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Role of Diosmin-Hesperidin Combination (Daflon® Tablets Servier) in Treatment of Vasomotor Rhinitis

Prof. Dr. Ezzat W.F., Prof. Dr. Sobhy T.S., Dr. Mady O.M., Shendy G.M.

Otorhinolaryngology Department, Faculty of Medicine, Ain Shams University, Egypt

Georgemousa553@gmail.com

Abstract: Background: Rhinitis is defined as inflammation of the membranes lining the nose, characterized by nasal symptoms including itching, rhinorrhea and nasal congestion. Rhinitis represents a global health problem affecting between 10% and 25% of the world population. Objectives: To review the efficacy of combination of diosmin and hesperidin effect on vasomotor rhinitis symptoms versus intranasal steroids only on improvement scale in improvement of symptoms of Vasomotor Rhinits. Patients and Methods: A meta-analysis examining the use of Diosmin hesperidin combination in treatment of vasomotor rhinitis in combination or in comparison with intranasal sterids. As our study involved examining only the existing peer-reviewed literature, Institutional Review Board approval was deemed unnecessary. /h/140903/Comparison between group A and group B regarding percentage of recovery: Group A: received Diosmin, Hesperidin combination (Daflon 500 mg tablets), group B: received intranasal steroids inhalers. Results: This study proved that Diosmin Hesperidin combination has a venotonic action on the nasal mucosa that decrease its secretions and decreases nasal obstruction and rhinorrhea and sneezing from vasomotor rhinitis patients. Our study is a collective analysis of retrospective and prospective cohort studies done separately in diosmin hesperidin combination in treatment of vasomotor rhinitis versus intranasal steroids in treatment of it. The data analysed and results showed statistically significant difference between two modalities of treatment between disomin hesperidin combination (flavinoids) which showing efficacy 86.96% and intranasal steroids showing efficacy 72.5%. Conclusion: The cost benefit relation valides the trial of use of Diosmin Hesperidin combination (Daflon ® Servier) in cases of vasomotor rhinitis non responsive to other lines of therapy.

[Ezzat W.F., Sobhy T.S., Mady O.M., Shendy G.M., Ezzat W.F., Sobhy T.S., Mady O.M., Shendy G.M. Role of Diosmin-Hesperidin Combination (Daflon® Tablets Servier) in Treatment of Vasomotor Rhinitis. N Y Sci J 2020;13(1):1-5]. ISSN 1554-0200 (print); ISSN 2375-723X (online). http://www.sciencepub.net/newyork. 1. doi:10.7537/marsnys130120.01.

Keywords: Diosmin-Hesperidin, Daflon, Vasomotor Rhinitis

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Electrophysiological assessment of central retina following intravitreal injection of Ranibizumab in cases of diabetic macular edema

Mina Wahid Sabry Nassif (MSCh), Osama Elsaied Shalaby (MD), Mohamed Hosny El-Bradey (MD), Heba Mohamed Shafik (MD)

Ophthalmology Department, Faculty of Medicine, Tanta University, Egypt

Abstract: Background: Diabetic retinopathy (DR) is one of the leading reasons of blindness throughout the world, and diabetic macular edema (DME) is a major complication of DR which leads to visual acuity loss, so early diagnosis and adequate treatment is a must to overcome this disaster. The aim of this study is to evaluate electrophysiological responses of central retina following intravitreal injection of Ranibizumab in cases of diabetic macular edema in correlation with optical coherence tomography (OCT). Patients and Methods: A prospective, observational study involved 24 eyes of 20 patients suffering from diabetic macular edema. All the study participants underwent full ophthalmological assessment with measuring central foveal thickness (CFT) using Heidelberg Optical Coherence Tomography (OCT spectralis). Multifocal electroretinography (mfERG) was performed using RetiMax device in accordance with the ISCEV guidelines. Patients were examined at baseline (pre-injection) and one month after three intravitreal injections of Ranibizumab at monthly intervals (post-injection). The mfERG parameters our study focused on included, relative retinal density of response, P1 wave amplitude and implicit time in the central ring R1. Results: The results showed that intravitreal injection of Ranibizumab is accompanied by improvement in BCVA, reduction in central foveal thickness as seen in OCT and improvement in mfERG parameters in the form of increased relative retinal density of response, increased P1 wave amplitude and decreased P1 wave implicit time in the central ring R1. So according to our study multifocal ERG can be used as an effective method in the follow up of patients with central-involved diabetic macular edema after intravitreal injection of Ranibizumab. It can also be used to detect the patient’s response to injection. It is obvious that mfERG has a potential role in demonstrating functional retinal impairment in patients with diabetic macular edema. Also our study showed that intravitreal Ranibizumab is not only able to reduce macular edema, but also can aid in the recovery of inner retinal cell function. Thus effectiveness of Ranibizumab in diabetic macular edema (DME) is demonstrated structurally and functionally as it improved the electrophysiological profile in eyes with DME by improving the macular function. Conclusions: Functional changes in the retina of patients with central-involved diabetic macular edema assessed by mfERG can complement OCT findings.

