bluuebunny/crossref_metadata_2025_split huggingface dataset:
Insertion of Intrauterine Contraceptive Device at Cesarean Section: Randomized Clinical Trial
Authors: Elkholy A G A , Sweed M S , Bartella H N 
Published: May 2020

Abstract

Background
Postpartum period is highly vulnerable period to unintended pregnancy as there are limited contraceptive options available in the breast feeding women. At the same time ovulation is highly unpredictable in non breast feeding or non exclusive breast feeding women. an ideal time to begin contraception, as women are highly motivated to adopt contraception at this time, which also has the advantages of being convenient for both women and health care providers.

Objective
To evaluate and compare the efficacy of IUD (Pregna T Cu 380A) insertion at cesarean section and after puerperium in terms of expulsion rate, pain and amount of bleeding.

Patients and Methods
This study is a randomized Clinical Trial that was conducted at Ain Shams University Maternity Hospital during the period from December 2017 to May 2018. The study was approved by institute ethics committee of Ain Shams University Hospitals.

Results
There were no statistical significant differences in the rates of wound infection, postoperative pain, volume of bleeding, signs of infection, additional analgesic needs, dyspareunia and number of days till bleeding stops between both groups. There was no statistical significant between both groups as regard expulsion of IUD in the present study.

Conclusion
IUD is a contraceptive device which is commonly inserted after puerperium. This study will focus on insertion IUD during cesarean section.
Hospital Versus Home Management in Women with Pre-Labor Rupture of Membranes: RCT
Authors: Ammar E E M A , Hussein A M , Khaled R A 
Published: May 2020

Abstract

Background
Pre-labor rupture of membranes (premature rupture of membranes (PROM) is defined as rupture of fetal membranes before onset of labor in women after 37 weeks of gestation. And it accounts for 10% of all gestations. Latent period is the interval between PROM and time of onset of labor. More accurate prediction of latency period could help prepare patients for anticipated length of hospital stays.

Objective
To find out if there is difference between home management and hospital expectant management in women with PROM as regard maternal and fetal outcomes.

Patients and Methods
Our study is a prospective randomized controlled trial to compare hospital versus home management in women with PROM, whom came to Ain Shams Maternity Hospital, as regard latency period, successful vaginal delivery, chorioamnionitis, NICU admission, and time from rupture of membrane till delivery, who attending the emergency room during the period from June 2017 till June 2018. A total of 152 pregnant women were included in this study who met inclusion and exclusion criteria, they divided into 2 groups, each 76 woman. Group A discharged home after initial assessment, Group B admitted to hospital.

Results
The present study found that there was a highly statistically significant difference (p &lt; 0.001) between home group and hospital group as regard length of hospital stay. While there was no significant correlation (p &gt; 0.05) between the two groups as regard mode of delivery or adverse maternal or neonatal outcomes.

Conclusion
As regard home management for women with PROM in comparison with hospital management, they had longer latent period as well as longer time interval between PROM and delivery, but had a shorter hospitalization stay without negative impact on maternal or fetal outcome. In times of increasing financial pressure on the medical system, outpatient management for PROM seems to be a viable option. Also multiparous women were more satisfied with their care, and reported that they ‘would participate in the study again’ if they were cared for at home rather than in hospital.
Titrated oral misoprostol solution versus vaginal misoprostol for labor induction in primi gravid ladies
Authors: Abdalfattah I M , Mohammed W E , El-gaml A A 
Published: May 2020

Abstract

Background
It is now generally accepted that the uterine cervix plays an important role during pregnancy and labor and that it depends on an active ripening process within the cervix; which is necessary for successful labor induction.

Aim of the Work
to test the safety and efficacy of titrated oral misoprostol compared to vaginal misoprostol for labor induction in term gravid ladies.

