Ahmed AbdelKader Fahmy; Mohamed ElSokkary and Sherihan Sayed. The Value of Oral Sildenafil in the Treatment of Female Infertility: A Randomized Clinical Trial

Abstract: Background: Sildenafil citrate leads to smooth muscle relaxation and vasodilation. This may enhance endometrial development. The aim of this work isto study the effect of oral sildenafil citrate on pregnancy rate, endometrial thickness and number of follicles in women undergoing induction of ovulation with clomiphene citrate (CC). Patients and methods: this study included 70 infertile patients who were randomly divided into 2 groups. After ovulation induction with CC, patients in the treatment group received oral sildenafil citrate 25 mg 3 times daily from day 8-13 of the cycle and patients in control group received placebo. Results: the pregnancy rate, endometrial thickness and number of follicles were significantly higher in the treatment group. Side effects were significantly more in the treatment group compared to the placebo group (p=0.003). Among patients in the treatment group, the most common side effect was headache which was found in 7 patients (20%) versus non in the placebo group. Conclusion: sildenafil citrate increased pregnancy rate in females undergoing induction of ovulation by CC 50 mg which may be attributed to the increase in endometrial thickness and number of follicles

Uterocervical angle versus cervical length in the prediction of spontaneous preterm birth in women with history of spontaneous preterm birth: a prospective observational study

Abstract Background Preterm delivery is a leading cause of neonatal mortality and morbidity. History of spontaneous preterm birth is the greatest risk factor for another preterm delivery. So, every effort should be made to prevent the recurrence of preterm delivery in this vulnerable group. This study aimed to evaluate the predictive ability of the anterior uterocervical angle and cervical length in preterm birth. Patients and Methods This was a prospective cohort study that included 70 patients with a history of spontaneous preterm birth. Ultrasound measurements of cervical length and anterior uterocervical angle were set to be measured for each patient at three visits; first between 16 0/7 and 24 0/7 weeks, second between 24 1/7 and 32 0/7 weeks, and the third was between 32 1/7 and 36 6/7 weeks. The correlation between both measures and the prediction of preterm birth among study participants was the primary outcome of the study. Neonatal outcome among the study patients was a secondary measure of outcome. Results The incidence of preterm birth among study participants was 31.41%. Cervical length and uterocervical angle showed progressive decrease and increase respectively throughout pregnancy. At the 2nd visit, the two measures were significantly different between those who delivered at term and those with preterm delivery with the cervical length being significantly shorter in the preterm arm (3.0 ± 0.49 versus 3.38 ± 0.36, p  89.8° at the second visit predicted preterm birth with 81.8% sensitivity and 70.8% specificity while cervical length ≤ 3.22 cm at the second visit predicted preterm birth with 68.1% sensitivity and 62.5% specificity. Multivariant logistic regression analysis showed that uterocervical angle > 89.8° at the second visit increased the odds ratio for preterm birth by 9. Conclusion Uterocervical angle can be a useful ultrasound marker for the prediction of preterm birth among high risk patients. A cutoff value of 89.8° can be used as a threshold above which prophylactic measures such as cervical cerclage or progesterone therapy can be provided. Trial registration NCT05632003 (First posted date: 30/11/2022)

Likelihood of motorcyclists transferring to safer mode of transport in Cairo, Egypt

Road traffic injuries and mortality are mainly caused by motorcycle crashes. Practically, 50% of people who meet their death in road traffic accidents (RTAs) are motorcyclists. The issue is increasingly articulated in progressing nations where the use of motorcycles has gained popularity in the past decades. Moreover, death and fatalities caused by accidents involving motorcyclists are also in the rise due to the increasing trend. Hence, motorcyclists are encouraged to use alternative modes of transportation that are safer in the attempt to minimise losses. As a result, a policy ought to be created to enhance urban transportation service and control motorcycle proprietorship. The current research that lays the groundwork aims to contribute a more elaborated analysis on motorcycle user mode decision conduct as well as an excellent comprehension of the conceivable efforts that can be taken to support motorcyclists to shift to a safer mode of transportation, particularly bus. In the current research work, the binary logit mode choice model was created for two elective modes in order to distinguish the separate practices of motorcyclists and bus users and assess their reactions to a situation that can minimize both time and expenses involved in bus travel. In addition, it should be noted that this paper surveyed a total of 327 travellers from Greater Cairo Region (GCR) in Egypt, the bus users were identified through revealed preference, while the motorcyclists were identified through revealed and stated preference surveys. In this case, travel time, travel cost, age, sexual orientation, income level, trip purpose, education level, and privacy significantly influence motorcycle user mode decision conduct. The likelihood of motorcyclists to utilize the use of buses was additionally analyzed dependent on a situation of minimized bus travel time and travel cost. These elements are very important in a program that attempts to draw in motorcyclists to utilize public transport, particularly bus. The outcomes can help the process of decision making on all levels in assigning the necessary assets prudently for the advancement of urban transportation services, reduced number of road traffic crashes, and increased road safety. This examination, which is the first of its sort in Egypt, assesses the model choice behaviour for motorcyclists

PCR: a sensitive diagnostic tool for Trypanosoma evansi in camels in Egypt

Camel Trypanosomiasis, or Surra, or El Debab as better known, caused by Trypanosoma evansi constitutes an economically important disease that affects the health and production of camels. Two-hundred and ninety-five samples from camels of different ages and sexes were collected from five geographic locations in Egypt (Behera, Cairo, South Sinai, Matrouh, Halayeb and Shalateen). Giemsa-stained smears that were prepared from blood samples were examined microscopically, while PCR coupled with DNA sequencing was applied for molecular detection and phylogenetic analysis. Microscopic and molecular findings revealed a prevalence of 0.34% and 50.51% in the examined camels through stained blood smears and PCR techniques, respectively. T. evansi is enzootic in Egypt, and the PCR technique could preferably be applied in surveillance studies as a more sensitive detection method