[Mina Wahid Sabry Nassif, Osama Elsaied Shalaby, Mohamed Hosny El-Bradey, Heba Mohamed Shafik. Electrophysiological assessment of central retina following intravitreal injection of Ranibizumab in cases of diabetic macular edema. N Y Sci J 2020;13(1):6-13]. ISSN 1554-0200 (print); ISSN 2375-723X (online). http://www.sciencepub.net/newyork. 2. doi:10.7537/marsnys130120.02.

Keyword: Electrophysiological, central retina, Ranibizumab, diabetic macular edema

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Left Ventricular Global Longitudinal Strain after Revascularization of Acute ST- Segment Elevation Myocardial Infarction.

Mohamed A. Emara MSc, Abu Omar M.A. MD. Mai M. Salama MD, Mohamed A. Abdelaal MD

Cardiology department, Faculty of medicine, Tanta University.

maabouomar@gmail.com

Abstract: Background: Speckle tracking echocardiography (STE) cannot be considered are cent technique any more. Its high feasibility, reproducibility, and accuracy have been widely demonstrated and it has been applied to different aspects of the daily clinical practice specially is chemic heart disease and patients who present with ST segment elevation acute myocardial infarction (STEMI). Objectives: The aim of this study is to compare LV regional and global function assessed by 2D-speckle tracking imaging between STEMI patients reperfused by primary Percutaneous Coronary Intervention (PCI) and those reperfused by thrombolytic therapy and pharmaco invasive PCI. Methods: Two hundred patients presenting with a cute STEMI, 100f the maunder went primary percutaneous coronary intervention (PCI) received fibrinolytic therapy then pharmaco invasive PCI were enrolled. Left ventricular global longitudinal strain (GLS) was calculated in both groups after the PCI. Results: 200 patients (138 males, 62 females) with manage of 58.6±11.0 years were evaluated. The results showed a significant difference between GLS of both groups in favor of group I treated with Primary PCI with mean GLS of 13.892±1.656% in group Ian mean GLS of 11. 18 ± 2.207% in group II (P value<0.001). Left ventricular rejection fraction was assessed also by M-mode echocardiography but there was no statistical significant difference between both groups (P value=0.094). Conclusion: primary PCI has a better impact on post revascularization left ventricular systolic function than pharmacoinvasive PCI assessed by measuring left ventricular Global longitudinal strain using 2D-speckle tracking echocardiography which appeared to be more sensitive tool than the traditional left ventricular ejection fraction assessment with M-mode echocardiography for assessment of LV systolic function.

[Mohamed A. Emara, Abu Omar M.A., Mai M. Salama, Mohamed A. Abdelaal. Left Ventricular Global Longitudinal Strain after Revascularization of Acute ST- Segment Elevation Myocardial Infarction. N Y Sci J 2020;13(1):14-23]. ISSN 1554-0200 (print); ISSN 2375-723X (online). http://www.sciencepub.net/newyork. 3. doi:10.7537/marsnys130120.03.

Keywords: Left; Ventricular; Global; Longitudinal; Strain; Revascularization; Acute ST; Segment; Elevation; Myocardial Infarction

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Assessment of Pancreatic Volume and Fat Content in Type 2 Diabetic Patients by Multi-Detector Computed Tomography

Tarek Gabr Ahmed Zaki Abdellateef, M.B.B.CH.¹, Rania Essam El-Dien Mohammed Ali, MD.², Hanan Ahmad Nagy, MD.³, Waleed Samy Youssef, MD.⁴

¹Ismailia Teaching Oncology Hospital, Egypt.

