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.

TLH had a longer operation time, yet, less blood loss, shorter hospital stay, less postoperative pain and fewer complications, compared to TAH and VH using EBVS.

Objective: To examine further the dynamics of adrenal steroidogenesis in selected groups of patients with polycystic ovary syndrome (PCOS) compared to normal ovulatory women of the same age. Materials and Methods: Serum cortisol, testosterone, dehydroepiandrosterone sulphate (DHEAS), androstenedione (A), luteinizing hormone (LH), follicle-stimulating hormone, prolactin, 17-hydroxyprogesterone (17-OHP) and sex hormone-binding globulin (SHBG) were measured in the early follicular phase of the period. In addition, 2-day dexamethasone suppression and short adrenotropic hormone (ACTH) stimulation tests were performed for the study group and controls. Results: Serum testosterone (4.3 ± 1.8 nmol/l), LH (7.6 ± 1.9 IU/l), and 17-OHP (4.7 ± 2.3 nmol/l) were higher while SHBG (24.7 ± 14.2 nmol/l) was lower in patients than the control. Testosterone was significantly suppressed after dexamethasone suppression test while the level of 17-OHP increased significantly in patients more than the control after 60 min of ACTH stimulation. In the PCOS, the ratio of 17-OHP/A showed a significant increase after ACTH stimulation while that of DHEAS/A decreased when compared to controls. Conclusion: The study suggests a contribution of adrenal cytochrome P-450C dysregulation in PCOS. This suggestion could lead to another method of treating some PCOS patients when the usual anti-androgens might not be fully effective in controlling most of the symptoms.

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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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Embryo transfer is a critical final step in the in vitro fertilization (IVF) cycle. Much attention has been paid to standardizing the procedures of embryo transfer to improve pregnancy outcome. Objective. To identify the impact of embryo thawing-loading interval (the time interval passing from thawing to loading of frozen embryo into the catheter) on pregnancy outcome. Results. The study was divided into quartiles according to thawing-loading interval in minutes (G I: <60; G II: 60–119; G III: 120–239; G IV: 240 and above). Numerical variables are presented as median and interquartile range, and inter-group differences are compared using the Mann-Whitney U test. Categorical variables are presented as numbers and percentages, and differences are compared using the chi-square test for trend. After adjustment for the age of women, time of previous failed ICSI (Intracytoplasmic sperm injection) trials, number and maturity of transferred embryos, a thawing-loading interval between 60–119 minutes (adjusted odds ratio = 2.222, 95% CI = 1.370 to 3.603, p-value = 0.001) or between 120–239 minutes (adjusted odds ratio = 1.924, 95% CI = 1.172 to 3.161, p-value = 0.010) was independently associated with increased probability of clinical pregnancy compared with a thawing-loading interval of <60 minutes. On the other hand, a thawing-loading interval of ≥240 minutes significantly decreased the probability of clinical pregnancy (adjusted odds ratio = 0.378, 95% CI 0.215 to 0.664, p-value = 0.001). Conclusion. After adjusting for potential confounders, this analysis found that a thawing-loading interval between 60–239 minutes was independently associated with better pregnancy outcomes compared with a thawing-loading interval of <60 minutes. On the other hand, a thawing-loading interval of ≥240 minutes was significantly associated with a worse outcome. Key words: embryo transfer, IVF (in vitro fertilization), frozen embryo, thawing-loading interval