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Biomedical subjects

M A Sattar

Publications and source records attributed to M A Sattar.

At least 19 recordsLinked to original sources
PubMed1999

Management of long-standing unexplained infertility: A prospective study.

OBJECTIVE: Our purpose was to evaluate a protocol for the management of long-standing unexplained infertility. STUDY DESIGN: A prospective study was conducted at an in vitro fertilization-embryo transfer center with 485 patients with the diagnosis of long-standing unexplained infertility. Patients were treated by means of controlled ovarian hyperstimulation and intrauterine insemination for a maximum of 3 cycles. Those who did not become pregnant underwent in vitro fertilization and intracytoplasmic sperm injection on sibling oocytes. RESULTS: Among 485 patients, 921 cycles of controlled ovarian hyperstimulation and intrauterine insemination were performed. The pregnancy rate was 15.7% per cycle and 29.8% per patient. Among those who did not become pregnant, 131 patients underwent in vitro fertilization and intracytoplasmic sperm injection into sibling oocytes; 48 women became pregnant (36.7%). There was total failure of the in vitro fertilization oocytes in 23 cycles (17.6%). CONCLUSION: Management of long-standing unexplained infertility with controlled ovarian hyperstimulation and intrauterine insemination resulted in a reasonable pregnancy rate. Treatment by means of in vitro fertilization and intracytoplasmic sperm injection into sibling oocytes among patients who did not become pregnant resulted in a good pregnancy rate. The overall results showed that the proposed protocol for management of unexplained infertility is satisfactory.

Embryo Transfer↗
PubMed1999

Multifetal pregnancy reduction: modification of the technique and analysis of the outcome.

OBJECTIVE: To modify the technique of multifetal pregnancy reduction and to study the outcome of reduced twins in comparison with nonreduced twins and high-order multiple gestations. DESIGN: Prospective controlled study. SETTING: The Egyptian IVF-ET Center, Cairo. PATIENT(S): Seventy-five patients with high-order multiple pregnancies resulting from assisted reproduction. Controls were 40 nonreduced twin pregnancies and 22 high-order multiple gestations. INTERVENTION(S): Transvaginal ultrasonically guided multifetal pregnancy reduction was performed. The first 30 cases were done using KCl as a cardiotoxic agent. The modified technique was used for the last 45 cases at an earlier gestational age (approximately 7 weeks) by eliminating the use of KCI and by aspirating the embryonic parts. MAIN OUTCOME MEASURE(S): Miscarriage rate, gestational age at delivery, birth weight, and pregnancy complications. RESULT(S): Using the modified technique, the miscarriage rate was 8.8% and 41 patients delivered between 32 and 39 weeks of gestation (mean+/-SD, 36.9+/-2.45 weeks). The mean (+/-SD) birth weight was 2,450.51+/-235.44 g. The miscarriage rate, fetal wastage rate, mean gestational age, and mean birth weight were similar in reduced and nonreduced twins and were significantly better than in nonreduced triplets and quadruplets. CONCLUSION(S): The modified technique of multifetal pregnancy reduction significantly improved outcomes, which were similar to those of nonreduced twins resulting from assisted reproduction and significantly better than those of nonreduced triplets and quadruplets.

Female↗
PubMed1998

Teapot myositis.

Explore the source record for details and available documents.

Aged↗
PubMed1998

Complications of medically assisted conception in 3,500 cycles.

OBJECTIVE: To investigate the incidence of complications in the use of assisted reproductive technology in the management of infertile couples. DESIGN: Retrospective study. SETTING: The Egyptian IVF & ET Center, Maadi, Cairo, Egypt. PATIENT(S): Two thousand nine hundred twenty-four patients underwent IVF-ET or intracytoplasmic sperm injection (ICSI) in 3,500 cycles. INTERVENTION(S): IVF-ET, ICSI, ejaculate sperm, epididymal sperm aspiration, and testicular sperm extraction. MAIN OUTCOME MEASURE(S): Complications of the procedure and complications of pregnancy in 702 patients. RESULT(S): Fifteen hundred ovum pickups for IVF-ET and 2,000 ovum pickups for ICSI were performed. Clinical pregnancy occurred in 1,078 patients (30.8%). Four groups of complications were identified. Complications of the procedure occurred in 291 patients (8.3%). Complications of pregnancy included ectopic pregnancy in 1.9%, heterotopic pregnancy in 0.2%. abortion in 20.6%, multiple pregnancy in 28%, pregnancy-induced hypertension in 10%, preterm labor in 21.5%, low birth weight in 30.5%, and intrauterine death in 2%. Coincidental complications occurred in five patients (0.15%). Other complications that were difficult to measure included psychological breakdown and socioeconomic problems. CONCLUSION(S): Assisted reproductive technology is effective for the management of infertility and has an acceptable incidence of complications. Complications rarely endanger the life of the patient. When this line of treatment is offered, the indications should be definitive. Patients should be monitored properly and measures should be taken to minimize the incidence of complications.

