ORIGINAL_ARTICLE
Using β hCG, prolactin and IGFBP I single or in Pairs to diagnose PROM
Background: When diagnosing premature rupture membranes is query, choosing the appropriate management needsadditional confirmatory test. Based on their metabolomics, some biochemical markers have been proposed as diagnosticaids. A perfect test could be composed of combining more than one marker. Combining markers is not arbitrary as somecombinations could inversely impact the diagnostic accuracy of the test.Aim: Improving sensitivity and specificity of diagnosis of preterm premature rupture of membranes by combining quantitativeinsulin like growth factor binding protein 1 (IGFBP-1) with quantitative βHCG and/or quantitative prolactin in cervicovaginalfluid.Materials and Methods: It is a cross sectional study. IGFBP-1, prolactin and β-HCG concentrations in vaginal fluid wereexamined in 180 patients with sure membrane state and the diagnostic accuracy of each marker and each combination wasdetermined. The study was conducted between January 2018 and September 2018 in Ain-Shams University MaternityHospital after the approval of the institutional ethics committee. Informed consent has been obtained from the patientsbefore participation.Results: The sensitivity, specificity, PPV, and NPV of Prolactin with cutoff point 11 μIU/ml are 84.4, 73.2, 73.8,and 79.5, respectively, gives accuracy percentage 75.4%. The sensitivity, specificity, PPV, and NPV of ILGFBP-1 withcutoff point 102 μIU/ml are 88.3, 93.5, 100, and 69.4 respectively gives accuracy percentage 81.5%. The sensitivity,specificity, PPV, and NPV of Β-HCG with cutoff point 104 mIU/mL are 85.1, 83.9, 96.2, and 72.8 respectively givesaccuracy percentage 79.9%. The sensitivity, specificity, PPV, and NPV of the combination of IGFBP-1 and β-HCGare 78.4, 100, 100 and 64 respectively gives accuracy percentage 89.7. The sensitivity, specificity, PPV, and NPV of thecombination of IGFBP-1 and prolactin are 78.4, 100, 100 and 68.7, respectively, gives accuracy percentage 84.2. Thesensitivity, specificity, PPV, and NPV of the combination of β-HCG and prolactin are 79.8, 100, 100 and 63.6 respectivelygives accuracy percentage 77.2.Conclusion:Combining IGFBP-1 and β-HCG is the best diagnostic combination to detect amniotic fluid presence invaginal fluid. Combined IGFBP-1 and prolactin offered very little improvement compared to IGFBP-1 alone. Addingprolactin to β-HCG decreased accuracy than each of the other two markers alone.
https://ebwhj.journals.ekb.eg/article_125771_7f9c717e58ca98be17b436036488e7f0.pdf
2020-11-01
255
263
10.21608/ebwhj.2020.21883.1069
β-hCG
insulin like growth factor binding protein 1 (IGFBP-1)
premature rupture of membranes (PROM)
prolactin
Mohammad
El-Ghannam
1
Department of Obstetrics and Gynecology, Faculty of Medicine, Ain-Shams University, Cairo
AUTHOR
Hassan
Khairy
hassankhairy308@gmail.com
2
Department of Obstetrics and Gynecology, Faculty of Medicine, Ain-Shams University, Cairo
AUTHOR
Mohammad
Mohammad
3
Department of Obstetrics and Gynecology, Faculty of Medicine, Ain-Shams University, Cairo
AUTHOR
Mohammed
El Safty
4
Department of Obstetrics and Gynecology, Faculty of Medicine, Ain-Shams University, Cairo
AUTHOR
Amira
ABOZEID
abozeidamira7@gmail.com
5
El Galaa Teaching Hospital
LEAD_AUTHOR
ORIGINAL_ARTICLE
Vaginal misoprostol versus carbetocin in decreasing blood loss in abdominal momectomy : Randomized controlled trial
Background: Uterine fibroids are the most common female pelvic tumors occurring in about 15% to 30% of women in thereproductive age. When fibroids are associated with symptoms surgical intervention is often indicated.Aim: The aim of the study is to evaluate the efficacy of administration of carbetocin in comparison to vaginal misoprostol in decreasing blood loss in women undergoing abdominal myomectomy. Materials and Methods: The present study is a randomized controlled study carried out in Ain-Shams University Maternity Hospitals. The study included 44 women with age ranged from 25 to 40 years old, subjects were distributed randomly into two equal groups; group 1 included 22 patients who will receive 400 ug misoprostol vaginally, one hour preoperative. Group 2 included 22 patients who will receive bolus of 100 ug carbetocin slowly intravenously once starting anesthesia. Results: Laboratory investigations in this study revealed that there was no statistical significant difference between study groups as regards age, BMI and Parity, Preoperative hemoglobin and HCT (P >0.05). As regards postoperative investigations of Hb and HCT highly statistical significant difference between study groups was found between both groups (P<0.001). In comparing study groups there were no significant differences between women of both groups regarding estimated blood loss, postoperative Hb, postoperative HCT, calculated estimated blood loss, need for blood transfusion and hospital stay (P >0.05). Conclusion: These results showed no statistical difference was found between misoprostol and cabetocin groups in estimated blood loss, calculated estimated blood loss, need for blood transfusion and hospital stay.
