Objective: To evaluate the effect of long-term use of depot medroxyprogesterone acetate (DMPA) on bone mineral density (BMD). Methods: A cross-sectional study was performed with 150 women using DMPA and 136 women using nonhormonal methods of contraception in rural Sohag Governorate, Upper Egypt. Socioeconomic scores were measured using the 1983 Fahmy and El Sherbeny system, model II. The mineral density of the left calcaneus was measured by ultrasonographically. Results: If the overall mean T score was significantly lower for the DMPA than for the control group, osteopenia and osteoporosis were more prevalent among DMPA users only for participants of the lowest socioeconomic level. There was a mild negative correlation between duration of DMPA use and T score, and when contraception duration was considered the differences in T scores between the DMPA and control groups were significant. Conclusion: Prescribing DMPA only for the short term to women of a low socioeconomic level and counseling them about its effect on bone density may be a practical approach.

Objective: To evaluate the effect of long-term use of depot medroxyprogesterone acetate (DMPA) on bone mineral density (BMD). Methods: A cross-sectional study was performed with 150 women using DMPA and 136 women using nonhormonal methods of contraception in rural Sohag Governorate, Upper Egypt. Socioeconomic scores were measured using the 1983 Fahmy and El Sherbeny system, model II. The mineral density of the left calcaneus was measured by ultrasonographically. Results: If the overall mean T score was significantly lower for the DMPA than for the control group, osteopenia and osteoporosis were more prevalent among DMPA users only for participants of the lowest socioeconomic level. There was a mild negative correlation between duration of DMPA use and T score, and when contraception duration was considered the differences in T scores between the DMPA and control groups were significant. Conclusion: Prescribing DMPA only for the short term to women of a low socioeconomic level and counseling them about its effect on bone density may be a practical approach.

Objective: To evaluate the effect of long-term use of depot medroxyprogesterone acetate (DMPA) on bone mineral density (BMD). Methods: A cross-sectional study was performed with 150 women using DMPA and 136 women using nonhormonal methods of contraception in rural Sohag Governorate, Upper Egypt. Socioeconomic scores were measured using the 1983 Fahmy and El Sherbeny system, model II. The mineral density of the left calcaneus was measured by ultrasonographically. Results: If the overall mean T score was significantly lower for the DMPA than for the control group, osteopenia and osteoporosis were more prevalent among DMPA users only for participants of the lowest socioeconomic level. There was a mild negative correlation between duration of DMPA use and T score, and when contraception duration was considered the differences in T scores between the DMPA and control groups were significant. Conclusion: Prescribing DMPA only for the short term to women of a low socioeconomic level and counseling them about its effect on bone density may be a practical approach.

Objective: To evaluate the effect of long-term use of depot medroxyprogesterone acetate (DMPA) on bone mineral density (BMD). Methods: A cross-sectional study was performed with 150 women using DMPA and 136 women using nonhormonal methods of contraception in rural Sohag Governorate, Upper Egypt. Socioeconomic scores were measured using the 1983 Fahmy and El Sherbeny system, model II. The mineral density of the left calcaneus was measured by ultrasonographically. Results: If the overall mean T score was significantly lower for the DMPA than for the control group, osteopenia and osteoporosis were more prevalent among DMPA users only for participants of the lowest socioeconomic level. There was a mild negative correlation between duration of DMPA use and T score, and when contraception duration was considered the differences in T scores between the DMPA and control groups were significant. Conclusion: Prescribing DMPA only for the short term to women of a low socioeconomic level and counseling them about its effect on bone density may be a practical approach.

Objective: To evaluate the effect of long-term use of depot medroxyprogesterone acetate (DMPA) on bone mineral density (BMD). Methods: A cross-sectional study was performed with 150 women using DMPA and 136 women using nonhormonal methods of contraception in rural Sohag Governorate, Upper Egypt. Socioeconomic scores were measured using the 1983 Fahmy and El Sherbeny system, model II. The mineral density of the left calcaneus was measured by ultrasonographically. Results: If the overall mean T score was significantly lower for the DMPA than for the control group, osteopenia and osteoporosis were more prevalent among DMPA users only for participants of the lowest socioeconomic level. There was a mild negative correlation between duration of DMPA use and T score, and when contraception duration was considered the differences in T scores between the DMPA and control groups were significant. Conclusion: Prescribing DMPA only for the short term to women of a low socioeconomic level and counseling them about its effect on bone density may be a practical approach.

Objective: To evaluate the effect of long-term use of depot medroxyprogesterone acetate (DMPA) on bone mineral density (BMD). Methods: A cross-sectional study was performed with 150 women using DMPA and 136 women using nonhormonal methods of contraception in rural Sohag Governorate, Upper Egypt. Socioeconomic scores were measured using the 1983 Fahmy and El Sherbeny system, model II. The mineral density of the left calcaneus was measured by ultrasonographically. Results: If the overall mean T score was significantly lower for the DMPA than for the control group, osteopenia and osteoporosis were more prevalent among DMPA users only for participants of the lowest socioeconomic level. There was a mild negative correlation between duration of DMPA use and T score, and when contraception duration was considered the differences in T scores between the DMPA and control groups were significant. Conclusion: Prescribing DMPA only for the short term to women of a low socioeconomic level and counseling them about its effect on bone density may be a practical approach.

