The mean age of the menopause in Egypt is 46.7 years, which is low compared to many countries, but this age has been rising recently. The incidence of menopause-associated symptoms in Egyptian women is higher than in the West, probably because of the different 'sociocultural attitudes' towards the menopause in different communities. Bone mineral density charts have been constructed for Egyptian women and show that, in general, they have a lower bone mineral density compared to their Western counterparts. After the menopause, they suffer from osteoporosis, particularly at the femoral neck. Egyptian women do not know much about the menopause, except that the incidence of osteoporosis is increased. Their attitude towards the menopause is generally positive and about one-third of them regard the menopause as 'a normal physiological change'. Nevertheless, there exists a need for an awareness campaign in order to educate them about this important stage of their lives.

Objective:To evaluate the relation between uterine killer (uK) cells and unexplained repeated miscarriage (RM). Material and Methods: Eighty women with unexplained repeated miscarriage and missed miscarriage of current pregnancy were studied.Fetal viability and gestational age of the current pregnancy were confirmed by ultrasound, followed by suction evacuation to collect abortion specimens and uterine wall curettage to collect decidua specimens. Abortion specimens were collected for long-term monolayer cell culture and subsequent chromosome analysis using conventional G-banding. Decidua specimens were subjected to immunohistochemical staining using monoclonal antibodies specific to CD56+ and CD16+ expressed by uK cells.Results: CD56+ CD16+ uK cells were found in 85% [68/80] of the studied decidua specimens of women with unexplained repeated miscarriage; 88.5% [54/61] had normal abortion karyotyping and 73.7% [14/19] had abnormal abortion karyotyping. Moreover, 73.75% [59/80] of the studied women with a past history of early miscarriage had CD56+ CD16+ uK cells in their decidua specimens, and 66.25% [53/80] of studied women with a past history of late miscarriage had CD56+ CD16+ uK cells in their decidua specimens; the association between early and late miscarriage and CD56+ CD16+ uK cells in decidua specimens was significant. Conclusion:CD56+CD16+ uK cells were predominant in the decidua specimens of the studied women with repeated miscarriage. A significant association was found between the presence of CD56+ CD16+ uK cells in the studied decidua specimens and unexplained repeated miscarriage. (J Turk Ger Gynecol Assoc 2015; 16: 214-8) Keywords: Obstetrics, uterine killer cells, repeated miscarriage Received: 27 April, 2015 Accepted: 14 October, 2015 Relationship between uterine natural killer cells and unexplained repeated miscarriage Material and MethodsEighty women with unexplained repeated miscarriage and missed miscarriage of current pregnancy were included for evacuation and curettage because of a current missed miscarriage (>8 weeks, diagnosed by ultrasound). The women were studied after proper counseling, consent, and approval of the ethical committee. Unexplained repeated miscarriage was defined as ≥2 previous miscarriages after <20 weeks' gestation. A thorough history was obtained and a thorough examination was performed for all studied women, followed by trans-vaginal ultrasound to confirm fetal the viability and gestational age of the current pregnancy by a sonographer who was blinded to the patients' data. Peripheral venous samples were collected from the studied women for oral glucose tolerance tests; thyroid stimulating hormone assays; prolactin, serum anticardiolipin, and lupus anticoagulant assays; as well as activated protein C resistance tests, Leiden factor V and prothrombin gene mutations, and protein C, S, and anti-thrombin III deficiency tests. Women with septic miscarriage, documented endocrinopathies (diabetes, thyroid disorders, or hyperprolactinemia), uterine anomalies, p...

SummaryCongenital solitary cysts of the liver seldom exceed 10 cm in diameter. Four such cases were seen over a 5-year period in a city with a catchment population of about 800,000. One of these cysts was asymptomatic, but the others were complicated by intracystic haemorrhage, probable perforation and cyst-enteric fistula. Pre-operative liver scans and findings at laparotomy indicated a different treatment in each case--observation, aspiration, enucleation and drainage.

Fetal growth retardation is associated with abnormal umbilical flow velocity. We have begun a systematic study of growth factors and their relationship to this specific pattern of growth retardation. Using a specific double-antibody epidermal growth factor (EGF) 125I-radioimmunoassay, we studied urinary EGF in normal pregnancy from 5 to 42 weeks of gestation, and amniotic fluid EGF from 18 to 24 weeks. EGF levels increased from early pregnancy until 21-28 weeks, when they declined to a level at term similar to non-pregnant controls and first-trimester pregnancy levels. There was no significant difference in urinary EGF levels between women delivering appropriate-for-gestational-age (AGA) infants, and those delivering small-for-gestational-age infants (SGA). We conclude that the urinary EGF is not different in the SGA pregnancy from normal pregnancy.

Urinary incontinence is a silent epidemic severely affecting the quality of life of women. Clinical assessment alone has been shown to be an ineffective way of assessing women with lower urinary tract dysfunction; hence, there is a need for urodynamic studies. Nevertheless, urodynamics cannot explain all the symptoms and is not always available. Ultrasound scan is becoming more useful in the field of urogynaecology. It is safe, non-invasive and acceptable technique for the patients. In this review, we explore the place of modern ultrasound in managing women attending urogynaecology clinic.