The primary aim of this study was to test the hypothesis that sexual dysfunction is higher in infertile females in relation to normal healthy women through comparing total and sexual domains scores ...in both groups. The secondary objectives were: to determine factors affecting occurrence of female sexual dysfunction (FSD) in all sample and to determine factors affecting the different sexual domain scores within the infertile group.
This cross sectional study was done at Cairo University Hospital. 200 infertile and 200 control females were evaluated using the Female Sexual Function Index (FSFI) questionnaire. Total score less than 26.55 signified sexual dysfunction. Husbands were evaluated by Sexual Health Inventory for Men (SHIM) questionnaire. A score less than 22 signified erectile dysfunction (ED).
Proportion of females with sexual dysfunction was higher in the infertile versus control group (47% versus 30%, 95%CI for the difference: 8%, 26%, p-value:<0.001). Total, orgasm, satisfaction and pain scores were significantly lower in infertile versus control group (mean±SD: 26.8±3.8 versus 27.9±3.5, p-value: 0.003; 4.2±0.7 versus 4.6±0.6, p-value: 0.01; 4.9±0.5 versus 5.2±0.5, p-value: 0.004 and 3.9±0.9 versus 4.4±0.7, p-value:<0.001 respectively). Husband SHIM erectile score was significantly lower in the infertile group (median score (range): 19 (5, 25) versus 22 (12, 25), p-value: 0.001). After adjustment for 15factors by logistic regression, the odds ratio of having FSD was 2.6 (95%CI: 1.5, 4.5, p-value: 0.001) in the infertile relative to control females. Secondary (versus primary) infertility was negatively correlated with arousal score (B (95%CI): −0.6 (−0.02, −1.2), p-value: 0.003) while duration of infertility was negatively correlated with arousal, satisfaction and pain domains scores (B (95%CI): −0.2 (−0.08, −0.32), p-value: 0.04; −0.2 (−0.1, −0.3), p-value: 0.005; −0.2 (−0.06, −0.34), p-value: 0.03 respectively).
sexual dysfunction is more prevalent in infertile versus control group. Infertility clinicians should be aware of this problem to assess and treat their patients to improve their quality of life.
Background: Cesarean section rate has increased dramatically worldwide but there is still debate about the optimum operative technique of cesarean section.
Objective: The purpose of this study was to ...assess the effect of rectus muscle reapproximation at cesarean delivery on the postoperative pain.
Methods: This study was a prospective, double-blind, randomized controlled trial. It included 280 primigravidas, with a singleton pregnancy, who underwent elective lower segment cesarean section at term. The patients were randomly allocated into two equal groups; Group (A): undergoing rectus muscle reapproximation, and Group (B): not undergoing rectus muscle reapproximation. Postoperative pain was assessed by visual analogue scale (VAS) from 0 (no pain) to 100 (maximum pain). Postoperative analgesia, operative time, changes in hemoglobin level, length of hospital stay, and occurrence of postoperative complication were also assessed.
Results: Postoperative pain score at the end of the first 24 hours and at the end of the next 24 hours were significantly higher among the group of rectus muscle reapproximation (a difference in VAS pain score of: 5, 95% confidence interval: 0.1-11, p value: .02) and (a difference of 1, 95% confidence interval: 0.1-2.9, p value: .01), respectively. As regards the narcotic use in the first 24 hours after cesarean section, in the form of injections of meperidine 50 mg, it was significantly higher among the group of rectus muscle closure (a difference of 10 mg, 95% confidence interval 3-21.7 mg, p value: .02). While in the next 24 hours, the NSAIDs use, in the form of diclofenac sodium injection, was significantly higher among the group of rectus muscle reapproximation (a difference of 10 mg, 95% confidence interval 3.7-31.7 mg, p value: .02).
Conclusions: Rectus muscle reapproximation among women undergoing primary caesarian section is associated with significant increase in the postoperative pain and analgesic requirements.
Objective
To determine the accuracy of the posterior cervical angle (PCA) compared with the cervical length and the Bishop score in predicting the outcome of induction of labor (IOL).
Methods
The ...present prospective observational study included IOL candidates who had their PCA and cervical length assessed by transvaginal ultrasonography and the Bishop score at the Obstetrics and Gynecology Department, Kasr El‐Aini Hospital, Cairo University, Cairo, Egypt, between April 1 and July 31, 2017. The accuracy of these tests in predicting successful IOL (defined as vaginal delivery) was compared.
