tamer taha - Academia.edu (original) (raw)

Papers by tamer taha

Research paper thumbnail of Consequences of exposure to electromagnetic waves of mobile phones on fetal blood flow and heart rate

Research paper thumbnail of Bio-modulated mice epithelial endometrial organoids by low-level laser therapy serves as an invitro model for endometrial regeneration

Reproductive Biology, 2021

Endometrial regeneration is a dynamic process that is not well understood. The destruction of the... more Endometrial regeneration is a dynamic process that is not well understood. The destruction of the endometrium with the formation of intrauterine adhesions is known as Asherman's syndrome. The lesions range from minor to severe adhesions and their impact on pregnancy is well documented. Operative hysteroscopy is the mainstay of diagnosis and treatment of intrauterine adhesions. Nevertheless, the recurrence rates remain high. It was recorded that low-level laser therapy in low doses has a stimulatory effect on different tissues while the high dose produces a suppressive effect. Organoid is a three-dimensional assembly that displays architectures and functionalities similar to in vivo organs that are being developed from human or animal stem cells or organ-specific progenitors through a self-organization process. Our prospective was to study the effect of Low-Level Laser Therapy (LLLT) on mouse epithelial endometrial organoids regarding cell proliferation and endometrial regeneration as a new modality of treatment. An in vitro clinical trial to generate mouse epithelial organoid model and testing LLLT using He:Ne 632.8 nm device on organoids proliferation, function, and their response to ovarian hormones was performed. Trying endometrial regeneration by culturing organoids with decellularized uterine matrix (DUM) and studying the LLLT effect on the regeneration process. LLLT produced a proliferative effect on the epithelial mouse organoids confirmed by Ki67 and PCNA IHC. The organoids could regenerate the epithelial layer of the endometrium in vitro on DUM and LLLT could help in this process. In conclusion, organoids whether control or bio-stimulated proved a new modality to regenerate the endometrium.

Research paper thumbnail of Laser Vaginal Rejuvenation

Perceptions in Reproductive Medicine, 2018

Historical background Vaginal rejuvenation or tightening is over thousand year old. In 1050 AD, t... more Historical background Vaginal rejuvenation or tightening is over thousand year old. In 1050 AD, the female physician Trota de Ruggiero from Salerno Italy mentioned in her work De Curis Mulierum (Treatments for women) five nonsurgical recipes for "restoring virginity". Later she contributed to another work De Ornatu Mulierum (Women's Cosmetics), which in addition to two other works written by other medieval physicians comprised the compendium on women's medicine commonly known as the Trotula. The Curis Mulierum ensemble became the most widely disseminated and translated works on women's medicine in later medieval Europe. The techniques described in Trotula to suture vaginal lacerations at birth forms the basis for all modern vaginoplasty procedures [1]. In 2002 David Matlock an Ob and Gyn in Beverly Hills started offering vaginoplasties to enhance sex. He trademarked his style of vaginoplasty in newspaper ads. Then he developed a franchise model for others to learn the procedures using a trademarked terminology. He started this business with heavy advertising in journals and in meetings. Meanwhile the cosmetic surgery exploded in popularity worldwide, owing to the introduction of reality TV, Botox, credit card market and social media. Since then, the market starts to offer a great variety of options for vaginal rejuvenation to the women concerning about their genitalia. In addition with the worldwide use of the internet, many cosmetic centers are offering such treatment modalities which become now accusable to women and young girls and recently has invaded the Middle East market [2]. Now a days With the availability of this media and huge market, many women become now aware of the options offered to enhance

Research paper thumbnail of Uterine Epithelial Progesterone Receptor Governs Uterine Receptivity Through Epithelial Cell Differentiation

Endocrinology, 2020

Progesterone receptor (PGR) is indispensable for pregnancy in mammals. Uterine PGR responds to th... more Progesterone receptor (PGR) is indispensable for pregnancy in mammals. Uterine PGR responds to the heightened levels of ovarian progesterone (P4) after ovulation and regulates uterine gene transcription for successful embryo implantation. Although epithelial and stromal P4-PGR signaling may interact with each other to form appropriate endometrial milieu for uterine receptivity and the subsequent embryo attachment, it remains unclear what the specific roles of epithelial P4-PGR signaling in the adult uterus are. Here we generated mice with epithelial deletion of Pgr in the adult uterus (Pgrfl/flLtfCre/+ mice) by crossing Pgr-floxed and Ltf-Cre mice. Pgrfl/flLtfCre/+ mice are infertile due to the impairment of embryo attachment. Pgrfl/flLtfCre/+ uteri did not exhibit epithelial growth arrest, suggesting compromised uterine receptivity. Both epithelial and stromal expressions of P4-responsive genes decreased in Pgrfl/flLtfCre/+ mice during the peri-implantation period, indicating that ...

Research paper thumbnail of Strengths of community and health facilities based interventions in improving women and adolescents’ care seeking behaviors as approaches for reducing maternal mortality and improving birth outcome among low income communities of Egypt

BMC Health Services Research, 2020

Background Provision of emergency obstetric care is considered the key for maternal mortality red... more Background Provision of emergency obstetric care is considered the key for maternal mortality reduction worldwide. This study evaluated the impact of community- and facility-based educational programs on provision of emergency obstetric care in Egypt. The study focused on evaluating utilization of the available health services and care seeking behaviors of mothers in the childbearing period. Methods We implemented a package of community- and facility-focused educational interventions in two of Egypt’s lowest income governorates. At facility level, health professionals at rural health units from 21 villages over 5 years were trained. Mass media gathering, individual teaching at health facilities, printed materials and home-based care sessions were provided. Collectively, these interventions were designed to focusing on recognition of the early warning signs during pregnancy, delivery and postpartum period for timely referral to hospitals for 20,494 women and adolescents mothers. Resu...