https://ebwhj.journals.ekb.eg/article_125772_234b98d0f758251762a70659dd22c802.pdf
2020-11-01
264
272
10.21608/ebwhj.2019.19210.1053
Abdominal myomectomy
carbetocin
misoprostol
Amro
Elhoussieny
amroelhoussieny@gmail.com
1
Department of Obstetrics and Gynecology, Faculty of Medicine, Ain-Shams University, Egypt
AUTHOR
Mohamed
Mohamed
2
Department of Obstetrics and Gynecology, Faculty of Medicine, Ain-Shams University, Egypt
AUTHOR
Heba
Allam
hebaallam@gmail.com
3
Department of Obstetrics and Gynecology, Faculty of Medicine, Ain-Shams University, Egypt
AUTHOR
Dina
Atef
dinaatef779@gmail.com
4
Gynecology and Obstetrics Department, Faculty of Medicine - Ain Shams University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Gene polymorphisms and risk of preeclampsia in Egyptian women
Aim: The aim of this study was to evaluate the possible association between ACE I/D, AT1 receptor 1166 A:C, AT2receptor-1332 A:G, and MMP-9-1562 C:T polymorphisms and risk of preeclampsia in Egyptian women.Materials and Methods: This case-control study included 108 pregnant women was allocated into two groups, 54pre-eclamptic women group and control group which included 54 normotensive pregnant women. Genotyping of AT1 1166A:C and AT2 −1332 A: G were performed by duplex polymerase chain reaction-restriction fragment length polymorphismPCR-RFLP. Genotyping of I/D polymorphism of ACE was carried out by PCR and genotyping of MMP-9 −1562C/T wasperformed by tetra-primer amplification refractory mutation system T- ARMS–PCR.Results: The DD genotype of ACE gene was significantly associated with increased risk of preeclampsia[OR (95% CI) = 2.47 (0.72–8.5), p = 0.02] and the D allele was significantly associated with an increased risk ofpreeclampsia [OR (95% CI) = 1.95 (1.08–3.54), p = 0.02]. The AT2 GG genotype frequency was significantly higher inpreeclampsia [OR (95% CI) = 3.24 (1.25–8.41), p = 0.002] and the G allele [OR (95% CI) = 2.41 (1.39–4.18), p = 0.002]. However, the AT1 CC and MMP9 TT genotypes frequency were insignificantly associated with preeclampsia.Conclusion: ACE gene I/D and -1332A/G of AT2 receptor polymorphisms, but not AT1 receptor gene A1166C andMMP-9 (-1562 C/T) polymorphisms, could be related to the risk of preeclampsia in Egyptian women.
https://ebwhj.journals.ekb.eg/article_125773_bd28b318e1ee9a8ffea21464e7095086.pdf
2020-11-01
273
283
:10.21608/ebwhj.2019.19794.1056
Angiotensin converting enzyme
angiotensin II type 1-2 receptors
Matrix metalloproteinase 9
preeclampsia
Mohamed
Ibrahem
dr_mohamed_abdelmoniem@yahoo.com
1
Department of Obstetrics and Gynecology, Faculty of medicine, Zagazig University, Zagazig, Egypt.
