Hawa Saleh Rezeg, Abtisam Ateeyah Alsaliheen, MS Elmahaishi
Objective: The objective of the study was to compare the effectiveness of different treatment options in the management of infertility across three cases in morbidly obese women with polycystic ovary syndrome (PCOS). Case study & results: The first case is 30 years old with secondary infertility for two years with two abortions and a body mass index (BMI) is 69, she tried all lifestyle modifications with no response to weight reduction and she was conceived spontaneously without fertility treatment and subsequent antenatal care progressed without any complications until 36 weeks complicated with raised blood sugar beyond the normal level but not so high and intrauterine fetal death one week later ended by spontaneous normal vaginal delivery. The second case is 24 years old with BMI 66 is undergone weight reduction, ovulation induction with clomiphene citrate and gonadotropin injections with good ovulation response but no pregnancy, in vitro fertilization was performed but aborted at 8 weeks gestation, one year later after the use of metformin and ovulation induction with injections patient conceived and her pregnancy complicated by pre-eclampsia, gestational diabetes treated with insulin and preterm delivery. The third case is 40 years old with primary infertility for 5 years with BMI 70, she is known case diabetes mellitus 10 years back controlled with insulin, and hypertension on treatment, undergone bariatric surgery and one year later IVF was done after the failure of multiple ovulation induction, her diabetes mellitus and hypertension control well with treatment and delivered at 39 weeks by elective cesarean section with a birth weight of 4.5 kg. Discussion: PCOS is a genetic condition, worsened by obesity. The prevalence of obesity in PCOS women is up to 80%. There is a strong relationship between PCOS and obesity making the condition more complex. The majority of women with PCOS are either overweight or obese and the pathogenesis of obesity in PCOS has not yet been exactly identified. Obesity has adverse effects on fertility through anovulation, poor implantation, and quality oocyte. Conclusion: The ideal treatment of infertility in morbidly obese PCOS women has not been defined, but generally, before deciding which treatment option is preferred, proper weight loss and control of the metabolic state are carried out for successful pregnancy
{"title":"Successful Pregnancy in Morbidly Obese Women of Polycystic Ovary Syndrome With Various Treatment Options With Individual Consequences: Case Series","authors":"Hawa Saleh Rezeg, Abtisam Ateeyah Alsaliheen, MS Elmahaishi","doi":"10.33425/2768-4598.1033","DOIUrl":"https://doi.org/10.33425/2768-4598.1033","url":null,"abstract":"Objective: The objective of the study was to compare the effectiveness of different treatment options in the management of infertility across three cases in morbidly obese women with polycystic ovary syndrome (PCOS). Case study & results: The first case is 30 years old with secondary infertility for two years with two abortions and a body mass index (BMI) is 69, she tried all lifestyle modifications with no response to weight reduction and she was conceived spontaneously without fertility treatment and subsequent antenatal care progressed without any complications until 36 weeks complicated with raised blood sugar beyond the normal level but not so high and intrauterine fetal death one week later ended by spontaneous normal vaginal delivery. The second case is 24 years old with BMI 66 is undergone weight reduction, ovulation induction with clomiphene citrate and gonadotropin injections with good ovulation response but no pregnancy, in vitro fertilization was performed but aborted at 8 weeks gestation, one year later after the use of metformin and ovulation induction with injections patient conceived and her pregnancy complicated by pre-eclampsia, gestational diabetes treated with insulin and preterm delivery. The third case is 40 years old with primary infertility for 5 years with BMI 70, she is known case diabetes mellitus 10 years back controlled with insulin, and hypertension on treatment, undergone bariatric surgery and one year later IVF was done after the failure of multiple ovulation induction, her diabetes mellitus and hypertension control well with treatment and delivered at 39 weeks by elective cesarean section with a birth weight of 4.5 kg. Discussion: PCOS is a genetic condition, worsened by obesity. The prevalence of obesity in PCOS women is up to 80%. There is a strong relationship between PCOS and obesity making the condition more complex. The majority of women with PCOS are either overweight or obese and the pathogenesis of obesity in PCOS has not yet been exactly identified. Obesity has adverse effects on fertility through anovulation, poor implantation, and quality oocyte. Conclusion: The ideal treatment of infertility in morbidly obese PCOS women has not been defined, but generally, before deciding which treatment option is preferred, proper weight loss and control of the metabolic state are carried out for successful pregnancy","PeriodicalId":486907,"journal":{"name":"Archives of Clinical Trials","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136246663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Oblique Lumbar Interbody Fusion (OLIF) is a newly developed minimally invasive lumbar interbody fusion procedure used to treat a variety of degenerative lumbar spine diseases. The OLIF procedure has the advantages of less trauma, less bleeding, faster recovery, significant indirect decompression, large bone graft area, high fusion rate, and preservation of posterior column structures, but it needs to be performed under the condition of familiarity with the patient's anatomical approach to avoid injury to nerves, blood vessels, and other structures. In this paper, we review the new clinical advances in the application of anatomy for OLIF surgery in terms of the abdominal wall, blood vessels, lumbar major muscle, window between blood vessels and lumbar major muscle, nerves, and ureter.
