Objective: To assess the effectiveness and safety of double-dose methotrexate in comparing to single-dose methotrexate for management of ectopic pregnancy. Methods:A prospective randomized-controlled trial was conducted on 200 patients with ectopic pregnancy at the Obstetrics and gynecological Departments of Zagazig University, Egypt between June, 20 11 to May 2014. Patients were randomized into two groups, (group 1) who received a single dose 50 mg per meters squared surface area methotrexate (50 mg/m 2 IM on day 1) intramuscularly or (group 2), who received double-dose methotrexate regimen (50 mg/m 2 intramuscularly on days 1 and 4). The outcomes were; success rate, time duration of fall down of b-hcg to < 15 mlU/mL and undesirable effects of methotrexate. Results:In general, there is significant differences between both groups as regard the success rate and the duration of fall down β-hCG. The success rate was better in group 2 than in group 1 (90% versus 78.75%, P=0.01). The duration of fall down β-hCG until < 15 mlU/mL was shorter in group 2 (P=0.01). There was no significant difference between groups in adverse effects.Conclusion: Double-dose methotrexate as one of regimens of medical management of undisturbed ectopic pregnancy had more effectiveness and success rate than that of single-dose regimen with equivalent safety.
Gestational diabetes mellitus (GDM) complicates a significant number of pregnancies. Blood glucose control improves perinatal outcomes. Medical nutrition therapy is the foundation in management. Aim of This Study. To evaluate efficacy of metformin in comparison to insulin for managing GDM. Methods. In prospective randomized comparative study, 150 antenatal women whose pregnancies had been complicated by GDM and did not respond to diet alone were recruited from antenatal clinics at Obstetrics Department in Zagazig University Hospitals from November 2012 to December 2014. They were divided randomly into two groups, 75 patients in each, and were subjected to either insulin or metformin medication. Outcomes were comparing the effects of both medications on maternal glycemic control, antenatal complications, and neonatal outcome. Results. No significant difference in controlling high blood sugar in GDM with the use of metformin or insulin (P = 0.95, 0.15). Maternal complications in both groups had no significant difference and fetal outcomes were as well similar except the fact that the hypoglycemia occurred more in insulin group with P value 0.01. Conclusion. Glycaemic control in GDM can be achieved by using metformin orally without increasing risk of maternal hypoglycemia with satisfying neonatal outcome.
Endocan could be a reliable marker to predict the survival in epithelial ovarian cancer patients.
Background: Primary dysmenorrhea is the most common cyclic pelvic pain affecting quality of life. Incidence of primary dysmenorrhea was reported to be between 20% and 90% in different societies. Women that assigned in sports experienced fewer episodes of symptoms of dysmenorrhea. Several studies have shown that the reduction of dysmenorrhea in women, who regularly exercise may be due to effects of hormonal changes on uterine epithelial tissues or an increase in endorphin levels. It appears that exercise has analgesic effects that act in a non-specific way. Aim of study:To prove that physical exercises can manage primary dysmenorrheal thorough using two types (stretching and core strengthening exercises) and compare between them as regard the intensity and duration of pain Type of study: This randomized controlled study conducted on 150 females with primary dysmenorrhea attended to zagazig university hospital outpatient clinic. They were randomly assigned to two exercises and one control groups using a computer-generated randomization list. The interference groups were asked to comprehensive either active stretching or core strengthening practice for 8 weeks (4 days per week, 2 times a day, 10 min) at home. Pre-test and two post tests for all the groups were examined for pain intensity using Visual Analog Scale (VAS).and pain duration by hours. Data were entered into SPSS statistical soft ware (v. 20) and analyzed using independent t-test, repeated measures ANOVA, Mean and Bonferroni Post hoc test. Besides, P<0.05 was considered statistically significant. Results:Intensity and duration of pain were significantly reduced in exercise groups (P<0.001) as comparing to control group but no significant differences between readings of post test in both interventions groups. Conclusion:Active stretching or core strengthening exercises seem to be an easy, non-pharmacological method for managing primary dysmenorrhea. It was believed that contracted ligamentous bands in the abdominal region were the causative factor for physical compression of nerve pathways and their irritation, so the proposed series of stretching exercise was considered very effective as it will increase the blood flow and metabolism of the uterus so reduces dysmenorrheal symptoms [11]. It was believed that the purpose of core strengthening is to combine the concepts of lumber stabilization and how instability can lead to injury and pain specifically during stressful times of the female body and one of these repetitive stressful times is dysmenorrhea [12]. The lumber portion of spine is sturdy and designed to take the force of the body and it also involved in the origin and insertion of certain musculature and nerve innervations to their correlated areas. If at any time a certain part of the lumbar spine is weak, it is not as its optimal level to handle functional stress, which can result in pain throughout the abdomen, low back, or thighs. These areas just happen to be the same areas that are affected by females suffering from dysmenorrhea [13]....
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