Background: Teenage pregnancy is a social problem distributed worldwide, has many significantimplications on mother and her baby, specifically, in developing countries. The risk of adolescentpregnancy and outcome remains a public health problem in both developed and undevelopedcountries, which leads to maternal and neonatal morbidity and mortality.Patients and methods:This is a prospective study that included 200 teenage pregnant mothers who admitted to normallabor room for delivery or those who attended to outpatient obstetric clinic at Qena UniversityHospital "between April 2019 to April 2020". Information about socio- demographic data, medicalhistory, reproductive history, current pregnancy and its complications and delivery and its outcomesare btained. Clinical examinations, Laboratory and postoperative assessment of the mother for pospartumhemorrhage was done, also assessment of newborns for Apgar score after 1 and 5 minuteswas done. Then follow up of mothers till the end of perperium and assess breast feeding.Results: The results were analyzed using Chi-square(x2) test. P (predictive) value of <0.05 wereconsidered as a significant association between sociodemographic characteristics. Also there issignificant relationship between extended family and complications of pregnancy.Conclusion: The study determined that the majority of the teenage pregnant mothers were illiterate,housewives, moderate economic status, passive smokers, and without past medical diseases,neglected the antenatal care. Risk of preeclampsia and low Apgar score were higher among teenagepregnant mothers.Recommendations: The study recommends that on pregnant teenager to have appropriate antenatalcare as well as social support to avoid medical problems during pregnancy.
Background: Freezing of embryos and gametes is considered one of the corner stones ofART. Its application increases both IVF safety and efficiency.Aim and objectives: the aim of the present study is to compare cleaved embryo andblastocyst freezing to determine the optimal time for embryo cryopreservation,Subjects and methods: A randomized clinical trial, it was involved 300 cases of infertilepatients who will undergo ICSI cycles and embryo freezing at the assisted reproductionunit, Qena University hospital, South Valley University, Egypt after complete infertilityevaluation. Population was divided into two groups: Group 1 (n =150), underwent embryofreezing at day 3 then will undergo FET (Cleaved embryo). Group 2 (n =150), willunderwent embryo freezing at day 5 then will undergo FET (Blastocyst) The duration ofthe study had been from 6 to 12 months,Results: the results revealed that there is high significant difference between the studiedgroups as regard Total number of survival more survival was observed in blastocystgroup, while there is no significant difference between the studied groups as regardcompleted transfer.Conclusion: The maintenance of embryo culture until day 5 may be a more sensibleapproach for the correct identification of best quality embryos with the highest probabilityof success for both transfer and freezing.
Background: Worldwide hysterectomy is the most commonly performed major gynecologicalsurgical procedure. Benign diseases are responsible for more than 70% of the indications forhysterectomy include menstrual disorders, myomas, pelvic pain, and uterine prolapse.Objectives: to determine outcomes of total laparoscopic hysterectomy in Qena University Hospitalas regard of operative time, hospital stay and complications.Patients and Methods: This was a descriptive observational clinical study. It was conducted on 50cases in the period between April 2016 to march 2019 (3 years). Patients with differentindications for hysterectomy were recruited from the outpatient clinic of department of obstetricsand gynecology, Qena University hospital, South Valley University, Egypt after completeevaluation.Results: it was clear that (40%) heavy menstrual bleeding/ fibroid; (50%) had endometrialhyperplasia and (10%) had other diagnosis. Regarding operative time distribution, our resultsshowed that (70%) had operative time <90 min; (28%) were 90-120 min and (2%) were >120min.In our study there were no operative complications. Regarding estimated blood loss, (24%) hadestimated blood loss <120 ml, (22%) had estimated blood loss 170 ml and (54%) had estimatedblood loss >170 ml. Regarding post-operative complications , our results showed that that (4%)had fever more than 38 degree after the first 24h, (4%) had reactionary hemorrhage (vaginal orinternal) and (2%) had wound infection. In our study, it was obvious that the conversion tolaparotomy was (0%). post-operative pain was recognized by VAS. (70%) of the study group hadmild, (26%) had moderate, and (4%) had severe post-operative pain. Regarding the hospital staydistribution of the study group, it was found that (90%) stayed <48h, (6%) stayed 48-72 hrs and(4%) stayed >72 hrs.Conclusion: Total laparoscopic hysterectomy is safe and feasible method for gynecologicaldiseases. TLH may offer specific benefits for properly selected patients. Its advantages are lowerpost-operative complications, less postoperative pain, shorter hospital stay and faster return toactivity.