{"title":"Research Progress of the Anatomical Structure of the Surgical Approach for Oblique Lumbar Interbody Fusion","authors":"Jiajia Wang, Yi Li, Bo Liao","doi":"10.33425/2768-4598.1032","DOIUrl":"https://doi.org/10.33425/2768-4598.1032","url":null,"abstract":"Oblique Lumbar Interbody Fusion (OLIF) is a newly developed minimally invasive lumbar interbody fusion procedure used to treat a variety of degenerative lumbar spine diseases. The OLIF procedure has the advantages of less trauma, less bleeding, faster recovery, significant indirect decompression, large bone graft area, high fusion rate, and preservation of posterior column structures, but it needs to be performed under the condition of familiarity with the patient's anatomical approach to avoid injury to nerves, blood vessels, and other structures. In this paper, we review the new clinical advances in the application of anatomy for OLIF surgery in terms of the abdominal wall, blood vessels, lumbar major muscle, window between blood vessels and lumbar major muscle, nerves, and ureter.","PeriodicalId":486907,"journal":{"name":"Archives of Clinical Trials","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136246654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Narges R Ben Halim, Hamza Elmahaishi, Mohamed Said Elmahaishi
Sex selection is an option for couples who want to avoid passing a sex- linked genetic disease to their baby. For example, some females are carriers for over 350 X-linked diseases, even if the disease does not directly affect them. Hemophilia and Duchenne muscular dystrophy are examples of diseases that occur with a recessive gene on the X chromosome. Some choose the sex of their baby because of a personal preference like "Family balancing." Many studies were done before to prefer one gender upon another. When we look at the statistics the chances of having a boy or a girl are almost the same and there is no medical evidence to suggest we can influence Design: Prospective randomized controlled study. Setting: The study was conducted at LAMIS Clinic for Obstetrics & Gynecology from January 2015 to February 2022 and still continue up today. The study started after observation that use of cyclofert female capsules before conceptions leads to more probability to male sex embryos. Our study contains five thousand patients who received cyclofert female capsules at dose of two capsules per day for at least two months before conceptions. The data was compared with another one thousands patients who receive placebo. The two groups divided into three according to the age group. All patient included were on natural cycles and no ovulation inductions used, irrespective of the parity. Objectives: To rule out that the observation which is noted that increase male gender embryos related to use of cyclofertfemal capsules or not. Results: The overall pregnancy rate irrespective of the age was 86.02% (4301/5000) & 66.6% (666/1000) for the cyclofert group and the placebo group respectively. Overall abortion rate for cyclofert group was 1.4% (60/4301) while 9.3% (62/666) for placebo group. 89.69% (3804/4241) of the total pregnancy were male gender in cyclofert Group, while at placebo group it was 41.23 % (249/604), (p<0.05 statistically significant). Conclusion: Gender selection could be work by non-invasive, not expensive, effective, affordable, and available without complication method by giving cyclofert female capsules, which is, increases the pregnancy rate, reduces the rate of abortion and increases the male gender embryos. Although, there is no guarantee that the baby will actually be one sex or the other, but cyclofertfemal capsules can influence what type of sperm cell will reach an ovum, and fertilize it. Therefore, yes, male gender selection may be technically possible.
