Objective: This study aims to assess the ability and the safety of fasting among patients who underwent PPCI within two specified periods. Methods: This study was a Retrospective Cohort Study with a convenience sample size of 200 consecutive patients who were divided into two groups based on the duration of their last primary PCI for an attack of acute myocardial infarction (AMI) and the start of the month of Ramadan. The patients were admitted to the Causality Department of the Surgical Specialty Hospital-Cardiac Center, Erbil/Iraq. Group I included patients undergone PPCI 6 weeks or less before the start of Ramadan while group II included patients undergone PPCI for more than 6 weeks before the start of the fasting month of Ramadan. Furthermore, each of these two groups was subdivided based on their ability to complete the Ramadan Intermittent Fasting (RIF) with no recurring or worsening of symptoms into those who fasted the whole Ramadan month, those who did not fast, those who could not continue fasting, and those who passed away. At the end of the RIF, patients’ symptoms were recorded along with their status according to the New York Heart Association (NYHA). Results: In a comparison of the proportion of fasting and non-fasting patients among the two groups, 14% in group I were able to complete the 30 days of intermittent fasting during the Ramadan month while this percentage in group II was 54% (P-value=0.001). Among our findings, there were significant associations between post-PCI symptoms (exertional shortness of breath and palpitations) and RIF (P-values=0.001and P-values=0.004, respectively). With regards to New York Heart Association (NYHA) classifications assessment, Group I had a higher proportion of patients classified as Class III and Class IV compared to Group II (P-value=0.001) meaning patients were more symptomatic during the lesser interval between the start of the fasting month and the primary PCI.  Conclusion: Patients with PPCI within the first 6 weeks after the procedure, as well as patients with NYHA class III, are at a higher risk for health deterioration and are advised not to observe RIF.

Background: The rise of Primary Percutaneous Coronary Intervention (PPCI) procedure as an option for treating Coronary Artery Diseases demands addressing a variety of concerns in the recovery period and afterward including fasting the Ramadan month in the countries with the prevailing Muslim population. Therefore this study aims to assess the ability and the safety of fasting among patients who underwent PPCI within two specified periods.Method: This study was a prospective observational study with a sample size of 200 consecutive patients that have been divided into two groups based on the duration of their last PCI for an attack of Acute Myocardial Infarction (AMI). The patients were admitted to the Causality Department of the Surgical Specialty Hospital-Cardiac Center, Erbil/Iraq. The studied data have been analyzed using the Statistical Package for Social Science version 25 (SPSS), and a P-value of ≤0.05 was considered statistically significant.Results: The proportion of fasting and non-fasting patients showed a significant association with the duration of their last PCI procedure with a P-value of 0.001 as 14% in Group I (patients with less than 6 weeks duration post-PCI) successfully fasted the month while it was 54% in Group II (Patients with more than 6 weeks duration post PCI). Among our findings, there were significant associations with P-values of 0.001 between post-PCI symptoms and Ramadan fasting. In regards to NYHA classifications assessment, Group I had a higher proportion of patients classified as Class III and Class IV compared to Group II with a significant P-value of 0.001 with proportions of class III classification in Group I of 14.3% among fasting, 17.1% among non-fasting, and 58.3% among those who could not continue their fasting while in Group II, the proportions showed 3.7% among fasting, 6.7% among non-fasting, and 0% among those who could not continue their fasting.Conclusion: We discourage fasting among patients who have undergone Percutaneous Coronary Intervention within the first 6 weeks, as well as patients who have NYHA class III and above as they are highly liable for deterioration and can not continue their fasting.

Background: Dysfunctional uterine bleeding (DUB) is one of the commonest condition for which patient seeks out medical consultation. The prevalence increases with the increase of age peaking before menopause. Objective: The aim of this work is to evaluate the effect of this new form of levonorgestrel-releasing IUD on the treatment of patients with abnormal uterine bleeding. Subjects and methods: A prospective age-specific comparative analysis of 61 peri-menopausal women presented with dysfunctional uterine bleeding who constituted the study group. They underwent hysteroscopy and endometrial sampling during an 18 months period from June 2014 to January 2016 at Ain Shams University Materity Hospital. Prior to metraplant-E application, all the patients in this study were in the age of 25-58 years old. Results: The role of Metraplant-E in the treatment of abnormal uterine bleeding (AUB) was evaluated. Sixty-one women with failed attempt(s) of medical treatment unwilling or unfit for hysterectomy were treated with Metaplant-E. Menstrual blood loss was assessed by pictoral bleeding assessment chart (PBAC), bleeding index (B.I) and total bleeding score (T.B.S/month). The bleeding patterns in the form of the mean menstrual blood loss estimated by bleeding index and the mean menstrual loss estimated by the total bleeding score/month and PBAC decreased significantly (p = 0.001). The quality of life scale (Likert scale) improved significantly (p = 0.001). All 15 cases who had endometrial sampling demonstrated progestational effect on histo-pathological examination. Conclusion: Metraplant-E was found to be effective in managing dysfunctional menorrhagia on both clinical and histopathological levels. Keywords: Metraplant-E, LNG-IUS, Menorrhagia, Contraceptives INTRODUCTIONDysfunctional uterine bleeding (DUB) is one of the commonest condition for which patient seeks out medical consultation. The prevalence increases with the increase of age peaking before menopause. The peri-menopausal women who have anovulatory cycle resulting in DUB. The normal menstrual cycle is defined as having a mean interval of 28 ± 7 days with a men duration of 4 ± 3 days. The upper limit of normal menstruation is 80 ml per menstruation. Any deviation from the normal cycle and the amount of loss is regarded as abnormal uterine bleeding. Dysfunctional uterine bleeding (DUB) is one of the commonest causes of abnormal uterine bleeding. It is defined as heavy and/or irregular menstruation in the absence of detectable pelvic pathology, pregnancy or general bleeding disorder. It affects 20 to 30 % of women and accounts for 12 % of gynecological referrals. DUB can be ovulatory or anovulatory. Anovulatory DUB occurs at extreme reproductive age (adolescence and peri-menopausal age)