Contraceptive intrauterine device (IUD) is a successful method of contraception which has been used for more than 30 years. The objectives of our study were to evaluate the correlation between abnormal uterine bleeding in IUD users and uterine artery Doppler [pulsitility index (PI); Resistant index (RI)] using transvaginal ultrasound and Doppler. The study included 120 women from obstetrics and gynecology department Hospital. ,divided into three groups: Group I included forty female using coipper intrauterine device withbleeding Group II included forty female using CIUD without bleeding. Group III included forty ladies as a control group. All fulfill the inclusion and exclusion criteria History was obtained. Examination was done: Routine investigations: The Results Of This Work Were:- As regard to Doppler findings, it was noted that RI was significantly lower in group I in comparison to group II and group III and Pulsitility index (PI) followed the same pattern as RI. We can conclude that detection of PI and RI in the uterine artery could be used to identify patients at risk of developing excessive bleeding after copper IUD insertion.

Aim: In some regionsof Bayannaoer arsenicconcentration in well drinking water is higherthan the international standard of 10 µg/L. The purpose of this study is to evaluate the impact of exposures to arsenic in drinking water on generalized anxiety disorder (GAD). Materials and Methods: Asurvey was conducted in2016 among villagers in Hangjinhou County,Bayannaoer City, Inner Mongolia. A questionnaire was used to inquire about GAD, arsenic related neurological symptoms. Arsenic concentration in the water was measured and arsenicosis prevalence was assessed. Multinomial logistic regression and ordinal logistic regression were performed to evaluate the association of abnormal arsenic levels on increased GAD symptoms. Results: 446 participants were enrolled. Subjectswith exposure to water arseniclevels>10 µg/L were significantly more likely to have mild GAD than controls (adjusted odds ratio [AOR] =2.3, 95% confidence interval [CI], 1.1-4.8). Participants who were diagnosed with arsenicosis were more likely to report mild anxiety than minimal anxiety compared to those who did not (AOR=2.3, 95% CI, 1.3-4.1). Survey respondents with palpitations, forgetfulness, headaches, dizziness, decreased taste, decreased hearing,loss of touch,abnormal warm and cold sensation, blurred vision, numbness and tingling were more likely to report mild, moderate and severe anxiety. Conclusions: Arsenic exposure was associated with a higher risk of GAD. Screening for arsenic exposure should be incorporated into the evaluation of GAD, in areas where arsenic in drinking water is known to be abnormal.

Background: Surgical site infections (SSIs) pose considerable morbidity and account for up to 20% of all nosocomial infections in surgical patients Aim of the Work: to determine the efficacy & safety of irrigation of subcutaneous tissue by Gentamicin for caesarean section Incision in reducing the risk of post-caesarean wound complications among obese women compared with placebo. Patients and Methods: This prospective randomized clinical trial study was conducted on total 132 obese patients who underwent elective cesarean section at Ain Shams University Maternity hospitals. This study was conducted on obese women undergoing caesarean section at Ain Shams University Maternity Hospital with the following inclusion and exclusion criteria. Patients were distributed randomly into 2 groups using a computer based program: Group (A) N = 66: CS with Irrigation of subcutaneous tissue by placebo (200 ml of saline 0.9 %). Group (B) N = 66: CS with irrigation of subcutaneous tissue by Gentamicin solution (1mg/kg gentamicin in 200 ml of saline 0.9%). Results: The results of this study revealed that the rate of SSI was less in gentamycin (3%) (n=2/66) than control group (4.5%) (n=3/66) with no statistical significance between them. Postoperative hospital stay and readmission rate due to SSI for the gentamycin group were also shorter but not statistically different in compared to the control group. Applying local gentamycin antibiotic irrigation during wound closure after cesarean section in obese patients is not recommended. NO role of local gentamycin irrigation in subcutaneous tissue in prevention of wound surgical site infection. Conclusion: as evident from the current study, in obese women undergoing elective CS, wound irrigation with Gentamicin is not superior to wound irrigation with placebo (saline 0.9) regarding efficacy & safety.

