteroscopic findings were found in 58.5%. Uterine anomalies was present in 21%, including septate uterus and intrauterine adhesion (IUAs) were present in 12.5%. Endometrial polyps were present in 8.5%, bicornute uterus in 4.5%, unicornuate uterus in 4.5% while submucous myomas were present in 7.5%. It was found that 48.5% need hysteroscopic intervention including 21% need septectomy 12.5% need adhesiolysis, 6.5% need myomectomy while 8.5% need polypectomy. The study found that no statistically significant difference between patients with normal hysteroscopic finding and patients with abnormal hysteroscopic finding as regard age, time of previous abortion and number of previous abortion. But there was statistically significant difference as regard number of previous delivery and abnormal HSG. CONCLUSIONS: It appears that hysteroscopy is a useful tool in the diagnosis and treatment of the causes of recurrent miscarriage that can be performed safely without anesthesia in most cases. The prevalence of uterine anomalies in patients with recurrent miscarriages is 54.5%, septate uterus is the most common anomaly and for this reason uterine anomalies should be systematically assessed in patients with recurrent miscarriage.

Assessment of nutritional status of pediatric cancer patients.

The study was done to identify which parameters are most useful to be used for nutrition assessment in pediatric cancer patients. The study included 70 pediatric cancer patients (48 males and 22 females) age 4-10 years. Patients were classified into 3 groups based on type of cancer (Lymphoma, leukemia and rhabdomyosarcoma). The period of the study was divided into 3 stages according to treatment (initial, during and at the end of the 6 months period). The patients were subjected to nutrition assessment through using 24 hours dietary recall and anthropometric measurements. Also the relationship between nutrient intake and socioeconomic status of the patients was studied. The results showed positive between each of triceps skinfold (TSF), arm circumference (AC), arm muscle circumference (AMC), height (Ht) and weight categories (as a percent of ideal body weight). These parameters can be used to assess nutritional status of pediatric cancer patients throughout the stages of treatment. The results of the 24 hours dietary recall showed a decrease in protein and caloric intake of all the patients by the end of the 6 months period. All the patients had low intake of vitamins A and C and calcium. A positive correlation was found between the intake of these 3 nutrients and socioeconomic level of the patients.

Microbiological investigation and nutritional evaluation of selected fast food meat.

The study was designed into two parts: the first part was to determine individual attitudes and beliefs toward fast food in general. One hundred individuals (15-45 yrs old) were involved in this study (50 males and 50 females). The second part of the study was carried out to evaluate microbiological contamination and nutritive value of the selected fast food meat (Hardee's fried burger, Saudi-American burger, kentucky fried chicken, Al-Baik broast chicken and shawerma beef). The results indicated that individuals 25-45 yrs. old were the most fast food consumers. The main reason behind increasing individual's preferences toward fast food was found to be for fun and inspiration. Among individuals under study 46% of males and 20% of females purchased fast food more than 4 times per week. Prevalence of overweight and obesity respectively were 38% and 22% among males and 34% and 14% among females. Bacillus cereus and E. coli were detected in a number of less than 10/g in all the selected fast food meat. The number of coliforms detected in Hardee's burger and Saudi-American burger were 10/g, while less than 10/g were detected in the remaining fast food meat. However, the number of Staph. aureus detected in Hardee's burger and Saudi-American burger was 20/g and 10/g respectively. On a per 100 g basis, energy (Kcal), protein (g), fat (g) and sodium (mg) content were found in the range of 179.62-295.29, 13.05-26.06, 8.9-21.13 and 640-920 respectively. Sodium content of all the selected fast food meat exceeded the recommended daily adequate intake for adults (males and females). The observations of the present study indicated the need for a nutrition education program to correct consumers' attitudes and beliefs towards fast food and to provide information on how a given menu item contributes to their dietary goal.