Amniotic membrane (AM) can promote proper epithelialization with suppression of excessive fibrosis by creating a supportive milieu for regeneration of chronic ulcer bed.ObjectiveThe objective of this study is to investigate whether AM scaffold can modulate the healing of a wound by promoting tissue reconstruction rather than promoting scar tissue formation.Subjects and methodsAM was obtained and prepared and then applied to patients with chronic leg ulcers who were randomly divided into two different groups. Group I (control group) included eleven patients in whom ulcers were treated with conventional wound dressings that were changed daily for 8 weeks. Group II (study group) included 14 patients in whom the AM was placed in contact with the ulcer and held in place with a secondary dressing, which was changed daily. Follow-up was done to detect healing rate and detection of ulcer size, assessment of pain, and to take ulcer images (days 0, 7, 14, 21, 30, 45, and 60).ResultsIn group I, all ulcers showed no reduction in their size, and ulcer floor remained the same. Healthy granulations were present in two ulcers (18.2%) and absent in nine ulcers (81.8%). There was no improvement of pain level in the eleven ulcers. In group II, complete healing of 14 ulcers occurred in 14–60 days with a mean of 33.3±14.7; healing rate range was 0.064–2.22 and the mean 0.896±0.646 cm2/day. Healthy granulations were present in 13 ulcers (92.9%) and absent in one ulcer (7.1%). Three ulcers (21.4%) were of mild severity (grade 1 ulcers) while eleven ulcers (78.6%) were of moderate severity (grade 2 ulcers). The healing rate was faster in ulcers of mild severity (1.7±0.438 cm2/day) in comparison to ulcers of moderate severity (0.673±0.498 cm2/day). Eleven cases (78.6%) showed improvement in their pain level on a scale from 0 to 10.ConclusionAM graft can be of value in wound healing. Further studies are needed to confirm these findings.
Uterine fibroids are benign tumors of the myometrium with a diverse range of manifestations. Fibroids can dramatically increase in size during pregnancy due to the increase in estrogen levels. After delivery, the fibroids usually shrink back to their pre-pregnancy size. Uterine myomas may have many complications, including abnormal uterine bleeding, infertility, pressure on nearby organs, degeneration, and malignant transformation. No previous reports have indicated that a fistula may develop between a uterine fibroid and the bowel loops, although previous studies have documented the occurrence of fistulas from the uterus to the bowel following myomectomy or uterine artery embolization performed to treat a myoma. In our case report, we document the rare complication of a fistula occurring between a degenerated myoma in the posterior wall and the ileum 1 week postoperatively in a patient who underwent a Caesarean section but did not have a history of uterine artery embolization.
Aim: To evaluate and compare the efficacy of methotrexate injection in management of persistent simple ovarian cyst versus the use of transvaginal ultrasound aspiration alone. Patients and Methods: This randomized controlled study was conducted at Tanta University Hospitals in the period from April 1, 2016 to October 31, 2016. Patients were randomly allocated into two groups; each group has 25 patients with benign persistent simple ovarian cyst. Group I: Patients were subjected to transvaginal aspiration of the cyst. Group II: patients were subjected to methotrexate injection inside the cyst. Patients in both group were followed up at 1, 3, 6 months after procedure for the recurrence and occurrence spontaneous pregnancy. Results: The mean age in group I was 28.8 years, and the mean age in group II was 26.52 years with non-significant difference. Also there was non-significant difference between both groups regarding size of the cyst. No case recorded to have a cyst recurrence in group II and four cases in group I within six months with significant difference (P value 0.037), and there was non-significant differences as regard the pregnancy rate and complications. Conclusion: Transvaginal intra-cystic methotrexate injection is a safe and effective choice for management of persistent simple benign ovarian cyst.
Background: Intrauterine growth restriction (IUGR) is a condition in which the fetus does not reach its growth potential. It is well known that a fetus affected with late IUGR has smaller abdominal size. The aim of the study is to evaluate the fetal liver size, fetal hepatic artery blood flow and other fetal vascular Doppler indices in cases of late IUGR. Methods: This observational analytical, cross-sectional study was carried out on 100 pregnant women at or above 32 weeks. Participants were divided into two groups: Group 1 (study group): 50 pregnant women as study group who were affected with IUGR. Group 2 (control group): 50 normally pregnant women as control group. Results: There was no statistically significant correlation between fetal weight and liver length. There was a positive highly statistically significant correlation between symphysial fundal height and the estimated fetal weight by ultrasound in cases of IUGR. There was a statistically significant decrease in the liver size in IUGR compared to the normal group. There was a statistically significant reduced hepatic arterial Doppler indices. Conclusions: Reduced liver size and hepatic arterial Doppler indices (PI, RI) can be valid diagnostic methods in IUGR. SFH, in fetuses suffering from IUGR when compared to normal cases, was correlated with EFW.
Background In developing countries, women are unwilling to accept cesarean delivery due to their old-style principles and sociocultural customs. Those women are frequently sent to hospitals with life-threatening problems and in these circumstances the cesarean section (CS) is done as an emergency operation. Aim We aimed to determine the incidence of vaginal delivery and its outcome in Tanta University Hospital. Patients and methods This prospective cohort study was conducted at Obstetrics and Gynecology Department, Tanta University Hospital during the period from August 2018 to January 2019. All women in labor during the period of the study were the target population of the study. Results Prevalence of normal vaginal delivery (NVD) was found to be 59.3% of all deliveries in our study. No significant difference was found between NVD and CS as regards neonatal outcome. Postpartum hemorrhage was the most common complication after NVD representing 5.5% of all cases. NVD were found to decrease with increased age of women, number of gravida, parity of studied women, and with increased abortions. It was found to increase with increased gestational age. Conclusion The prevalence of NVD at Tanta University Hospitals was 59.3% compared with 40.7% for cesareans and the outcome of delivery did not differ between NVD and CS.
Background: Embryo transfer (ET) refers to a step in the process of assisted reproduction in which one or several embryos are placed into the uterus of a female with the intent to establish a pregnancy. This technique, which is often used in connection with in vitro fertilization (IVF), has widely been used in animals or human. The aim of this study was to compare Trans abdominal ultrasound (TAUS) with Trans vaginal ultrasound (TVUS) methods for guidance of (ET) regarding clinical pregnancy rate and patient appreciation of pain during embryo transfer. Methods: This prospective, randomized, controlled study was conducted on 100 patients undergoing cryopreserved or fresh morula or blastocyte who were randomized (computer generated program) into 2 groups. Group I (the study group): 50 patients were subjected to embryo transfer under trans abdominal ultrasound guidance and Group II (controlled group): 50 patients were subjected to (ET) under (TAUS). Results: There were no statistically significant differences regarding fresh and cryopreserved. TVUS group demonstrated significant reduction of duration compared to TAUS ones. Minimal pain was observed in TVUS cases compared to TAUS ones. Higher success rate and lower failure rate were demonstrated in TVUS group compared to TAUS group. Conclusions: TVUS seems to have higher success rate with less pain sensation as well as shorter duration of the procedure in comparison with TAUS.
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