Research paper thumbnail of Enhancing the value of women’s reproductive rights through community based interventions in upper Egypt governorates: a randomized interventional study

International Journal for Equity in Health, 2019

Background In 2012, the WHO described the quality of health care as the route to equity and digni... more Background In 2012, the WHO described the quality of health care as the route to equity and dignity for women and children. Aim of the work To provide community based support and empowerment to women in childbearing period to seek optimal prenatal, natal and postnatal healthcare. Achieving this is anticipated to decrease maternal morbidity and mortality in Egypt. Subjects and methods An interventional study was conducted among women in childbearing period in the poorest two governorates of Upper Egypt. The study passed through three stages over three and a half years; pre-interventional assessment of awareness (n = 1000), educational interventions targeting the health providers and all women in childbearing period in their communities (n = 20,494), and post-intervention evaluation of change in awareness of their rights for prenatal, natal and postnatal care (no = 1150). Results The studied indicators relating to receiving care in pregnancy, labor, and puerperium have changed dramati...

Research paper thumbnail of Fetal Biometric Charts and Reference Equations for Pregnant Women Living in Port Said and Ismailia Governorates in Egypt

Open Access Macedonian Journal of Medical Sciences, 2018

AIM: To construct new fetal biometric charts and equations for some fetal biometric parameters fo... more AIM: To construct new fetal biometric charts and equations for some fetal biometric parameters for women between 12th and 41st weeks living in Ismailia and Port Said Governorates in Egypt.MATERIAL AND METHODS: This cross-sectional study was carried out on 656 Egyptian women (from Ismailia and Port Said governorates) with an uncomplicated pregnancy, and all were sure of their dates. The selected group was between the 12th and 41st weeks of gestation, recruited from the district general hospital in Ismailia and Port Said to measure ultrasonographically biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL), then for each measurement separate regression models were fitted to estimate both the mean and the Standard deviation at each gestational age.RESULTS: New Egyptian charts were reported for BPD, HC, AC, and FL. Reference equations for the dating of pregnancy were presented. The mean of the previous measurements at 12th and 41st weeks ...

Research paper thumbnail of Differentially expressed genes: OCT -4, SOX 2, STAT 3, CDH 1 and CDH 2, in cultured mesenchymal stem cells challenged with serum of women with endometriosis

Journal of Genetic Engineering and Biotechnology, 2018

Endometriosis is a common chronic gynecological disorder defined as the presence of ectopic funct... more Endometriosis is a common chronic gynecological disorder defined as the presence of ectopic functional endometrial tissues, outside uterine cavity, primarily on the pelvic peritoneum and the ovaries. Several studies revealed a correlation between aberrant stem-cell activity in the endometrium and endometriosis. Yet the molecular and cellular behaviors of mesnchymal stem cells in development of endometriosis are hampered by lack of invitro experiments. Our aim was to explore morphological and molecular changes associated with mesenchymal stem cells (MSCs) exposition to serum derived from women with severe endometriosis. Two cell cultures of MSCs isolated from endometrial tissues of two endometriosisfree women. Each cell culture was treated individually with the serum of women with endometriosis (experimental group/n = 7), and serum of women without endometriosis (control group/ n = 4) for 14 days. Quantitative Real-Time PCR was performed later to reveal expression of OCT-4, CDH1 and CDH2, STAT3 and SOX2 genes. Morphologically, cells showed no significant changes. However from molecular point of view, we found increased expression in OCT-4, CDH1 and CDH2. For STAT3 and SOX2 we did not find a significant difference. This study shows that endometriosis serum induced molecular changes in human endometrial MSCs (EnMSCs) that might be related to altered cell behavior which may be a step in differentiation that may be completed invivo by other factors to complete the process of transition. Further researches are needed for optimization to reach differentiation.

Research paper thumbnail of Building Oncofertility Core Competency in Developing Countries: Experience From Egypt, Tunisia, Brazil, Peru, and Panama

Journal of global oncology, 2018

Little is known about oncofertility practice in developing countries that usually suffer from a s... more Little is known about oncofertility practice in developing countries that usually suffer from a shortage of health services, especially those related to cancer care. To learn more about oncofertility practice in developing countries, we generated a survey to explore the barriers and opportunities associated with oncofertility practice in five developing countries from Africa and Latin America within our Oncofertility Consortium Global Partners Network. Responses from Egypt, Tunisia, Brazil, Peru, and Panama were collected, reviewed, and discussed. Common barriers were identified by each country, including financial barriers (lack of insurance coverage and high out-of-pocket costs for patients), lack of awareness among providers and patients, cultural and religious constraints, and lack of funding to help to support oncofertility programs. Despite barriers to care, many opportunities exist to grow the field of oncofertility in these five developing countries. It is important to conti...

Research paper thumbnail of Effect of laser-assisted zona thinning, during assisted reproduction, on pregnancy outcome in women with endometriosis: randomized controlled trial

Archives of gynecology and obstetrics, 2018

To compare the ICSI-ET outcomes in patients with endometriosis with or without laser-assisted zon... more To compare the ICSI-ET outcomes in patients with endometriosis with or without laser-assisted zona pellucida thinning. Randomized controlled trial. The study was conducted in the Obstetrics & Gynecology Department, Cairo University hospital, and two private IVF centers in Cairo & Beni-Suif from July 2015 to January 2017 upon infertile and known endometriosis patients who planned to do ICSI-ET. Before randomization, all patients received the same ovarian stimulation preparation, oocyte retrieval procedures, and the same intracytoplasmic sperm injection procedures. After randomization, laser-assisted hatching was performed only for embryos of 158 patients, while the other group (n = 150) no laser-assisted hatching was made. The verification of pregnancy was achieved by the serum hCG concentration 14 days after the embryo transfer, and the clinical pregnancy was confirmed 2 weeks later by the presence of gestational sac with pulsating fetal pole on vaginal ultrasonography. The main out...