Chi-Square Distribution↗
PubMed1996

Intracytoplasmic sperm injection and conventional in vitro fertilization for sibling oocytes in cases of unexplained infertility and borderline semen.

PURPOSE: In a prospective study, conventional IVF and intracytoplasmic sperm injection (ICSI) were performed on sibling oocytes of 22 patients with unexplained infertility (Group A) and 24 patients with borderline semen (Group B). RESULTS: In Group A, there was no significant difference (P = 0.070) in the fertilization rate per oocyte between ICSI (63%) and conventional IVF (50.7%), however, there was total failure of fertilization in conventional IVF in 5 of the 22 patients with IVF and none in ICSI. In group B, there was a significant difference (P < 0.001) between the fertilization rate per oocyte in ICSI (59%) and conventional IVF (27.1%). There was total failure of fertilization in 11 patients after conventional IVF and none after ICSI. CONCLUSIONS: The study showed that 22.7% of unexplained infertility and 45.8% of patients with borderline semen would have lost their chance of embryo transfer completely because of total failure of fertilization if ICSI was not performed on some oocytes in this cycle.

Adult↗
PubMed1996

Recombinant follicle-stimulating hormone in the treatment of patients with history of severe ovarian hyperstimulation syndrome.

OBJECTIVE: To compare the low-dose recombinant FSH and hMG protocols in treatment of patients with history of severe ovarian hyperstimulation syndrome (OHSS). DESIGN: A prospective study on 22 patients with history of severe OHSS. Group A (n = 14) was treated with low-dose recombinant FSH 40 cycles and group B (n = 8) was treated with low-dose hMG in 26 cycles. SETTING: The Egyptian IVF-ET Center, Cairo, Egypt. PATIENT(S): Twenty-two patients with a history of severe OHSS. INTERVENTION(S): Ovulation induction. MAIN OUTCOME MEASURE(S): Estradiol, number of follicles, number of hMG ampules, pregnancy rate (PR), and the development of OHSS. RESULT(S): The cancellation rate, mean E2 level on day of hCG, mean number of days of stimulation, and the mean number of ampules per cycle were 10%, 523 +/- 166 pg/mL (conversion factor to SI unit, 3.671), 17.8 +/- 5.4, and 19 +/- 6.5 in group A and 19.2%, 554 +/- 152 pg/mL, 14.6 +/- 2.5, and 16.1 +/- 3.6 in group B, respectively. Treatment resulted in eight pregnancies (20% per cycle) and two abortions (25%) in group A. In group B, four pregnancies resulted (15.4% per cycle) and two patients aborted (50%). No cases of OHSS developed in both groups. There were no significant differences in all parameters between the two groups. CONCLUSION(S): Recombinant FSH low-dose protocol proved to be as effective as low-dose hMG in producing reasonable ovulation and PRS in polycystic ovary syndrome patients with a history of severe OHSS and the protocol was safe concerning the risk of development of OHSS.

Abortion, Spontaneous↗
PubMed1996

Alpha-1 adrenoceptor subtypes involved in mediating adrenergically induced antinatriuresis and antidiuresis in two kidney, one clip Goldblatt and deoxycorticosterone acetate-salt hypertensive rats.

