Introduction: Dilated cardiomyopathy is one of the most common heart muscle diseases in developed countries. Troponins have emerged as the most reliable clinical measure of myocyte injury. Despite the widespread use of cardiac troponins as biomarkers for diagnosis and risk stratification, their condition in cardiomyopathy is not known. Patients and methods: The study was conducted on 20 children with dilated cardiomyopathy, attending the Cardiology Unit of Children Hospital in Assiut University, for recurring episodes of heart failure. Determination of serum level of cardiac troponin I (cTnI) was done on admition and discharge after relief of presenting symptoms. Results: Serum cTnI concentrations ranged from 0.11 to 0.15 ng/ml (0.12 ± 0.003) on admition and from 0.1 to 0.14 ng/ml (0.11 ± 0.004) on discharge, all are within the normal range, but there is a significant decrease in serum cTnI concentrations on remetion. Conclusion: Serum cardiac troponin I (cTnI) does not increase in dilated cardiomyopathy, however in patients having DCM who presented wtith hear failure (HF), assay of cTnI can be used for follow up of these patients. Further studies are needed to support this proposal. [Khalid A. Sanousy, Faisal-Alkhatib Ahmed and Osman M. Esam. Cardiac Troponin I in Dilated Cardiomyopathy. J Am Sci 2012;8(12): 535-540]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 74

ABSTRACT Background: This study was conducted to decide the best line of management of intrauterine growth restricted fetuses with absent end-diastolic blood flow in umbilical artery. This was guided by studying short term morbidity and mortality among these infants. Patients and methods: We conducted a prospective study which included seventy-four pregnant women, at 32-36 weeks gestation, with intrauterine growth restriction, (birth weight 10th percentile), with absent end-diastolic blood flow in umbilical artery, biophysical profile 8/10 and negative contraction stress test. Patients were divided into two groups, group A and group B. Group (A), included 34 patients, was subjected to termination within 24 hours form recruitment and group (B), included 40 patients, was subjected to expectant management. Setting: Woman's Health Center, Assiut University. Results: In group A 6 infants died in neonatal period (17.6%), in group B, 3 fetuses died in utero (7.5%) and 4 infants died in neonatal period (10%). The Cesarean delivery rate was significantly higher in group B than group A (82.5% vs. 73.5%). Referral to pediatric care unit was significantly higher in group A than group B (85.3% vs. 77.5%). Neonatal morbidity was significantly higher in group a than group B. Conclusions: There was no significant difference in perinatal deaths between expectant and active management protocols. Neonatal morbidity was significantly lower in group with expectant management. Key words: Expectant management, intrauterine growth restriction, blood flow.

ABSTRACT Background: This study was conducted to decide the best line of management of intrauterine growth restricted fetuses with absent end-diastolic blood flow in umbilical artery. This was guided by studying short term morbidity and mortality among these infants. Patients and methods: We conducted a prospective study which included seventy-four pregnant women, at 32-36 weeks gestation, with intrauterine growth restriction, (birth weight 10th percentile), with absent end-diastolic blood flow in umbilical artery, biophysical profile 8/10 and negative contraction stress test. Patients were divided into two groups, group A and group B. Group (A), included 34 patients, was subjected to termination within 24 hours form recruitment and group (B), included 40 patients, was subjected to expectant management. Setting: Woman's Health Center, Assiut University. Results: In group A 6 infants died in neonatal period (17.6%), in group B, 3 fetuses died in utero (7.5%) and 4 infants died in neonatal period (10%). The Cesarean delivery rate was significantly higher in group B than group A (82.5% vs. 73.5%). Referral to pediatric care unit was significantly higher in group A than group B (85.3% vs. 77.5%). Neonatal morbidity was significantly higher in group a than group B. Conclusions: There was no significant difference in perinatal deaths between expectant and active management protocols. Neonatal morbidity was significantly lower in group with expectant management. Key words: Expectant management, intrauterine growth restriction, blood flow.

ABSTRACT Background: This study was conducted to decide the best line of management of intrauterine growth restricted fetuses with absent end-diastolic blood flow in umbilical artery. This was guided by studying short term morbidity and mortality among these infants. Patients and methods: We conducted a prospective study which included seventy-four pregnant women, at 32-36 weeks gestation, with intrauterine growth restriction, (birth weight 10th percentile), with absent end-diastolic blood flow in umbilical artery, biophysical profile 8/10 and negative contraction stress test. Patients were divided into two groups, group A and group B. Group (A), included 34 patients, was subjected to termination within 24 hours form recruitment and group (B), included 40 patients, was subjected to expectant management. Setting: Woman's Health Center, Assiut University. Results: In group A 6 infants died in neonatal period (17.6%), in group B, 3 fetuses died in utero (7.5%) and 4 infants died in neonatal period (10%). The Cesarean delivery rate was significantly higher in group B than group A (82.5% vs. 73.5%). Referral to pediatric care unit was significantly higher in group A than group B (85.3% vs. 77.5%). Neonatal morbidity was significantly higher in group a than group B. Conclusions: There was no significant difference in perinatal deaths between expectant and active management protocols. Neonatal morbidity was significantly lower in group with expectant management. Key words: Expectant management, intrauterine growth restriction, blood flow.

