Salivary Versus Serum Approaches in Assessment of Biochemical Hyperandrogenemia

Background: Biochemically, hyperandrogenism is established by elevated circulating levels of free or total serum testosterone and an increased free androgen index. Approximately, 60‑80% of women with polycystic ovarian syndrome (PCOS) demonstrate elevated circulating androgen levels. Aim: This prospective observational randomized study was to investigate the likelihood of using the salivary luteinizing hormone (LH), free testosterone (FT) and dehydroepiandrosterone sulfate (DHEAS) levels instead of serum values in diagnosing biochemical hyperandrogenemia in women with PCOS. Subjects and Methods: This study was conducted on 75 women having PCOS in addition to 20 normal fertile women (control group). Venous blood and salivary samples were taken in the 3rd day of the cycle to measure LH and FT and DHEAS levels. Results: Biochemical hyperandrogenemia prevails in 40% of women with PCOS. Salivary levels of LH, FT and DHEAS correlate with their corresponding serum values, with a higher sensitivity of salivary more than serum approach. Conclusion: Saliva provides a sensitive, simple, reliable, non‑invasive and uncomplicated diagnostic approach for biochemical hyperandrogenemia.Keywords: Biochemical hyperandrogenemia, dehydroepiandrosterone sulfate, luteinizing hormone, polycystic ovarian syndrome, saliva, testosteron

Correlation Between Insulin, Leptin and Polycystic Ovary Syndrome

Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women of fertile age. Insulin can stimulate ovarian androgen production in normal women and in women with PCOS. Leptin levels were reduced among women with PCOS treated with insulin sensitizers. Aim: This study aims to investigate the serum levels of insulin and leptin in and their relationship with the endocrine and metabolic peculiarities of PCOS. Subjects and Methods: The study was carried out on 125 women during the reproductive age group, had primary infertility and diagnosed as having PCOS according to Rotterdam criteria. Patients were recruited from Tanta University Hospital, during the period May 2011 to December 2012. Cases were classified into two groups: Patient’s group comprised 75 women having PCOS and control group entailing 50 normal fertile healthy women. All women were subjected to: History taking, clinical examination, assessment of body mass index (BMI), ultrasonographic examination and hormonal assay to estimation serum leptin, insulin, follicle stimulating hormone, luteinizing hormone, progesterone and free testosterone value. Statistical analysis was performed by Statistical Product and Service Solutions (IBM, USA) version 10.0. Student t‑test was used to compare numerical variables while correlation was performed to determine the relationship between the variables. The value of P < 0.05 was taken as significant. Results: We found a significant positive correlation between leptin, BMI, age and a trivial upbeat correlation between leptin and insulin. The most interesting result is the significant positive correlation between insulin and leptin. Conclusion: There is a link between elevated serum leptin and insulin levels to obesity in PCOS suggesting that most probably they are responsible for the complicated picture of PCOS in obese patients.Keywords: Hyperinsulinemia, insulin, leptin, obesity, polycystic ovary syndrom

Ultrasound Evaluation of the Uterine Scar Thickness after Single Versus Double Layer Closure of Transverse Lower Segment Cesarean Section

Background: The degree of the lower uterine segment (LUS) thinning and the risk of uterine scar defect have been studied. However, the relationship between the methods of closure and the degree of thinning needs further elucidation. Aim: The aim of this study was to determine whether a LUS transverse cesarean section (CS) closure method in one or two layers affects subsequent scar thickness.Subjects and Methods: In this prospective study, 150 women were enrolled and randomly assigned to one‑ or two‑layer closure of the LUS incision. Patients were divided into two groups. Each group included 75 patients, of primigravidae with gestational age from 38 weeks to 40 weeks one group had a single layer closure and the other had a double layer closure.Results: We found an increase in the thickness of LUS‑CS scar in cases with double layer closure of the incision than a single layer closure as depicted by ultrasonography after 2 days and 2 weeks post‑operative.Conclusion: These findings suggest that the number of closing layers of CS directly affect the thickness of the scar. Keywords: Cesarean section, one layer, scar thickness, two layer