LEAD_AUTHOR
Magdy
Ibrahim
imagdy@link.net
2
Department of Medical Biochemistry, Faculty of Medicine, Zagazig University, Egypt,
AUTHOR
Amira
Al-Karamany
dr_amira_s85@yahoo.com
3
Department of Medical Biochemistry, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Rasha
Etewa
rashaetewa@gmail.com
4
Department of Pathology/Medical Biochemistry, College of Medicine, Jouf University, Sakaka, Saudi Arabia
AUTHOR
ORIGINAL_ARTICLE
Protein S activity in women with unexplained infertility
Aim: To the best of our knowledge, no previous studies have addressed the association of unexplained infertility with protein S activity. This case-control study was performed to evaluate the prevalence of protein S activity in women with unexplained infertility and to compare its prevalence in normal fertile women.Materials and Methods: This is a case-control study conducted to evaluate the prevalence of protein S activity inwomen with unexplained infertility conducted at Ain-Shams University Maternity Hospital. A total of 30 women withunexplained primary infertility and another 30 fertile women of matched age group as their control were recruited fromSeptember 2018 to March 2019. Using STA Compact Max® Coagulation System protein S was measured. STA-staclot kitsupplied by Stago, France is a clotting assay for measuring protein S activity in human citrated plasma. A venous bloodsample (3 ml) was collected from every participant at any day of the menstrual cycle then the samples were collectedin (3.2%) sodium citrate tubes (venous blood must be mixed with the sodium citrate immediately after collection byturning upside down gently the tube 3 or 4 times), then centrifugation performed as fast as possible less than an hour toobtain platelet-poor plasma and centrifuged at 2500g for 15 min (platelet poor plasma). Samples and test reagents areloaded into the instrument where sample handling, reagent delivery, analysis, and reporting of results are performedautomatically. Results: This study failed to find a relationship between protein S activity and unexplained infertility compared to the normal fertile population. Despite finding none in the unexplained infertility sample population with protein S deficiency and one in the control group, this difference failed to reach significance.Conclusion: In conclusion, this study failed to find any association between protein S activity and unexplained infertilitybut this study showed that the mean of protein S percentage in group 1 (cases) is lower than the mean in group 2 (controls).
https://ebwhj.journals.ekb.eg/article_125774_662214d2fb726df84b2032b28ed2572d.pdf
2020-11-01
284
290
10.21608/ebwhj.2020.20279.1058
Protein S
thrombophilia and infertility
Unexplained infertility
Mohammed
El-Sokkary
1
Department of Obstetrics and Gynecology, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
AUTHOR
Bassem
Islam
bassemislam@gmail.com
2
Department of Obstetrics and Gynecology, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
AUTHOR
Esraa
Alshawadfy
esraaalshawadfy@gmail.com
3
Ob&gyne, faculty of medicine , Ain shams university
LEAD_AUTHOR
ORIGINAL_ARTICLE
Oxytocin versus sublingual misoprostol for induction of labour in term prelabour rupture of membranes: A randomized controlled trial
Background: Induction of labor is one of the most common interventions practiced in modern obstetrics. In the developedWorld, the ability to induce labor has contributed to the reduction in maternal and perinatal mortality and morbidity.Aim: This study aimed to evaluate the effect of pre-labour administration of sublingual misoprostol versus oxytocin in term PROM on maternal and fetal outcomes. Materials and Methods: In a randomized single-blind controlled trial at department of obstetrics and gynecology, Menoufia University between September 2018 and October 2019. A total of 100 pregnant women who had spontaneous rupture of membrane and unripe cervix were enrolled. The group A underwent Oxytocin infusion according to low-dose standard protocol and the group B received 50 microgram sublingual Misoprostol every 6 hours. Results: There was a significant reduction in induction duration hours between Misoprostol group than Oxytocin group (p < 0.001). Second stage of labour was significantly shorter in misoprostol group. Although, some maternal sideeffects were non-significantly higher in misoprostol group. There was no significant difference between Oxytocin and Misoprostol groups regarding neonatal condition. Conclusion: pre-labour administration of sublingual misoprostol in patients with singleton term pre-labour rupture of membranes shorten duration of both active phase and second stage of labour significantly in comparison with oxytocinadministration.