²professor of Radiodiagnosis & Medical Imagining, Faculty of Medicine, Tanta University, Egypt

³lecturer of Radiodiagnosis and Medical Imaging, Faculty of Medicine, Tanta University, Egypt

⁴professor of Internal Medicine, Faculty of Medicine, Tanta University, Egypt

drtarekgabr@gmail.com, rany1997@yahoo.com, hanan.nagy84@hotmail.com, waleed.samy@med.tanta.edu.eg

Abstract: Background: Fat accumulation in the pancreas and decreased its size can influence pancreatic function attributed to insulin resistance or B-cell dysfunction. Various imaging studies were expected to produce reliable information regarding assessment of any change in pancreatic volume and fat content to provide better, more convenient diagnostic alternatives rather than the needle biopsy techniques. The aim of this study was to assess the value of multidetector computed tomography in estimation of pancreatic volume and fat content with assessment of the relation between these parameters and the development of type 2 diabetes. Results: The type 2 diabetic patients group had relatively smaller pancreatic sizes (mean value of 49.97 ±3.40 cm³), higher pancreatic fat content (mean value of -5.49 ±1.28 HU), and higher laboratory findings to confirm the presenting diabetic history compared to the control group workers who had relatively larger pancreatic sizes (mean value of 63.80 ±5.16 cm³), lower pancreatic fat content (mean value of -2.43 ±0.67 HU), and normal laboratory findings confirming the presenting non-diabetic state. Conclusion: Measurement of pancreatic volume and fat content by multidetector computed tomography can be used as an important tool for screening individuals with high risk for development of type 2 diabetes mellitus.

[Tarek Gabr Ahmed Zaki Abdellateef, Rania Essam El-Dien Mohammed Ali, Hanan Ahmad Nagy, Waleed Samy Youssef. Assessment of Pancreatic Volume and Fat Content in Type 2 Diabetic Patients by Multi-Detector Computed Tomography. N Y Sci J 2020;13(1):24-33]. ISSN 1554-0200 (print); ISSN 2375-723X (online). http://www.sciencepub.net/newyork. 4. doi:10.7537/marsnys130120.04.

Key word: Multidetector computed tomography (MDCT), Pancreatic volume, Pancreatic fat, Type 2 diabetes mellitus.

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Assessment of Accuracy of Different Intraocular Lens Formulas in Aphakic Children for Secondary Implantation

Osama Zein Elabdeen Shousha (MSCh), Amr Fawzy Sharaf (MD), Rabab Mohamed Elseht (MD), Said Mohamed Shalaby (MD)

Ophthalmology Department, Faculty of Medicine, Tanta University, Egypt

Abstract: Purpose: to evaluate the accuracy of pediatric intraocular lens (IOL) calculation formulas in predicting refractive outcome in aphakic eyes for secondary implantation with axial lengths (AL) equal to or less than 22.0mm and under the age of six years. Aim of the study: This study was intended to assess the most accurate intraocular lens calculation formula in pediatric aphakic cases doing secondary intraocular lens implantation. Methods: A prospective study was conducted on 30 eyes of 20 patients (8 males and 12 females), 10 unilateral and 10 bilateral. They underwent secondary IOL implantation after obtaining an informed and written consent from the parents. Preoperative keratometry was done by a portable autorefractometer. Axial length and anterior chamber depth was measured using A -scan of Pac Scan 300AP. Patients were divided into two groups. According to the axial length (AL), group A with Al ≤ 20mm and group B (> 20, <22 MM). According to the age, group C ≤ 2 years and group D (>2, < 6 years). IOL calculation was made using the three formulas (Holladay 1, Hoffer Q, Haigis) for each eye, IOl was implanted according to one of them and the refractive outcome was compared with the other two formulas. Estimation error (E) and Absolute Error (AE) were calculated at one and half months for each eye. The predictive accuracy of each formula in each group was analyzed by comparing the Absolute Error (AE). The Kruskal Wallis test was used to compare differences in the (AE) of the formulas. A statistically significant difference was defined as p-value<0.05. Results: In group A, the Hoffer Q had the lowest mean absolute error. In group B, there were no statistically significant differences in mean absolute error between the three formulas. In group C the percentage of target refraction within ± 1D was higher with Hoffer Q (P- value ≤ 0.05) but in group D the percentage of target refraction within ± 1D was also higher with Hoffer Q but (P-value> 0.05) which means that there are no difference between the three formulas in this age group. Conclusion: Hoffer Q was the most predictable in axial length group ≤ 20 mm but in axial length > 20, < 22 mm the three formulas were equally predictable. In age group ≤ 2 years we detect a significant difference as Hoffer Q was the most predictable formula but in age group > 2 and < 6 years the three formulas were equally predictable.

