Objective-To determine whether in patients presenting with posturally related syncope administration of salt increases plasma volume and improves orthostatic tolerance. Patients with poor tolerance of orthostatic stress tend to have lower than average plasma and blood volumes. Design-A double blind placebo controlled study in 20 patients and an open study in 11 of the effects of giving 120 mmoUday of sodium chloride. Patients-31 patients presenting with episodes of syncope who had no apparent cardiac or neurological disease. Plasma volume was determined by Evans blue dye dilution, orthostatic tolerance by time to presyncope in a test of combined headup tilt and lower body suction, and baroreceptor sensitivity by the effect of neck-suction on pulse interval. Results-8 weeks after treatment, 15 (70%) of the 21 patients given salt and three (30%) of the placebo group showed increases in plasma and blood volumes and in orthostatic tolerance, and decreases in baroreceptor sensitivity. Improvement was related to initial salt excretion in that patients who responded to salt had a daily excretion below 170 mmol. The patients in the placebo group who improved also showed increases in salt excretion. Conclusions-In patients with unexplained syncope who had a relatively low salt intake administration of salt increased plasma volume and orthostatic tolerance, and in the absence of contraindications, salt is suggested as a first line of treatment.

1. Studies were carried out on 43 otherwise healthy patients referred for investigation for attacks of syncope of unknown cause and on six healthy volunteers. 2. Plasma volume was determined by Evans Blue dye dilution and blood volume was estimated using haematocrit. Carotid baroreceptor sensitivity was determined from the changes in pulse interval in response to subatmospheric pressures applied to the neck overlying the carotid sinuses, and orthostatic tolerance was assessed as the time to presyncope in a test of head-up tilt, followed by the addition of graded lower body suction. 3. Eight patients and one volunteer fainted during head-up tilt alone, 23 patients and two volunteers fainted during tilt with lower body suction at -20 mmHg and 12 patients and three volunteers either fainted during suction at -40 mmHg or tolerated the entire procedure. 4. Although plasma and blood volumes were higher in males than females, the values normalized for either body weight or for calculated lean body mass were not different between male and female patients and asymptomatic volunteers. The subjects showing the greatest resistance to syncope were found to have significantly larger plasma and blood volumes (P < 0.0001) and significantly smaller baroreceptor sensitivities (P < 0.0002) than those who fainted earlier.(ABSTRACT TRUNCATED AT 250 WORDS)

This study was conducted to evaluate the anatomical and functional results of sigmoid colon vaginoplasty. From June 2000 to June 2005, 26 patients with congenital vaginal agenesis were evaluated and treated with sigmoid colon reconstruction at Ain Shams University Maternity Hospital as a primary procedure in 17 patients and a secondary procedure in 9 patients after previous failed Abbe-McIndoe vaginoplasty elsewhere. The anatomical results were good in 22 patients, while 3 patients suffered from introital stenosis. Two of them were treated successfully by dilatation while one required Z-plasty. Eight patients were lost to follow-up and only ten patients are currently sexually active as the rest were divorced or remained unmarried. Of the sexually active patients, 8 (80%) had satisfactory intercourse whereas 2 (20%) complained of dyspareunia. Sigmoid colon vaginoplasty has satisfactory long-term anatomical and functional results and should be considered as primary option for the treatment of vaginal agenesis.

Endometrial injury using a Pipelle catheter in the stimulation cycle may improve pregnancy rates in women undergoing intrauterine insemination.

The Risk of Malignancy Index (RMI) is used for the prediction of ovarian malignancy. It includes menopausal status, carbohydrate antigen 125 serum levels, and ultrasound criteria. Three-dimensional power Doppler (3-DPD) is a reproducible investigation for assessment of tumor vascularity, classifying vascularity to avascular, parallel, and chaotic patterns. In this study; 3-DPD was added to RMI for prediction of malignancy in 400 cases of ovarian masses. Sensitivity of RMI for prediction of malignancy was 88%, with a cutoff value of 202.5 at 95% confidence interval. Sensitivity of 3-DPD for prediction of malignancy was 75%, adding 3-DPD to RMI increased its sensitivity to 99%. Considering the pilot nature of the study, further studies are needed to corroborate such findings.