Patients and Methods
This prospective, single-blinded randomized controlled clinical trial was conducted at Ain-Shams University Maternity Hospital during the period between August 2017 and August 2018. 120 pregnant women planned for induction of labor were recruited in the study according to the inclusion / exclusion criteria. Subjects included in the study were randomized into two groups: patients who received oral 200 ug misoprostol in 200 ml water titrated over 24 hours and placebo tablets vaginally which resemble vagiprost tablets (25 microgram misoprostol) and the second group contained pients who received vaginal misoprostol 25microg maximum four doses, and placebo solution of 200 ml of tap water.

Results
titrated oral misoprostol is as effective in promoting cervical ripening and inducing labor as intravaginal misoprostol, oral Misoprostol has a similar maternal and perinatal safety profile to vaginal misoprostol.

Conclusion
This new approach to oral misoprostol administration was successful in minimizing the risk of uterine hyper-stimulation, which has been a feature of misoprostol use for induction of labor, at the expense of a somewhat slower response. Oral Misoprostol has a similar maternal and perinatal safety profile compared to vaginal misoprostol.
Intravaginal isosorbide mononitrate in addition to misoprostol versus misoprostol only for induction of labor: a randomized controlled trial
Authors: Harb H M , Mansour D Y , Abouahmed Y M A M E 
Published: May 2020

Abstract

Background
Induction of labor is still a controversial obstetric procedure. The need to shorten delivery time has been recognized and practiced for centuries. Although the indications have clearly changed during the past decades from a need to expel a dead fetus to an effective solution to reduce the threat to the mother and her precious fetus, effective and safe methods of achieving delivery must always have been the primary objectives. Induction is indicated when the benefits to either mother or fetus outweigh those of pregnancy continuation. Nitric oxide donors(NO donors) such as isosorbide mononitrate could be of a great use for cervical ripening because of their effect on release of prostaglandins and vasodilation while having no or little effect on uterine activity ; since they are relatively safe and has low number of non-vital adverse effect if used with caution, they could be added to misoprostol to shorten to time needed for cervical ripening thus accelerating the whole process of induction of labor.

The Aim of this study
was to evaluate safety & efficacy of nitric oxide donors such as intravaginal isosorbide mononitrate in addition to misoprostol versus misoprostol only for the whole process of induction of labor.

Patients and Methods
in a prospective randomized double-blind placebo-controlled clinical trial which was conducted at Ain Shams Maternity University Hospital in Cairo from January 2018 to June 2018, 50 women were included in induction of labor, they were randomly divided into 2 group: Group I consisted of 25 patients, each patient was given 1 tablet of isosorbide mononitrate 40mg vaginally once and one tablet of misoprostol 25mcg vaginally; Group II consisted of 25 patients, each patient was given 1 tablet of misoprostol 25mcg vaginally. Misoprostol were given for a maximum of 5 doses (one 25mcg vaginal tablet) with interval of 6 hours between each tablet. This clinical trial was registered in clinicaltrial.gov registry with number: NCT03523754.

Results
there was a statistically significant difference between Isosorbide mononitrate & Misoprostol group versus Misoprostol only group regarding induction to delivery time ( mean 19.55 ± 1.41 to 22.94 ± 1.44 hours respectively, P-value &lt;0.001) , induction to active phase interval (mean 10.67 ± 1.83 to 13.81 ± 0.52 hours respectively, P-value &lt;0.001), maternal headache (36% to 12% respectively, P-value =0.047).

Conclusion
Isosorbide mononitrate appears to be a safe agent when used with misoprostol for induction of labor. It decreases induction to delivery time and induction to active phase time.
Value of Ultrasonographic Guidance For Operative Hysteroscopy on the Safety and Outcome of the Procedure: Randomized Control Trial
Authors: Amer M I , Elbasuony W , Ali M A 
Published: May 2020

Abstract

Background
Hysteroscopy is a minimally invasive intervention that can be used to diagnose and treat many intrauterine and endocervical problems. Hysteroscopic polypectomy, myomectomy are just a few of the commonly performed procedures. Hysteroscopy has nearly replaced standard D&C for the management of abnormal uterine bleeding (AUB), as it allows for direct visualization and diagnosis of intrauterine abnormalities, and it often offers an opportunity for simultaneous treatment. Operative hysteroscopy is a safe procedure resulting in complication in 0.95-3% of cases. The most frequently observed complications include hemorrhage (2.4%), uterine perforation (1.5%), and cervical laceration (1-11%). Another rare complication is excessive fluid absorption with or without resultant hyponatremia. Can use of ultrasound guidance during operative hysteroscopy decrease the rate of the operative complication?