Research paper thumbnail of MicroRNA expression analysis in endometriotic serum treated mesenchymal stem cells

EXCLI journal, 2017

Endometriosis is defined by presence of endometrial-like-tissue outside the uterus. Recently, ect... more Endometriosis is defined by presence of endometrial-like-tissue outside the uterus. Recently, ectopic endometriotic lesions have been suggested to originate by abnormal differentiation of endometrial mesenchymal stem cells (eMSCs). MicroRNAs (miRNAs) play an important role in the pathophysiology of endometriosis. Through a PCR array approach, we aimed to assess the differential expression of microRNAs in human eMSC treated in culture with sera derived from women with severe endometriosis. Sera were collected from five patients with severe endometriosis and three control women and added individually in the culture medium to conduct experimental and control eMSC sets, respectively. Regular microscopic follow-up for cell morphology was performed. SYBR Green based real-time PCR array was used to assess the expression of 84 miRNAs. Bioinformatics analysis was done to predict the target genes of the significantly dysregulated miRNAs and their enriched biological processes and pathways. Th...

Research paper thumbnail of Von Willebrand disease among Egyptian women suffering from menorrhagia

Evidence Based Womenʼs Health Journal, 2016

Aim of the work The aim of the present study was to estimate the prevalence of von Willebrand dis... more Aim of the work The aim of the present study was to estimate the prevalence of von Willebrand disease (vWD) among Egyptian women suffering from menorrhagia and without pelvic pathology. Patients and methods This multicenter, prospective cohort study involved 1476 women who complained of menorrhagia at the outpatient clinics of five medical centers in Egypt. Only 359 were diagnosed with dysfunctional uterine bleeding without screening for bleeding disorders, which is not a routine work up among most gynecologists. Those women were tested for von Willebrand factor antigen (vWF Ag), von Willebrand factor activity (vWF Ac), complete blood count, prothrombin time, and international normalized ratio. Results Among the screened women, 17.8% (64/359) had been diagnosed with vWD. The vast majority (81%) had deficient vWF Ag (52/64), whereas only 19% (12/64) were suffering from defective function of the factor. None of our women had type III vWD. There was a significant positive correlation between vWF Ag or vWF Ac and the hemoglobin level (r = 0.231 and 0.174, respectively), whereas the correlation showed a significant negative pattern between vWF Ag and international normalized ratio (r =-0.230, Po0.001). Furthermore, the less activity of the factor the more the menorrhagia days among women recruited (r =-0.422, Po0.001). Conclusion Inherited bleeding disorders are not an uncommon cause of menorrhagia; therefore, it is recommended to test for those disorders especially in the absence of pelvic pathology or with additional bleeding symptoms. We endorse testing for vWD factor and activity among Egyptian women with dysfunctional uterine bleeding and absent pelvic pathology or unresponsive to traditional treatment.

Research paper thumbnail of Estradiol and luteinizing hormone concentrations in the follicular aspirate during ovum pickup as predictors of in vitro fertilization (IVF) outcome

Middle East Fertility Society Journal, 2017

Background: A relationship between 'oocyte quality' and follicular fluid hormones is expected, si... more Background: A relationship between 'oocyte quality' and follicular fluid hormones is expected, since its formation coincides with the 'oocyte maturation' phase. The aim of this study was to find a possible relation between oocyte quality with follicular luteinizing hormone (LH) and estradiol (E 2) as hormonal parameters of oocyte quality during ovum pickup for intracytoplasmic sperm injection (ICSI). Methods: Concentrations of LH and E 2 in individual follicular fluid samples obtained during assisted reproduction treatment were related to oocyte nuclear maturation, fertilization and embryo grading. E 2 and LH differences between individual groups of oocytes and embryos were calculated using the paired Student's t test and ANOVA test. Results: Follicular E 2 levels showed a significant positive correlation with oocyte nuclear maturation, fertilization and embryo grading being higher in follicles whose oocytes had matured nucleus (475 ± 142.9 ng/ml vs. 332 ± 76.4 ng/ml, P value <0.001), normally fertilized (502.5 ± 131.3 ng/ml vs. 339.8 ± 78.3 ng/ml, P value <0.001) and developed into good quality embryos (596.9 ± 72.4 ng/ml grade A vs. 511.7 ± 73 ng/ml grade B vs. 310.9 ± 57 ng/ml grade C, P value <0.001). However Follicular LH was only positively correlated with oocyte nuclear maturation. Conclusions: The local follicular environment may play a key role in the observed differences in oocyte quality. Our results suggest that the use follicular E 2 may be of value in the assessment of oocyte quality. If there is a marker for oocyte quality, it would be possible to select oocytes rather

Research paper thumbnail of Time interval between delivery of the fetus by cesarean section and placental separation using cord traction in relation to the amount of blood loss

Medical Research Journal, 2015

Objective The aim of this study was to estimate the best time interval needed to start delivering... more Objective The aim of this study was to estimate the best time interval needed to start delivering the placenta following fetal delivery in cesarean section (CS) that allows placental delivery with decreased incidence of undue morbidity. Patients and methods This prospective study was conducted on patients attending the Labor Ward, Cairo University Hospital (Egypt). A total of 120 pregnant women who had an indication for elective or emergency CS were studied between October 2009 and May 2010. Women admitted for CS were randomly assigned to one of the four study groups: group A, group B, group C, and group D. The patients were assigned according to the time before beginning cord traction to deliver the placenta after fetal delivery (15, 30, 45, and 60 s, respectively). The primary outcome was the time taken for the placenta to separate, and the secondary outcome measured the morbidity during placental separation. Results In this study, we found that women who had traction on their placentas after 60 s (group D) had the best results in the amount of blood loss from the placental bed (125.36 ± 7.96 ml, n = 30), as well as the least time interval for complete delivery of the placenta (24.7 ± 4.41 s, n = 30), with less complications (16%, n = 30). Conclusion This study suggests that waiting for 1 min after delivery of the fetus before starting cord traction could help in reducing the amount of blood loss from the placental bed. Moreover, this reduces the time interval needed for placental separation after starting cord traction.