Background: A prospective randomized study was used to effect of urinary bladder catheterizationon UTI, time of first-void discomfort, time of ambulation, hospital stay, and urinary retention inwomen undergoing cesarean section.Objectives: The aim of study was to assess the feasibility and outcome of cesarean section withoutFoley's Catheter.Patients and Methods: This Study included 100womens who had the Foley's catheter inserted justbefore cesarean section and 100womens who had not use Foley's catheter during section inObstetric and Gynacology department in Qena University Hospital. Prospective method were usedto assess patient discomfort with the first postoperative void after , time of ambulation , timehospital stay and need for cathetherization.Result: This study included 200 patients 100 patient with urinary catheter and 100 without urinarycatheter mean age of the studied group 25.8±5.5, mean gestational age 37.9 ±1.1 weeks, mean forNo. of C.S 1.08±.7, mean duration of C.S 48.5 ±5 minutes. 99% of patients have no bladder injurywhile 1% have bladder injury.99%of patients complaining of urine retention .mean time of retention4.8 minutes .mean for post voiding volume 18.02 cc. 4%of patient complaining of voidingdifficulty.6.5% of patients complaining of dysuria . urine analysis before C.S(pus cell) 4.2 ±1.43Urine analysis after 1 week 33.3 ±5.8Uncatheterized patients had a shorter hospital stay.Conclusion: Routine use of indwelling urinary catheter in cesarean section patient with a stablehemodynamic condition is not necessary.
Background: The Desarda repair technique of inguinal hernia repair introduced in 2001 is still notconsidered standard tissue based hernia repair technique. We compared the tissue based Desarda techniquewith standard Lichtenstein repair in treatment of primary inguinal hernia.Objectives: The aim of this study was to compare the short term outcomes of Desarda technique versusLichtenstein hernioplasty in inguinal hernia repair.Patients and methods: A total of 81 participants (41 in the Lichtenstein arm and 40 in the Desarda arm)were enrolled into this single centre double-blind randomised controlled trial. The outcome measures wereevaluated at 1–2 h, 3, 7 and 14 days. The primary outcomes measured were recurrence and chronic pain. Inaddition to early and late complications, foreign body sensation, and return to everyday activity whichexamined and evaluated in hospital after surgery.Results: During one year follow up, no recurrence was detected in each group . Chronic groin pain wasexperienced by 5.6% and 4.2% of patients from Desarda and Lichtenstein groups respectively (P = 0.68).There was no significant statistical difference in mean postoperative VAS scores for pain at the five timepoints between the two study groups. There was significantly shorter operating time and earlier return tonormal gait in favor of Desarda repair. Foreign body sensation was not different between the two groups..Conclusions: Successful inguinal hernia treatment without mesh implantation can be achieved usingDesarda repair, as it is effective as the standard Lichtenstein procedure. Shorter operating time, early returnto normal gait and lower cost (no mesh) are potential benefits of Desarda repair. The suitability of Desardarepair for patients found to have thin, weak or divided external oblique aponeurosis intraoperatively needsfurther evaluation.
Oncoplastic medical procedure consolidates plastic careful systems with sound careful oncologicstandards. The objective is to totally extract the malignant growth, with wide careful edges whilekeeping up or improving cosmesis. For huge, inadequately characterized, or ominously arrangedtumors, standard lumpectomies may prompt unsuitable restorative outcomes notwithstandingclose or included resection edges. Comparable issues may happen for littler tumors in littlebosoms. Joining of the two careful orders evades or limits poor restorative outcomes after wideextraction. It builds the quantity of ladies who can be treated with breast‐conserving medicalprocedure by permitting bigger bosom extractions with progressively satisfactory correctiveoutcomes. Oncoplastic medical procedure requires a multidisciplinary approach and exhaustivepreoperative arranging. It is totally important to enroll the participation and coordination ofcareful oncology, plastic medical procedure, radiology, pathology, restorative oncology, andradiation oncology. Oncoplastic medical procedure requires a way of thinking that the presenceof the bosom after tumor extraction is significant.
Background: The role of first-trimester history-indicated cerclage among women with a twinpregnancy and a history of preterm birth have not been evaluated.Objectives; to evaluate the value of cervical cerclage in twin pregnancies as regard ofPregnancy outcomePatients and methods:This is a prospective cohort study was performed in Obstetrics and Gynecology Department QenaUniversity Hospital, during a period from 1 march 2019 to 1 march 2020". Information aboutdemographic data, medical history, reproductive history, current pregnancy and its complicationsand delivery and its outcomes are obtained.Clinical examinations, laboratory and ultrasonicassessment of studied group.Result:98 pregnant women involved in the study andgestational age at delivery of the studied group < br />show that 11(11.2%) their gestational age at delivery was ranged between 12-<28 weeks and25(25.5%) their gestational Age at delivery was ranged between 28-<37 weeksand 62(63.3%) theirgestational age at delivery was ranged between 37-40 weeks.Neonatal deaths of studiedgroupwere17(9.77%)of total number (174) of newborns of studiedgroup < br />Conclusion: History-indicated cervical cerclage performed in women with a twin gestation and ahistory of preterm birth appeared to have an overall positive effect on maternal and neonataloutcomes, as evidenced by significantly reduced rates of PPROM, preterm delivery and neonatalmorbidity and mortality.
