First pages:

مستوى مصل الدم للهرمون مضاد مولر AMH كاداة تشخيصية للاستجابة لتحريض الاباضة في مرضى متلازمة المبيض المتعدد الكيسات PCOS == Serum Level Of AMH As A Prognostic Tool For Response To Ovulation Induction In Pcos Patients

Author name: فرح حسام الدين سعران

Supervisor name: صالحة علي حسين | بتول عبد الواحد

General topic: Medicine

Specific topic: Obstetrics and Gynecology

Degree: Higher Diploma

University: University of Kufa - Faculty Of Medicine - Department Of Obstetrics And Gynecology

Language: English

University location: Najaf

First pages:

Abstract: متلازمة المبيض المتعدد الكيسات (PCOS) هواضطراب شائع جدا التي تحدث في 4? الى 7? من النساء في سن الانجاب. من المعروف انPCOSغالبا ما يترافق مع الاصابة بالامراض التناسلية وزيادة خطرالاصابة بسرطان بطانة الرحم،والتشخيص له اهمية خاصة لانه يعتقد الان بانPCOS له ا | From the observation that some PCOS patients were known to have high serum level AMH and it has been shown to be useful in its diagnosis, however; the clinical significance of high serum AMH level in prediction of ovarian response to medical therapy was under studied we are doing this study aiming to test the value of serum AMH level as a marker of sever disease and may be subsequent resistance to medical therapy. (AMH) has glycoprotein dimmer structure.AMH is produced by the granulose cells. AMH level in the plasma of PCOS patient are two or three times higher than average and begin to decline five years later than healthy womenObjectivesThe main objective of the study is to estimate the AMH level as a prognostic factor in PCOS infertile women on ovulation induction, also to describe some risk factors of infertility and their association with the AMH level.MethodologyA cross sectional study has been carried out in the outpatient clinic at Al Sadr infertility center under supervision of specialist gynecologist on 60 patients. The data has been collected by a questionnaire which contains demographic characteristics, gynecological history, physical examination and some laboratory investigations. The data collected by simple random to select the case from the outpatient clinics in the fact of 4 - 5 infertile women one day/week, then a period of time required for following up them after the ovulation induction The data have been collected during the period from the 1st of February till the 30 of September 2015.ResultsThere was a high statistically significant difference (P 0.000) in mean AMH among the cases with negative PT from those with positive PT, also the higher level of AMH strongly linked (P 0.023) with the presence of acne as a symptom of PCOS. There was no correlation of AMH with the age, LH, FSH, prolactin, TSH, size of dominant follicle and infertility duration. While it was positively correlated (P 0.000) with the age of menarche, BMI (P 0.000), Serum testosterone (P 0.002) andendometrial thickness (P 0.000).Conclusions & RecommendationsAMH is a useful test to study folliculogenesis and ovarian potential in various situations of infertility and for identification of PCOS. High levels of AMH are commonly associated with pregnancy failure.So, a recommendation of AMH level measuring for all PCOS patients should be done in order to know the prognosis during the ovulation induction.

العلاقة بين البروتين التفاعلي عالي الدقة في حالات سمدمية الحمل مع او بدون تخلف نمو الجنين == Associationbetween Highly Sensitive C - Reactive Protein Level In Cases Of Preeclampsia With Or Without Intrauterine - Growth Restriction

Author name: روسم جاسم محمد

Supervisor name: الاء محمد صادق

General topic: Medicine

Specific topic: Obstetrics and Gynecology

Degree: Higher Diploma

University: University of Kufa - Faculty Of Medicine - Department Of Obstetrics And Gynecology

Language: English

University location: Najaf

First pages:

Abstract: سمدم?ةالحملھوخلل?ص?بتقر?با 4% منالنساءاثناءالحملوتترتبعل?ھمخاطركث?رةبالنسبةل?موالطفل. نعرفتسممالحملعللىانھا?صابةالحد?ثةغ?رالمسبوقةبارتفاعضغطالدماثناءالحملبعدا?سبوع 20 منالحملوالمصحوبةبوجودبروت?نفيالبول.البروت?نالتفاعليعاليالدقةھومؤشرك?م?ائيبامكانناق?اسھف | Preeclampsia is a hypertensive disorder that affects 4% of pregnant women , in which the exact cause cannot identified it is one of the major causes of maternal and fetal morbidity and mortality as it causes death of more than 6300 women annually , also it puts a burden on perinatal outcome as prematurity and Intrauterine growth restriction.Continuous search for predictive markers of severe PE is important and can be used to target high risk women for effective preventive treatment.Aim of study : to evaluate that Highly Sensitive C - Reactive Protein can be used as maker for severity of PE and whether it can be used to predict development of Intrauterine growth restrictionPatients and methods : this is convenient a cross - sectional study includes 80 pregnant women with their age 18 - 35 years , their gestational age 32 - 40 weeks , admitted to AL - Zahraa teaching hospital , whose diagnosed as PE based on BP and proteinurea. Full history and clinical examination were performed, venous blood aspirated for each women for biochemical analysis, Liver functions tests, Renal function tests Highly Sensitive C - Reactive Protein, and Doppler ultrasound.Results : The patients divided into those with mild PE and severe PE, with or without IUGR. No significant difference between the level of hsCRP and the severity of PE as p value was(0.779), but there is significant difference between the presence of IUGR and the level of hsCRP when it is 2mg/L as the p value was(0.020).Conclusion : We conclude that s.hsCRP is not sign

دراسة علاقة طول عنق الرحم المقاس بالسونار الداخلي مزامنة مع كمية السائل الامنيوسي في توقع وقت حدوث الولادة المبكرة خلال سبعة ايام من تمزق غشاء السائل الامنيوسي المبكر == Transvaginal Cervical Length & Amniotic Fluid Index : Can They Predict Delivery Latency Following Preterm Premature Rupture Of Membrane

Author name: وسن غائب حسون غائب

Supervisor name: امال منير مبارك

General topic: Medicine

Specific topic: Obstetrics and Gynecology

Degree: Higher Diploma

University: University of Kufa - Faculty Of Medicine - Department Of Obstetrics And Gynecology

Language: English

University location: Najaf

First pages:

Abstract: توقع حدوث الولادة عند الحوامل المصابات بتمزق غشاء السائل الامنيوسي المبكريساعد الحامل على تهيئه نفسها لدخول المستشفى لاجراء اللازم لها واعطاءالجرعةالمنشطةلرئة الطفل وادخاله الى وحده العناية المركزة لحديثي الولادة.هدف الدراسة : تهدف الدراسة الى قياس طول عن | Patients with PPROM are often hospitalized for a prolonged period of time and deliver premature infants who frequently require neonatal intensive care. These women and their infants contribute significantly to obstetric &neonatal health care costs. The prediction of delivery latency could help direct the need for specific interventions such as hospitalization, intensive monitoring, timing of antenatal steroids.Objective : To determine whether transvaginal CL, AFI,or a combination of both can predict delivery latency within 7 days in women presenting with PPROM.Methods and Study Design : This was a prospective observational study of TVCL measurements in 80 singleton pregnancies with PPROM between 24 - 34 weeks. Transvaginal ultrasonography was performed with TOSHIBA SSA - 340A(Tokyo - Japan) apparatus 7.5MHz transvaginal probe, to measure the CL&AFI. Delivery latency was defined as the period from the initial TVCL after PPROM to delivery of the baby with our primary outcome being delivery within 7 days of TVCL. The independent predictability of significant characteristics for delivery within 7 days was determined using multiple logistic regression.Sensitivity, specificity, and predictive values were used to determin, whether the presence of a short TVCL, AFI or a combination of both affected the risk of delivery within 7 days.Result : Our study in women with PPROM show the validity of CL in predicting labor when the cut off value2cm the sensitivity=52.6%, specificity=69%, PPV=60.6%, NPV =61.7% and Accuracy=61.25%.The validity of AFI when the cut off value 5cm the sensitivity=71.1%, specificity=50%, PPV=56.3%, NPV=65.6% and Accuracy=60%.With combination of CL&AFI in predicting time of labor after PPROM the sensitivity=50%, specificity=92.8%, PPV=86.4%, NPV=67.2% and Accuracy 72.5%.In women with PPROM the rate of gestational age ? 30 weeks that labored within 7 days 44.7% and those labored more than 7 days 55.3%.Also the rate of gestational age >30 weeks that delivered within and after 7 days are 50%.According to the parity we found the mean value of those delivered within 7 days are 1.24 and those after 7 days are 1.28.Conclusion : Our study shows there is increase in positive predictive value when combination of AFI and CL in prediction of time of labour so women with AFI?5 and CL?2 had 86.4% risk of delivery within 7 days after PPROM. Also the study found there was no significant association between gestational age, or parity with the prediction time of labor.