[Osama Zein Elabdeen Shousha, Amr Fawzy Sharaf, Rabab Mohamed Elseht, Said Mohamed Shalaby. Assessment of Accuracy of Different Intraocular Lens Formulas in Aphakic Children for Secondary Implantation. N Y Sci J 2020;13(1):34-39]. ISSN 1554-0200 (print); ISSN 2375-723X (online). http://www.sciencepub.net/newyork. 5. doi:10.7537/marsnys130120.05.

Keywords: Accuracy of Different Intraocular Lens, Aphakic Children, Secondary Implantation

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The Metabolic Syndrome in Multiple Sclerosis Patients

Prof. Dr. Mahmoud Mohamed Abd EL Sayed, Mohamed Ahmed Zaki and Marwan M. Abd El Samie

Neurology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Marwan.alshugairi@gmail.com

Abstract: Background: The impact of comorbidity on multiple sclerosis (MS) is a new area of interest. Limited data on the risk factors of metabolic syndrome (MetS) is currently available. This study was conducted to study the prevalence of metabolic syndrome in MS patients and to identify components of metabolic syndrome in MS patients and get find the relationship between different components of metabolic syndrome and different types of MS. Patients and methods: A total of 60 cases with MS were included in the study. All cases were subjected to complete history taking, thorough physical examination, and routine laboratory investigations. EDSS, and the criteria of metabolic syndrome were assessed in all cases. Results: The study cases with MS who were classified into two groups: Group A: metabolic syndrome (14 subjects), and Group B: with no metabolic syndrome (46 subjects). The age was significantly higher in the metabolic syndrome group. A positive correlation was detected between EDSS with disease duration, number of relapse and number of steroid pulses. On multivariate regression analysis, increased blood pressure, increased body weight, increased waist circumference and higher BMI were revealed to be an independent risk factors for development of metabolic syndrome. Conclusion: Older age is a significant risk factor for having metabolic syndrome in multiple sclerosis patients. Moreover, metabolic syndrome negatively affects EDSS in MS cases.

[Mahmoud Mohamed Abd EL Sayed, Mohamed Ahmed Zaki and Marwan M. Abd ElSamie. The Metabolic Syndrome in Multiple Sclerosis Patients. N Y Sci J 2020;13(1):40-47]. ISSN 1554-0200 (print); ISSN 2375-723X (online). http://www.sciencepub.net/newyork. 6. doi:10.7537/marsnys130120.06.

Keywords: Metabolic; Syndrome; Multiple; Sclerosis; Patient

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Evaluation of Chorioretinal Changes in Posterior Uveitis Using Optical Coherence Tomography

Dalia Abd-El-Rahman El-Feky (MSCh), Hammouda Hamdy Ghoraba (MD), Hamdy Abd El- Azim El- Koumy (MD), Sharif Yousef El – Emam (MD)