{"title":"Does gender selection works? An observational study","authors":"Narges R Ben Halim, Hamza Elmahaishi, Mohamed Said Elmahaishi","doi":"10.33425/2768-4598.1030","DOIUrl":"https://doi.org/10.33425/2768-4598.1030","url":null,"abstract":"Sex selection is an option for couples who want to avoid passing a sex- linked genetic disease to their baby. For example, some females are carriers for over 350 X-linked diseases, even if the disease does not directly affect them. Hemophilia and Duchenne muscular dystrophy are examples of diseases that occur with a recessive gene on the X chromosome. Some choose the sex of their baby because of a personal preference like \"Family balancing.\" Many studies were done before to prefer one gender upon another. When we look at the statistics the chances of having a boy or a girl are almost the same and there is no medical evidence to suggest we can influence Design: Prospective randomized controlled study. Setting: The study was conducted at LAMIS Clinic for Obstetrics & Gynecology from January 2015 to February 2022 and still continue up today. The study started after observation that use of cyclofert female capsules before conceptions leads to more probability to male sex embryos. Our study contains five thousand patients who received cyclofert female capsules at dose of two capsules per day for at least two months before conceptions. The data was compared with another one thousands patients who receive placebo. The two groups divided into three according to the age group. All patient included were on natural cycles and no ovulation inductions used, irrespective of the parity. Objectives: To rule out that the observation which is noted that increase male gender embryos related to use of cyclofertfemal capsules or not. Results: The overall pregnancy rate irrespective of the age was 86.02% (4301/5000) & 66.6% (666/1000) for the cyclofert group and the placebo group respectively. Overall abortion rate for cyclofert group was 1.4% (60/4301) while 9.3% (62/666) for placebo group. 89.69% (3804/4241) of the total pregnancy were male gender in cyclofert Group, while at placebo group it was 41.23 % (249/604), (p<0.05 statistically significant). Conclusion: Gender selection could be work by non-invasive, not expensive, effective, affordable, and available without complication method by giving cyclofert female capsules, which is, increases the pregnancy rate, reduces the rate of abortion and increases the male gender embryos. Although, there is no guarantee that the baby will actually be one sex or the other, but cyclofertfemal capsules can influence what type of sperm cell will reach an ovum, and fertilize it. Therefore, yes, male gender selection may be technically possible.","PeriodicalId":486907,"journal":{"name":"Archives of Clinical Trials","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136246662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To elucidate the effects of the timing of banana intake on postprandial glucose spike and glucose metabolism. Methods: This randomized parallel-group comparison study was designed to randomize 54 adults aged 41- 60 years into three groups. The first group consumed 120 g of banana at breakfast daily for 2 weeks, the second group consumed 120 g of banana after dinner daily for 2 weeks, and the third consumed no banana or banana-containing food for 2 weeks. The participants in each group wore a continuous glucose monitor on their arms for 2 weeks to measure their blood glucose trend. Body composition and serum biomarkers were evaluated before and after intervention. Results: There were 16 participants in the banana-at-breakfast group, 16 in the banana-after-dinner group, and 15 in the control group. We defined a postprandial blood glucose increase of >140 mg/dL as a “glucose spike.” When comparing the glucose spike incidence ratio (incidence of glucose spikes divided by number of times measured), the point estimate of the incidence ratio of banana-at-breakfast group at dinner compared with breakfast was 1.55 (point estimate. 95% confidence interval: 1.09- 2.20), that of banana-after dinner group 1.83 (point estimate. 95% confidence interval: 1.28-2.61), and control group 2.03 (point estimate. 95% confidence interval: 1.36-3.04). In addition, the banana-afterdinner and control groups showed a higher incidence ratio, compared with the banana-at-breakfast group. Glycoalbumin decreased significantly in the banana-at- breakfast group compared with the other groups. Conclusions: The results showed that glucose spikes were less generated when consuming bananas at breakfast than when consuming them after dinner or not consuming them at all. The level of glycoalbumin, an index for average blood glucose, was lower in the banana-at-breakfast group than in the banana-after-dinner and control groups within 2 weeks. Clinical Trial Registry: UMIN 000050025