This study characterized the alpha-1 adrenoceptor subtypes involved in adrenergically induced antinatriuresis and antidiuresis in pentobarbital-anesthetized deoxycorticosterone acetate (DOCA)-salt and two kidney, one clip (2K1C) Goldblatt hypertensive rats. In the DOCA-salt rats, phenylephrine infusion (100 microgram kg(-1) hr(-1) close renal arterially) caused increases in blood pressure of 5 to 10%, decreases in renal blood flow of 5 to 12%, whereas there were large reversible decreases in urine flow and absolute and fractional sodium excretions of 55 to 70%. The presence of chloroethylclonidine (10 microgram kg(-1) hr(-1) to block alpha-1B adrenoceptors) had no effect on the magnitude of the phenylephrine-induced excretory responses, but after 5-methylurapidil (10 microgram kg(-1) hr(-1) to block alpha-1A adrenoceptors) they were abolished. Infusion of phenylephrine in the 2K1C hypertensive rats caused small hemodynamic and renal blood flow responses with marked 55 to 70% reductions in urine flow and absolute and sodium excretion. The phenylephrine-induced antinatriuresis and antidiuresis, which was probably due to activation of alpha-1 adrenoceptors present on the renal tubular epithelial cells, and the fact that these tubular responses were blocked by 5-methylurapidil but not by chloroethylclonidine in both DOCA-salt and 2K1C Goldblatt hypertensive models, means that the alpha-1A adrenoceptors was the major functional subtype present.

Animals↗
PubMed1996

Successful intracytoplasmic sperm injection without performing cytoplasmic aspiration.

OBJECTIVE: To compare the effect of cytoplasmic aspiration versus no aspiration before intracytoplasmic sperm injection (ICSI) on the rate of oocyte damage, fertilization rate, and embryo quality. DESIGN: A randomized prospective study on sibling oocytes. SETTING: The Egyptian IVF-ET Center, Cairo, Egypt. PARTICIPANTS: Fifty-eight patients who were infertile due to male factor who underwent 60 ICSI cycles. INTERVENTION: Intracytoplasmic sperm injection was performed on randomly allocated metaphase II oocytes with cytoplasmic aspiration in group I and without cytoplasmic aspiration in group II before sperm injection. MAIN OUTCOME MEASURE: Fertilization rate, oocyte damage rate, and embryo quality. RESULTS: Normal fertilization rate per injected oocyte was 61.4% in group I compared with 62.5% in group II. The damage rate per injected oocyte was 16.8% in group I compared with 4.6% in group II. Grade I embryos were 24.5% in group I compared with 48.5% in group II. CONCLUSION: Cytoplasmic aspiration before sperm injection in ICSI is not essential for oocyte activation. It did not improve the rate of normal fertilization. On the other hand, it increased the damaged oocyte rate and the rate of cytoplasmic fragments.

Adult↗
PubMed1995

alpha1-Adrenoceptor subtypes mediating antinatriuresis in Wistar and stroke-prone spontaneously hypertensive rats.

This study examined the alpha1-adrenoceptor subtypes involved in mediating adrenergically induced Na+ reabsorption in the kidney of pentobarbitone anaesthetised Wistar and stroke-prone spontaneously hypertensive rats (SHRSP). Close renal-arterial phenylephrine (50-100 mu g kg-1 h-1) administration in Wistars, with regulated renal perfusion pressure, caused small reductions in renal haemodynamics but large reductions, of 35%, 64% and 57% (all P < 0.05), in urine volume, absolute and fractional Na+ excretions. The magnitude of these excretory responses to phenylephrine were similar in the presence of the alpha1B-adrenoceptor alkylating agent, chloroethylclonidine (10 mu g kg-1 h-1), but were blocked during administration of the alpha1A-adrenoceptor antagonist, 5-methylurapidil (10 mu g kg-1 h-1). Phenylephrine infusion in the stroke-prone spontaneously hypertensive rats caused changes in renal haemodynamics and fluid excretion of comparable magnitude to that achieved in Wistars which was blocked by 5-methylurapidil but not chloroethylclonidine. These observations suggest that in Wistar and stroke-prone spontaneously hypertensive rats the adrenergically induced Na+ reabsorptive responses are mediated by alpha1A-adrenoceptors.

Animals↗
PubMed1995

In vitro fertilization in a spontaneous cycle: a successful simple protocol.

