Different methods of termination of second trimester pregnancy at Women′s Health Hospital, Assiut University: efficacy and complications

Background: Termination of pregnancy in second trimester is one of the greatest challenges in modern obstetrics practice and is more risky than during first trimester. Now the main concern of the obstetrician is to provide the most effective, safest, and cost-effective regimen with least or no complications. Describe the different indications, technique and complications of different methods of TOP used at Women’s Health Hospital, Assiut University.  Identify gap between current practice and guidelines and setting recommendations for filling gap to improve outcomeMethods: Studying the different methods used for all cases with gestational age 13-24 weeks attending at Women′s Health Hospital, Assiut University from the 1st July 2015 to the 1st June 2016, for second trimester termination of pregnancy who are eligible for termination of pregnancy, with exclusion criteria including any case with scared uterus, multiple pregnancy and rupture of membranes.Results: Of the 146 patients, 55 patients received misoprostol alone, 13 cases used foley’s catheter alone, 67 cases received misoprostol in combination with foley’s catheter and hysterotomy done in 9 patients (4 after failed induction and the rest as primary procedure). In present work the most common complication recorded was retained placental parts, 39 patients (26,5%) followed by surgical evacuation. Uterine perforation occurred accidentally in 3 cases during evacuation followed by laparotomy and repair of perforation without hysterectomy. Infection recorded in 3 cases (1.7%). Sever haemorhage occurred in 4 cases where they needed hysterotomy.Conclusions: All methods used in the department showed efficacy. Misoprostol induction was associated with a shorter induction-abortion interval but was associated with higher risk of retained placenta. Foley's catheter induction was more prolonged but it was associated with almost no complication. The most common complication was retained placenta except those who used Foley's catheter as they had no retained placental parts

The impact of excision of benign nonendometriotic ovarian cysts on ovarian reserve: a systematic review

Background Benign nonendometriotic ovarian cysts are very common and often require surgical excision. However, there has been a growing concern over the possible damaging effect of this surgery on ovarian reserve. Objective The aim of this metaanalysis was to investigate the impact of excision of benign nonendometriotic ovarian cysts on ovarian reserve as determined by serum anti-Müllerian hormone level. Data Sources MEDLINE, Scopus, ScienceDirect, and Embase were searched electronically. Study Design All prospective and retrospective cohort studies as well as randomized trials that analyzed changes of serum anti-Müllerian hormone concentrations after excision of benign nonendometriotic cysts were eligible. Twenty-five studies were identified, of which 10 were included in this analysis. Data Extraction Two reviewers performed the data extraction independently. Results A pooled analysis of 367 patients showed a statistically significant decline in serum anti-Müllerian hormone concentration after ovarian cystectomy (weighted mean difference, –1.14 ng/mL; 95% confidence interval, –1.36 to –0.92; I2 = 43%). Subgroup analysis including studies with a 3-month follow-up, studies using Gen II anti-Müllerian hormone assay and studies using IOT anti-Müllerian hormone assay improved heterogeneity and still showed significant postoperative decline of circulating anti-Müllerian hormone (weighted mean difference, –1.44 [95% confidence interval, –1.71 to –1.1; I2 = 0%], –0.88 [95% confidence interval, –1.71 to –0.04; I2 = 0%], and –1.56 [95% confidence interval, –2.44 to –0.69; I2 = 22%], respectively). Sensitivity analysis including studies with low risk of bias and excluding studies with possible confounding factors still showed a significant decline in circulating anti-Müllerian hormone. Conclusion Excision of benign nonendometriotic ovarian cyst(s) seems to result in a marked reduction of circulating anti-Müllerian hormone. It remains to be established whether this reflects a real compromise to ovarian reserve

Spectrophotometric determination of tizanidine and orphenadrine via ion pair complex formation using eosin Y

A simple, sensitive and rapid spectrophotometric method was developed and validated for the determination of two skeletal muscle relaxants namely, tizanidine hydrochloride (I) and orphenadrine citrate (II) in pharmaceutical formulations. The proposed method is based on the formation of a binary complex between the studied drugs and eosin Y in aqueous buffered medium (pH 3.5). Under the optimum conditions, the binary complex showed absorption maxima at 545 nm for tizanidine and 542 nm for orphenadrine. The calibration plots were rectilinear over concentration range of 0.5-8 μg/mL and 1-12 μg/mL with limits of detection of 0.1 μg/mL and 0.3 μg/mL for tizanidine and orphenadrine respectively. The different experimental parameters affecting the development and stability of the complex were studied and optimized. The method was successfully applied for determination of the studied drugs in their dosage forms; and to the content uniformity test of tizanidine in tablets

HyCAD-OCT: A Hybrid Computer-Aided Diagnosis of Retinopathy by Optical Coherence Tomography Integrating Machine Learning and Feature Maps Localization