Ophthalmology Department, Faculty of Medicine, Tanta University, Egypt

Abstract: Background: Posterior uveitis is a sight threatening condition worldwide particularly among the working-age population and it may be the first presentation of serious systemic disease. Etiologically, posterior uveitis may be the result of infectious, non-infectious or ‘masquerade’ causes as described by the international uveitis study group (IUSG). Noninfectious uveitis with no associated systemic disease or other precipitant is termed ‘idiopathic’. Involvement of posterior segment structures as described by the standardization of uveitis nomenclature (SUN) may be focal, multifocal, or diffuse. Due to a wide variety of phenotypic features, the diagnostic approach is not that simple including careful history taking, comprehensive review of systems, précised ocular examination, targeted laboratory workup, and tailored ocular imaging. Retinal & choroidal imaging is very important in diagnosing pathologies and monitoring inflammatory process and treatment of posterior uveitis. Fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) are the most commonly used imaging techniques. Aim of the study: This controlled, selective, cross-sectional study aimed to evaluate chorioretinal changes in eyes with newly diagnosed posterior uveitis using swept source optical coherence tomography (SS-OCT). Patients and Methods: The study was performed on 44 eyes of 30 patients with freshly diagnosed acute posterior uveitis (in 14 patients, the disease was bilateral) and 30 eyes of 15 normal age/sex/refraction-matched individuals as control group. Results: The mean age of the patients was 32 years (range 12 to 56 years) and of the controls was 33 years (range 15 to 53 years). This study was conducted on 13 male and 17 female patients with 6 male and 9 female controls. In the study, 40.91% of cases showed posterior uveitis with spillover anterior uveitis. Best corrected visual acuity (BCVA) was measured in all participants using decimal notation and the mean (0.149 ± 0.141) was markedly decreased. A complete fundus examination, fundus photography and FFA were done to all patients and we documented a variable degree of vitritis in all eyes, retinitis in 11 eyes of 10 patients, choroiditis in 12 eyes of 6 patients, and chorioretinitis in 21 eyes of 14 patients. Retinal vasculitis was found in 15 eyes and 20 eyes had optic neuritis. Non-infectious uveitis was clinically diagnosed, with or without a definite entity classification, in 26 cases and 4 cases had infectious etiology (clinically and laboratory diagnosed). SS-OCT was done for all participants and we found that in acute posterior uveitis the structural changes were macular edema (ME) in all eyes (cystoid ME in 11 eyes and spongy ME in 33 eyes), neurosensory detachment (NSD) in 16 eyes, thickened choroid in all patients and interrupted photoreceptor layers in 19 eyes. Changes in the choroidal architecture were documented in 18 eyes and focal hyper-reflective thickening of the retinal pigment epithelium (RPE)/choriocapillaris complex was found in 13 eyes. Two SS-OCT parameters were measured in all participants retinal thickness (RT) using early treatment diabetes retinopathy study (ETDRS) map {in the form of central subfield (CSF), mean inner macular (MIM) and mean outer macular (MOM) thickness} and subfoveal choroidal thickening (SFCT). Our results revealed that both parameters were significantly greater in diseased than in control eyes. Interestingly, we detected significant topographical changes in the macula of our patients using ETDRS map, the thickest macular region was the parafoveal area (inner ring) followed by the peri foveal area (outer ring) and the CSF was least affected. Significant negative correlation was found between RT {CSF, MIM and MOM thickness}and BCVA and cystoid macular edema (CME) was associated with more reduction in BCVA than spongy ME. Also, NSD had negative significant relation with BCVA. Moreover, SFCT had a significant negative correlation with BCVA and a statically significant relation with NSD. A positive weak correlation between RT and SFCT was found but the result was statically insignificant. Conclusion: SS-OCT yields reasonable amount of data regarding morphological changes of the vitreoretinal interface, retina, and choroid in acute posterior uveitis.

[Dalia Abd-El-Rahman El-Feky, Hammouda Hamdy Ghoraba, Hamdy Abd El- Azim El- Koumy, Sharif Yousef El–Emam. Evaluation of Chorioretinal Changes in Posterior Uveitis Using Optical Coherence Tomography. N Y Sci J 2020;13(1):48-55]. ISSN 1554-0200 (print); ISSN 2375-723X (online). http://www.sciencepub.net/newyork. 7. doi:10.7537/marsnys130120.07.

Keywords: Chorioretinal Changes, Posterior Uveitis, Optical Coherence Tomography

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Hysteroscopy versus 3D Ultrasound in detecting uterine cavity abnormalities in infertile patients with Endometriosis

Islam Ibrahim Mashaal, M.Sc.; Safaa Kamal Marei, M.D.; Manal Fathy Hamisa, M.D. and Mohamed Ahmed Talat El Sharawy, M.D.