Objective
To assess the value of ultrasound guidance for operative hysteroscopy on decreasing the complication and improving the success rate of the procedure.

Patients and Methods
It is estimated that a sample size of 88 patients that were divided to 44 patients in the Ultrasound guidance group and 44 patients in the group that didn’t perform ultrasound. The patients were encountered from those presented at the gynecology clinic of the Ain Shams university hospital or those presented at ECDU with the inclusion criteria in the period between December 2017 to November 2018. The patients were approached to participate on study and a written informed consent was taken from all the patients.

Results
Comparative study between the 2 groups revealed; highly significant increase in success rate in ultrasound guided hysteroscopy (USH) group; compared to conventional hysteroscopy (CH) group; with highly significant statistical difference (p &lt; 0.01) and non-significant difference as regards failure and complications rates (p &gt; 0.05).

Conclusion
Our study found that ultrasound assistance for difficult hysteroscopy reported that ultrasound appears to be a safe and reliable method of assistance.
Subcutaneous Tissue Irrigation with Povidone Iodine in Decreasing the Rate of Surgical Site Infection Following Cesarean Section: (Randomized Control Trial)
Authors: Abdelrahman A H N , Samy M M , Shawky M E A , Azmy G A 
Published: May 2020

Abstract

Background
Cesarean section remains to be one of the most common surgical procedures performed worldwide and available data indicate that surgical interventions constitute approximately 0.4%–40.5% of all deliveries. Surgical site infections (SSIs) are reported to occur in up to 8.4% of women having a caesarean section (CS) with many negative effects, including pain, prolonged hospitalisation or readmission, need for antibiotics, return to theatre and increasing costs.

Objective
In women undergoing elective caesarian section, subcutaneous tissue irrigation with povidone Iodine may decrease the rate of surgical site infection.

Patients and Methods
The study included any female from 20 to 35 years old of gestational age 38 week or older with viable fetus, BMI 20-30 Kg/m2. Patient excluded were those with preoperative haemoglobin less than 10, prolonged rupture of membranes, diabetic, hypertensive or with any medical disorder including autoimmune diseases.

Results
The result of our study demonstrated that the use of povidone iodine 1% solution doesn’t have an added benefit in decreasing the incidence of SSI.

Conclusion
We conclude that the use of povidone iodine 1% solution in irrigation of subcutaneous tissue prior to skin closure in elective caesarian deliveries does not have an added benefit in decreasing the incidence of SSI and is, thus, not recommended at time being.
Hystroscopic cornual nerve block in operative hysteroscopy: a Randomized controlled trial
Authors: Amer M I , Abdelaleem M M , Elrefaey Y M 
Published: May 2020

Abstract

Background
Hysteroscopy has become a standard investigation for a lot of gynecological cases and found to be effective in detecting intrauterine pathology and treating it. It is usually performed as an outpatient procedure under either local or no anesthesia.

Aim of the Work
to assess the anesthetic efficacy of intracornual nerve block versus placebo in reducing pain & discomfort during operative hysteroscopy.

Patients and Methods
This randomized, double-blind, placebo-controlled study was conducted on 58 patients at the Early Cancer Detection and Endoscopy Unit (Ain Shams university Hospital) after taking Full ethical approval for the study. Patients referred for outpatient hysteroscopy (between march 2018 and December 2018) were informed about the possible role of intracornual nerve block in reducing pain that could be experienced during the procedure, and were asked to participate. Signed informed consent was obtained from all patients who agreed to participate in the study.

Results
Among the 42 women who underwent successful operative intervention, the visual analogue score for assessment of intra-operative pain was statistically significantly lower in the LA-ICOB group compared to the placebo-ICOB group. In the same context, the number of patients requiring extra analgesia (either as NSAIDs or opioid analgesics) was statistically significantly larger in the placebo-ICOB group compared to the LA-ICOB group.

