Prevalence of chronic endometritis in unexplained implantation failure

Background: The actual prevalence of chronic endometritis (CE) in the general population is still ill-defined. Aim of the study: was to evaluate the effects of chronic endometritis on implantation failure at ICSI through its prevalence at hysteroscopy and histology, in a population of women who experienced implantation failure at ICSI. Patients and methods: This was a prospective observational cross-sectional study that has been conducted in the International Islamic Center for Population Studies and research – Al Azhar University from 2017 till 2022. The study was conducted on 150 women who were affected by infertility and one unexplained implantation failure or more at ICSI. Results: In our study, hysteroscopy is a reliable diagnostic technique for CE in unexplained implantation failure and is highly reliable in excluding CE with sensitivity, specificity, accuracy, PPV and NPV as 96.5%, 88.17%, 91.3%, 83.3% and, 97.6% respectively. Conclusion: This study suggests that hysteroscopy is a useful diagnostic tool in women with unexplained implantation failure as regard CE diagnosis. However, endometrial samples should be obtained during hysteroscopy to increase the diagnostic accuracy

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population