Aim: To compare different outcomes of vitrification and slow freezing of isolated pre-antral follicles and to evaluate different cryo-devices vitrification of isolated follicles. Methods: pre-antral follicles were isolated from mouse ovaries and cryopreserved using vitrification and slow freezing. A preliminary was carried out to select the optimal cryo-devices vitrification of isolated follicles. A total of 414 follicles were randomly distributed among four groups: control (CT) fresh (n=100) , nylon mesh (n=96) , electron microscopy grid (n=120) , and micro-capillary tips (n=116) . Subsequetly, a total of 979 follicles were randomly assigned to three different group: CT fresh (n=256), vitrification (n=399) and Slow freezing (n=324). CT and cryopreserved/thawed follicles were cultured in vitro and examined daily for development . final maturation was triggered with human chorionic gonadotrophin and rates of oocyte maturation were calculated. The Ultra-structure of cryopreserved / thwed follicles was studied using electron microscopy. Meiotic spindle presence and organization in mature oocytes were examined using the oosight imaging system. Result: Micro-capillary tips resulted in poor immediate post-warming survival but no differences were observed in the subsequent in vitro development characteristics between different cryo-devices. Nylon mesh proved to be the easiest carrier, particularly when large numbers of follicles at the end of the culture period (P 0.0001) However all other outcome measures were comparable between both techniques. Conclusions: Isolated follicles were more vulnerable to cryodamage after slow freezing as compared to vitrification

Aim: To compare different outcomes of vitrification and slow freezing of isolated pre-antral follicles and to evaluate different cryo-devices vitrification of isolated follicles. Methods: pre-antral follicles were isolated from mouse ovaries and cryopreserved using vitrification and slow freezing. A preliminary was carried out to select the optimal cryo-devices vitrification of isolated follicles. A total of 414 follicles were randomly distributed among four groups: control (CT) fresh (n=100) , nylon mesh (n=96) , electron microscopy grid (n=120) , and micro-capillary tips (n=116) . Subsequetly, a total of 979 follicles were randomly assigned to three different group: CT fresh (n=256), vitrification (n=399) and Slow freezing (n=324). CT and cryopreserved/thawed follicles were cultured in vitro and examined daily for development . final maturation was triggered with human chorionic gonadotrophin and rates of oocyte maturation were calculated. The Ultra-structure of cryopreserved / thwed follicles was studied using electron microscopy. Meiotic spindle presence and organization in mature oocytes were examined using the oosight imaging system. Result: Micro-capillary tips resulted in poor immediate post-warming survival but no differences were observed in the subsequent in vitro development characteristics between different cryo-devices. Nylon mesh proved to be the easiest carrier, particularly when large numbers of follicles at the end of the culture period (P 0.0001) However all other outcome measures were comparable between both techniques. Conclusions: Isolated follicles were more vulnerable to cryodamage after slow freezing as compared to vitrification

Antenatal care and child-birth care are essential components of maternal and perinatal health. The following benefits are expected: reduction of maternal and perinatal morbidity and mortality, Strengthening the relationship between women/ her family/ community/ and health care provider. Women's dissatisfaction with routine hospital care or even harm caused by some hospital procedures and the impersonal treatment by medical personnel lead to shift from hospital to home delivery and from doctors to midwives. This study is the first attempt to describe women's responses to medical management of their pregnancy and delivery in women's health hospital Assiut University – Egypt. A qualitative approach in data collection was adopted to gain view of women's perception. A total number of 770 women (544 in-patients and 226 out-patients) were interviewed. The findings showed that 79% were satisfied and 21% were unsatisfied. The causes of unsatisfaction are discussed.