Conclusion
This study proved that the use of intracornual nerve block in operative hysteroscopy is both beneficial and effective in reducing pain and discomfort that could associate operative hysteroscopy procedure.
Comparison between laparoscopic and vaginal suturing in closing the vaginal vault in Total Laparoscopic Hystrectomy
Authors: Fahmy A A , Labib K M , Elnahas M A 
Published: May 2020

Abstract

Background
Hysterectomy is defined as surgical removal of the uterus. It is one of the most gynecological operations all over the world. Benign diseases are responsible for more than 70% of the indications for hysterectomy. e.g: fibroids, pelvic pain and menstrual disorders.

Aim of the study
to

compare between laparoscopic route and vaginal route in vaginal vault closure in total laparoscopic hysterectomy.

Patients and Methods
This comparative study was carried out between March 2018 and October 2018, at Ain Shams maternity hospital and Helwan materinity hospital, a prospective randomized control comparative study of 32 ladies undergoing total laparoscopic hysterectomy after obtaining the approval of the local ethical committee and a fully-informed written consent.

Results
A total of 32 patients were included in the study and they were divided into 2 groups each group consisted of 16 patients, the first group of patients underwent laparoscopic suturing and the second group underwent vaginal suturing. Each group was further subdivided into vertical (8 patients) and horizontal (8 patients). Both groups were matched for age, parity, BMI, menstrual status, comorbidities, previous cesarean sections and indications for hysterectomy.

Conclusion
Vaginal vault closure can be performed safely and effectively both vaginally and laparoscopically.Vaginal route for vault closure was shorter and easier than laparoscopic route.Vaginal horizontal suturing was comparable to vaginal vertical. Laparoscopic vertical was easier and faster than laparoscopic horizontal.
Association between Letrozole Dose and Pregnancy Rate in Clomiphene-Resistant Women with Polycystic Ovary Syndrome Randomized Controlled Trial
Authors: Elhoussieny A S , Mohamed M E , Elkotb A M , Elsharnobi K R 
Published: May 2020

Abstract

Background
Among couples experiencing difficulty conceiving, unexplained infertility is a fairly common diagnosis, occurring in approximately 10–20% of cases. One of the options available to women with unexplained infertility is ovulation induction, which is most commonly achieved using clomiphene citrate.

Aim of the Work
To evaluate the effect of high dose letrozole protocol (7.5 mg, 10 mg for 5 days compared with standard letrozole protocol 5 mg for 5 days) in the management of clomiphene-resistant women with polycystic ovary syndrome.

Patients and Methods
Randomized controlled clinical trial. The current study was conducted in Ain Shams University Maternity Hospital. The study included a total of 120 women. The study population was randomized using a Computer generated randomization system into 3 groups: Group A: standard letrozole regimen (5mg /day starting from day 2 to for 5 days).

Group B
received letrozole (7.5 mg/day from day 2 for 5 days).

Group C
received letrozole (10 mg/day from day 2for 5 days).

Results
We found that there were insignificant differences between study groups as regard age, BMI and Duration of infertility p-value 0.997,0.873,0.927 respectively, there was insignificant differences between study groups as regard parity and Ovulation status p-value 0.575,0.897 respectively, there was insignificant differences between study groups as regard serum level of FSH,LH, E2 and Testosterone p-value 0.911, 0.821, 0.811, 0.954 respectively.

