INTRODUCTIONThe puerperium (postpartum period or postnatal period) is the period following delivery, during which the hormonal levels and most of the changes in the organs and systems evoluted during pregnancy involute back to its prepregnancy condition. The duration of puerperium starts immediately after the birth of a child and lasts for six weeks during which complete physiological and psychological adjustment occurs, and despite of the indisputable importance of this part of human reproductive process it does not get an adequate attention as the other aspects of obstetrics and gynecology. Iron deficiency is the commonest Nutritional deficiency disorder in the world, affecting more than two billion people. World Health Organization (WHO) show that iron deficiency anemia (IDA) in pregnancy is a big problem with a prevalence over 14% of pregnant women in the first world countries to an average of 56% in the third world countries. 2-3Anemia after the delivery of a child is a common problem throughout the world with the highest prevalence in the developing counties where it represents a major cause of maternal morbidity and mortalities. It has been estimated that 20% of maternal deaths related to delivery, are caused mainly by peripartum hemorrhage and anemia, at the same time where hemorrhage takes all the focus and gets the big attention, post-partum (pp) anemic state takes almost little care by researchers. 4 Anemia of postpartum period is caused by moderate-toheavy blood loss just before, during or after delivery that ABSTRACT Background: The objective of the present study was to compare effect of towel curettage as a new technique, to no curettage in caesarean section on postpartum period duration and hemoglobin level. Methods: Prospective, randomized controlled trial included 403 eligible participants that were attending Elshatby maternity hospital in the duration of this study (2016) and scheduled for primary caesarean section. The patients were randomized into two groups A and B. Group A had towel curettage after manual separation of the placenta, where the decidua and the placental bed were thoroughly curetted by a surgical towel. Group B had manual separation of placenta only. Results: Towel curettage actually shortens the puerperal bleeding days by almost a week and the volume of blood loss by around half a gram/dl, a situation that could be of great concern in the developing countries where iron deficiency anemia can be considered endemic. Conclusions: Suzan towel curettage is a new, simple, cheap methods that deceases duration of puerperium and the amount of useless blood loss post-partum, which may save a good percentage of women from suffering the negative influences of iron deficiency anemia.

Background: Viral hepatitis in pregnant women can be caused by multiple types of hepatitis viruses and can cause a wide range of symptoms and complications, ranging from asymptomatic infection to maternal and fetal deaths. Objective: The aim of this study was to evaluate the sero-prevalence and the associated factors of viral hepatitis B (HBV), viral hepatitis C (HCV) and viral hepatitis E (HEV) among the Egyptian pregnant females. Methods: This cross-sectional study was conducted in the period from January to July 2017 in two selected antenatal clinics; El-shat by maternity university hospital at Alexandria city and El-Behera health insurance antenatal clinic at Damanhur city on 261 apparently healthy gravid women. Eligible women were evaluated by a questionnaire about socio-demographic data and viral serological tests were done at El-shat by maternity University Hospital Laboratory. Results: The overall HBs-Ag sero-prevalence in the pregnant women included in this study was 7 cases (2.7%) and HCV-RNA PCR was 4 cases (1.5%). Of the total study participants, none of them (0%) were anti-HEV IgM positive and 48 cases (18.4%) were anti-HEV IgG positive. According to our results, neither age of the woman, place of residence, past family history of hepatitis virus infection nor having a pet animal had any strong association to be considered as an associated factor for acquiring HEV infection. Conclusion: Although it seems that there are many improvements in the prevalence of different hepatitis viruses in the country, hepatitis viral infections are still high enough to continue their preventive programs and health education, to protect the mothers and their fetuses from the hazardous effects of these serious infections.

The aim of this work was to compare the use of local intrauterine moist heat infusion to intrauterine antibiotics infusion, for treatment of subclinical endometritis which affects reproduction and milk production. 42 repeat breeder cows were divided into 4 groups, group 1 was the untreated control (=10 cows). Group 2 (=10 cows) was treated by 50 ml of Oxytetracycline 5% intrauterine for three successive weeks. Group 3 (=10 cows) intrauterine infusion with 30 ml saline adding to them 10 ml Gentamycin 10% and 10 ml penicillin and streptomycin for three successive weeks. Group 4 (=12 cows) intrauterine infusion with 50 ml sterile boiling water (≈100˚C) was applied directly to the uterus for only one time. Leukogram was done before and after treatment, it showed leukocytosis and neutrophilia in all the study groups. After treatment for 36 hours and one week, there were no significant changes in the leukogram results of groups 1, 2 and 3. While in Group 4 showed decreasing in numbers of leukocytes (11.92 ± 0.75) and neutrophils (0.87 ± 0.16) to its normal limits after 36 hours and one-week post-treatment. Our new method gave the highest cumulative pregnancy rate 83.3% while other groups using antibiotics or antibiotics with saline gave lower pregnancy rate 40% and 50% respectively (P > 0.001). We named this new treatment method "Samia-treat; SAT". SAT is a whole new and effective treatment for cases of repeat breeder which are caused by SCE in dairy cows; it caused increase in reproductive performance and cumulative pregnancy rate without over use of antibiotics.

Background: The objective was to compare the difference between removing vicryl suture thread after skin healing or burry the knots and leaving it to be absorbed in situ, after subcuticular skin closure of Pfannesteil incisions.Methods: Prospective, randomized controlled trial included 449 eligible participants were prospectively recruited between July 2016 and June 2017. All selected patients had a pfannenstial incision with subcuticular skin closure using 2-0 absorbable vicryl stiches (for primary caesarean section or extra peritoneal surgical approach to the prostate, bladder and distal ureters). The left side knot was buried under the skin edge and a knot in the midline and the right edge was made. After 10 days postoperative, the right half of the stitch thread and the two knots were removed, and the left half of the thread was left in situ. Patients were observed for any complication at time of stitch removal, after one month and after 6 months' post-operative.Results: Wound infection rate, hypertrophic scars, keloids and skin itching were significantly higher in the un-removed wound sides while skin dehiscence was significantly higher in the removed wound sides.Conclusions: Leaving behind absorbable suture material after wound healing -when used in subcuticular pfannenstial skin closure- is associated with increased rates of wound infection, hypertrophic scars, itching and keloids, which of course overweight any known benefits of the technique.

Tumor infiltrating lymphocytes (TILs) are used in evaluating the prognosis and determining treatment of different types of cancer with variable degrees of success. The usage of checkpoint inhibitor immunotherapy as a treatment variety for cancer and Adoptive cell therapy is associated with many complications, severe side effects and high expenses. Recently, in a limited number of metastatic GIT and breast cancers, the identification of T-cell specific against so-called tumor neo-antigens and Adoptive transfer of those lymphocytes resulted in some improvement. In 2020, Detection of a T cell receptor (TCR) in a T cell clone that recognized and killed most human cancer cell lines in vitro via the monomorphic MHC class I-related protein MR1, offers an opportunity for pan-cancer therapy Twenty three years earlier, Moist Heat was used successfully to activate a whole different and new immune response that was able to detect genetic mutation in the affected cancer cells and cured many cases of squamous and basal cell carcinomas. In this commentary review, we aimed to revise the literature for updates of TILs usage in cancer prognosis and treatment.