https://ebwhj.journals.ekb.eg/article_125775_6c4f0547f119ab23d57c14ab302371a6.pdf
2020-11-01
291
297
10.21608/ebwhj.2020.20284.1060
Induction
misoprostol
oxytocin
pre-labour rupture of membranes
Nasser
Abdel-Aal
1
Department of Obstetrics and Gynecology, Faculty of Medicine, Menoufia University, Egypt
AUTHOR
Abdelhaseib
Saad
abdelhaseibsaad@gmail.com
2
Department of Obstetrics and Gynecology, Faculty of Medicine, Menoufia University, Egypt
AUTHOR
Waleed
Yehia
yehiawaleed30@gmail.com
3
Department of Obstetrics and Gynecology, Faculty of Medicine, Menoufia University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Measurement of Cerebro-Placental Doppler Ratio and Amniotic Fluid Index as a Predictor of Perinatal Outcome in Prolonged Pregnancy
Background: The terms post-term, prolonged, postdates and post mature are often loosely used interchangeably to signifypregnancies that have exceeded a duration considered to be the upper limit of normal.Objective: The aim of this work was to study the role of Doppler velocimetry of the umbilical and middle cerebral arteriesrepresented by the cerebroplacental ratio and amniotic fluid volume in the prediction of adverse fetal outcome in post-termpregnancies.Materials and Methods: This is a prospective case control study conducted at Ain-Shams University Teaching Hospitalfor Obstetrics and Gynecology, Egypt. The study included 50 pregnant patients who were divided into two groups; group1included 25 pregnant ladies with gestational age of 41 weeks attending the casuality department in labour or in prodromaof labor. while, group 2 included 25 pregnant ladies with gestational age of 41 weeks not in labor and reaching thehospital for ANC, who were selected for termination based on the biophysical profile and poor Doppler indices or CTGchanges. All patients were submitted to antenatal fetal surveillance tests including modified biophysical profile (MBPP)which consists of the non-stress test (NST), amniotic fluid index (AFI), and color Doppler velocimetry of fetoplacentaland fetal vessels including MCA PI, UA PI, and CPR. The accuracy of cerebroplacental ratios (the middle cerebral arteryPI divided by the umbilical artery PI) and amniotic fluid volume as a means of predicting intrauterine fetal distress andadverse perinatal outcome in post-term pregnancies.Results: Cerebroplacental ratio showed the highest sensitivity (95%) in comparison with other parameters, so it is a goodtest to reassure the obstetricians of the fetal well being. Prominent changes in AFI (i.e. <50% increase or decrease) is notassociated with adverse perinatal outcome irrespective of the rate of change provided that the final value remains >5.0 cm. Asignificant association with FHR decelerations and presence of meconium is proved to exist when AFI is <5.0 cm.Conclusion: The addition of cerebral/umbilical ratios to antenatal surveillance protocols is expected to improve the perinataloutcome. It should be tried in the various high risk pregnancies whenever uteroplacental insufficiency is suspected.
https://ebwhj.journals.ekb.eg/article_125776_224745322584a6f203956e90c1a9765c.pdf
2020-11-01
298
307
10.21608/ebwhj.2020.20645.1064
Doppler Ultrasound
Perinatal outcome
post-term
Pregnancy
Noha
Rabei
rabeinoha@gmail.com
1
Department of Obstetrics and Gynecology, Faculty of Medicine, Ain-Shams University
AUTHOR
Mohamed
Taha
mta@ebwh.com
2
Department of Obstetrics and Gynecology, Faculty of Medicine, Ain-Shams University,
AUTHOR
Mohamed
Etman
mohamedetman@gmail.com
3
Department of Obstetrics and Gynecology, Faculty of Medicine, Ain-Shams University,
AUTHOR
Omar
Naser
nomar1639@gmail.com
4
Ob and gyne. Faculty of medicine . Assiut university
LEAD_AUTHOR
ORIGINAL_ARTICLE
Prevalence of thyroid dysfunction and thyroid autoimmunity in infertile women
Aim: This study aimed to determine the prevalence of thyroid autoimmunity (antithyroglobulin and antithyroid peroxidase)and thyroid dysfunction (hypo- or hyperthyroidism) among women with different causes of infertility.Materials and Methods: A cross-sectional study was carried out among 255 patients with infertility who were recruitedfrom the gynecology clinic, Kasr Al Ainy Hospitals, Cairo University, Egypt. Patients were divided into 4 groups. Group < br />A including infertile women with either unexplained or anovulatory infertility with/without associated male factor,group B including infertile women with a tubal (mechanical) factor of infertility with/without associated male factor,group C including infertile women with both anovulation and tubal factor with/without associated male factor and acontrol group including women with exclusive male factor. Serum levels of TSH, antithyroid peroxidase (anti-TPO) andantithyroglobulin (anti-TG) were measured in all patients.Results: The TSH level was abnormal in 22 out of 255 women (9.8%). 44 (17.3%) were positive for anti-TPOantibodies, 26 (10.2%) were positive for anti-TG antibodies. Seventy patients (27.5%) had TSH levels above 2.5 mIU/L.No significant difference was found between different causes of infertility in TSH or antithyroid antibodies. There was apositive correlation between frequencies of both positive anti-TG and secondary infertility in group B.Conclusion: There is no significant relationship between thyroid dysfunction and the type of infertility (functional ormechanical), or its duration. According to our study, the prevalence of antithyroid antibodies seems to be the same ininfertile women and control. Antithyroglobulin might be associated with secondary infertility due to tubal factor.
