Subfertility in women with familial Mediterranean fever.

AIM: The aim of this study was to examine the causes and different modalities used for management of subfertile patients with familial Mediterranean fever (FMF). MATERIAL AND METHODS: The study comprised of 74 infertile women with FMF. All patients were diagnosed as having FMF. All patients underwent a full infertility work-up. They were scheduled to expectant treatment, ovulation induction and timed intercourse, intrauterine insemination or intracytoplasmic sperm injection. RESULTS: Anovulation was reported in 18 patients (24.32%). Anovulation was due to polycystic ovary syndrome in 12 (16.22%) cases and due to other causes in six patients (8.11%). Excessive clear peritoneal fluid was present in 56 (57.67%) and male-factor infertility was present in 14 couples (18.91%). Ovulation induction and timed intercourse was adopted for a maximum of six cycles and intrauterine insemination for three cycles. In vitro fertilization/intracytoplasmic sperm injection was needed in six cases using standard long agonist protocol. Twenty-six women became pregnant. CONCLUSION: 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.

Pressure-Controlled Ventilation with Volume Guarantee Compared to Volume-Controlled Ventilation with Equal Ratio in Obese Patients Undergoing Laparoscopic Hysterectomy.

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/m2 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: (T1): after the anesthetic induction while in supine position by 10 min, (T2 and T3): after the CO2 pneumoperitoneum and Trendelenburg positioning by 30 and 60 min, respectively, and (T4): 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.

Types and Outcome of Fetal Urinary Anomalies in Low Resource Setting Countries: A Retrospective Study.

BACKGROUND: Congenital anomalies of the kidney and urinary tract in the developing countries have a poor prognosis due to limited experience in antenatal and postnatal management. PATIENTS AND METHODS: A 3-year retrospective study was carried out from January 2011 to December 2013. The following data were collected and analyzed: maternal age, gravidity, parity, gestational age at diagnosis, and ultrasonography findings. Final diagnosis after birth, the performed surgeries, follow-up data, as well as survival at one year were also analyzed. RESULTS: The mean age of the included patients was 28 years (range 20-35 years). The mean parity was 1.7 (range 0-4). The mean gestational age at diagnosis was 26 weeks (range 15-36 weeks). Consanguinity was reported in 10 cases (24.4 %). There were 25 males and 16 females. Bilateral renal agenesis was the commonest type (19.5 %). The anomalies of kidneys and urinary tract in our cases were associated with other anomalies in 8 cases (19.5 %). Oligohydramnios was detected in bilateral renal agenesis and posterior urethral valve. Surgical interference during the first 6 months was performed in 6 cases; pyeloplasty for unilateral or bilateral hydronephrosis was performed in 5 cases; and excision of solitary renal cyst performed in one case. By the end of the first year, two of the three cases with chronic renal disease, who were under peritoneal dialysis, died, and three cases who had undergone pyeloplasty were lost to follow-up. CONCLUSION: Among the 41 cases with antenatally diagnosed renal and urinary malformations; bilateral renal agenesis was the commonest anomaly (19.5 %). There were high rates of induction of abortion, IUFD, and neonatal deaths. The poor outcome may be due to lack of experience in performing invasive therapeutic fetal procedures.

Impact of a Lifestyle Modification Program on Menstrual Irregularity among Overweight or Obese Women with Polycystic Ovarian Syndrome.

PURPOSE: This study aimed to evaluate the impact of a lifestyle modification program on menstrual irregularity among overweight and obese women with polycystic ovarian syndrome. METHODS: A quasi experimental research design was used to conduct this study on 82 women with polycystic ovarian syndrome at the Gynecology and Obesity clinics of Mansoura University Hospital, Egypt. Two groups were included; the study group received a lifestyle modification program for 48 weeks, while the control group was not subjected to this program. Data collection was done for the following variables, a structured interview questionnaire was used to assess the women's general characteristics, menstrual patterns, and 24-hour dietary recall and the researcher took anthropometric measurements and assessed hirsutism by the Ferriman-Gallwey scale. RESULTS: After one year of lifestyle modification, the number of menstrual cycles significantly increased from 2.7+/-1.6 to 6.9+/-1.5 (t=12.26, p<.001) in the study group compared to insignificant minor changes among the control group (t=0.69, p=.488). Additionally, 58.5% were menstruating regularly compared to none in the control group (chi2=33.93, p<.001). CONCLUSION: Participating in a lifestyle modification program was effective in reducing menstrual cycle's irregularity among overweight and obese women with PCOS. Thus, it is recommended to motivate the nurses in counseling the PCOS women on lifestyle modifications.

RETRACTED: Reducing blood loss at abdominal myomectomy with preoperative use of dinoprostone intravaginal suppository: a randomized placebo-controlled pilot study.

This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal). This article has been retracted at the request of the Editor-in-Chief. The editorial board has found that it was exceedingly unlikely that randomisation had been conducted properly for all the trials Dr. Shokeir has co-authored and documented a number of examples of data copying between tables in different studies. When these examples are taken together, in the view of the Editor-in-Chief it is likely that this trial authored by Dr Shokeir is based on fabricated data. The journal has not received the original dataset or a satisfactory response from Dr Shokeir with an explanation regarding the stated concerns after several months, so the article must be retracted.