Research paper thumbnail of Stem cells restored ovarian function and folliculogenesis in rats following induced ovarian failure

Research paper thumbnail of Prediction of ovarian malignancy using plasma cell-free DNA

Medical Research Journal, 2015

Objective Evaluation of cell-free DNA (cf-DNA) as a noninvasive tool to discriminate between mali... more Objective Evaluation of cell-free DNA (cf-DNA) as a noninvasive tool to discriminate between malignant and benign ovarian growth. Patients and methods DNA was extracted from the plasma of 50 women with ovarian lesion. A total of 20 women with pathologically proven malignancy and 30 women with benign ovarian lesions were included. Quantification of cf-DNA was performed using real-time PCR. cf-DNA was correlated with the histopathology. Results The preoperative plasma cf-DNA level was statistically significantly higher (P < 0.0001) in the malignant group (3.6 ± 1.7 ng/ll) compared with the benign group (0.71 ± 0.69 ng/ml) with 5.04-fold higher in the malignant group than in the benign counterpart. The mean level of cf-DNA in women with benign ovarian lesion (0.71 ± 0.69 ng/ml) did not reach statistically significant difference (P = 0.2) when compared with the mean level among women having endometriotic cysts (0.60 ± 0.44 ng/ml). In addition, there was no correlation between the CA-125 and cf-DNA levels (r = 0.127, P = 0.07), with sensitivity of 96% and specificity of 84%, with a cutoff limit of 1.4 ng/ml in diagnosing malignancy. Conclusion Detection of cf-DNA holds promise as a diagnostic test for women with ovarian cancer. We recommend its incorporation into the workup investigations for women attending with adnexal mass.

Research paper thumbnail of Detection of cell-free fetal DNA in plasma of pregnant women using multiplex quantitative fluorescent-PCR

Medical Research Journal, 2011

Objective To test the sensitivity and specificity of retrieved cell-free fetal DNA (cff-DNA) from... more Objective To test the sensitivity and specificity of retrieved cell-free fetal DNA (cff-DNA) from maternal plasma in the first and second trimesters for future use in clinical practice as a safe noninvasive prenatal diagnostic tool. Methods Maternal blood was drawn from 25 women from the outpatient antenatal clinic of the National Research Centre between 10 + 0 and 12 + 6 weeks of gestation for quantitative fluorescent-PCR (QF-PCR). DNA was extracted from maternal buffy coat and from 0.8 ml cell-free maternal plasma samples using a QIAamp DNA Blood Mini Kit. All women were followed up until delivery according to the antenatal unit protocol, when neonatal blood was collected for a confirmatory QF-PCR. PCR amplifications were performed using the Amp FlSTR Identifier PCR Amplification Kit, which coamplifies the repeat regions of 15 short tandem repeat loci. Segments of the X and Y homologous genes were also amplified for sex identification. Conclusion Circulatory cff-DNA can be easily enriched from the plasma of pregnant women as early as 10 weeks' gestation and onward. This technique relies on informative markers and the availability of parental DNA. Therefore, it can be used as a routine method for prenatal screening for common chromosomal or sex-linked aneuploidies.

Research paper thumbnail of FSHR gene polymorphisms affect the ovarian response to rFSH stimulation in Egyptian patients undergoing ARTs

Medical Research Journal, 2014

Objective The aim of the study was to assess the potential of follicle-stimulating hormone recept... more Objective The aim of the study was to assess the potential of follicle-stimulating hormone receptor (FSHR) gene polymorphism for predicting ovarian response to FSH stimulation. Methods We retrospectively analyzed clinical data of 150 infertile women younger than 40 years who were attending the National Research Center infertility clinic, Egypt. These women were divided into two groups: group I patients (75 patients) were considered as poor ovarian responders according to the 'Bologna criteria' and group II patients (75 patients) were considered as good responders. Analysis of FSHR gene polymorphism at position 680 was carried out after the women were genotyped. Results Among Egyptian women, the frequency of the Asn/Asn genotype was significantly more prevalent in the poor responder group (65.3%) compared with the good responder group (24.0%) (P < 0.05); the Ser/Asn genotype was seen in 34.7% of poor responders compared with 64% of good responders and the Ser/Ser phenotype was seen only in good responders (12%). Conclusion It was found that polymorphism + 2039A > G (p.Asn680Ser) of FSHR could be suggested as a good predictor of ovarian response upon controlled FSH stimulation.

Research paper thumbnail of Is Mini-Mental Score Examination Scoring a New Predictor of Uncontrolled Hypertension?

The Journal of Clinical Hypertension, 2014

Essential hypertension is an important risk factor for target organ damage. The brain is among th... more Essential hypertension is an important risk factor for target organ damage. The brain is among the target organs infrequently visited. The authors evaluated whether an abnormal Mini-Mental Score Examination (MMSE) score predicts uncontrolled hypertension even if office blood pressure is normal. Seventy-seven hypertensive patients were included. The cognitive function of each patient was assessed using MMSE and a customized brain magnetic resonance imaging study. Patients were classified into normal cognitive function group and mild, moderate, and severe cognitive impairment groups. A significance level of P=.05 was used. There was a higher percentage of uncontrolled BP in every cognitive impairment class. In patients older than 65 years, MMSE score had a sensitivity and specificity of 94% and 83%, respectively, in the prediction of uncontrolled hypertension. MMSE is a simple test to run in the clinic to predict whether patients have well-controlled blood pressure.

