No abstract

This study comprised 74 infertile patients with familial Mediterranean fever (FMF), among which 26 women became pregnant. Pregnancies were followed according to the standard antenatal follow-up protocol of high-risk pregnancies. The principal outcome measures were the termination of pregnancy and its upshot. This study comprised 74 infertile patients with FMF. Of the cases, 12 (16.22%) had antiphospholipid syndrome (APS); 16 patients (21.62%) had a history of previous abdominal/pelvic surgery, which might have been contributing to delay of conception; 66 patients (89.18%) were on drug therapy by corticosteroids, colchicines and other agents. A total of 10/22 patients were delivered by caesarean section for complicated pregnancies. Six of the newborns were positive for the MEFV gene. Favourable pregnancy outcome occurs in patients with FMF treated with colchicine before and after pregnancy. Neonatal outcome was similar to that expected in the general population.

The causes of infertility in patients with FMF are not different from those expected in the general population. Treatment of the problem should be causal, adopting the conventional lines of treatment up to in vitro fertilization/intracytoplasmic sperm injection when appropriate. Colchicine is the treatment of choice and it is important to use it in its proper doses to control the disease.

Background: Laparoscopic hysterectomy operations especially for obese patients necessitate Trendelenburg position and pneumoperitoneum with carbon dioxide, which could affect cardiac and pulmonary functions. The present study aimed to compare the impact of pressure-controlled ventilation with volume-guaranteed (PCV-VG) and volume-controlled ventilation (VCV) with equal ratio ventilation (ERV), i.e., I: E ratio of 1:1 on hemodynamics, respiratory mechanics, and oxygenation. Patients and Methods: Eighty females with body mass index (BMI) >30 kg/m 2 and with physical status American Society of Anesthesiologists Classes I and II undergoing laparoscopic hysterectomy were allocated randomly to either PCV-VG (Group P) or VCV with ERV (Group V). The ventilation parameters, hemodynamics, and arterial blood gases (ABGs) analysis were recorded at four times: (T 1 ): after the anesthetic induction while in supine position by 10 min, (T 2 and T 3 ): after the CO2 pneumoperitoneum and Trendelenburg positioning by 30 and 60 min, respectively, and (T 4 ): after desufflation and resuming the supine position. Results: The peak inspiratory pressure in Group P recorded significant lower values than in Group V while the dynamic compliance was greater significantly in Group P than in Group V. No significant differences were reported as regards the ABG analysis, oxygenation, and hemodynamic data between both groups. Conclusion: In obese females undergoing laparoscopic hysterectomy surgeries, PCV-VG was superior to VCV with ERV as it provided higher dynamic compliance and lower peak inspiratory pressure that could be preferable, especially in those patients in whom cardiopulmonary function could be more susceptible to impairment.

Objective: This study aimed to evaluate the effect of subcutaneous sterile water injection at the lumbosacral region on labour back pain. Methods: A quasi-experimental, pre/post test design was utilized to carry out this trial at the Labour and Delivery room, Mansoura University Hospital, Egypt. Sixty three primiparous in spontaneous active labour, indicated a low back pain ≥ 7 on numeric pain rating scale, and expected to have spontaneous vaginal delivery were included in this study as a one study group. Participants had received 4 subcutaneous sterile water injections of 0.1 ml at the lumbosacral region for once. Using three tools data were collected; the 1st was a structured interviewing questionnaire schedule to assess the participants basic characteristics, the 2nd was the numeric pain rating scale to evaluate the baseline pain intensity changes at ten minutes, one, two and three hours post injection, while the 3rd tool was the 5-points Likert scale for mother's satisfaction with the pain relief. Results: The baseline pain score was 8 ± 0.8. It was reduced by 2.5, 3.5, 4.5, and 5 points at 10 minutes, one, two, and three hours post injection respectively. Strong satisfaction with the used method for pain relief was reported by 87.3% of the mothers, while only 3.2% were dissatisfied. Conclusions: It can be concluded that subcutaneous sterile water injection is an effective labour back pain relief method. This leading the investigators to recommend; raising the awareness of the labour and delivery nurses about this method in order to implement it in practice.