The use of single dose of oral misoprostol (600µg) at home in management of first trimester miscarriages in El-Mukala, Yemen

Background: In the management of first trimester miscarriage, the use of oral misoprostol is beneficial for patients as it offers a more discrete and less invasive route for those women who find vaginal administration unacceptable. In spite of high incidence of side-effects from use of oral misoprostol women still found oral route satisfactory.Methods: This study was a prospective cohort study done at El-Mukala maternal and child hospital and Hadhramout maternal and child university hospital in the period between 1st October 2014 and 30th September 2015. All pregnant women (less than 14 weeks) who were diagnosed as an embryonic pregnancy or missed miscarriage were included in the study. Every patient received single dose of oral misoprostol 600 µg in half full stomach at home. The primary outcome measure was complete miscarriage rate.Results: One-hundred women were included in the study. The mean age of study participants was 26.25±4.08 years, the mean BMI was 27.35±3.6 while the mean parity was 2.6±1.5.Ten cases needed emergency surgical evacuation within the period of first 48 hours. Complete miscarriage had occurred in 75 cases, 65 of them in the first 48 hours. Fifteen cases presented by incomplete miscarriage after waiting for one week. They needed surgical evacuation at the end of 7 days due to still considerable intrauterine contents.Conclusions: In our closed community in El-Mukala, Yemen, the use of oral misoprostol in single dose of 600 µg at home as a method for termination of first-trimester miscarriage was effective (75%, success rate), tolerable regarding side effects, has the advantage of high confidentiality and privacy resulting in good satisfaction

Vaginal misoprostol before elective cesarean section for preventing neonatal respiratory distress: a randomized controlled trial

Objective: The current study aims to evaluate the efficacy of vaginal misoprostol before elective cesarean section (ECS) for preventing the occurrence of neonatal respiratory distress (RD). Materials and Methods: A randomized controlled trial (NCT03239327) was carried out in a tertiary-care university-affiliated hospital between June 2016 and August 2017. All eligible pregnant women scheduled for ECS were randomly allocated in a 1:1 ratio to two groups. One group, the Misoprostol group, received a misoprostol 50 mcg vaginal tablet 60 minutes before ECS while the other, the Control group, received no drugs before ECS. The primary outcome was the rate of neonatal RD among the study groups. Results: The study included 146 women in each arm, with no significant difference between the baseline characteristics of members in each group. Primary outcomes resulted in 22 (15.1%) newborns in the misoprostol group having RD at birth versus 44 (30.1%) newborns with RD in the control (P =0.02). No differences were found between the groups regarding the need for neonatal intensive care unit (NICU) admission (P =0.61), duration of NICU stay (P =0.08) and neonatal mortality rate (P =0.73). Conclusion: Prophylactic vaginal misoprostol at a dose of 50 mcg administered 60 minutes before ECS could reduce the rate of neonatal RD and improve the neonatal respiratory outcomes

Seismic Microzonation of Central Khartoum, Sudan

A preliminary seismic microzonation of Central Khartoum, Sudan is proposed. Khartoum, the capital of Sudan, is located at the confluence of White and Blue Niles. The city is heavily populated. The Central Khartoum with its high rise buildings is the center of governmental and business activities and is located on strip adjacent to the Blue Nile. Geological and geotechnical data indicated that the subsoil conditions at Central Khartoum are characterized by alluvial deposits underlain by Nubian Sandstone below a depth of 20 m. The alluvial deposits locally known as Gezira formations, consist of clays grading into silt and sand with depth. Macro seismic zonation of Sudan and its vicinities, developed by the authors, gave the ground acceleration at the bed rock surface. The effect of alluvial deposits at Central Khartoum on propagation of seismic motion parameters to the ground surface is investigated in this study. Correlations are proposed for pertinent cyclic soil properties such as shear modulus, damping, and shear wave velocity. The classical shear beam model developed by Idriss and Seed is used to study the effect of local soil conditions on ground motion parameters. In absence of strong motion records, artificial time histories of ground motion parameters are used. Plots showing the time histories of ground motion parameters at the ground surface are obtained. The results indicated amplification of ground acceleration of up to 1.15. Because of the presence of saturated loose to medium dense sand at some locations within Central Khartoum, the risk of earthquake-induced liquefaction is evaluated. The susceplity of subsoils in Central Khartoum to liguefaction is evaluated probabilistically by modifying the classical method developed by Seed and Idriss. The risk of earthquake-induced liquefaction is computed by combining the seismic hazard and the conditional probability of liquefaction. The study showed that the risk of liquefaction is low