Research paper thumbnail of Consequences of exposure to electromagnetic waves of mobile phones on fetal blood flow and heart rate

Research paper thumbnail of Bio-modulated mice epithelial endometrial organoids by low-level laser therapy serves as an invitro model for endometrial regeneration

Reproductive Biology, 2021

Endometrial regeneration is a dynamic process that is not well understood. The destruction of the... more Endometrial regeneration is a dynamic process that is not well understood. The destruction of the endometrium with the formation of intrauterine adhesions is known as Asherman's syndrome. The lesions range from minor to severe adhesions and their impact on pregnancy is well documented. Operative hysteroscopy is the mainstay of diagnosis and treatment of intrauterine adhesions. Nevertheless, the recurrence rates remain high. It was recorded that low-level laser therapy in low doses has a stimulatory effect on different tissues while the high dose produces a suppressive effect. Organoid is a three-dimensional assembly that displays architectures and functionalities similar to in vivo organs that are being developed from human or animal stem cells or organ-specific progenitors through a self-organization process. Our prospective was to study the effect of Low-Level Laser Therapy (LLLT) on mouse epithelial endometrial organoids regarding cell proliferation and endometrial regeneration as a new modality of treatment. An in vitro clinical trial to generate mouse epithelial organoid model and testing LLLT using He:Ne 632.8 nm device on organoids proliferation, function, and their response to ovarian hormones was performed. Trying endometrial regeneration by culturing organoids with decellularized uterine matrix (DUM) and studying the LLLT effect on the regeneration process. LLLT produced a proliferative effect on the epithelial mouse organoids confirmed by Ki67 and PCNA IHC. The organoids could regenerate the epithelial layer of the endometrium in vitro on DUM and LLLT could help in this process. In conclusion, organoids whether control or bio-stimulated proved a new modality to regenerate the endometrium.

Research paper thumbnail of Laser Vaginal Rejuvenation

Perceptions in Reproductive Medicine, 2018

Historical background Vaginal rejuvenation or tightening is over thousand year old. In 1050 AD, t... more Historical background Vaginal rejuvenation or tightening is over thousand year old. In 1050 AD, the female physician Trota de Ruggiero from Salerno Italy mentioned in her work De Curis Mulierum (Treatments for women) five nonsurgical recipes for "restoring virginity". Later she contributed to another work De Ornatu Mulierum (Women's Cosmetics), which in addition to two other works written by other medieval physicians comprised the compendium on women's medicine commonly known as the Trotula. The Curis Mulierum ensemble became the most widely disseminated and translated works on women's medicine in later medieval Europe. The techniques described in Trotula to suture vaginal lacerations at birth forms the basis for all modern vaginoplasty procedures [1]. In 2002 David Matlock an Ob and Gyn in Beverly Hills started offering vaginoplasties to enhance sex. He trademarked his style of vaginoplasty in newspaper ads. Then he developed a franchise model for others to learn the procedures using a trademarked terminology. He started this business with heavy advertising in journals and in meetings. Meanwhile the cosmetic surgery exploded in popularity worldwide, owing to the introduction of reality TV, Botox, credit card market and social media. Since then, the market starts to offer a great variety of options for vaginal rejuvenation to the women concerning about their genitalia. In addition with the worldwide use of the internet, many cosmetic centers are offering such treatment modalities which become now accusable to women and young girls and recently has invaded the Middle East market [2]. Now a days With the availability of this media and huge market, many women become now aware of the options offered to enhance

Research paper thumbnail of Uterine Epithelial Progesterone Receptor Governs Uterine Receptivity Through Epithelial Cell Differentiation

Endocrinology, 2020

Progesterone receptor (PGR) is indispensable for pregnancy in mammals. Uterine PGR responds to th... more Progesterone receptor (PGR) is indispensable for pregnancy in mammals. Uterine PGR responds to the heightened levels of ovarian progesterone (P4) after ovulation and regulates uterine gene transcription for successful embryo implantation. Although epithelial and stromal P4-PGR signaling may interact with each other to form appropriate endometrial milieu for uterine receptivity and the subsequent embryo attachment, it remains unclear what the specific roles of epithelial P4-PGR signaling in the adult uterus are. Here we generated mice with epithelial deletion of Pgr in the adult uterus (Pgrfl/flLtfCre/+ mice) by crossing Pgr-floxed and Ltf-Cre mice. Pgrfl/flLtfCre/+ mice are infertile due to the impairment of embryo attachment. Pgrfl/flLtfCre/+ uteri did not exhibit epithelial growth arrest, suggesting compromised uterine receptivity. Both epithelial and stromal expressions of P4-responsive genes decreased in Pgrfl/flLtfCre/+ mice during the peri-implantation period, indicating that ...

Research paper thumbnail of Strengths of community and health facilities based interventions in improving women and adolescents’ care seeking behaviors as approaches for reducing maternal mortality and improving birth outcome among low income communities of Egypt

BMC Health Services Research, 2020

Background Provision of emergency obstetric care is considered the key for maternal mortality red... more Background Provision of emergency obstetric care is considered the key for maternal mortality reduction worldwide. This study evaluated the impact of community- and facility-based educational programs on provision of emergency obstetric care in Egypt. The study focused on evaluating utilization of the available health services and care seeking behaviors of mothers in the childbearing period. Methods We implemented a package of community- and facility-focused educational interventions in two of Egypt’s lowest income governorates. At facility level, health professionals at rural health units from 21 villages over 5 years were trained. Mass media gathering, individual teaching at health facilities, printed materials and home-based care sessions were provided. Collectively, these interventions were designed to focusing on recognition of the early warning signs during pregnancy, delivery and postpartum period for timely referral to hospitals for 20,494 women and adolescents mothers. Resu...