Department of Obstetrics and Gynecology, Faculty of Medicine, Tanta University, Egypt

Abstract: Objective: The objective of this study is to compare hysteroscopy versus 3D ultrasound, in detecting abnormal uterine cavity lesions in infertile women suffering from endometriosis. Study design: 3DTVUS was done followed by hysteroscopy for all cases (number=50). Data obtained were compared and analyzed to estimate the accuracy of 3DTVUS Results: There was statistically significant agreement between 3D ultrasonography and hysteroscope in overall diagnosis of abnormal uterine findings (P value <0.001 and Kappa 0.794). As regards prediction of uterine anomalies, 3D U/S showed 73.7% sensitivity, 100% specificity, 100% positive predictive value (PPV), 89.7% negative predictive value (NPV), and 92% test accuracy. Conclusion: The 3D TVS is a sensitive method to diagnose the endometrial cavity lesions or abnormalities. It is relatively inexpensive, is not time-consuming, non-invasive and can be performed in settings. 3D sonography has a high level of accuracy for most uterine anomalies. Thus, routine use of three dimensional transvaginal ultrasound is a sensitive method to evaluate the endometrial cavity lesions or abnormalities, before resorting to invasive procedures such as hysteroscopy. Hysteroscopy should be resorted to in cases of doubtful lesions as it can detect small intrauterine lesions which could be missed by TVS. Moreover, hysteroscopy is the gold standard for evaluation of uterine causes of infertility as it allows direct visualization of the uterine cavity.

[Islam Ibrahim Mashaal, Safaa Kamal Marei, Manal Fathy Hamisa, and Mohamed Ahmed Talat El Sharawy. Hysteroscopy versus 3D Ultrasound in detecting uterine cavity abnormalities in infertile patients with Endometriosis. N Y Sci J 2020;13(1):56-66]. ISSN 1554-0200 (print); ISSN 2375-723X (online). http://www.sciencepub.net/newyork. 8. doi:10.7537/marsnys130120.08.

Keywords: 3DTVUS, hysteroscopy, uterine cavity, Endometriosis

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[N Y Sci J 2020;13(1):67-73]. ISSN 1554-0200 (print); ISSN 2375-723X (online). http://www.sciencepub.net/newyork. 9.

withdrawn

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Functional and Structural Correlation in Wet Age Related Macular Degeneration after Ranibizumab Injection

Mai Barakat Al Helaly (MSCH), Tamer El-Sayed Wasfy (MD), Magdy Salah Moussa (MD), Yasser Ragab Serag (MD).

Ophthalmology Department, Faculty of Medicine, Tanta University, Tanta, Egypt

Abstract: Background and aim: Age related macular degeneration (AMD) is a major cause of visual impairment in the elderly in developed countries. Choroidal Neovascular Membrane (CNV) accounts for about 80% of severe vision loss in AMD patients. The aim of this study is to correlate macular structure assessed by optical coherence tomography (OCT) with macular function assessed by multifocal electroretinography (mfERG) and best corrected visual acuity (BCVA) in cases of neovascular age related macular degeneration (nvAMD) before and after intravitreal injection of Ranibazumab. Patient and methods: A prospective study was carried out on 30 eyes of 27 patients with nvAMD who underwent full ophthalmological evaluation including BCVA, macular SD-OCT and mfERG. Ellipsoid zone (EZ) was assessed at the fovea and 500µ temporal, superior, nasal and inferior. mfERG responses were recorded in R1 and R2. BCVA, SD-OCT and mfERG were compared before and 1 month after 3 loading doses of intravitreal Ranibizumab injection. Results: BCVA improvement and EZ restoration were positively correlated but not statistically significant. Improvement of BCVA was correlated with the improvement in P1 response density and Avg P1+P2 amplitude in R1+R2. EZ restoration was associated with increased N1 amplitude in R1 and with increased Avg P1+P2 amplitude. BCVA and EZ were not correlated with P1 amplitude or P1 latency. Conclusion: mfERG is an objective test that has the potential to be used in the follow up of nvAMD cases after Ranibizumab injection.

[Mai Barakat Al Helaly, Tamer El-Sayed Wasfy, Magdy Salah Moussa, Yasser Ragab Serag. Functional and Structural Correlation in Wet Age Related Macular Degeneration after Ranibizumab Injection. N Y Sci J 2020;13(1):74-79]. ISSN 1554-0200 (print); ISSN 2375-723X (online). http://www.sciencepub.net/newyork. 10. doi:10.7537/marsnys130120.10.