Background: It is well known that clear cell carcinoma of the ovary (CCC) demonstrates different clinical behaviors from other epithelial ovarian cancer and has strong association with endometriosis, thromboembolic complication, hypercalcemia, and large pelvic mass. The introduction of cisplatin-based chemotherapy significantly changed the postoperative management of ovarian cancer patients. Different studies showed a better response rate of CCC to chemotherapy with paclitaxel plus carboplatin regime than with the conventional platinum-based regimens. Aim: The purpose of this study was to evaluate the patients’ clinical characteristics and treatment results for clear cell carcinoma (CCC) of the ovary treated in paclitaxel-platinum chemotherapy in comparison with those treated in conventional platinum-based chemotherapy after primary surgery Methods: We retrospectively reviewed the medical records of 40 patients with CCC who received treatment in the department of obstetrics and gynecology, Samsung Medical Center from March, 1996 to April 2006. The clinical characteristics, treatment results and follow-up data were collected from medical records and/or telephone surveys. Results: Mean age was 47 years (range 30–72 years). Patients with age less than 50years were 62.5%. Tumors were 15% (6/40) stage IA, 2.5% (1/40) stage IB, 37.5% (15/40) stage IC, 5% (2/40) stage II, 32.5% (13/40) stage III, and 7.5% (3/40) stage IV. Patients with CCC were more likely to have FIGO stage I & II disease than FIGO stage III & IV (60% vs. 40%). Five-year progression-free survival and overall survival were 91% and 80% in stage I & II, 36% and 55% in stage III & IV, respectively (5-yr PFS; P<0.01, 5-yr OS; P=0.03). With a median follow-up of 45 months (2-112 months), 75% (18/24) of stage I/II patients are alive, while 19% (3/16) of stage III/IV patients are alive. 37.5% (15/40) of the patients presented with endometriosis. Except for one patient who was referred by a local clinic, all patients underwent cytoreductive surgery. The rate of optimal debulking (= 1cm residual tumor diameter) was 90% (36/40). Overall, for women treated with platinum-based chemotherapy, 75% (27/36) had clinically complete responses to adjuvant chemotherapy. But there was no survival benefit according to chemotherapeutic differences in the patients who received cytoreductive surgery followed between conventional platinum-based chemotherapy (CAP or CP) and by paclitaxel and platinum-based chemotherapy (P=0.40). Univariate analysis showed that stage was the only favorable prognostic factor for women with clear cell carcinoma of the ovary (P=0.04). Conclusions: Our results suggest that CCC has a distinct clinical behavior, similar to previous studies, that frequently presents at early- stages and is associated with endometriosis. In addition, there was a close correlation between the level of CA-125 and survival, and there was no survival benefit according to chemotherapeutic differences. ?CAP (CP) VS TP(TC)?

Background: Teenage pregnancy is a major threat to adolescent health globally which remains a challenging issue requiring urgent resolution over the world. Objectives: To find out to awareness and attitude regarding teenage pregnancy among adolescent girls. Materials and Methods: A descriptive cross- sectional design was carried out among 334 adolescent girls of school students of Chandannath Municipality, Jumla. Results: More than half of adolescent girls (68%) had inadequate, 26% had moderate and least 6% had adequate awareness regarding teenage pregnancy. However, majority (58.1%) of adolescent girls had favorable attitude, that they believed teenage pregnancy as wrong while only (34.4%) of them had neutral attitude and least (7.5%) of them had unfavorable attitude which support teenage pregnancy. There was no relation between awareness and attitude regarding teenage pregnancy and types of family, level of education of father and mother. Conclusion: In this study, half of respondents had inadequate awareness regarding teenage pregnancy even though majority of them had favorable attitude regarding teenage pregnancy. There was no significant difference between demographic variables with awareness and attitude regarding teenage pregnancy. The study had highlighted the need for awareness program regarding teenage pregnancy in school as well as in community.