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Aim of the work: The objective of this trial was to compare between bilateral total salpingectomy (BTS) as a theoretically more effective ovarian cancer (OvCa) risk-reducing primary prevention and bilateral partial salpingectomy (BPS) [stander tubal ligation (STL)] procedures at time of cesarean section (CS) for parturients who completed their reproductive desire and requesting permanent sterilization regard to the impacts of both procedures on ovarian reserve parameters at one year post-sterilization as well as the surgical consequences of both procedures. Patients and Methods: This is a prospective, randomized, open-label, concealed allocation, parallel group, superiority trial was conducted at three surgical sites in El-Qulobia, Egypt including Benha University Hospital, Obstetrics and Gynecology Department between October 2015 and October 2017. 120 parturients undergoing CS were allocated to BTS (intervention group) (60) and BPS (control group) (60). Main outcomes were one year post-sterilization differences in ovarian reserve (OR) parameters including hormonal as well as two-dimensional and three-dimensional transvaginal ultrasonographic parameters ; namely, anti-müllerian hormone (AMH) (ng/ml), follicular stimulating hormone (FSH) (mIu/ml), peak systolic velocity (PSV) (cm/s), antral follicle count (AFC) (n), vascular index (VI) (%), flow index (FI) (0-100), vascular flow index (VFI) (0-100), calculated ovarian age [OvAge (year)] and ovarian volume. Ancillary outcomes were surgical feasibility and surgical consequences. Results: 102 women completed the one-year follow up (85%), 50 in the BTS group and 52 in the BPS group and there were no statistically significant differences regarding the ovarian reserve parameters at one year post-sterilization including AMH, FSH, AFC, VI, FI, VFI OvAge and ovarian volume (P > 0.05). Also, there were no statistically significant differences regarding items included in surgical. consequences comparison (P > 0.05) as well as surgical sterilization feasibility (100% vs 100%, p = 1). Also, there were no apparent complications due to sterilization procedures in both groups. Conclusion: Impacts of bilateral total salpingectomies (BTS) on ovarian reserve as sterilizing procedure during cesarean section as well as rates of surgical consequences are similar with that of bilateral partial salpingectomies (BPS) (STL). So, BTS could be recommended over BPS (STL) for women completing their reproductive desire, despite its better efficacy as ovarian cancer reducing surgery as well as its better clinical and sterilizing efficacy remained to be elucidated. .

Objective: To access the safety and efficacy outcomes of a new abdominal Hysterosacopexy with CESA (Cervicosacropexy) DynaMesh kit in treating advanced uterovaginal prolapse in young women aiming in uterine preservation pelvic organ prolapse (POP) surgery. Patients and Methods: Prospective nonrandomized controlled clinical trial enrolled consecutive women attending the gynecology and obstetrics Department, Benha University Hospital for treatment of POP of stage II or greater on POP quantification (POPQ) system on the apical domain. Participants underwent abdominal hysterosacropexy utilizing CESA mesh kit of DynaMesh. POPQ staging, women symptoms, and quality of life were evaluated before and after surgery, as well as surgery-related morbidity. Results: The current study enrolled 20 women, all women were followed up for a period of 18 months postoperatively. Significant post-surgical anatomical success was recorded across both POPQ anterior (point Aa, Ba) (P ≤ 0.0001, P ≤ 0.0001), apical (point c, d) (P ≤ 0.0001, P≤ 0.0001) and Posterior (point Ap, Bp) (P ≤ 0.0001, P≤ 0.0001) domains. Significant post-surgical functional improvements were recorded across prolapse symptoms, (bulge symptoms, overactive bladder, stress urinary incontinence, bowel dysfunction, sexual dysfunction) (

Aim:The main objective of this trial was to compare the therapeutic efficacy, gastrointestinal and systemic tolerability as well as compliance on oral medicinal iron consumption and total related drugs costs between sustained released ferrous sulphate (SRFS) oral capsules and soft gelatinous capsules of non-ionic ferric (Fe +3 ) polymaltose complex (IPC) in treating gestational iron deficiency anemia (GIDA) in second (2 nd ) and early third (3 rd ) trimester. Patients and Methods:This prospective, open-label, randomized, parallel group, concealed allocation, controlled, multicenter superiority trial was conducted at Benha University Hospital (BUH) and two private clinics in El-Qalubia, Egypt, from October 2016 to December 2017. We screened 500 pregnant women, 310 women were eligible and consented to participate in GIDA trial. All women included were had typical mild or moderate iron deficiency anemia (IDA) as their hemoglobin (HB), and serum ferritin (SF) was ≤ 10.5 or 11 to ≥ 8 gm/dl and ≤ 15 ng/ml respectively. 155 women were allocated to either consume 100mg elemental iron (EI) of dried SRFS (60 capsules of ferroful® / four weeks) in the SRFS arm or 100 mg EI of IPC (28Haemojet® capsules /4weeks) in IPC arm. Main outcomes were the change (Δ) in HB and SF at 4 weeks (T 1 ), 8 weeks (T 2 ), 12 weeks (T 3 ) from baseline levels (T 0 ) as well as incidence of gastrointestinal and systemic adverse side events (ASE) of consumed oral iron capsules and women compliance on drug intakes in addition to direct and indirect drug costs.Results: 298 women started oral iron intake , 150 in SRFS arm and 148 in IPC arm, while at the end of study period (12 weeks), 20 (12.9%) women in SRFS versus 4 (2.6%) in IPC had severe ASE and stopped consumption of oral iron (Δ pp 10.3% at 95% C.I of 4.44, 16.68, P = 0.0004). At any follow up periods T1, T2, T3 the changes in HB were significantly higher in IPC group (P = 0.0001, P = 0.0064, P = 0.012) and changes in SF between T3 and T0 was (58.11 ± 32.34 in SRFS vs 69.63 ± 13.61 with Δ 95% CI of -11.52 (-5.97, -17.06, P = 0.0001). Also percentage of women who consumed ≥ 75% of oral iron capsules / 4 weeks were significantly higher in IPC arm than SRFS arm P = 0.006, P =0.040, P = 0.007. Moreover, the total costs of direct and indirect used drugs were significantly less in IPC arm than SRFS group at T1, T2, T3(P < 0.0001, P < 0.0001, P < 0.0001). No severe sequels were noted in pregnancy outcomes could be attributed to used medicinal oral iron. Conclusion:Oral non -ionic ferric (Fe +3 ) iron polymaltose complex was more effective, more tolerable as well as women were more complaint on its consumption and its total costs were lower than sustained released ferrous sulfate dried capsules in treating mild and moderate gestational iron deficiency in second and early third trimesters.