Optical Coherence Tomography (OCT) imaging has major advantages in effectively identifying the presence of various ocular pathologies and detecting a wide range of macular diseases. OCT examinations can aid in the detection of many retina disorders in early stages that could not be detected in traditional retina images. In this paper, a new hybrid computer-aided OCT diagnostic system (HyCAD) is proposed for classification of Diabetic Macular Edema (DME), Choroidal Neovascularization (CNV) and drusen disorders, while separating them from Normal OCT images. The proposed HyCAD hybrid learning system integrates the segmentation of Region of Interest (RoI), based on central serious chorioretinopathy (CSC) in Spectral Domain Optical Coherence Tomography (SD-OCT) images, with deep learning architectures for effective diagnosis of retinal disorders. The proposed system assimilates a range of techniques including RoI localization and feature extraction, followed by classification and diagnosis. An efficient feature fusion phase has been introduced for combining the OCT image features, extracted by Deep Convolutional Neural Network (CNN), with the features extracted from the RoI segmentation phase. This fused feature set is used to predict multiclass OCT retina disorders. The proposed segmentation phase of retinal RoI regions adds substantial contribution as it draws attention to the most significant areas that are candidate for diagnosis. A new modified deep learning architecture (Norm-VGG16) is introduced integrating a kernel regularizer. Norm-VGG16 is trained from scratch on a large benchmark dataset and used in RoI localization and segmentation. Various experiments have been carried out to illustrate the performance of the proposed system. Large Dataset of Labeled Optical Coherence Tomography (OCT) v3 benchmark is used to validate the efficiency of the model compared with others in literature. The experimental results show that the proposed model achieves relatively high-performance in terms of accuracy, sensitivity and specificity. An average accuracy, sensitivity and specificity of 98.8%, 99.4% and 98.2% is achieved, respectively. The remarkable performance achieved reflects that the fusion phase can effectively improve the identification ratio of the urgent patients’ diagnostic images and clinical data. In addition, an outstanding performance is achieved compared to others in literature

Gynecological and Related Morbidities among Ever-MarriedOmaniWomen

To assess the prevalence and correlates of gynecologic and related morbidity in Omani women, a nationally representative sample of Omani women selected by a multi-stage, stratified probability sampling procedure was selected (total = 364). Questionnaire interview, physical and gynecological examination, and laboratory investigations were used to elicit information. The prevalence of lower reproductive tract infections was 22.4%, upper reproductive tract infections 2.7%, and cervical dysplasia was very rare. Genital prolapse was present in 10%, 11% had a urinary infection, 27% were anaemic, 23% were hypertensive, and 54% were either overweight or obese. The predictors of common morbidities were assessed using regression analysis according to a pre-specified conceptual model. (Afr J Reprod Health 2004; 8[3]:188-197

A Novel Dual Prediction Scheme for Data Communication Reduction in IoT-Based Monitoring Systems

Internet of things (IoT) based monitoring systems became commonplace. These systems are built upon a large number of devices and sensors. The data collection task of a large number of sensors and devices in an IoT system includes a massive number of data communications. The more the number of devices, the critical is the network bottleneck. In this context, the dual prediction scheme was proposed as a solution for mitigating the large size of communication volumes. The dual prediction scheme consists of a model for predicting future measurements based on historical data. This model is duplicated on both sides, the edge side (i.e., sensor) and the data collection device (i.e., cluster head). The literature includes several works which proposed many dual prediction schemes based on several techniques such as filters and moving average. The literature does not include utilizing the ensemble learning models. This motivates this work to investigate the gradient boosting regression model’s performance compared to the existing solutions. The proposed and state-of-the-art models are evaluated on a realistic dataset. The obtained results show that the proposed model outperforms the existing dual prediction schemes in terms of communication reduction

Synthesis and biological evaluation of new pyrimidine derivatives

980-9854-Oxo-2-thioxo-1,2,3,4-tetrahydropyrimidine (2-thiouracil) 1 is reacted with a series of diazotized aromatic amines to give compounds 2a-f. On the other hand compound 1 is s-methylated by methyl iodide giving 4-oxo-2-methylthioxo 1,2,3,4­-tetrahydropyrimidine 3, which inturn is reacted with a series of diazotized aromatic amines giving arylazo derivatives of the type 4a-e. In another reaction compound 1 is hydrolysed by monochloroacetic acid in hydrochloric acid into 2,4-dioxo,1,2,3,4­tetrahydropyrimidine (uracil) 5 which is reacted with a series of diazotized aromatic giving aryl azo compounds of the type 6a-f. The products showed some cytotoxic activity in addition to antibacterial activity (compounds 2a, 4c, 4d and 6d) and antimicrobial activity (compounds 2a, 4a-e and 6a-f)

Effect of single subconjunctival injection of bevacizumab on primary pterygium: clinical, histopathological and immunohistochemical study