https://ebwhj.journals.ekb.eg/article_125777_249160a47e3ba9c1f890857d2d837b78.pdf
2020-11-01
308
315
10.21608/ebwhj.2020.36665.1102
Ahmed
Wali
ahmed.wali@kasralainy.edu.eg
1
Cairo University
LEAD_AUTHOR
Walaa
Abdelfattah
walaafattah@cu.edu.eg
2
Department of Clinical and Chemical pathology, Faculty of Medicine, Cairo University, Egypt
AUTHOR
Shimaa
Abd-El-Fatah
shimaa.mostafa@kasralainy.edu.eg
3
Department of Obstetrics and Gynecology Faculty of Medicine, Cairo University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Preemptive analgesia for primary dysmenorrhea : A randomized controlled clinical trial
Background: Spasmodic dysmenorrhea is one of the commonest painful attacks that affects young ladies. Non steroidalanti-inflammatory (NSAID) drugs are considered as one of the main treatment options. Different pain management modalities concern with pretreatment with analgesia before the painful stimuli that defined as preemptive analgesia.Aim: This study aimed to evaluate the possible effect of administration of NSAIDs before the onset of pain in the anticipating menstrual cycle. Materials and Methods: One hundered young ladies ranged from 15-25 years old were randomly divided into two groups. Group 1 received mefinamic acid 2 days before the anticipating date of menstruation and continued throughout the first 2 days of menstruation and group 2 received the same medication however started with the onset of symptoms only. Results: Both groups were comparable regarding age, education and menstrual characters. The average pain score was nearly the same in both groups (8.78 ± 1.07 and 8.66 ± 1.04) and it was significantly decrease after intervention in both groups. The decrease in pain score was more in the girls treated before menstruation (4.24 ± 1.57) compared to (7.20 ± 1.77) in the girls treated after onset of menstruation and the difference was statistically significant. The percentage decrease in pain score among the girls of premenstrual treatment ranged from 14.28% to 80.0% with median decrease 55.56%, compared to 0.0% to 62.5% with median decrease 10.56% in the group treated at onset of menstruation. The difference was also statistically significant (P <0.001). Conclusion: NSAIDS can be used effectively to prevent and control primary dysmenorrhea associated symtoms if used before the appearance of symptoms, and targeted groups are in great chance to practice an easier life throughout the entiremenstrual cycle.