Research paper thumbnail of Enhancing the value of women’s reproductive rights through community based interventions in upper Egypt governorates: a randomized interventional study

International Journal for Equity in Health, 2019

Background In 2012, the WHO described the quality of health care as the route to equity and digni... more Background In 2012, the WHO described the quality of health care as the route to equity and dignity for women and children. Aim of the work To provide community based support and empowerment to women in childbearing period to seek optimal prenatal, natal and postnatal healthcare. Achieving this is anticipated to decrease maternal morbidity and mortality in Egypt. Subjects and methods An interventional study was conducted among women in childbearing period in the poorest two governorates of Upper Egypt. The study passed through three stages over three and a half years; pre-interventional assessment of awareness (n = 1000), educational interventions targeting the health providers and all women in childbearing period in their communities (n = 20,494), and post-intervention evaluation of change in awareness of their rights for prenatal, natal and postnatal care (no = 1150). Results The studied indicators relating to receiving care in pregnancy, labor, and puerperium have changed dramati...

Research paper thumbnail of Fetal Biometric Charts and Reference Equations for Pregnant Women Living in Port Said and Ismailia Governorates in Egypt

Open Access Macedonian Journal of Medical Sciences, 2018

AIM: To construct new fetal biometric charts and equations for some fetal biometric parameters fo... more AIM: To construct new fetal biometric charts and equations for some fetal biometric parameters for women between 12th and 41st weeks living in Ismailia and Port Said Governorates in Egypt.MATERIAL AND METHODS: This cross-sectional study was carried out on 656 Egyptian women (from Ismailia and Port Said governorates) with an uncomplicated pregnancy, and all were sure of their dates. The selected group was between the 12th and 41st weeks of gestation, recruited from the district general hospital in Ismailia and Port Said to measure ultrasonographically biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL), then for each measurement separate regression models were fitted to estimate both the mean and the Standard deviation at each gestational age.RESULTS: New Egyptian charts were reported for BPD, HC, AC, and FL. Reference equations for the dating of pregnancy were presented. The mean of the previous measurements at 12th and 41st weeks ...

Research paper thumbnail of Differentially expressed genes: OCT -4, SOX 2, STAT 3, CDH 1 and CDH 2, in cultured mesenchymal stem cells challenged with serum of women with endometriosis

Journal of Genetic Engineering and Biotechnology, 2018

Endometriosis is a common chronic gynecological disorder defined as the presence of ectopic funct... more Endometriosis is a common chronic gynecological disorder defined as the presence of ectopic functional endometrial tissues, outside uterine cavity, primarily on the pelvic peritoneum and the ovaries. Several studies revealed a correlation between aberrant stem-cell activity in the endometrium and endometriosis. Yet the molecular and cellular behaviors of mesnchymal stem cells in development of endometriosis are hampered by lack of invitro experiments. Our aim was to explore morphological and molecular changes associated with mesenchymal stem cells (MSCs) exposition to serum derived from women with severe endometriosis. Two cell cultures of MSCs isolated from endometrial tissues of two endometriosisfree women. Each cell culture was treated individually with the serum of women with endometriosis (experimental group/n = 7), and serum of women without endometriosis (control group/ n = 4) for 14 days. Quantitative Real-Time PCR was performed later to reveal expression of OCT-4, CDH1 and CDH2, STAT3 and SOX2 genes. Morphologically, cells showed no significant changes. However from molecular point of view, we found increased expression in OCT-4, CDH1 and CDH2. For STAT3 and SOX2 we did not find a significant difference. This study shows that endometriosis serum induced molecular changes in human endometrial MSCs (EnMSCs) that might be related to altered cell behavior which may be a step in differentiation that may be completed invivo by other factors to complete the process of transition. Further researches are needed for optimization to reach differentiation.

Research paper thumbnail of Building Oncofertility Core Competency in Developing Countries: Experience From Egypt, Tunisia, Brazil, Peru, and Panama

Journal of global oncology, 2018

Little is known about oncofertility practice in developing countries that usually suffer from a s... more Little is known about oncofertility practice in developing countries that usually suffer from a shortage of health services, especially those related to cancer care. To learn more about oncofertility practice in developing countries, we generated a survey to explore the barriers and opportunities associated with oncofertility practice in five developing countries from Africa and Latin America within our Oncofertility Consortium Global Partners Network. Responses from Egypt, Tunisia, Brazil, Peru, and Panama were collected, reviewed, and discussed. Common barriers were identified by each country, including financial barriers (lack of insurance coverage and high out-of-pocket costs for patients), lack of awareness among providers and patients, cultural and religious constraints, and lack of funding to help to support oncofertility programs. Despite barriers to care, many opportunities exist to grow the field of oncofertility in these five developing countries. It is important to conti...

Research paper thumbnail of Effect of laser-assisted zona thinning, during assisted reproduction, on pregnancy outcome in women with endometriosis: randomized controlled trial

Archives of gynecology and obstetrics, 2018

To compare the ICSI-ET outcomes in patients with endometriosis with or without laser-assisted zon... more To compare the ICSI-ET outcomes in patients with endometriosis with or without laser-assisted zona pellucida thinning. Randomized controlled trial. The study was conducted in the Obstetrics & Gynecology Department, Cairo University hospital, and two private IVF centers in Cairo & Beni-Suif from July 2015 to January 2017 upon infertile and known endometriosis patients who planned to do ICSI-ET. Before randomization, all patients received the same ovarian stimulation preparation, oocyte retrieval procedures, and the same intracytoplasmic sperm injection procedures. After randomization, laser-assisted hatching was performed only for embryos of 158 patients, while the other group (n = 150) no laser-assisted hatching was made. The verification of pregnancy was achieved by the serum hCG concentration 14 days after the embryo transfer, and the clinical pregnancy was confirmed 2 weeks later by the presence of gestational sac with pulsating fetal pole on vaginal ultrasonography. The main out...