Key words: neovascular age related macular degeneration, Ellipsoid zone, mfERG, BCVA

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Laparoscopic repair of cesarean scar defect

Mohamed Mahmoud Elsayed*, Ayman Shehata Dawood, Hesham Mohamed Borg, Hesham Abdelaziz Salem

Department of Obstetrics and Gynecology, Faculty of Medicine, Tanta University, Tanta, Egypt

E-mail: senior alves112@gmail.com

Abstract: Background: The aim of this study istoevaluate the feasibility, efficacy and outcome of laparoscopic repair of cesarean scar defect. Methods: This is a prospective cohort clinical study conducted on (19) patients with Cesarean Scard effect attending Obstetrics and Gynecology Department in Tanta University Hospital under went laparoscopic repair of the defect and follow up by Transvaginal Ultrasound and MRI after three months for the remaining myometrial thickness and improvement of symptoms. Results: This study was conducted on (19) patients with CS defect attended Obstetrics and Gynecology Department in Tanta University Hospital. Two patients were missed during the follow up and were excluded from the data analysis. So the number of participating women was 17 case under went laparoscopic repair and showed significant improvement of symptoms and postoperative anatomic outcomes. Conclusions: Laparoscopic repair of cesarean scar defect in symptomatic patients with abnormal uterine bleeding, dysmenorrhea, chronicpelvic pain and/or infertility showed significant improvement of symptoms and good postoperative  anatomic outcomes.

[

Mohamed Mahmoud Elsayed, Ayman Shehata Dawood, Hesham Mohamed Borg, Hesham Abdelaziz Salem. Laparoscopic repair of cesarean scar defect. N Y Sci J 2020;13(1):80-85]. ISSN 1554-0200 (print); ISSN 2375-723X (online). http://www.sciencepub.net/newyork. 11. doi:10.7537/marsnys130120.11.

Keywords: Cesarean section, Complications of Cesarean section, cesarean scar defect, Ultrasonography, MRI, Laparoscopy, Repair of isthmocele.

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Oral Dydrogesterone versus Vaginal Progesterone in Luteal Phase Support in Assisted Reproductive Technique

Nahla Abd El Maboud El Behery*, Ahmed Mohamed Othman, Ashraf El Mohammady Ghareeb

Department of Obstetrics and Gynecology, Tanta University, Tanta, Egypt

E-mail: dr_nahoola@yahoo.com

Abstract: Background: The aim of this study is to compare oral progesterone (Dydrogesterone) with vaginal progesterone suppository for luteal phase support as regard pregnancy rate in ICSI cycles. Methods: This is a prospective, randomized clinical trial conducted on (40) females < 40 years old. with Infertility duration less than 5 years with Regular menstrual cycle attends to inpatients and outpatient’s clinic of Obstetrics & Gynecology department, Tanta University Hospitals. Twenty patients received 10 mg dydrogesterone tablet (Tonadogest; Techno pharma; Egypt) four times daily and Twenty patients received 400mg vaginal progesterone suppository (Prontogest; Marcyrl; Egypt) twice daily from the day of oocyte retrieval until a pregnancy test become positive and continue till 10 weeks. Results: No difference between oral dydrogesterone and vaginal progesterone in luteal support of IVF/ICSI stimulated cycles according to pregnancy rate and Oral dydrogesterone show better patient satisfaction. Conclusions: There is potential benefits for pregnancy and miscarriage rate with both drugs. oral dydrogesterone can be alternative option instead of vaginal progesterone suppository for luteal phase support.

[Nahla Abd El Maboud El Behery, Ahmed Mohamed Othman, Ashraf El Mohammady Ghareeb. Oral Dydrogesterone versus Vaginal Progesterone in Luteal Phase Support in Assisted Reproductive Technique. N Y Sci J 2020;13(1):86-92]. ISSN 1554-0200 (print); ISSN 2375-723X (online). http://www.sciencepub.net/newyork. 12. doi:10.7537/marsnys130120.12.

Keywords: Luteal Phase Support, Oral Dydrogesterone, Vaginal Progesterone, Assisted Reproductive Technique

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Nexus between CO₂, Trade openness, Economic growth, and Health expenditures in Pakistan: An application of the ARDL bounds testing approach.

