Background and Aims Fecal microbiota transfer (FMT) is a potential treatment for irritable bowel syndrome (IBS). Several randomized trials have tested FMT effects using different routes of administration, doses, and sample sizes. We aim to assess the overall efficacy of FMT for IBS patients and the safety of the intervention. Methods We systematically searched four databases for randomized control trials that studied the efficacy and safety of FMT in IBS patients. Results We included 8 randomized trials (472 patients) that compared FMT with placebo in IBS patients. Pooled results showed no statistically significant difference between FMT and control groups in the overall change in IBS symptom severity (IBS‐SSS) at 1 month ( p = 0.94), 3/4 months ( p = 0.82), and at the end of trials ( p = 0.67). No significant difference in the total number of respondents between the FMT and control groups (risk ratios = 1.84, [95% confidence interval (CI) = 0.82–2.65], p = 0.19). Although the oral route of administration showed a significant difference in the number of respondents ( p = 0.004), there was no statistically significant difference in the IBS‐SSS when subgrouping the oral route of administration (mean difference = 47.57, [95% CI = −8.74–103.87], p = 0.10). Conclusion FMT is not an effective treatment to relieve all the symptoms of IBS. Even in the groups that showed relatively significant improvement after FMT, the effect was proven to wear off over time and the re‐administration carries a low success rate. Future research should consider different bacterial‐based interventions such as probiotics or specific antibiotics.

Placenta accreta spectrum (PAS) can cause complications like hysterectomy or death due to massive pelvic bleeding. We aim to evaluate the efficacy of two different arterial ligation techniques in controlling postpartum haemorrhage and minimizing bleeding complications. We searched six databases. 11 studies were finally included into our review and analysis. We graded their quality using the Cochrane tool for randomized trials and the NIH tool for retrospective studies. Our analysis showed that internal iliac artery ligation has no significant effect on bleeding control (MD = −248.60 [−1045.55, 548.35] P = 0.54), while uterine artery ligation significantly reduced the amount of blood loss and preserved the uterus (MD = −260.75, 95% CI [−333.64, −187.86], P < 0.00001). Uterine artery ligation also minimized the need for blood transfusion. Bleeding was best controlled by combining both uterine artery ligation with uterine tamponade (MD = 1694.06 [1675.34, 1712.78], P < 0.00001). This combination also showed a significant decrease in hysterectomy compared to the uterine artery ligation technique alone. Bilateral uterine artery ligation in women with placenta accreta spectrum can effectively reduce the amount of bleeding and the risk of complications. The best bleeding control tested is a combination of both, uterine artery ligation and cervical tamponade. These techniques may offer an easy and applicable way to preserve fertility in PAS patients. Larger randomized trials are needed to define the best technique.

Background Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) represent a range of both psychiatric and physical symptoms that impair quality of life and interfere with daily activities in females. Aims To assess the prevalence of PMS and PMDD in Egypt, Jordan and Syria, its demographic associations and the potential link to sexual harassment (SH). Methods We used an Arabic version of the premenstrual symptoms screening tool (PSST) to assess the prevalence of PMS and PMDD. Another two-part questionnaire was used to assess the harassment experience. Results 22,021 women agreed to fill the questionnaire; the majority (65%) aged 18–25 years old. PMS was more prevalent in Egyptian women 77.7% followed by women from Jordan 72.9% then Syria 66.3%. PMDD prevalence followed the same order (40%, 34.7% and 28.2%). Both conditions were significantly associated with obesity and working in medical careers (P = .001). 5733 women agreed to share their sexual harassment experience. Results showed a significant association between the diversity and frequency of sexual harassment and the frequency of the pre-menstrual conditions, PMS Frequency was 87.6%, 80.7% and 78% in participants who were harassed on daily basis Vs. once weekly or monthly vs. few times in their lifetime (p = .04). A similar statistically significant difference was noticed regarding having PMDD (66.4% vs. 47.6% vs. 42.5%). Conclusion The study showed high levels of both PMS and PMDD. The data provided by this study also sheds light on a potential link between SH and developing Pre-menstrual disorders.

Introduction: Irritable bowel syndrome (IBS) is the most common functional GIT disorder. Bacillus coagulans (BC) is a potent spore-forming probiotic that has been proposed as a potent supplement that can improve GIT dysbiosis and relieve IBS symptoms. We aim to assess the effect of BC on different IBS symptoms. Methods: We searched seven databases for RCTs that compare the use of BC versus placebo in the management of IBS symptoms. Results: Our search finally retrieved seven RCTs after extensive screening. Our analysis revealed that BC significantly improved the severity of IBS symptoms such as urgency {MD: -1.05, 95% CI: -1.33; -0.77}, bowel habit satisfaction {MD: -1.40, 95% CI: -1.68; -1.13}, straining {MD: -1. 22, 95% CI: -1.61; -0.82}, the passage of gas {MD: -1.25, 95% CI: -1.51; -0.99}, incomplete evacuation {MD: -1.06, 95% CI: -1.55; -0.57}, and the total score of symptom severity {MD: -10.13, 95% CI: -11.61; -8.66, (P < 0.00001)}. We also found a significant improvement in the physician’s global assessment score at 8 weeks {MD: 1.61, 95% CI: 0.61; 2.60, (P = 0.002)}; however, results were not significant at 4 weeks (P = 0.48). Moreover, our results indicate a significant decrease in the discomfort score after 4 and 8 weeks, the bloating score after 2, 4, 8, and 11 weeks and the vomiting score. Regarding abdominal pain, BC significantly lowered pain score after 2, 4, 8, and (11-13) weeks. Conclusion: BC is a very effective probiotic in reducing the severity of IBS symptoms and abdominal pain with no serious adverse events. Future studies are needed to assess the use of BC as a long-term regimen and compare different subspecies of BC.

DVT) (OR 1.24), interstitial lung disease (ILD) (OR 1.14), chronic kidney disease (CKD) (OR1.43), uveitis (OR 2.65), episcleritis (OR 1.78) and autoimmune hepatitis (AIH) (OR 1.54) . However, psoriasis (OR 0.49), vasculitis (OR 0.87) , ankylosing spondylitis (OR 0.82) and osteoporosis (OR 0.63) were less common in African American IBD patients (Table ). Conclusion: Our large cohort of IBD patients demonstrates significant racial differences in the prevalence of EIM of IBD in the United States. The association between race and extraintestinal inflammation in IBD patients is unclear. Further research into racial variations in the pathophysiology of EIM in IBD patients is required.