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Biomedical subjects

Mamdoh Eskandar

Publications and source records attributed to Mamdoh Eskandar.

4 recordsLinked to original sources

Multiple repeat caesarean sections: complications and outcomes.

OBJECTIVE: To compare the complications and outcomes of Caesarean section (CS) in women who have had three or more previous lower segment Caesarean sections with those in women with one previous CS. METHODS: We performed a retrospective study of 371 patients undergoing repeat CS. Of these, 115 (31%) had previously had three or more Caesarean sections (group 1) and 256 (69%) had previously had one CS (group 2). All 371 patients had the repeat CS performed at Abha Maternity Hospital, Saudi Arabia between June 2002 and May 2004. Demographic data, complications, and outcomes were compared using the Student t and chi-square tests. RESULTS: There were statistically significant differences between the two groups with respect to mean maternal age, parity, gestation at delivery, and experience of the surgeon (P < 0.05). CS was performed as an emergency in 38 (32.9%) and 186 (72.6%) of patients in groups 1 and 2 respectively (P < 0.05). The consultant was involved in the decision to perform CS in 215 (84.6%) of patients with one previous CS. There were significant differences between the two groups in the type of skin incision, the presence of dense adhesions during surgery, and bladder injury (P < 0.05). There were no statistically significant differences in birth weight, stillbirth rate, low Apgar score, blood loss during surgery, duration of surgery, or the duration of postoperative hospital stay. CONCLUSION: The prevalence of dense intra-abdominal adhesions and of bladder injury during CS was higher in women with a history of three or more previous CS than in women with one previous CS. Placenta previa and Caesarean hysterectomy occurred with equal frequency in each group, and wound dehiscence and uterine rupture were rare.

Adult↗

Is recombinant follicle-stimulating hormone more effective in IVF poor responders than human menopausal gonadotrophins?

BACKGROUND: The objective of this study was to determine if the recombinant human follicle-stimulating hormone (rFSH) is more effective than human menopausal gonadotrophin (hMG) in IVF poor responders. MATERIAL/METHODS: A prospective comparative study over a 2-year period. The setting was the Tertiary IVF Center, King Faisal Specialist Hospital and Research Center. A total of 150 patients were selected from 277 patients with poor response in previous hMG-stimulated cycles who were willing to undergo another cycle of treatment. Seventy-five patients stimulated with rFSH were compared with 75 control subjects (matched for age, early follicular phase FSH, and body mass index) stimulated with urinary hMG. The number of follicles, number of oocytes retrieved, cycle cancellations, and pregnancy rates were the main outcome measures. RESULTS: There were no statistical differences in numbers of follicles (6.2 versus 5.7; p=0.97), oocytes recovered (4 versus 3.3; p=0.15), cycle characteristics, or pregnancy rates between hMG- and rFSH-stimulated cycles (p=0.32). CONCLUSIONS: Recombinant follicle-stimulating hormone (rFSH) has no advantage over urinary human menopausal gonadotrophin (hMG) on ovarian performance or the outcome of IVF-ET in poor responders' IVF cycles.

Adult↗

Is 24-h sperm motility a useful IVF measure when male infertility is not apparent?

OBJECTIVE: To examine the relationship of 24-h sperm motility between post insemination and fertilization in vitro, in a population with no apparent semen abnormalities. A retrospective study from July 1998 to June 2000. MATERIAL AND METHODS: Four hundred and seventy-one consecutive in-vitro fertilization (IVF) cycles for which the primary diagnosis was not male infertility (total motility count > 40 x 106) were studied. Linear regression was used to examine the general relation between 24-h sperm motility and IVF. The cohort with 0% 24-h motility was compared with all other cycles using the t-test and the chi2-test. Test quality was assessed using the positive likelihood ratio. RESULTS: Overall fertilization was 58 +/- 16%. There were 45/471 cycles (9.5%) with zero fertilization. Linear regression of percent fertilization vs. 24-h motility showed no relationship (r = 0.01). The cohort with 0% 24-h motility had a lower fertilization rate 29 +/- 19% (P = 0.05), and had a higher incidence of no fertilization 7/21 (P = 0.01). The positive likelihood ratio was 4.6. CONCLUSIONS: Zero 24-h motility indicates occult male infertility, and a positive result indicates a fair to good test. Overall there was no relationship between sperm survival at 24 h post insemination and fertilization in vitro. However, 0% 24-h sperm motility was associated with reduced fertilization

Female↗

Right lower quadrant pain in females. Is it appendicitis or gynecological?

OBJECTIVE: To determine if a gynecological consultation is needed for patients who are labeled to have acute appendicitis. METHODS: A retrospective study carried out in Assir Central Hospital, Abha, Kingdom of Saudi Arabia. Fifteen female patients who were clinically diagnosed and operated upon for acute appendicitis were discovered intra-operatively to have unrelated gynecological lesions, are presented. RESULTS: Histopathological reports on the removed appendices revealed 80% "normal" and 20% "mildly inflamed". Seven (46.7%) of the patients had right ovarian cysts (one of them, bilateral); 4 (26.7%), corpus luteum cysts, and 4 had bilateral salpingitis, bilateral pyosalpinx, right ovarian cyst with bilateral salpingitis and ruptured right tubal pregnancy each. The majority (60%) of the women were in the 20-30-year-age bracket. CONCLUSION: The need for gynecological review of female patients of childbearing age presenting with lower abdominal pain is stressed. Ultrasonography is an important adjunct in improving diagnostic accuracy in such cases.

Abdominal Pain↗