Research paper thumbnail of MicroRNA expression analysis in endometriotic serum treated mesenchymal stem cells

EXCLI journal, 2017

Endometriosis is defined by presence of endometrial-like-tissue outside the uterus. Recently, ect... more Endometriosis is defined by presence of endometrial-like-tissue outside the uterus. Recently, ectopic endometriotic lesions have been suggested to originate by abnormal differentiation of endometrial mesenchymal stem cells (eMSCs). MicroRNAs (miRNAs) play an important role in the pathophysiology of endometriosis. Through a PCR array approach, we aimed to assess the differential expression of microRNAs in human eMSC treated in culture with sera derived from women with severe endometriosis. Sera were collected from five patients with severe endometriosis and three control women and added individually in the culture medium to conduct experimental and control eMSC sets, respectively. Regular microscopic follow-up for cell morphology was performed. SYBR Green based real-time PCR array was used to assess the expression of 84 miRNAs. Bioinformatics analysis was done to predict the target genes of the significantly dysregulated miRNAs and their enriched biological processes and pathways. Th...

Research paper thumbnail of Von Willebrand disease among Egyptian women suffering from menorrhagia

Evidence Based Womenʼs Health Journal, 2016

Aim of the work The aim of the present study was to estimate the prevalence of von Willebrand dis... more Aim of the work The aim of the present study was to estimate the prevalence of von Willebrand disease (vWD) among Egyptian women suffering from menorrhagia and without pelvic pathology. Patients and methods This multicenter, prospective cohort study involved 1476 women who complained of menorrhagia at the outpatient clinics of five medical centers in Egypt. Only 359 were diagnosed with dysfunctional uterine bleeding without screening for bleeding disorders, which is not a routine work up among most gynecologists. Those women were tested for von Willebrand factor antigen (vWF Ag), von Willebrand factor activity (vWF Ac), complete blood count, prothrombin time, and international normalized ratio. Results Among the screened women, 17.8% (64/359) had been diagnosed with vWD. The vast majority (81%) had deficient vWF Ag (52/64), whereas only 19% (12/64) were suffering from defective function of the factor. None of our women had type III vWD. There was a significant positive correlation between vWF Ag or vWF Ac and the hemoglobin level (r = 0.231 and 0.174, respectively), whereas the correlation showed a significant negative pattern between vWF Ag and international normalized ratio (r =-0.230, Po0.001). Furthermore, the less activity of the factor the more the menorrhagia days among women recruited (r =-0.422, Po0.001). Conclusion Inherited bleeding disorders are not an uncommon cause of menorrhagia; therefore, it is recommended to test for those disorders especially in the absence of pelvic pathology or with additional bleeding symptoms. We endorse testing for vWD factor and activity among Egyptian women with dysfunctional uterine bleeding and absent pelvic pathology or unresponsive to traditional treatment.

Research paper thumbnail of Estradiol and luteinizing hormone concentrations in the follicular aspirate during ovum pickup as predictors of in vitro fertilization (IVF) outcome

Middle East Fertility Society Journal, 2017

Background: A relationship between 'oocyte quality' and follicular fluid hormones is expected, si... more Background: A relationship between 'oocyte quality' and follicular fluid hormones is expected, since its formation coincides with the 'oocyte maturation' phase. The aim of this study was to find a possible relation between oocyte quality with follicular luteinizing hormone (LH) and estradiol (E 2) as hormonal parameters of oocyte quality during ovum pickup for intracytoplasmic sperm injection (ICSI). Methods: Concentrations of LH and E 2 in individual follicular fluid samples obtained during assisted reproduction treatment were related to oocyte nuclear maturation, fertilization and embryo grading. E 2 and LH differences between individual groups of oocytes and embryos were calculated using the paired Student's t test and ANOVA test. Results: Follicular E 2 levels showed a significant positive correlation with oocyte nuclear maturation, fertilization and embryo grading being higher in follicles whose oocytes had matured nucleus (475 ± 142.9 ng/ml vs. 332 ± 76.4 ng/ml, P value <0.001), normally fertilized (502.5 ± 131.3 ng/ml vs. 339.8 ± 78.3 ng/ml, P value <0.001) and developed into good quality embryos (596.9 ± 72.4 ng/ml grade A vs. 511.7 ± 73 ng/ml grade B vs. 310.9 ± 57 ng/ml grade C, P value <0.001). However Follicular LH was only positively correlated with oocyte nuclear maturation. Conclusions: The local follicular environment may play a key role in the observed differences in oocyte quality. Our results suggest that the use follicular E 2 may be of value in the assessment of oocyte quality. If there is a marker for oocyte quality, it would be possible to select oocytes rather

Research paper thumbnail of Time interval between delivery of the fetus by cesarean section and placental separation using cord traction in relation to the amount of blood loss

Medical Research Journal, 2015

Objective The aim of this study was to estimate the best time interval needed to start delivering... more Objective The aim of this study was to estimate the best time interval needed to start delivering the placenta following fetal delivery in cesarean section (CS) that allows placental delivery with decreased incidence of undue morbidity. Patients and methods This prospective study was conducted on patients attending the Labor Ward, Cairo University Hospital (Egypt). A total of 120 pregnant women who had an indication for elective or emergency CS were studied between October 2009 and May 2010. Women admitted for CS were randomly assigned to one of the four study groups: group A, group B, group C, and group D. The patients were assigned according to the time before beginning cord traction to deliver the placenta after fetal delivery (15, 30, 45, and 60 s, respectively). The primary outcome was the time taken for the placenta to separate, and the secondary outcome measured the morbidity during placental separation. Results In this study, we found that women who had traction on their placentas after 60 s (group D) had the best results in the amount of blood loss from the placental bed (125.36 ± 7.96 ml, n = 30), as well as the least time interval for complete delivery of the placenta (24.7 ± 4.41 s, n = 30), with less complications (16%, n = 30). Conclusion This study suggests that waiting for 1 min after delivery of the fetus before starting cord traction could help in reducing the amount of blood loss from the placental bed. Moreover, this reduces the time interval needed for placental separation after starting cord traction.