An Arabic CCG approach for determining constituent types from Arabic Treebank

AbstractConverting a treebank into a CCGbank opens the respective language to the sophisticated tools developed for Combinatory Categorial Grammar (CCG) and enriches cross-linguistic development. The conversion is primarily a three-step process: determining constituents’ types, binarization, and category conversion. Usually, this process involves a preprocessing step to the Treebank of choice for correcting brackets and normalizing tags for any changes that were introduced during the manual annotation, as well as extracting morpho-syntactic information that is necessary for determining constituents’ types. In this article, we describe the required preprocessing step on the Arabic Treebank, as well as how to determine Arabic constituents’ types. We conducted an experiment on parts 1 and 2 of the Penn Arabic Treebank (PATB) aimed at converting the PATB into an Arabic CCGbank. The performance of our algorithm when applied to ATB1v2.0 & ATB2v2.0 was 99% identification of head nodes and 100% coverage over the Treebank data

Evaluation of the uterine cavity by office hysteroscopy in patients with infertility and recurrent pregnancy loss: a cross sectional study

Background: The aim of the present study is to determine role of hysteroscopy in women presented with primary or secondary infertility and in women presented with recurrent pregnancy loss.Methods: This cross-sectional study was conducted at Obstetrics and Genecology Department, Women Health Hospital Assiut University, Egypt from October 2016 to February 2018. Reproductive aged women who are suspected as having intrauterine pathology, such as submucosal myoma, endometrial polyps or other endometrial pathological findings based on the transvaginal ultrasound were enrolled. All patients were scheduled for office hysteroscopy as an outpatient. An informed consent was obtained prior to participation in the study.Results: Hysteroscopy was performed in 139 infertile women and 41 cases of repeated pregnancy loss. With regard to infertile patients; 67.6% of the patients had normal findings, 10.1% of the patients had intrauterine adhesion, 8.6% of the patients had intrauterine polyp. 5.8% of the patients had septate uterus and 3.6% of the patients had depressed fundus. With regard to patients with recurrent pregnancy loss; 51.2% of the patients had normal findings, 21.9% of the patients had partial septum, 9.8% of patients had intrauterine adhesions, 7.3% of patients had intrauterine polyp and 4.9% of the patients had submucous myoma.Conclusions: It was concluded that hysteroscopy should be considered as routine investigation in evaluation of women with primary and secondary infertility

Prevalence of blighted ovum in first trimester of pregnancy: a hospital based study

Background: The aim of this study is to know the prevalence of blighted ovum among pregnant women in 1st trimester attending our hospital during their antenatal visits and to know the fate of blighted ovum either if there is spontaneous expulsion of the sac or need of medical induction or surgical evacuation.Methods: This observational study was conducted at Obstetrics and Genecology Department, Women Health Hospital and Sahel Selim Hospital, Egypt from November 2015 to February 2018. All patients recruited in this study attended the antenatal care clinics for antenatal follow-up during their first-trimester of pregnancies.Results: All cases of the study were less than 14 weeks. The mean gestational age was 8.93±1.01 (7.0-11.0) weeks. In patients less than 20 years old, (73%) there is a significant increase in surgical treatment (dilatation & curettage) after failure of medical treatment, patients more than 40 years old (50.7%) there is a significant increase in medical treatment after success taking misoprostol so there is no need to a surgical treatment by (dilatation & curettage) in the majority of cases.Conclusions: The prevalence of blighted ovum was 15.6%. Also, the prevalence of blighted ovum was statistically significant increased with increase maternal age and also, we noticed that there was a statistically significant association between early pregnancy failure and a history of previous early pregnancy loss