Results
The analysis included 49 women with successful IOL and 21 women with unsuccessful IOL. The suggested cutoffs for the prediction of successful IOL were a PCA of more than 99.5°, a cervical length of less than 34 mm, and a Bishop score of more than five. The areas under the receiver operating characteristics curves for these three measures were not significantly different. However, a PCA of more than 99.5° had the best sensitivity (91.84%), specificity (90.48), positive predictive value (95.7%), negative predictive value (82.6%), positive likelihood ratio (9.64), and negative likelihood ratio (0.09) compared with the other two predictors.
Conclusion
A PCA of more than 99.5° yielded the best accuracy in predicting successful IOL compared with the cervical length and the Bishop score.
ClinicalTrials.gov
NCT03113227.
The posterior cervical angle was a better measure for predicting the success of induction of labor than the cervical length and the traditional Bishop score.
Objective
To test the hypothesis that there is a higher rate of unsuccessful induction of labor (IOL) in post-term obese pregnant women compared to non-obese ones.
Methods
In this prospective cohort ...study, 144 obese (BMI > 30) and 144 non-obese (BMI < 29.9) post-term (> 41 weeks) pregnant women were recruited. IOL was done by misoprostol or amniotomy and oxytocin infusion according to the Bishop score. Comparison of percentage of failed IOL in both groups (primary outcome) was performed by the Chi-test. Logistic regression and multivariable regression were performed to assess the odds ratio (OR) of cesarean section (CS) and coefficient of delay in labor till vaginal delivery (VD) in obese versus (vs) non-obese groups. Adjustment for gestational age, parity, Bishop Score, membrane rupture and amniotic fluid index was done in both regression analyses.
Results
CS rate was significantly higher in obese group 26.4 vs 15.9%; difference in proportion (95% CI) 0.1 (0.01, 0.19);
P
value 0.02. 106 (73.6%) obese women and 121 (84.1%) non-obese women delivered vaginally. In addition, the duration till VD was significantly higher in obese group (22 vs 19 h,
P
value 0.01). After adjustment for possible confounding factors, the CS was still higher in the obese group in comparison to non-obese group (OR 2.02; 95% CI 1.1, 3.7;
P
value 0.02). This finding suggested that obesity was an independent factor for failure of IOL. In addition, after adjustment for these confounders, obesity had the risk of increasing labor duration by 2.3 h (95% CI 0.1, 4.5) in cases that ended in VD.
Conclusion
Based on our results, we conclude that there is a higher risk of CS in obese postdate pregnant women undergoing IOL in comparison to non-obese counterparts. Therefore, obstetricians should pay more attention to advising pregnant women about optimal weight gain during pregnancy and counseling about the chances of VD in cases of IOL.
ClincalTrial.gov ID
NCT02788305.
To measure the accuracy of the ultrasonographic features in predicting adenomyosis and to determine if there is a role for uterine artery Doppler in adenomyosis prediction.
A prospective comparative ...study.
Cairo University hospital.
Three hundred and fifty-two women who were scheduled for hysterectomy for various indications underwent preoperative transvaginal ultrasound scan (TVS) and uterine artery Doppler velocimetry in an attempt to diagnose adenomyosis. All the results were then correlated with histopathological results after hysterectomy.
Forty-eight participants were ultrasonographically diagnosed as having adenomyosis from which 37 patients were histologically confirmed. Both groups were comparable in age, but adenomyosis tend to occur in multiparas. We found that subendometrial linear striations, myometrial cysts’ number and poor endometrial delineation were significantly associated with adenomyosis. Sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of TVS for diagnosing adenomyosis were: 75.68%, 90.79%, 49.12%, 96.95% and 89.20%, respectively. Heterogenous myometrial echotexture was the most common ultrasonographic feature in adenomyotic cases. Neither uterine artery resistance index nor pulsatility index showed significant association with adenomyosis.
TVS is a potentially valuable tool in predicting adenomyosis especially when subendometrial linear echogenic striations, myometrial cysts, and poor endometrial delineations were found. However, uterine artery Doppler has no diagnostic values.
To detect the serum levels of folate and B12 in both preclamptic and normotensive pregnant women and to determine whether there is any relation between these levels with the uterine and umbilical ...artery Doppler indices as well as the pregnancy outcome.