OBJECTIVE: To study the efficacy of a simple protocol of in vitro fertilization in the spontaneous natural cycle. METHOD: A prospective study using in vitro fertilization in a natural cycle for the treatment of infertility due to tubal factor. RESULTS: Fifty-eight patients were monitored by vaginal ultrasound and LH in urine for 229 cycles. In 49.8% of the cycles the pick-up was canceled because of the early LH rise or failure to visualize a dominant follicle. Ovum pick-up was performed in 112 cycles and oocyte retrieval rate was 87.5%. Embryo transfer was performed in 86 cycles, pregnancy rate per pick-up was 10.2%, and there was no pregnancy wastage. CONCLUSION: IVF in a spontaneous cycle is a simple, low cost and safe treatment, which yields reasonable PR, for young regularly menstruating women with tubal factors of infertility.

Adult↗
PubMed1994

Evidence for an alpha 1-adrenoceptor subtype mediating adrenergic vasoconstriction in Wistar normotensive and stroke-prone spontaneously hypertensive rat kidney.

We wished to characterise the alpha 1-adrenoceptor subtypes mediating renal vasoconstrictor responses in pentobarbital anaesthetised normotensive rats and stroke-prone spontaneously hypertensive rats (SPSHR). Renal nerve stimulation, close renal arterial administration of phenylephrine (PE, a mixed alpha 1a- and alpha 1b-adrenoceptor agonist) and methoxamine (a putative alpha 1a-adrenoceptor agonist) resulted in frequency and dose-dependent renal vasoconstrictor responses. Both dihydropyridine calcium channel antagonist amlodipine (200 micrograms kg-1 plus 50 micrograms kg-1 h-1 and twice this dose) and the alpha 1a-adrenoceptor antagonist 5-methylurapidil (5 micrograms kg-1 plus 1.25 micrograms kg-1 h-1 and twice this dose) suppressed renal nerve-, PE-, and methoxamine-induced vasoconstrictions by between 21 and 59% (p < 0.05-0.001) in normotensive rats and SPSHR. The alpha 1b-adrenoceptor alkylating agonist chloroethylclonidine (5 micrograms kg-1 plus 1.25 micrograms kg-1 h-1 and twice this dose) attenuated renal nerve-mediated vasoconstrictions by 20% (p < 0.01), but not those induced by PE and methoxamine. This pattern of agonist and blocking drug interaction suggests that the renal postjunctional alpha 1-adrenoceptors require extracellular calcium and are sensitive to 5-methylurapidil, characteristics of the alpha 1a-adrenoceptor subtype. Moreover, a similar situation exists at the renal resistance vessels of SPSHR.

Adrenergic alpha-Antagonists↗
PubMed1993

Management of severe ovarian hyperstimulation syndrome by ascitic fluid aspiration and intensive intravenous fluid therapy.

OBJECTIVE: To assess the value of intensive intravenous (IV) fluid therapy and ascitic fluid aspiration in the management of severe ovarian hyperstimulation syndrome. METHODS: Forty-two women with severe ovarian hyperstimulation syndrome were treated by ultrasonically guided transvaginal aspiration of ascitic fluid and IV fluid infusion. Ten women with the same condition treated conservatively constituted a comparison group. The main outcome measures included percentage change in hematocrit, creatinine clearance, and urine output before and after aspiration. The duration of hospital stay was compared between the groups. RESULTS: Marked improvement of symptoms and general condition followed soon after aspiration. Hematocrit readings decreased by 22%, creatinine clearance increased by 79.3%, and urine output increased by 220.7%. The average volume of aspirated fluid was 3900 mL. The average duration of hospital stay was 3.8 days in the treated women. In the comparison group, severe symptoms and electrolyte imbalance continued for an average of 9 days, and the average hospital stay was 11 days. CONCLUSION: Intensive IV fluid therapy and transvaginal aspiration of ascitic fluid are safe and effective in improving symptoms, preventing complications, and shortening the hospital stay in severe ovarian hyperstimulation syndrome.

Ascites↗
PubMed1991

Cryopreservation of the occasionally improved semen samples for intrauterine insemination: a new approach in the treatment of idiopathic male infertility.

