Impact of GnRH Agonists and GnRH Antagonists on Embryo Quality, Endometrial Thickness and Pregnancy Rate in In-vitro Fertilization

Objective: To compare the effects of GnRH agonists (long protocol) and GnRH antagonists (short protocol) on embryo quality, endometrial thickness (ET) and pregnancy rate in human in vitro fertilization (IVF). Subjects & Methods: In this quasi experimental study 237 patients underwent short protocol and 175 long protocol of IVF. hCG was administrated when 2 or more follicles reached the size of 18mm. After 34-36 hours’ oocytes were retrieved transvaginally. ET was carried out after 3-5 days under ultrasound guidance. Rising β-hCG concentration confirmed the diagnosis of pregnancy. Results: There was no significant difference in proportion of primary and secondary sub fertility between the two groups. Regarding female age, embryo quality and endometrial thickness no significant difference was found between two groups. Number of attempts, no of oocytes, fertilization & cleavage rate, maturation of oocytes and embryos transferred were significantly associated with both long and short protocols. Conclusion: Ongoing research in assisted reproductive technology has identified some issues which are important from the patient point of view such as ovarian hyper stimulation and safe successful pregnancy. This study shows that pregnancy rate is better with long protocol but that is not statistically significant. More studies should be designed with increase power for suitable comparison of long GnRH agonist protocols with short GnRH antagonist protocols.&nbsp

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

Prevalence of asymptomatic bacteriuria and its antibacterial susceptibility pattern among pregnant women

Background and Aim: The condition of asymptomatic bacteriuria in pregnancy is common, and up to 40% of women developing pyelonephritis in pregnancy may suffer low birth weight and membrane’s premature rupture. The present study intended to investigate the incidence of asymptomatic bacteriuria and its antibacterial susceptibility pattern among pregnant women. Patients and Methods: This cross-sectional study was carried out on 183 pregnant women attending Obstetrics and Gynecology Department of Ayub Teaching Hospital, Abbottabad from December 2021 to May 2022. Pregnant women with asymptomatic bacteriuria attended the ANC services and willing to provide written consent were enrolled. Standard bacteriological procedures were followed for bacterial isolates identification using biochemical tests, colony characteristics, and Gram-staining. Kirby- Bauer disk diffusion technique was used for Antimicrobial susceptibility test on Muller-Hinton agar medium and Clinical Laboratory Standard Institute guidelines was used for interpretation of zone of inhibition diameter. Midstream urine samples were collected from each study participant and standard microbiological methods to culture urine, identify the pathogen, and conduct sensitivity tests. Data analysis was done in SPSS version 27. Results: The prevalence of asymptomatic bacteriuria was 14.2% (n=26) among pregnant women.&nbsp

INTERNATIONAL JOURNAL OF AGRICULTURE & BIOLOGY Full Length Article Boron Seed Priming Improves the Seedling Emergence, Growth, Grain Yield and Grain Biofortification of Bread Wheat

To cite this paper: Iqbal, S., M. Farooq, S.A. Cheema and I. Afzal, 2017. Boron seed priming improves the seedling emergence, growth, grain yield and grain biofortification of bread wheat. were better than other treatments of both B sources in improving germination and early seedling growth. In second experiment, wheat seeds primed with 0.01 and 0.05 M B solutions of both sources of B were sown in sand filled small pots. Seed priming with 0.01 M B solution of borax was better than other treatments in improving the germination and seedling growth. In third experiment, wheat seeds primed with 0.01 and 0.05 M B solution of borax only were sown. Seed priming with 0.01 M B solution increased the grain yield by 64% over control; however, increase in grain B contents was 27%. In conclusion, wheat seeds may be primed with 0.01 M B using borax to improve the grain yield and grain B contents in wheat

Effect of recombinant follicular stimulating hormone and human menopausal gonadotrophins on the oocytes number in patients undergoing assisted reproductive technique

Background &amp; Objective: The data regarding the effectiveness of various protocols used for controlled ovarian stimulation (COS) in assisted reproductive techniques (ART) in our own population is scant. This study compares recombinant follicular stimulating hormone (rFSH) and human menopausal gonadotrophins (HMG) in terms of follicular numbers and oocytes retrieved in Pakistani women undergoing ART. Methods: A total of 300 patients were selected out of 1,950 patients who visited the hospital for in vitro fertilization/intra cytoplasmic sperm insemination (IVF/ICSI) from June 2018 to December 2020. These patients were further divided into two categories: first category (1) was given long protocol and the second category (2) was given short antagonist protocol. Each category was further sub-divided into two groups; group A who received HMG, and group B who received rFSH for COS. Results: There was a significantly higher number of follicles and oocytes retrieved in category 1, with rFSH (20.01 &plusmn; 4.91, 15.19 &plusmn; 9.18) versus. HMG (16.07 &plusmn; 5.67, 11.10 &plusmn; 5.07) with a p-value (0.00, 0.004). On the other hand, in category 2, the number of follicles was insignificant (p-value = 0.319) in both groups. Contrary to that the number of oocytes retrieved was significantly higher with a p-value of &le; 0.05 in both groups. Conclusion: In COS in ART, long protocol with rFSH has much better results both in terms of follicular numbers and retrieved oocytes. While for the short protocol with the antagonist, rFSH has been demonstrated to be superior to HMG but that is limited to the number of oocytes.</p

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

No abstract available