Objectives: to estimate the effect of complement level changes on clinical manifestations, visceral damage andmortality in our patients with SLE.Patients and method(s): A cross sectional study including 50 patients attending to South Valley UniversityHospitals have been included in the study for assessment of complement levels in patients with SLE andcorrelating complement levels with renal, neuropsychiatric, cardiac and hematological manifestations of SLE.Result(s): The most common organ system involved was the musculoskeletal system, with arthritis in 76% ofthe cases. This was followed by cutaneous manifestations (72%), then lupus nephritis (62%), CNS lupus (44%),hematological (30%) and lastly CVS (12%). Non of our cases showed liver impairment. Around two thirds ofpatients with renal involvement had consumed complement, compared to only 26% among those with no renalinvolvement; with a significant difference. It also shows that there is no significant difference betweenhypertension and complement level. Over 72% of patients with CNS involvement had consumed complement,compared to only 32% among those with no CNS involvement; with a significant difference. There is nosignificant relation between blood disorders, arthritis, mucocutaneous in lupus patients and complementconsumption.Conclusion: Our study suggested that complement consumption was strongly associated with lupus nephritisand to a lesser extent; CNS lupus, but not with other organ involvement in SLE patients.
Back ground: Diabetes is one of the commonest and important metabolic disorders that affect thehealth of pregnant women and infant. About 3-10% of all pregnancies complicated by diabetesmellitus. There are two types of diabetes that occur in pregnancy, first is gestational diabetes thatfirst diagnosed during pregnancy and pre-gestational diabetes which starts before pregnancy.Adverse outcome are not confined to pre-gestational diabetes alone. Maternal and infant morbidityand mortality are also high amongst gestational diabetes.Objective: To detect relative frequency of various neonatal complications in infants born todiabetic mothers at Qena University Hospital and other hospitals inside Qena Governorate.Patients and methods: This is a cohort prospective study of neonates admitted at NICUdepartment or attended the outpatient clinic of nursery of Qena University Hospital and otherhospital inside Qena Governorate between April 2018 to March 2019.Results: In this cohort prospective study that included all patients who were either admitted atNICU department or attended the outpatients clinic of nursery at Qena University Hospital andother hospitals inside Qena Governorate between April 2018 to March 2019. Clinical evaluationwere done on 220 cases during the period of the study. The age of the patients ranged with a meanandSD1.2 + .7days, 164 infants have complications in our study with different presentations asdifficult breathing (54.5%), cyanosis(16.8%), jitterness(14.5%), yellowish discoloration(16.8%).The relative frequency of complications were, respiratory(54.5%), metabolic(39.5%),cardiac(16.8%), jaundice(16.8%), macrosomia(12.3%), skeletal(9.5%), hematological(8.6%) andneurological(5%).Conclusion: Bothmaternal diabetes ,gestational and pre-gestational diabetes mellitus lead tocomplications in infants born to those mothers. Respiratory complications were the most commoncomplications among the cases. Cardiac, macrosomia and neurological complications were higherin pre-gestational diabetes than gestational diabetes.
Background: Iron deficiency anemia (IDA) and beta thalassemia trait (β-TT) are most common causesof microcytic hypochromic anemia. When the diagnosis of iron deficiency anemia and thalassemiaminor, is based only on hematological parameters and erythrocyte morphology, It is necessary to carryout the gold standard tests to differentiate between these two types of anemia, once the therapeuticconduct is distinct for each case.Objective: This study aims to validate the red blood cell distribution width (RDW) for discriminationand differentiation between iron deficiency anaemia from beta thalassemia trait in Qena UniversityHospital.Patients and method(s): This study is a prospective descriptive hospital based study included 30patients (13 male and 17 female) who presented with microcytic hypochromic anemia by CBC notresponding to iron therapy and suspected as β-TT at pediatric outpatient clinic of Qena UniversityHospital and their ages ranging from 1 year to 10.5 years from January 2018 until December 2018.Result(s):This study is a prospective descriptive hospital based study included 30 patients with age ofthe patients ranges from 1 to 10.5 years .The data showed insignificant increase of red cell distributionwidth of RBCs among the studied cases of BTT group (18.06±3.51) compared to IDA group < br />(18.76±2.77)withp value < 0.584.Conclusion:Our study concluded that RDW adds useful but limited information in discrimination betweenβ-TT and IDA. So, iron profile and HbA2arestill the gold standard for differentiation between β-TT andIDA.