Conclusion
It seems that the use of higher doses of letrozole improve endometrial thickness and follicle number but it offers no advantage in terms of pregnancy rates over the lower (2.5 mg) dose.
Transverse Supraumbilical versus Pfannenstiel Incision for Cesarean Section in Morbidly Obese Women “A Randomized Controlled Trial”
Authors: Elsayed H M , Elmekkawi S F , Elkotb A M , Abdelhady R M , Elhossary H M A 
Published: May 2020

Abstract

Background
Cesarean section is one of the most common operative procedures performed in modern obstetrics, cesarean section is defined as the birth of a fetus through incision in the abdominal wall and the uterine wall. Obesity is currently the most prevalent health threat the world over and its influence on general health is rapidly increasing. Obesity has a dramatic impact on pregnancy outcome. Apart from an associated increased prevalence of diabetes and hypertension, obesity in pregnancy has been associated with poor perinatal and neonatal outcomes. Obese mothers have an increased risk of pregnancy complications such as anemia, hypertension, pre-eclampsia, preterm delivery, emergency cesarean section, and gestational diabetes and significantly increases the rate of cesarean section.

Aim of the Work
This study aimed to evaluate the efficacy and safety of transverse supraumbilical incision compared of pfannenstiel incision in morbidly obese women undergoing cesarean section.

Patients and Methods
This study was conducted in the casualties of Ain Shams University Maternity Hospital. Parallel, superiority randomized controlled trial with allocation ratios 1:1. All Participants 72 women will be randomly allocated into two groups; each group will be included 36 women, one group will be those who will undergo the transverse supraumbilical incision while other group will undergo pfannenstiel incision. Randomization will be performed in advance by computer using variable blocks the random number generator in MS Excel (Microsoft, Seattle, WA, USA).

Results
As regard risk analysis for the incidence of adverse outcomes TSU inicision is associated with significantly lower risk for wound complication compared with a pfannenstiel-type incision (RR = 0.19, 95% CI = 0.07 to 0.5, p-value=0.0008). The number needed to treat is 2.1 with a 95% CI ranging from 1.5 to 3.6. There is faster regain of intestinal motility in transverse supraumbilical incision compared with pfannenstiel incision. Mean post-operative hospital stay in transverse supraumbilical group was (2.4) hours while that of pfannenstiel group (2.9) hours with no significant difference.

Conclusion
The transverse supraumbilical incision showed definite advantages over pfannenstiel incision; being faster to preform, less blood loss, less post-operative pain, earlier regain of intestinal motility, earlier ambulation, shorter hospital stay. Another Aspect, being economic, saving more of the stuff’s time, utilizing less anesthesia and needing least instruments.
Assessment of Quality of Life in Advanced Non-Small Cell Lung Cancer Patients on Platinum-Based Chemotherapy Combinations
Authors: Abdelwahab S A , Tawfik A S , Mosalam N A , Ghazy E M E 
Published: May 2020

Abstract

Background
Lung cancer is the most commonly diagnosed cancer worldwide for both sexes. There are 1.8 million new cases in 2012 (12.9% of the total), 58% of which occurred in the less developed regions. The disease remains the most common cancer in men worldwide (1.2 million, 16.7% of the total) and the most common causes of cancer deaths worldwide for both sexes, estimated to be responsible for nearly one in five (1.59 million deaths, 19.4% of the total)

Aim of the Work
are to evaluate the effect of platinum-based chemotherapy combinations as a first line treatment on health related quality of life (HRQOL) in advanced NSCLC Egyptian patients and to assess tumor’s response to treatment and treatment toxicity.

Patients and Methods
A prospective, single arm clinical study, to evaluate the effect of palliative chemotherapy on advanced NSCLC patient’s health related quality of life before starting chemotherapy and after 3 cycles of treatment, patient’s response to treatment and toxicity related to treatment.

Results
61 patients completed the EORTC QLQ-C30 and the QLQ-LC13 for the evaluation of HRQoL before the 1st cycle of chemotherapy. Started with 70 patients, 9 were excluded during the study (because of a change in the chemotherapy protocol or because of treatment discontinuation during the following cycles of chemotherapy.

Conclusion
The present study explored self-reported quality of life in advanced NSCLC patients receiving chemotherapy, Aiming for a better understanding of how chemotherapy influences HRQoL. The importance of patient perception of their own health regarding the complexity of cancer, which is a disease that affects every dimension of life and the way in which individuals perceive the environment, the diagnosis, and the therapy. Therefore, the combination of periodic quality of life assessments and clinical practice should be more extensively.