Approaching a Dysmorphic Newborn

Background: Dysmorphology combines concepts, knowledge and techniques from field of embryology, clinical genetics and pediatrics. It deals with people who have congenital abnormalities and their families. Clinical delineation of dysmorphism and dysmorphic syndromes is crucial for patient management and family counseling. Patients and Method: Forty case mothers and neonates, 83 control mothers and neonates were recruited in the study. Face to face interviews were conducted with the mothers of both cases and controls. Case's mothers and neonates were subjected to certain investigations according to dysmorphic anomaly and when needed. Results: The study showed that increased risk of having a dysmorphic child was associated with high consumption of legumes and the use of kerosene in cooking stoves. Their Odd Ratio (OR) and Confidence Interval (CI) respectively were [OR=15558.0; CI 137.0-17716.2] and [OR=186.7; CI 42.3-824.5]. Maternal demographic risk factors were, medication intake (OR=29.62; CI 3.38-112.5), diseases during pregnancy (OR=24.13; CI 5.92-114.18), maternal occupation (OR=15.4; CI 1.78-132.8), and educational attainment (OR=2.85; CI 1.19-6.86). In rural areas the rate of having dysmorphic child is higher than that in urban areas (OR=11.85; CI 3.60-38.99), (p-value=0.00). Consanguinity (OR=4.35; CI 1.927-9.796), was a key risk factor contributing to dysmorphology. Drinking water which is obtained by pumps was significant in this study (OR=27.3; CI 3.4-222.7) as well as ghee consumption (OR=6.3; CI 2.4-16.4). Conclusion: In conclusion, the considerable challenge posed by dysmorphic abnormalities calls for the development of prevention programs through the establishment of community genetic services particularly those related to maternal education and environmental exposures. These primary prevention measures should be integrated into primary health care. Keywords: Dysmorphology, morphogenesis, dysmorphic syndromes, teratology, ecogenetics Egypt. J. Hum. Genet Vol. 9 (1) 2008: pp. 23-4

Frontal Electroencephalogram α‑Asymmetry during the Luteal Phase of the Menstrual Cycle in Women with Premenstrual Syndrome

Background: Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS) that causes significant distress and interferes with normal functioning. Aim: The aim of this work was to assess the resting frontal electroencephalographic patterns in females who meet criteria for PMS and PMDD. Subjects and Methods: This prospective observational study was conducted on 150 female participants, of which 145 had PMS, and 45 were control women. All cases were counseled about the procedure. Furthermore, a written consent was taken from every patient. Cases were asked about their current phase of the cycle, in order to determine cycle timing. The custom PMDD interview involved asking each woman a series of questions concerning PMDD symptoms. This structured interview was created from the DSM‑IV‑TR criteria for PMDD. Women with PMDD were asked to complete a daily symptom rating checklist for three consecutive cycles. The ensuing methods were undertaken for each patient, including history taking, general, local and fundus examination, and routine investigations, and were submitted to resting electroencephalogram (EEG) examination during both follicular and luteal phases of the cycle. Results: Seventy percent of women with PMS and 75% of women with PMDD exhibited left frontal activity at rest, during the luteal phase of the cycle (P <0.001). Conclusions: We concluded that resting luteal phase of EEG frontal asymmetry must be added to the research criteria for PMDD (DSM‑IV‑TR).Keywords: Electroencephalogram, premenstrual dysphoric disorder, premenstrual tension, premenstrual syndrome, Tanta University Hospita

In vitro culture and plant regeneration derived from ray florets of Chrysanthemum morifolium

Nine cultivars of Chrysanthemum morifolium were screened using the ray floret explants to determine the capability for plant regeneration on four media protocols and subsequently to find out the best genotype source linked with the optimum medium conditions for the high potentiality of shoot formation. The results indicated that all in vitro culture traits were highly significantly influenced by the differences in genotypes, medium protocols and their interaction. The percentage of explants whichdeveloped calli ranged from 73.83% “Ping Pong” to 25.67% “Palisade White” among the cultivars across the four medium protocols with an average of 48.28%. The highest percentage of embryogenic callus, shoot formation and mean value of shoot length was produced by cultivar "Delistar White" when calli were differentiated on medium protocol B. The medium protocol B showed the greatest potential for shoot length across the cultivars and it was significantly superior to all other medium protocolsexcept the medium protocol A. The present study indicated that the medium protocol “B” and then "A" appear to be the best protocols for plant regeneration. The cultivar "Delistar White" with the medium protocols B and then A, could be successfully utilized for further in vitro mutagenesis investigations

Prediction of Gestational Diabetes by Measuring First Trimester Maternal Serum Uric Acid Concentration

Background: Gestational diabetes mellitus (GDM) is a common complication in pregnancy, affecting more than 10% pregnancies worldwide. However, the true underlying causes remain to be fully elucidated.Aim: This study aimed at searching for any relation between first trimester uric acid concentration and the development of GDM.Subjects and Methods: The study was conducted on 250 first trimester pregnant females at risk of diabetes mellitus attending the outpatient clinic of Tanta University Hospital. All cases underwent estimation of first trimester‑fasting blood sugar and maternal serum uric acid concentration. Between 24 and 28 weeks’ gestation random blood sugar and glucose challenge test were done. Positive cases were confirmed by 3 h glucose tolerance curve.Results: The results demonstrated an association between first trimester maternal serum uric acid concentration obesity and GDM. Approximately, 41.4% (60/145) of non‑diabetic women were at first quartile, while 44.8% (47/105) of the diabetic women were at fourth quartile.Conclusion: We concluded that the cut‑off level of maternal serum uric acid of 4 mg/dl in the first trimester was associated with developing GDM. Therefore, we suggest that serum uric acid level should be done as routine test during the first antenatal care visit.Keywords: Impaired fasting glucose, multiple logistic‑regression analysis, type 2 diabetes mellitus, uric aci