Aim: To investigate the effect of chromium picolinate (CrP) on insulin resistance (IR) in polycystic ovary syndrome (PCOS). Methods: This double blinded randomized controlled trial was conducted in the Gynecology outpatient clinics at Ain Shams University Women's Hospital. Using closed and randomly mixed envelopes, 100 women were selected out of 400 PCOS patients. Eighty-five patients finished the study and were analyzed, 44 in group I and 41 in group II. They were randomly allocated to 6 months of either 1000 μg CrP (50 patients), or placebo capsules (50 patients). Patients were seen monthly to encourage similar diet control and physical exercise plans. The primary outcome was fasting glucose insulin ratio (FGIR), secondary outcomes included ovulation, regularity of the cycle, body mass index (BMI), fasting blood sugar (FBS), fasting serum insulin (FSI), and serum testosterone level. Results: There were no significant differences between women of both groups regarding pretreatment levels of FBS, FSI, FGIR, and serum testosterone. Use of CrP for 6 months was associated with significant reduction of BMI (P < 0.001) and FSI (P = 0.007), and significant rise in FGIR (P = 0.045). CrP significantly increased the chances of ovulation (P = 0.011) and regular menstruation (P = 0.002) by almost twofold after the fifth month of treatment. Conclusion: Chromium picolinate is useful in PCOS to reduce IR and stimulate ovulation.

In women with lower urinary tract symptom, transvaginal ultrasounds measured mean BWT seems to be an effective non invasive diagnostic tool for prediction of OAB.

Back ground:the third stage of labour begins immediately after the birth of the baby and ends with the expulsion of the placenta and fetal membranes.It is preceded by contraction and retraction of the uterus to reduce uterine size and expel the placenta with minimal haemorrhage. Placental cord drainage involves clamping and cutting of the umbilical cord after the birth of a baby and then, immediately unclamping the maternal side of the cord so the blood can drain freely into a container. Aim of the work:the aim of this study is to assess the effect of placental cord drainage during active management of the third stage of labour on reducing both blood loss and the length of the third stage. Materials and Methods:a randomized controlled trial was carried out on180 patients who underwent vaginal delivery at Ain Shams University Maternity Hospital labour ward.Population of this study were randomly assigned to either:Group A: 90 patients was the study group(cord drainage).Group B: 90 patients was the control group(no cord drainage). Moreover,the duration of third stage was compared as the primary outcome. The incidence of postpartum hemorrhage, retained placenta, manual removal of placenta, and the need for blood transfusion were compared. Results:the duration and amount of blood loss of third stage of labour was significantly lower in study group than control group.Furthermore,the Postoperative pulse rate,Systolic Blood Pressure, Diastolic Blood Pressure,Hemoglobin and hematocrit value were significantly higher in study group than control group. The retained placenta (manual removal),Postpartum hemorrhageand Blood transfusion were non-significantly less frequent among study group than among control group. Conclusion:active management of the third stage of labour with the cord drainage method significantly reduced postpartum hemorrhage and the duration of the third stage.

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Aim: Compare the effectiveness of administration of different doses of rectal misoprostol before cesarean section to reduce intra-and postoperative blood loss. Methods: A double-blind randomized clinical trial including 453 term pregnant woman scheduled for elective cesarean section where participants received either 200-, 400-or 600-μg misoprostol rectally before cesarean section. Study medications were administered after catheter insertion and shortly before skin incision. Primary outcome measures were intraoperative blood loss. Results: The intraoperative blood loss was higher in patients who received 200-μg misoprostol (464.6 AE 143.1 mL) than those who received 400 or 600 μg, yet, no statistical difference was found between the 400-(359.3 AE 120.9 mL) and 600-μg groups (330.8 AE 133.8 mL). The incidence of side effects as fever and chills increases with increasing the dose of misoprostol. Conclusion: Rectal administration of misoprostol for the prevention of post-partum hemorrhage and decreasing intraoperative blood loss during caesarian section is a good alternative to other uterotonics. Yet, the best dose to be used needs further research to be agreed upon.