Objectives: To test the hypothesis that c-Jun NH2-terminal Kinases (JNKs) inhibitors can reduce endometriosis in a baboon model with induced endometriosis. Design: Prospective randomized, placebo-controlled study in nonhuman primates Methodology: Laparoscopic induction of endometriosis was performed in 20 baboons using intrapelvic seeding of menstrual endometrium inside the pelvic cavity. Fifty days after induction, a pretreatment videolaparoscopy (baseline disease assessment) was performed. The type, surface area and volume of endometriotic lesions (typical, red, white, or suspicious) were recorded and the revised American Society for Reproductive Medicine score and stage were calculated. All 20 baboons were then randomized into 4 groups and treated for a total duration of 60 days. They received banana (placebo, n=5), 20 mg/kg JNK inhibitor orally (n=5), JNK Inhibitor + 10mg Medroxy progesterone acetate (MPA) orally (n=5), Cetrorelix acetate (GnRH antagonist) 3 mg per baboon every three days, subcutaneously (n=5). A posttreatment videolaparoscopy was performed 60 days after the start of medical treatment to compare the extent of endometriosis in the 4 groups. Data were analysed with nonparametric statistics. Results: In contrast with the placebo group, baboons treated with JNK Inhibitor, with JNK Inhibitor + MPA, or with Cetrorelix all showed a statistically significant reduction of the total surface area (p=0.03, 0.02,0.02) and volume (p=0.01,0.01,0.01) of endometriotic lesions after treatment when compared to their pelvic status before treatment. These data were confirmed when red lesions were analyzed separately. Remodelling of red active lesions into white lesions was observed more frequently (p=0.05) in baboons treated with the combination of JNK inhibitor and MPA than in baboons treated with placebo. Conclusion: JNK inhibitors effectively diminish the burden of endometriosis disease in a baboon model with induced endometriosis. The addition of MPA to JNK inhibitors may favor the healing process of endometriotic lesions. Support: Istituto di Ricerche Biomediche “A. Marxer” RBM S.p.A,Turin, Italy.

Background :This study was conducted to evaluate the efficacy and safety of 200 μg misoprostol administered vaginally every 4 hours to a maximum of 48 hours for second trimester intrauterine fetal death. Methods: We conducted a prospective, randomized trial comparing the efficacy and safety of misorostol either in its dry form (group A) or moistened with 1 ml saline (group B). The study population included 136 pregnant women between 14 and 24 weeks gestation who were seeking for termination of pregnancy because of intrauterine fetal death. Setting: Woman’s Health Center, Assiut University Hospitals. Results: All patients in both groups aborted within 48 hours (100% success rate), the median induction-abortion interval was significantly shorter in group B than in group A (p0.01) patients in group B had significantly short median induction-abortion interval(p0.01) , less total number of doses (p0.05) , less retained placenta ((p0.05), more aborton within 24 hours (p0.01), more aborton with the 1st dose(p0.01) but had more need for analgesia and more incidence of side effects (p0.01). Conclusion: The intravaginal administration of 200 μg misoprostol tablets moistened with saline every 4 hours was effective for second trimester pregnancy termination and superior to dry misoprostol tablets. However it was associated with more side effects whisch were well tolerated.

Background :This study was conducted to evaluate the efficacy and safety of 200 μg misoprostol administered vaginally every 4 hours to a maximum of 48 hours for second trimester intrauterine fetal death. Methods: We conducted a prospective, randomized trial comparing the efficacy and safety of misorostol either in its dry form (group A) or moistened with 1 ml saline (group B). The study population included 136 pregnant women between 14 and 24 weeks gestation who were seeking for termination of pregnancy because of intrauterine fetal death. Setting: Woman’s Health Center, Assiut University Hospitals. Results: All patients in both groups aborted within 48 hours (100% success rate), the median induction-abortion interval was significantly shorter in group B than in group A (p0.01) patients in group B had significantly short median induction-abortion interval(p0.01) , less total number of doses (p0.05) , less retained placenta ((p0.05), more aborton within 24 hours (p0.01), more aborton with the 1st dose(p0.01) but had more need for analgesia and more incidence of side effects (p0.01). Conclusion: The intravaginal administration of 200 μg misoprostol tablets moistened with saline every 4 hours was effective for second trimester pregnancy termination and superior to dry misoprostol tablets. However it was associated with more side effects whisch were well tolerated.

Background :This study was conducted to evaluate the efficacy and safety of 200 μg misoprostol administered vaginally every 4 hours to a maximum of 48 hours for second trimester intrauterine fetal death. Methods: We conducted a prospective, randomized trial comparing the efficacy and safety of misorostol either in its dry form (group A) or moistened with 1 ml saline (group B). The study population included 136 pregnant women between 14 and 24 weeks gestation who were seeking for termination of pregnancy because of intrauterine fetal death. Setting: Woman’s Health Center, Assiut University Hospitals. Results: All patients in both groups aborted within 48 hours (100% success rate), the median induction-abortion interval was significantly shorter in group B than in group A (p0.01) patients in group B had significantly short median induction-abortion interval(p0.01) , less total number of doses (p0.05) , less retained placenta ((p0.05), more aborton within 24 hours (p0.01), more aborton with the 1st dose(p0.01) but had more need for analgesia and more incidence of side effects (p0.01). Conclusion: The intravaginal administration of 200 μg misoprostol tablets moistened with saline every 4 hours was effective for second trimester pregnancy termination and superior to dry misoprostol tablets. However it was associated with more side effects whisch were well tolerated.