AIM: To evaluate the effect (clinically, histopathologically and immunohistochemically) and safety of a single intra-pterygium injection of bevacizumab. METHODS: Prospective interventional study comprised 40 eyes of 40 patients with primary fleshy pterygia who attended the Outpatient Clinic of Department of Ophthalmology, Assiut University Hospitals, Egypt from May 2015 to May 2016. Patients were randomly classified into 2 groups: the first group received a single intralesional injection of bevacizumab (Avastin; Genentech, San Francisco, CA, USA); the second group comprised patients who did not receive subconjunctival bevacizumab. Excision of pterygium and conjunctival auto graft was done in both groups. The excised pterygium tissues were subjected to histopathological and immunohistochemical evaluation. RESULTS: The study comprised 40 eyes of 40 patients (33 men, 7 women) of age range from 31-58y. The study group included 22 eyes. The control group included 18 eyes. A decrease in the vascularity of the pterygium was noted in all injected cases. The mean vessel count was higher in non-injected pterygia than that in injected pterygia and the difference was statistically significant (P=0.001). Also, the mean vessel count in both groups was significantly higher than normal conjunctive (P=0.005 and 0.001). A statistically significant difference in vascular endothelial growth factor (VEGF) expression between injected and non-injected cases was detected in the epithelial, stromal and endothelial cells (P=0.0001, 0.016, 0.014). No serious intraoperative complications occurred in both groups. CONCLUSION: The use of single intra lesional injection of Avastin in pterygium decreased vascularity and decreased VEGF expression in injected pterygium after one month. Our study proved the effect of single intra lesional injection of Avastin on pterygium. Further studies may enable limiting the need for surgery and improve quality of life for patients with pterygia

Neurotoxin-induced rodent models of Parkinson's disease : benefits and drawbacks

Parkinson’s disease (PD), the second most common neurodegenerative disorder, is characterized by cardinal motor impairments, including akinesia and tremor, as well as by a host of non-motor symptoms, including both autonomic and cognitive dysfunction. PD is associated with a death of nigral dopaminergic neurons, as well as the pathological spread of Lewy bodies, consisting predominantly of the misfolded protein alpha-synuclein. To date, only symptomatic treatments, such as levodopa, are available, and trials aiming to cure the disease, or at least halt its progression, have not been successful. Wong et al. (2019) suggested that the lack of effective therapy against neurodegeneration in PD might be attributed to the fact that the molecular mechanisms standing behind the dopaminergic neuronal vulnerability are still a major scientific challenge. Understanding these molecular mechanisms is critical for developing effective therapy. Thirty-five years ago, Calne and William Langston (1983) raised the question of whether biological or environmental factors precipitate the development of PD. In spite of great advances in technology and medicine, this question still lacks a clear answer. Only 5–15% of PD cases are attributed to a genetic mutation, with the majority of cases classified as idiopathic, which could be linked to exposure to environmental contaminants. Rodent models play a crucial role in understanding the risk factors and pathogenesis of PD. Additionally, well-validated rodent models are critical for driving the preclinical development of clinically translatable treatment options. In this review, we discuss the mechanisms, similarities and differences, as well as advantages and limitations of different neurotoxin-induced rat models of PD. In the second part of this review, we will discuss the potential future of neurotoxin-induced models of PD. Finally, we will briefly demonstrate the crucial role of gene-environment interactions in PD and discuss fusion or dual PD models. We argue that these models have the potential to significantly further our understanding of PD

Chemical constituents from Tribulus terrestris and screening of their antioxidant activity

Two oligosaccharides (1,2) and a stereoisomer of di-p-coumaroylquinic acid (3) were isolated from the aerial parts of Tribulus terrestris along with five known compounds (4-8). The structures of the compounds were established as O-β-D-fructofuranosyl-(2→6)-α-D-glucopyranosyl-(1→6)-β-D-fructofuranosyl-(2→6)-β-D-fructofuranosyl-(2→1)-α-D-glucopyranosyl-(6→2)-β-D-fructofuranoside (1), O-α-D-glucopyranosyl-(1→4)-α-D-glucopyranosyl-(1→4)-α-D-glucopyranosyl-(1→2)-β-D-fructofuranoside (2), 4,5-di-p-cis-coumaroylquinic acid (3) by different spectroscopic methods including 1D NMR ((1)H, (13)C and DEPT) and 2D NMR (COSY, TOCSY, HMQC and HMBC) experiments as well as ESI-MS analysis. This is the first report for the complete NMR spectral data of the known 4,5-di-p-trans-coumaroylquinic acid (4). The antioxidant activity represented as DPPH free radical scavenging activity was investigated revealing that the di-p-coumaroylquinic acid derivatives possess potent antioxidant activity so considered the major constituents contributing to the antioxidant effect of the plant