{"title":"The Effect of the Timing of Banana Intake on Postprandial Glucose Spike: Randomized Parallel-Group Comparison Study","authors":"Mitsuko Itoh, Hiroyoshi Inoue","doi":"10.33425/2768-4598.1034","DOIUrl":"https://doi.org/10.33425/2768-4598.1034","url":null,"abstract":"Objective: To elucidate the effects of the timing of banana intake on postprandial glucose spike and glucose metabolism. Methods: This randomized parallel-group comparison study was designed to randomize 54 adults aged 41- 60 years into three groups. The first group consumed 120 g of banana at breakfast daily for 2 weeks, the second group consumed 120 g of banana after dinner daily for 2 weeks, and the third consumed no banana or banana-containing food for 2 weeks. The participants in each group wore a continuous glucose monitor on their arms for 2 weeks to measure their blood glucose trend. Body composition and serum biomarkers were evaluated before and after intervention. Results: There were 16 participants in the banana-at-breakfast group, 16 in the banana-after-dinner group, and 15 in the control group. We defined a postprandial blood glucose increase of >140 mg/dL as a “glucose spike.” When comparing the glucose spike incidence ratio (incidence of glucose spikes divided by number of times measured), the point estimate of the incidence ratio of banana-at-breakfast group at dinner compared with breakfast was 1.55 (point estimate. 95% confidence interval: 1.09- 2.20), that of banana-after dinner group 1.83 (point estimate. 95% confidence interval: 1.28-2.61), and control group 2.03 (point estimate. 95% confidence interval: 1.36-3.04). In addition, the banana-afterdinner and control groups showed a higher incidence ratio, compared with the banana-at-breakfast group. Glycoalbumin decreased significantly in the banana-at- breakfast group compared with the other groups. Conclusions: The results showed that glucose spikes were less generated when consuming bananas at breakfast than when consuming them after dinner or not consuming them at all. The level of glycoalbumin, an index for average blood glucose, was lower in the banana-at-breakfast group than in the banana-after-dinner and control groups within 2 weeks. Clinical Trial Registry: UMIN 000050025","PeriodicalId":486907,"journal":{"name":"Archives of Clinical Trials","volume":"2012 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136246650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To describe the diagnosis and management of one case of pre rupture rudimentary horn pregnancy of unicornuate uterus in the early second trimester by clinical suspicion, sonography, and laparotomy. This paper presents a rare case in which a rudimentary horn pregnancy was suspected clinically at 15 weeks gestation with moderate to severe abdominal pain and diagnosed by sonographic criteria which revealed an empty uterine cavity with a pregnant uterine horn and confirmed by laparotomy. Which revealed a right unicornuate uterus and pre rupture a noncommunicating left rudimentary horn containing a gestational sac, fetus, and placental tissue. The patient underwent surgery, and the pre rupture rudimentary horn pregnancy with fallopian tube was resected and repair of the damaged uterine wall was made with no complications. The patient conceived spontaneously eight months after surgery and her antenatal care was regular without complications until 36 weeks gestation presented with mild left iliac fossa pain. Her vaginal examination revealed she is in labor; the patient prepared and operated the next day as elective cesarean section; the baby and the placenta were delivered without any difficulty. Rudimentary horn pregnancy is a dangerous kind of ectopic pregnancy and is considered as very rare condition which make difficulty in understanding the disease. Most of the clinicians instructed to be focus on prenatal ultrasound for an earlier diagnosis and management which results in a reduction in risk of maternal morbidity and mortality. Additionally, MRI can be used to confirm the diagnosis before an invasive procedure is undertaken.
{"title":"Unicornuate Uterus With Pre Ruptured Rudimentary Horn Pregnancy At 15 Weeks Gestation: Case Report","authors":"Hawa Saleh Rezeg, MS Elmahaishi","doi":"10.33425/2768-4598.1031","DOIUrl":"https://doi.org/10.33425/2768-4598.1031","url":null,"abstract":"To describe the diagnosis and management of one case of pre rupture rudimentary horn pregnancy of unicornuate uterus in the early second trimester by clinical suspicion, sonography, and laparotomy. This paper presents a rare case in which a rudimentary horn pregnancy was suspected clinically at 15 weeks gestation with moderate to severe abdominal pain and diagnosed by sonographic criteria which revealed an empty uterine cavity with a pregnant uterine horn and confirmed by laparotomy. Which revealed a right unicornuate uterus and pre rupture a noncommunicating left rudimentary horn containing a gestational sac, fetus, and placental tissue. The patient underwent surgery, and the pre rupture rudimentary horn pregnancy with fallopian tube was resected and repair of the damaged uterine wall was made with no complications. The patient conceived spontaneously eight months after surgery and her antenatal care was regular without complications until 36 weeks gestation presented with mild left iliac fossa pain. Her vaginal examination revealed she is in labor; the patient prepared and operated the next day as elective cesarean section; the baby and the placenta were delivered without any difficulty. Rudimentary horn pregnancy is a dangerous kind of ectopic pregnancy and is considered as very rare condition which make difficulty in understanding the disease. Most of the clinicians instructed to be focus on prenatal ultrasound for an earlier diagnosis and management which results in a reduction in risk of maternal morbidity and mortality. Additionally, MRI can be used to confirm the diagnosis before an invasive procedure is undertaken.","PeriodicalId":486907,"journal":{"name":"Archives of Clinical Trials","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136247443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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