This case controlled study comprised 79 pregnant patients with preeclampsia and 113 healthy, normotensive pregnant women with singleton pregnancies at gestational ages ranging from 34-40 weeks. Patients were not obese (BMI<30) and did not suffer from chronic hypertension, chronic renal or liver disease nor diabetes mellitus. Serum folate and B12 were detected in all cases. They were also subjected to a Doppler study of both the uterine and umbilical arteries. Serum folate and B12 blood levels as well as the Doppler study indices (RI and PI) were compared in both groups.
The serum folate level was significantly lower in preeclamptic patients than normal pregnant women (p<0.001). It was significantly correlated to uterine artery Doppler indices (RI and PI) and negatively correlated to umbilical artery Doppler indices (RI and PI). Low serum folate was significantly correlated to poor maternal outcome. Low serum folate was also significantly correlated to poor perinatal outcome. Serum B12 level was not significantly different in preeclamptic patients from the control group (P value=0.14).
Serum folate was significantly lower in preeclamptic pregnant women with a significant correlation to increased uterine and umbilical RI, PI and poor maternal and neonatal outcome.
Novel quinoxaline derivatives (
2a-d
,
3
,
4a
,
4b
and
5-15
) have been synthesized
via
the reaction of 4-methyl-3-oxo-3,4-dihydroquinoxaline-2-carbohydrazide (
1
) with different aldehydes, ketones, ...diketones, ketoesters, as well as hydrazine, phenyl isothiocyanate, carbon disulphide. The synthesized products have been screened for their
in vitro
anticancer and COX inhibitory activities. Most of the synthesized compounds exhibited good anticancer and COX-2 inhibitory activities. MTT assay revealed that compounds
11
and
13
were the most potent and exhibited very strong anticancer activity against the three cancer cell lines with IC
50
values ranging from 0.81 μM to 2.91 μM. Compounds
4a
and
5
come next and displayed strong anticancer activity against the three cancer cell lines with IC
50
values ranging from 3.21 μM to 4.54 μM. Mechanistically, compounds
4a
and
13
were the most active and potently inhibited EGFR with IC
50
= 0.3 and 0.4 μM, respectively. Compounds
11
and
5
come next with IC
50
= 0.6 and 0.9 μM, respectively. Moreover, compounds
11
and
13
were the most potent as COX-2 inhibitors and displayed higher potency against COX-2 (IC
50
= 0.62 and 0.46 μM, respectively) more than COX-1 (IC
50
= 37.96 and 30.41 μM, respectively) with selectivity indexes (SI) of 61.23 and 66.11, respectively. Compounds
4a
and
5
comes next with IC
50
= 1.17 and 0.83 μM and SI of 24.61 and 48.58, respectively. Molecular docking studies into the catalytic binding pocket of both protein receptors, EGFR and COX-2, showed good correlation with the obtained biological results. Parameters of Lipinski's rule of five and Veber's standard were calculated and revealed that compounds
4a
,
5
,
11
and
13
had a reasonable drug-likeness with acceptable physicochemical properties. Therefore, based on the obtained biological results accompanied with the docking study and physicochemical parameters, it could be concluded that compounds
4a
,
5
,
11
and
13
could be used as promising orally absorbed dual anti-inflammatory agents
via
inhibition of COX-2 enzyme and anticancer candidates
via
inhibition of EGFR enzyme and could be used as a future template for further investigations.
Novel quinoxaline derivatives (
2a-d
,
3
,
4a
,
4b
,
5-15
) have been synthesized and screened for their
in vitro
anticancer and COX-2 inhibitory activities. Compounds
4a
,
5
,
11
and
13
proved to be the most potent anticancer and COX-2 inhibitors.
Display omitted
•Synthesis of new bis(1H-benzodimidazol-2-yl) methanone complexes and their structural elucidation.•Geometry optimization for structural verification.•Intensive biological ...applications against microbes, free radicals and carcinoma cell lines.•Intensive In-silico assessments by using Swiss-ADME and pharmit software.