https://ebwhj.journals.ekb.eg/article_125778_5e79ef215357978bf85d620b3cf02aa9.pdf
2020-11-01
316
323
10.21608/ebwhj.2020.42330.1105
Awareness
barriers
educated young Egyptians
sexual and reproductive health problems
Heba
Nabil
nabilhanan406@gmail.com
1
Obstetrics and gynecology faculty of medicine Mansoura university
LEAD_AUTHOR
Hamed
Youssef
hamedyoussef@gmail.com
2
Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University
AUTHOR
Suzan
Tawfeek
suzantawfeek@gmail.com
3
Faculty of Nursing, Portsaid University
AUTHOR
Waleed
Elrefaie
waleedelrefaie@gmail.com
4
Department of Obstetrics and Gynecology, Faculty of Medicine, Portsaid University
AUTHOR
ORIGINAL_ARTICLE
Perceived barriers to accessing sexual and reproductive health services among educated young women in Egypt
Background: Youth have higher risk of sexual and reproductive health (SRH) problems, and consequently have a higherneed for SRH counselling. In Egypt, reproductive health (RH) awareness is generally poor especially among young womenattending high institutions that requires further attentions and research to explore the different barriers to access the RHservices.Aim: The aim of this study is to investigate the barriers to access SRH services among young educated Egyptians.Materials and Methods: A cross-sectional, community-based survey was conducted in Minia Governorate, Egyptthrough a self-funded research project during the period from January 2019 till September 2019. The invited samplewere 750 female university students. Approval by ethical committee of the Department of Obstetrics and Gynecology,Minia University Hospital was obtained. Descriptive and a cross-tabular descriptive statistical analysis of frequenciesand percentages were performed. Comparing means with a significance level of 0.05 was performed to investigate theassociation between the different variables.Results: A total of 48.1% of participants reported an unmet need of sexual and reproductive health counselling. Tendifferent barriers were described by the participants. The first four barriers in the order of importance were health serviceprovider’s attitudes (88.5%), misinformation in the communities (86.5%), cultural norms (86.5%) and health systembarriers (73.1%) while the logistics and the distance was rated on the bottom.Conclusion: It is imperative to ensure efficient and adequate SRH counselling among the vulnerable groups. Improvingthe access to SRH can be achieved by correction of the community misconceptions with adequate training of the healthservice providers.
https://ebwhj.journals.ekb.eg/article_125779_01f191434db745e827f04828469187da.pdf
2020-11-01
324
332
10.21608/ebwhj.2020.42332.1106
Awareness
barriers
educated young Egyptians
sexual and reproductive health problems
Mo’men
Mohammed
1
Department of Obstetrics and Gynecology, Faculty of Medicine, Minia University, Egypt
AUTHOR
Saad
Elgelany
elgelanysaad@gmail.com
2
Minia Maternity & Children University hospital Obstetrics & Gynecology department, faculty of medicine, Minia University, Egypt.
LEAD_AUTHOR
Khaled
Goma
khaledgoma@gmail.com
3
Department of Obstetrics and Gynecology, Faculty of Medicine, Minia University, Egypt
AUTHOR
Heba
Hassan
hebahassan@gmail.com
4
Department of Obstetrics and Gynecology, Faculty of Medicine, Minia University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Impact of Physical Activity on General Health among Menopausal Women
Aim: This study evaluated the role of physical activity in boosting the general health of menopausal women.Materials and Methods: This cross-sectional study was conducted at Suez-Canal University Hospital, Ismailia, Egypt.Hundred-ninety-one menopausal women were included. Their physical activity was assessed using the internationalphysical activity questionnaire (IPAQ), whereas their general heath was evaluated through the 28-item general healthquestionnaire (GHQ). Data were analyzed using SPSS, and results were considered statistically significant at a p-valueless than 0.05.Results: The majority of the enrolled women had a low-to-intermediate level of physical activity, whereas the rest (24%)encountered a high physical level. We found a statistically significant difference in general health subscales between thelow, intermediate and high physical levels (p < 0.001). In particular, women with low physical activity had higher totalGHQ scores compared to those with high physical activity had the lowest total GHQ scores. Moreover, women who wereobese (p < 0.001), diabetic (p < 0.001) and/or hypertensive (p < 0.001), complaining of vaginal dryness (p=0.02) and/orjoint and muscular discomfort (p < 0.001) had significantly higher total GHQ scores.Conclusion: Physical activity of menopausal women is significantly associated with their general health, as less activewomen had poor general health.
https://ebwhj.journals.ekb.eg/article_125780_2ea301babb81044c974daaa0fb1e6663.pdf
2020-11-01
333
347
10.21608/ebwhj.2020.43136.1109
General health
Menopause
Physical activity
Hanan
Ghoniem
ghoniemhanan6@gmail.com
1
Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
LEAD_AUTHOR
Mai
Abdelnaby
maiabdelnaby@gmail.com
2
Department of Rheumatology and Rehabilitation, Faculty of Medicine, Suez-Canal University, Egypt
AUTHOR