Background: Few reports demonstrated that increased inflammatory markers as well as platelet, coagulation, fibrinolytic activities in mitral stenosis (MS) decrease after percutaneous mitral valvotomy (PMV). The relationship between the inflammatory markers and platelet, coagulation, and fibrinolytic activities was not studied before. Methods: The study included 65 patients with MS undergoing PMV, and 23 controls. Markers of platelet activity (P-Selectin), thrombin activity (Prothrombin fragment1,2 “PF1,2” and thrombin antithrombin complex “TAT”), fibrinolysis (D-Dimer), and inflammation (interleukin 1B “IL1B”) were measured from venous samples obtained before and 2 weeks after PMV and in all controls. Results: All hemostatic and inflammatory markers were significantly higher in MS patients than the control and they significantly decreased after PMV. Only in PF1,2 the level became not significantly different from the control after PMV. The change in any of these variables didn’t correlate with the change in mitral valve area, mean transmitral pressure gradient, left ventriculat dimensions and function. P-selectin change was predicted by the changes in left atrial diameter “LAd” (r 0.4, P 0.02), pulmonary artery systolic pressure “PASP” (r 0.3, P 0.02) and IL1B (r 0.7, P 0.0001). D-dimer change had similar predictors; LAd (r 0.5, P 0.0001), PASP (r 0.3, p 0.04), and IL1B (r 0.5, P 0.0001). PF1,2 change was predicted with the change in IL1B (r 0.8, P 0.0001). TAT change was predicted by the changes in LAd (0.3, P 0.02) and right ventricular diameter “RVd” (r 0.3, P 0.04). IL1B change was predicted with the changes in aortic root diameter (0.4, p 0.02), RVd (r 0.5, P 0.04), and PASP (r 0.5, P 0.03). Conclusion: MS is associated with heightened inflammatory, platelet, thrombin, and fibrinolytic activities that decrease after PMV. Altered hemodynamics might play a possible role in some of these changes. Reduced inflammatory activity might have a role in reduced platelet, thrombin, and fibrinolytic activities after PMV.

Objective Poly cystic ovary syndrome (PCOS ) patients are abdominally obese with increased risk of developing metabolic disease as there is insulin resistance and high testosterone levels causing low adiponectin and gherlin level in PCOS patients.

OBJECTIVE: (a) To estimate the proportion of mesosalpngeal adipose tissue condensation (lipomesosalpnix) among infertile women subjected to diagnostic laparoscopy and (b) to test the feasibility and efficacy of some novel treatment modalities. DESIGN: (a) cross sectional and (b) longitudinal study. SETTING: A specialized endoscopic center. PATIENT(S): All infertile women scheduled for diagnoastic/therapeutic laparoscopy during the period between July 1994 and August 2010 were included in this study. INTERVENTION(S): Preoperative transvaginal ultrasonography as well as BMI for all cases. Laparoscopic documentation of mesosalpingeal condensation of adipose tissue (a). Histopathologic assessment of the adipose tissues of some cases. Bipolar needle coagulation Vs injection of 5 mL of Dermastabilon into the lipomesosalpnix (b). MAIN OUTCOME MEASURE(S): (a) number of cases with unilateral or bilateral lipomesosalpnix and (b) complete disappearance of the mass on proper treatment on second look laparoscopy. Results: Lipomesosalpnix was confirmed in 145 cases (5.7%) out of 2563 cases examined by laparoscopy. In all but 7 cases, lipomesososalpnix was diagnosed bilaterally (99.7%). There was insignificant correlation between those cases and high BMI when compared to the rest of cases. Infertility was unexplained by laparoscopy in 621 cases (24.3%) while laparoscopy diagnosed etiologic factors in 1942 (75.7%) cases. Lipomesosalpnix was seen in 46 (7.4 %) and 79 (3.9%) of the unexplained cases and explained cases respectively without a statistically significant difference (P 0.48). Unexplained infertility cases (46 cases) were divided into two groups according to the treatment modality. Bipolar needle coagulation was performed in 29 cases while 5 mL of Dermastabilon was injected into the lipomesosalpnix in 17 cases. Spontaneous pregnancy was achieved in 4 cases with unexplained infertility within 6 months following bipolar coagulation of lipomesosalpnix. Second look laparoscopy was performed for few cases (ongoing part). Conclusions: Despite being a rare laparoscopic finding, lipomesosalpnix should be reported and documented specially in cases with unexplained infertility. Whether to treat lipomesosalpnix or not and by which means require more studies with proper second look laparoscopy.