Research paper thumbnail of Stem cells restored ovarian function and folliculogenesis in rats following induced ovarian failure

Research paper thumbnail of Prediction of ovarian malignancy using plasma cell-free DNA

Medical Research Journal, 2015

Objective Evaluation of cell-free DNA (cf-DNA) as a noninvasive tool to discriminate between mali... more Objective Evaluation of cell-free DNA (cf-DNA) as a noninvasive tool to discriminate between malignant and benign ovarian growth. Patients and methods DNA was extracted from the plasma of 50 women with ovarian lesion. A total of 20 women with pathologically proven malignancy and 30 women with benign ovarian lesions were included. Quantification of cf-DNA was performed using real-time PCR. cf-DNA was correlated with the histopathology. Results The preoperative plasma cf-DNA level was statistically significantly higher (P < 0.0001) in the malignant group (3.6 ± 1.7 ng/ll) compared with the benign group (0.71 ± 0.69 ng/ml) with 5.04-fold higher in the malignant group than in the benign counterpart. The mean level of cf-DNA in women with benign ovarian lesion (0.71 ± 0.69 ng/ml) did not reach statistically significant difference (P = 0.2) when compared with the mean level among women having endometriotic cysts (0.60 ± 0.44 ng/ml). In addition, there was no correlation between the CA-125 and cf-DNA levels (r = 0.127, P = 0.07), with sensitivity of 96% and specificity of 84%, with a cutoff limit of 1.4 ng/ml in diagnosing malignancy. Conclusion Detection of cf-DNA holds promise as a diagnostic test for women with ovarian cancer. We recommend its incorporation into the workup investigations for women attending with adnexal mass.

Research paper thumbnail of Detection of cell-free fetal DNA in plasma of pregnant women using multiplex quantitative fluorescent-PCR

Medical Research Journal, 2011

Objective To test the sensitivity and specificity of retrieved cell-free fetal DNA (cff-DNA) from... more Objective To test the sensitivity and specificity of retrieved cell-free fetal DNA (cff-DNA) from maternal plasma in the first and second trimesters for future use in clinical practice as a safe noninvasive prenatal diagnostic tool. Methods Maternal blood was drawn from 25 women from the outpatient antenatal clinic of the National Research Centre between 10 + 0 and 12 + 6 weeks of gestation for quantitative fluorescent-PCR (QF-PCR). DNA was extracted from maternal buffy coat and from 0.8 ml cell-free maternal plasma samples using a QIAamp DNA Blood Mini Kit. All women were followed up until delivery according to the antenatal unit protocol, when neonatal blood was collected for a confirmatory QF-PCR. PCR amplifications were performed using the Amp FlSTR Identifier PCR Amplification Kit, which coamplifies the repeat regions of 15 short tandem repeat loci. Segments of the X and Y homologous genes were also amplified for sex identification. Conclusion Circulatory cff-DNA can be easily enriched from the plasma of pregnant women as early as 10 weeks' gestation and onward. This technique relies on informative markers and the availability of parental DNA. Therefore, it can be used as a routine method for prenatal screening for common chromosomal or sex-linked aneuploidies.

Research paper thumbnail of FSHR gene polymorphisms affect the ovarian response to rFSH stimulation in Egyptian patients undergoing ARTs

Medical Research Journal, 2014

Objective The aim of the study was to assess the potential of follicle-stimulating hormone recept... more Objective The aim of the study was to assess the potential of follicle-stimulating hormone receptor (FSHR) gene polymorphism for predicting ovarian response to FSH stimulation. Methods We retrospectively analyzed clinical data of 150 infertile women younger than 40 years who were attending the National Research Center infertility clinic, Egypt. These women were divided into two groups: group I patients (75 patients) were considered as poor ovarian responders according to the 'Bologna criteria' and group II patients (75 patients) were considered as good responders. Analysis of FSHR gene polymorphism at position 680 was carried out after the women were genotyped. Results Among Egyptian women, the frequency of the Asn/Asn genotype was significantly more prevalent in the poor responder group (65.3%) compared with the good responder group (24.0%) (P < 0.05); the Ser/Asn genotype was seen in 34.7% of poor responders compared with 64% of good responders and the Ser/Ser phenotype was seen only in good responders (12%). Conclusion It was found that polymorphism + 2039A > G (p.Asn680Ser) of FSHR could be suggested as a good predictor of ovarian response upon controlled FSH stimulation.

Research paper thumbnail of Is Mini-Mental Score Examination Scoring a New Predictor of Uncontrolled Hypertension?

The Journal of Clinical Hypertension, 2014

Essential hypertension is an important risk factor for target organ damage. The brain is among th... more Essential hypertension is an important risk factor for target organ damage. The brain is among the target organs infrequently visited. The authors evaluated whether an abnormal Mini-Mental Score Examination (MMSE) score predicts uncontrolled hypertension even if office blood pressure is normal. Seventy-seven hypertensive patients were included. The cognitive function of each patient was assessed using MMSE and a customized brain magnetic resonance imaging study. Patients were classified into normal cognitive function group and mild, moderate, and severe cognitive impairment groups. A significance level of P=.05 was used. There was a higher percentage of uncontrolled BP in every cognitive impairment class. In patients older than 65 years, MMSE score had a sensitivity and specificity of 94% and 83%, respectively, in the prediction of uncontrolled hypertension. MMSE is a simple test to run in the clinic to predict whether patients have well-controlled blood pressure.