ABSTRACT Objectives: To compare the efficacy and tolerance of two vaginal progesterone formulations (micronized capsules and pessaries) as luteal phase support after successful ovulation induction in patients with polycystic ovarian syndrome. Design: Randomized comparative study. Setting: Infertility clinic of Woman's Health Center, Assiut University. Patients and methods: 120 women diagnosed as polycystic ovarian syndrome and responded to successful ovulation induction by a minimal stimulation protocol, were enrolled in the study from August 2007 to April 2008. Progesterone was administered after ultrasound evidence of ovulation until menstruation occurred or up to 12th weeks if patients got pregnant. Patients were randomly divided into two equal groups to receive either of the two compounds. The first group received micronized progesterone capsules (2×100 mg twice/day) and the second group received progesterone pessaries (200 mg twice /day). Progesterone level, endometrial thickness, occurrence of clinical pregnancy, ongoing pregnancy and patient's tolerance were assessed. Pregnancy was confirmed by serum HCG estimation and 6 weeks gestation ultrasound. Results: Mid-luteal progesterone level was significantly higher in the second group. Thin endometrium was more encountered significantly higher in the first group. There was no significant difference between the occurrence of pregnancy and ongoing pregnancy in both groups. Patient's tolerance and satisfaction were significantly higher in the second group. Conclusion: Micronized progesterone capsules were equally effective as vaginal progesterone pessaries for supporting luteal phase and early pregnancy in patients with polycystic ovarian syndrome. Patients were more satisfied with vaginal progesterone pessaries because of easier application and minimal side effects. Key words: Luteal phase support, vaginal micronized progesterone, progesterone pessaries, polycystic ovarian syndrome.

Abstract The objective of this study was to investigate the role of follicular fluid (FF) cytokines in the peri-ovulatory FF during IVF cycles. FF from 112 women was obtained during oocyte retrieval for IVF. The concentrations of five cytokines [interleukin (IL)-1β, IL-6, IL-12, IL-13, and tumour necrosis factor alpha (TNF-α)] were measured in FF and their concentrations compared among women who became pregnant and those who did not. Thirty-one endometriosis patients, 15 idiopathic infertility, 21 tubal factor infertility, 15 ovarian factor infertility, and 30 patients with male factor infertility were included. Interleukin-13 and TNF-α were absent in the peri-ovulatory FF of all patients. Fifty-two patients achieved pregnancy, whereas 60 did not. Both pregnant and non-pregnant groups were comparable for age, parity, ovarian stimulation parameters, fertilization rates, and embryo freezing rates. Concentrations of FF IL-1β were not significantly different between pregnant and non-pregnant cycles. Concentrations of FF IL-6 were significantly higher in pregnant compared with non-pregnant cycles (P = 0.0005). Concentrations of FF IL-12 were significantly lower in pregnant compared with non-pregnant cycles (P = 0.0002). Higher concentrations of IL-12 and lower concentrations of IL-6 in the peri-ovulatory FF are associated with a negative outcome in IVF treatment. Interleukins-12 and IL-6 are biological markers that appear to affect IVF outcome. Keywords: cytokines, follicular fluid, pregnancy

Abstract The objective of this study was to investigate the role of follicular fluid (FF) cytokines in the peri-ovulatory FF during IVF cycles. FF from 112 women was obtained during oocyte retrieval for IVF. The concentrations of five cytokines [interleukin (IL)-1β, IL-6, IL-12, IL-13, and tumour necrosis factor alpha (TNF-α)] were measured in FF and their concentrations compared among women who became pregnant and those who did not. Thirty-one endometriosis patients, 15 idiopathic infertility, 21 tubal factor infertility, 15 ovarian factor infertility, and 30 patients with male factor infertility were included. Interleukin-13 and TNF-α were absent in the peri-ovulatory FF of all patients. Fifty-two patients achieved pregnancy, whereas 60 did not. Both pregnant and non-pregnant groups were comparable for age, parity, ovarian stimulation parameters, fertilization rates, and embryo freezing rates. Concentrations of FF IL-1β were not significantly different between pregnant and non-pregnant cycles. Concentrations of FF IL-6 were significantly higher in pregnant compared with non-pregnant cycles (P = 0.0005). Concentrations of FF IL-12 were significantly lower in pregnant compared with non-pregnant cycles (P = 0.0002). Higher concentrations of IL-12 and lower concentrations of IL-6 in the peri-ovulatory FF are associated with a negative outcome in IVF treatment. Interleukins-12 and IL-6 are biological markers that appear to affect IVF outcome. Keywords: cytokines, follicular fluid, pregnancy

Abstract The objective of this study was to investigate the role of follicular fluid (FF) cytokines in the peri-ovulatory FF during IVF cycles. FF from 112 women was obtained during oocyte retrieval for IVF. The concentrations of five cytokines [interleukin (IL)-1β, IL-6, IL-12, IL-13, and tumour necrosis factor alpha (TNF-α)] were measured in FF and their concentrations compared among women who became pregnant and those who did not. Thirty-one endometriosis patients, 15 idiopathic infertility, 21 tubal factor infertility, 15 ovarian factor infertility, and 30 patients with male factor infertility were included. Interleukin-13 and TNF-α were absent in the peri-ovulatory FF of all patients. Fifty-two patients achieved pregnancy, whereas 60 did not. Both pregnant and non-pregnant groups were comparable for age, parity, ovarian stimulation parameters, fertilization rates, and embryo freezing rates. Concentrations of FF IL-1β were not significantly different between pregnant and non-pregnant cycles. Concentrations of FF IL-6 were significantly higher in pregnant compared with non-pregnant cycles (P = 0.0005). Concentrations of FF IL-12 were significantly lower in pregnant compared with non-pregnant cycles (P = 0.0002). Higher concentrations of IL-12 and lower concentrations of IL-6 in the peri-ovulatory FF are associated with a negative outcome in IVF treatment. Interleukins-12 and IL-6 are biological markers that appear to affect IVF outcome. Keywords: cytokines, follicular fluid, pregnancy