A recent look for the implication and attitude of practicing female genital mutilation in upper Egypt: a cross sectional study

Background: Female genital mutilation (FGM) was defined as the partial or total removal of the female external genitalia for non-medical reasons The Demographic and Health Survey in Egypt in 2000 showed that 97% of married women included in the survey had experienced female genital mutilation.Methods: This is a cross sectional study to evaluate the current prevalence of FGM, current attitude of our society towards it after illegalization of it as a cross sectional survey of Upper Egypt. The most important point in this study is our evaluation of intention of these women whom exposed to FGM toward mutilation of their daughters or not and reasons for that. Statistical analysis was done using SPSS software version 21.Results: The study included 1175 women, from whom 89.1% were circumcised. Type 1 FGM was the most prevalent type practiced in about 58% of participants. Immediate complications occurred in 42.5% of women. Primary hemorrhage during circumcision was the most commonly reported immediate complication among 38.5% of them. Sexual problems were found in 40.5% of participants. Sixty-four women reported occurrence of hepatitis virus infection after the procedure. Moreover, 44 women were suffered from infertility and 72 women had an episode or chronic PID. Women who intend to circumcise their daughters are mostly those coming from rural areas (p=0.000) and housewives (p=0.000). Most of women (45.8%) who have the intent to circumcise their daughters claiming that it is religious based.Conclusions: The prevalence of FGM did not differ between urban and rural or between house wives and employee, lastly did not differ between different educational levels as most of them were encourage it thinking that it is of traditional, religious base and protect the girl from any abnormal sexual excitation. The women who intent not circumcise their daughters were from low educational level in its highest percentage and this was explained by occurrence of higher percentage of complications in spite of the highest percentage of operator was physician

Fecal Lactoferrin As A Diagnostic and Prognostic Marker in Egyptian IBD Patients

Background: Inflammatory bowel diseases (IBD) are organic chronic inflammation of the gastrointestinal tract characterized by variable disease activity with repeated periods of remission and exacerbation. Irritable bowel syndrome (IBS) is prevalent in up to fifth of population; diarrhea type has the broadest differential diagnosis. To distinguish inflammatory versus functional disorder fecal biomarkers as fecal lactoferrin (FL), being non-invasive acute phase proteins produced by inflamed mucosa, can help to avoid invasive procedures. Objective: The aim of this study was to assess sensitivity and specificity of fecal lactoferrin as a non-invasive biomarker in Egyptian patients with IBD and to detect its role in assessment of disease severity. Patients and methods: This comparative case control study was held through one year duration. Patients were recruited from Internal Medicine and Hepatology Department at a University Hospital. 50 subjects were classified into 3 groups: Group I included 30 patients with inflammatory bowel disease, Group II included 10 patients with irritable bowel syndrome, Group III included 10 healthy subjects as control group. Results: fecal lactoferrin assay (FLA) levels were highest in patients with IBD in comparison with IBS patients and healthy group. Moreover FLA levels also correlated significantly with disease severity in patients with IBD as higher levels of FLA were found in patients with severe ulcerative colitis (UC) or Crohn`s disease. Conclusion: Fecal lactoferrin can be used to differentiate IBD from IBS with 96.7% sensitivity and 100% specificity at cutoff value of 37 ug/ml while at cutoff value 7.2 ug/ml FLA has 100% sensitivity and specificity in differentiating IBD patients from healthy subjects in Egyptian population. Yet it can’t differentiate ulcerative colitis versus Crohn’s disease