Rafid Ullah Khan, Liu Mina, Wajid Ali Khan, Fazal Qadeem, Seniha Rawal

School of Public affairs, Nanjing University of Science and technology China

Abstract: This study aims to examine the nexus between CO₂, trade openness, economic growth, and health expenditures in Pakistan. Health is a significant element for wealth and revenue growth. Great wellbeing prompts higher profitability levels. CO₂ is the most important GHG that damages the environment and affects people's health. At the same time, economic growth often negatively, and vice versa, affects health conditions. The study conducted auto-regressive distributive lag (ARDL) using time series data from 1990–2017. The study findings show that the health expenditure, CO₂ emissions, and economic growth in Pakistan are significantly related both in the long-time period as well as in the short-term period. The bidirectional relationship of Granger causality was examined that health expenditures are the cause of CO₂ while there is no causality running from health expenditures to economic growth and trade openness. CO₂ emissions are not the Granger cause of health expenditures and TOP, while carbon emissions have a certain predictive effect on economic growth. GDP is not the Granger cause of HE and TOP, but there is a causality running from GDP to CO₂. Trade openness is not the granger cause of health expenditures, CO₂, and GDP.

[Rafid Ullah Khan, Liu Mina, Wajid Ali Khan, Fazal Qadeem, Seniha Rawal. Nexus between CO₂, Trade openness, Economic growth, and Health expenditures in Pakistan: An application of the ARDL bounds testing approach. N Y Sci J 2020;13(1):93-100]. ISSN 1554-0200 (print); ISSN 2375-723X (online). http://www.sciencepub.net/newyork. 13. doi:10.7537/marsnys130120.13.

Keywords: CO₂ emissions, Health expenditures, Trade openness, ARDL, Granger Causality

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CHA₂DS₂-VascHSF Score as a Predictor of No-Reflow in Patients with ST-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Intervention

Ahmed Muhammed Rashad MSc, Magdy M. El-Masry MD, Sahar A. El-Shedoudy MD and Ayman A. El-Sheikh MD.

Cardiology Department, Faculty of Medicine, Tanta University, Egypt

Abstract: Background: Primary percutaneous coronary intervention is the preferred reperfusion strategy used in patients with acute STEMI to prevent progression of myocardial necrosis. Besides the advantages of this strategy, there are situations in which myocardial reperfusion is not restored to its optimal level. Angiographic no-reflow phenomenon, a reduced coronary antegrade flow (TIMI flow grade ≤ 2 ) without mechanical obstruction after recanalization, predicts poor LV functional recovery and survival in the early phase of STEMI1. The no-reflow phenomenon is critical and, if not reversed, causes a high rate of morbidity and mortality. CHA₂DS₂-VASc score is used to estimate the risk of thromboembolism in patients with atrial fibrillation2. Objectives: The aim of this study was to evaluate the new CHA₂DS₂-VASc HSF Score as a predictor of no-reflow in patients who underwent primary percutaneous intervention. Methods: The present study was conducted on 100 patients admitted with STEMI and treated with 1ry PCI at cardiovascular medicine department Tanta University Hospitals within 6 months from June 2018 to December 2018. Patients were divided into 2 groups according to no-reflow phenomenon. Group 1 consisted of 34 patients that had noreflow phenomenon & group 2 consisted of 66 patients that had normal flow after primary PCI. Results: The occurrence of no-reflow phenomenon after primary PCI can be predicted using the simple CHA₂DS₂-VASc HSF Scoring system with 73.53 % sensitivity and 66.67 % specificity for a cut off level of ≥ 3 with (P=0.002). Conclusion: CHA₂DS₂-VASc HSF score can be used as a new, simple, and reliable tool to predict noreflow in patients with ST elevation myocardial infarction who underwent primary percutaneous coronary intervention.

[Ahmed Muhammed Rashad, Magdy M. El-Masry, Sahar A. El-Shedoudy and Ayman A. El-Sheikh. CHA₂DS₂-VASc HSF Score as a Predictor of No-Reflow in Patients with ST-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Intervention. N Y Sci J 2020;13(1):101-107]. ISSN 1554-0200 (print); ISSN 2375-723X (online). http://www.sciencepub.net/newyork. 14. doi:10.7537/marsnys130120.14.

Key Words: Percutaneous coronary intervention – ST segment elevation acute myocardial infarction –No-reflow phenomenon

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