OBJECTIVE: To assess the value of treating idiopathic male infertility by intrauterine insemination (IUI) of the occasionally improved cryopreserved semen. DESIGN: Two groups of idiopathic oligospermic patients were chosen at random and treated by IUI using processed fresh semen in group A and the best available cryopreserved semen samples pooled with fresh samples in group B. SETTING: Egyptian IVF-ET Centre, Maadi, CAiro, Egypt. PATIENTS, PARTICIPANTS: One hundred fifty infertile couples because of idiopathic oligoasthenospermia. INTERVENTION: Intrauterine insemination. MAIN OUTCOME MEASURE: The pregnancy rate was evaluated after an average of three treatment cycles. RESULTS: The pregnancy rate (PR) was significantly higher in group B when compared with group A. The improvement in the PR was highly significant in the subgroup of patients for whom reasonable semen samples could be collected and cryopreserved. CONCLUSIONS: Our study indicates that IUI with fresh semen pooled with cryopreserved occasionally improved semen samples for the treatment of oligoasthenospermia results in an improved PR.

Cryopreservation↗
PubMed1991

Plasma vitamin B12 binding proteins correlate with disease activity in patients with rheumatoid arthritis.

The unsaturated vitamin B12 (cobalamin) binding capacity (UB12BC), transcobalamin (TC) I, II and III were measured in plasma and synovial fluid of 55 patients (10 men and 45 women, 25-60 years of age) with rheumatoid arthritis. The vitamin B12 binding proteins in 55 clinically and haematologically normal subjects of similar age group and sex were also studied as controls. The mean plasma concentrations of UB12BC, TCI, II and III were all significantly raised in patients with rheumatoid arthritis (RA) as compared to the normal controls. The increase of all vitamin B12 binding proteins in these patients showed a positive correlation with the increase of total proteins and globulin concentrations, and a negative (inverse) correlation with the albumin concentrations in the plasma, suggesting that these biochemical changes may be systemic consequences of the inflammatory and immunological processes characteristic of rheumatoid arthritis. The UB12BC, TC I and TC III concentrations in the synovial fluid were significantly higher than the corresponding plasma concentrations of these vitamin B12 binding proteins in patients with RA. Vitamin B12 binding proteins in the synovial fluid in these patients were probably at least partly produced locally by inflammatory cells. The mean levels of plasma transcobalamins in patients with severe disease activity were significantly higher than in patients with median or least disease activity. Therefore these proteins may be further studied as possible additional markers of disease activity in patients with RA.

Adult↗
PubMed1990

Penicillamine in systemic sclerosis: a reappraisal.

In a 36-month prospective trial 21 patients with systemic sclerosis (diffuse systemic sclerosis 16 patients and 5 subjects with limited cutaneous subtype) were treated with D-penicillamine. In all patients with diffuse systemic sclerosis there was objective improvement. The degree and extent of skin involvement decreased significantly (p less than 0.001), whereas no objective improvement was noted in patients with limited cutaneous subtype. Further, no systemic progression of the disease was observed during the study period. Our results suggest that a prolonged treatment with D-penicillamine in small doses is not only beneficial and effective but also free of side-effects, if used at an earlier stage.

Adult↗
PubMed1990

Transvaginal ultrasonic needle guided aspiration of pelvic inflammatory cystic masses before ovulation induction for in vitro fertilization.

Transvaginal aspiration of pelvic cystic inflammatory masses guided by a real time ultrasound vaginal transducer is described. The technique was successfully used in 32 patients to aspirate these masses before ovulation induction for in vitro fertilization (IVF). It is a safe and simple procedure that resulted in significantly higher ovarian response to stimulation for IVF, easier ultrasonic follow-up of the follicles, significant increase in the average number of oocytes per pick-up, and significant increase in the number of embryos per transfer when compared with the control group.

Adult↗
PubMed1990

Pericardial tamponade and limited cutaneous systemic sclerosis (CREST syndrome)

A patient with limited cutaneous systemic sclerosis (ISSc) is described who presented with acute chest pain, dyspnoea and signs of cardiac tamponade requiring pericardiocentesis although the quantity of effusion was moderate. The haemodynamic data recorded from this patient suggested that pericardial fibrosis may be a major contributing predisposing factor to pericardial tamponade, while the cause of pericarditis and effusion remain obscure.

Cardiac Tamponade↗