Epidermal thickness (ET) has been suggested as a surrogate measure of psoriasis severity. Optical coherence tomography (OCT) is a recent imaging technology that provides real-time skin images to a depth of 1.8 mm with a micrometre resolution. OCT may provide an accurate in vivo measure of ET. It is, therefore, speculated that OCT may be used in the assessment of psoriasis vulgaris. A total of 23 patients with psoriasis vulgaris were systematically evaluated by OCT imaging and skin biopsy during treatment. Biopsies were graded for disease severity, and additional evaluation was done by the physician via psoriasis area and severity index (PASI) score, and by the patient through measures such as self-administered PASI, psoriasis life stress inventory index and dermatology life quality index. ET was calculated from OCT images. In comparison to normal skin, psoriasis appeared with a more irregular surface with a stronger entrance signal, a serrated dermoepidermal junction was found and a less signal intensity in the dermis as shown in OCT images. ET measured in untreated plaques was thicker reXecting epidermal hyperproliferation and inXammation. The changes were signiWcantly correlated with the biopsy grading (r2 = 0.41, p = 0.001) and ET signiWcantly decreased with treatment (p = 0.0001). ET correlated signiWcantly with self-reported measures of disease severity, but not with physicianassessed global PASI. The data suggest that OCT may be used to measure ET in psoriasis and the measurements correlate with several other parameters of disease severity. This implies that OCT assessment of psoriatic plaques may provide a useful method for non-invasive in vivo method to follow the evolution of psoriasis lesions.

To study the morphological patterns of pterygia and pingueculae using high-resolution anterior segment spectral domain optical coherence tomography (SD-OCT). Methods: Prospective cross-sectional study of 25 eyes presented with pterygia and pingueculae was conducted, and the eyes were examined by anterior segment SD-OCT. Results: We examined 25 eyes, including 13 eyes with primary pterygia, six eyes with recurrent pterygia, one case with a pseudopterygium and five eyes with pingueculae. Primary pterygia revealed elevation of the corneal epithelium by a wedge-shaped mass of tissue separating the corneal epithelium from the underlying Bowman’s membrane, which became wavy and interrupted. We found satellite masses of pterygium tissue advanced under the epithelium beyond the clinically seen pterygium margins. In recurrent pterygia, we detected that the central tip of the pterygium was more advanced and creeping beneath the basal corneal epithelium than the primary pterygium. In pseudopterygium, the SD-OCT images showed that the overgrowing membrane was not really attached to the underlying cornea. In cases of pingueculae, SDOCT revealed a wedge-shaped mass that was nearly similar in pattern to that of the pterygia but stopped at the limbal region. Immediately after removal of pterygia, we noticed many remnants of the pterygia masses over the corneal stroma in spite of the clinically clear appearance of cornea. Conclusions: SD-OCT provided us with high-resolution images of the pterygium and the pinguecula and showed clearly the anatomical relationship between the corneal tissues and these lesions. The use of this new modality of imaging may help to decrease the current recurrence rates after pterygium excision through using the anterior segment SD-OCT in the evaluation of these lesions.

Purpose: To study microperimetric macular sensitivity in diabetic macular oedema (DMO) in relation to lesion characteristics obtained by optical coherence tomography (OCT), colour fundus photography, and fluorescein angiography (FA). Methods: The study comprised 20 eyes in 15 patients with nonproliferative diabetic retinopathy and recently diagnosed untreated DMO. Investigations included microperimetry, fluorescein angiography, colour fundus photography, and OCT. All measures and gradings were made for each of the nine fields of an early treatment diabetic retinopathy study macula template. Statistical analysis was made using Spearman’s nonparametric test including field and mean values within fields. Comparisons were made within the study population and with a normative microperimetry database. Results: Subnormal microperimetric sensitivity was associated with cystoid macular oedema, both in foveal petaloid (r = )0.50, p = 0.02) and extrafoveal honeycomb patterns (r = )0.8, p 0.0001) and with outer nuclear layer cysts (r = )0. 5, p = 0.024), inner nuclear layer cysts (r = )0.31, p = 0.03), and hard exudate (r = )0.38, p = 0.0026). There was no detectable effect of focal noncystoid oedema (r = )0.16, p = 0. 48), diffuse noncystoid oedema (r = )0.14, p = 0.55), capillary nonperfusion (r = )0.33, p = 0.15), intraretinal haemorrhage (r = )0.15, p = 0.53), or serous retinal detachment (r = )0.11, p = 0.63). Foveal thickening was associated with locally reduced sensitivity (r = )0.54, p = 0.01). Foveal sensitivity was positively correlated to the visual acuity, with a correlation of 0.44 and a borderline significance (p = 0.0509). Conclusions: Macular hard exudates and cystoid oedema were associated with locally reduced sensitivity. Thus, the lesions associated with reduced sensitivity for a white-on-white stimulus were such lesions that cause light to be blocked or scattered before it reaches the photoreceptors, suggesting that optical effects are a major cause of sensitivity loss.