Author name: حسين مهدي حسين الخفاجي

Supervisor name: يسار محمد حسن الشماع

General topic: Medicine

Specific topic: Physiology

Degree: Doctorate

University: University of Kufa - Faculty Of Medicine - Department Of Physiology And Medical Physics

Language: English

University location: Najaf

First pages:

Abstract: في هذه الدراسة العرضية, تم اختيار 140 شخصا بصورة عشوائية, من بينهم 90 كان مصابا بالسكري والباقون كانوا سليمين ,لدراسة تاثير ارتداء طقم الاسنان الكلي والجزئي من قبل مرضى السكري على فحوصات كفاءة الرئتين وبالتحديد, , السعة الحيوية القسرية (FVC)و الحجم الزفير | In this cross sectional study, a total number of 140 subjects selected randomly, 90 of them were diabetic and the remaining were normal, to study the effect of complete and partial dentures wearing by diabetic patients on pulmonary function test particularly peak expiratory flow rate (PEFR), forced expiratory volume in the first second (FEV1), forced expiratory volume ratio (FEV1/FVC) ratio (FEV1%), forced vital capacity (FVC), and also the retropharyngeal space (RPS), the level of Endothelial selectin (E - selectin) and the level of Vascular Cell Adhesion Molecule - 1(VCAM - 1)was also compared, in this study, between the diabetic and the normal subjects.The results indicate that the spirolab III was accurate and reproducible and can be used in all related studies.The effect of wearing of complete and partial dentures by diabetic patients on FVC, FEV1, PEFR and also the degree of alteration of the RPS were measured.1) The results of the study shows a significant increase in values of FEV1, FEV1%, PEFR and retropharyngeal space (RPS) (p<0.05), while there was no significant change in the value of FVC after the replacement of complete denture.2) No statistically significant differences in the values of FVC, FEV1, FEV1%, PEFR and retropharyngeal space (RPS) was observed after replacement of partial denture without free end extension3) There was a significant increase in values of FEV1, FEV1%, PEFR and retropharyngeal space (RPS) (p<0.05), never the less there was no significant change in the value of FVC after the replacement partial denture with unilateral free end extension.4) There was a significant increase in values of FEV1, FEV1%, PEFR and retropharyngeal space (RPS) (p<0.05), However there was no significant change in the value of FVC after the replacement partial denture with bilateral free end extension5) The results showed that in poor and good control diabetic patients there was a significant decrease in the values of FEV1, PEFR, FEV1%and RPS after the removal of all types of dentures(p<0.05), while no significant change in FVC.6) Statistical significant increase in Serum E - selectin and VCAM - 1 level was found in diabetic patients when compared to that of the normal subjects (p<0.05).7) No statistical significant difference between serum E - selectin and VCAM - 1 level in diabetic patients after and before denture placement (p>0.05). The cause of the significant change in the values of FEV1, FEV1%, PEFR and retropharyngeal space (RPS) in case of complete and partial denture with free end extension replacement may be due to pressing of the retropharyngeal space bilaterally and unilaterally by the complete and partial denture and the FVC was not significantly changed because it may not be affected by denture support, while the elevated Serum E - selectin and VCAM - 1 level might indicate endothelial activation and inflammation.In conclusion we can conclude that 1. The spirolabIII used in this study is an accurate and reproducible device and can be used in the assessment of lung function test.2. Values of FEV1, FEV1%, PEFR and retropharyngeal space (RPS) where significantly higher after the replacement of complete denture and partial denture with bilateral and unilateral free end extension in diabetic patients (p<0.05), while there was no significant change in the value of FVC.3. No statistically significant differences in the values of FVC, FEV1, FEV1%, PEFR and retropharyngeal space (RPS) was observed after partial denture without free end extension has been replaced in diabetic patients.6. In poor and good control diabetic patients there was no significant change in the value of FVC, while the values of FEV1, PEFR, FEV1%and RPS where significantly decrease after the removal of all types of dentures.8. Statistical significant increase in Serum E - selectin and VCAM - 1 level was found in diabetic patients when compared to that of the normal subjects.9. The results for serum level of E - selectin and VCAM - 1 shows no significant difference diabetic patients after the placement of all types of dentures (p>0.05).