In the present study, a novel bis(1H-benzodimidazol-2-yl)methanone (H2L) ligand derived from the interaction of 1,2-phenylenediamine with diethyl 2-bromomalonate and its metal chelates of Zinc (II), Nickel (II), Copper (II) and Iron (III) were synthesized. The IR, NMR, and mass spectra were used to confirm the formation of the ligand. The new metal chelates were studied by analysis of elements, magnetic susceptibility measurements, Molecular vibrational and absorption spectra, and thermal analysis to describe their nature. The elemental analysis suggests metal to a ligand by 1:1 stoichiometry for all metal chelates under inspection. The ligand coordinates as a neutral tri-dentate towards the central metal ions through ONN donors that form a chelating five-member ring. The physicochemical studies suggested an octahedral geometry for the metal chelates under inspection. Various kinetic parameters have been determined from the thermal data by using Coats-Redfern route. The geometries of all current compounds were optimized by using the advanced program to verify the binding mode of the ligand towards the metal ions and to estimate common reactivity features. Mulliken charges were computed and N(9), N(16) and O(11) donors appeared with high negativity compared to the other donors, which supports their priority in coordination. Furthermore, the new synthesizers were screened in vitro for their biomedical capacity versus inspected strains of bacteria and fungi. Moreover, all the metal chelates have better biomedical efficiency than the ligand. Moreover, the in vitro antiproliferative influence of the BIM ligand and its chelates were screened versus variable carcinoma cell lines. The antiproliferative efficacy of the metal chelates was outstanding with significant IC50 values versus the tested cancer cells compared to the ligand alone. Interestingly, these outcomes have been confirmed via two silico approaches as Swiss/ADME and docking (MOE). Swiss/ADME study supposed the best bioavailability of BIM ligand and its Cu(II) metal chelate (BIMCu). While the MOE docking was performed for the most effective agent among all compounds (BIMCu). The reactivity of such a complex was recorded with 2rkb, 2bem and 4ewp proteins. Consequently, the promising feature of the BIMCu complex was clearly expected for liver cancer cells and bacteria.
Internet of Things (IoT) is a smart technology that allows communication between humans and all things that contain sensors, actuators, embedded electronics, software, or storage via the internet. As ...a result, IoT should be seen as a part of the overall Internet of the future, which is likely to be very different from what we are using today. Despite the advantages of IoT, energy efficiency is still considered one of the main challenges in IoT. There are many algorithms that have been proposed to solve the energy efficiency problem. Unfortunately, most of them have some drawbacks. As a result, an Enhanced Threshold Sensitive Distributed Energy-Efficient Clustering routing protocol (ETSDEEC) for WSN-based IoT was proposed in this paper. Hard and soft thresholds are used in the proposed protocol to determine whether nodes are allowed to send their sensed data. From the simulation, we found that the proposed ETSDEEC protocol performs better than EDEEC and TDEEC protocols in terms of network lifetime, energy dissipationand throughput. It is also found that the proposed ETSDEEC can improve the lifetime by 59.8% in comparison to EDEEC and about 37.7% in comparison to TDEEC protocols.
The aim of our study was to compare the outcome of pregnancy in patients who became pregnant within 24 months of renal transplantation and patients who became pregnant more than 24 months after renal ...transplantation.
The sample population of our prospective cohort study comprised of 44 patients who became pregnant following renal transplantation. In all cases, living donors were used for renal transplantation. The patients were allocated into either group A, which included 24 patients who became pregnant more than 24 months after renal transplantation, or group B, which included 20 patients who inadvertently became pregnant within 24 months of renal transplantation. Serum creatinine and 24-hour urinary protein concentration were measured each trimester. The incidences of preeclampsia and gestational diabetes, the timing and mode of delivery, the rate of preterm labor, and the mean fetal birth weight were determined.
The mean gestational ages in groups A and B were 35.8±3 weeks and 34.1±2.5 weeks, respectively. The mean fetal birth weights in groups A and B were 2,480±316 g and 2,284.5±262 g, respectively. These differences were statistically significant. The incidence of preterm labor was 45.8% in group A and 55% in group B. Proteinuria was significantly higher in group B during the third trimester of pregnancy. Preeclampsia occurred in 25% of the cases in group A and 30% of the cases in group B; this difference was not statistically significant. Gestational diabetes occurred in 2 out of 24 cases in group A and 2 out of 20 cases in group B. For group A and group B, normal vaginal delivery occurred in 58.3% and 55% of cases, respectively, and cesarean section was performed in 41.6% and 45% of cases, respectively.
A longer interval between renal transplantation and pregnancy is associated with better pregnancy outcome.
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