The demand of fertility preservation techniques has increased in the last decades, either because of health conditions or maternity delay. Nowadays the best option is the vitrification of oocytes and embryos, since it is a non-invasive technique, and avoids ethical, political and economic problems. Until recently, the open system of vitrification had been able to make 90% of human oocytes and embryos survive after freezing. The remaining 10% were sensitive patients over 40 years old or patients with a limited number of oocytes or fragile eggs, leading them to low or no chance of pregnancy. Besides, these techniques require very skilled manipulation and complicated protocols. The last challenge was to create an improved noninvasive vitrification method that gives possibilities to women in true difficulty and pain. The aim of this work is to present a very successful vitrification method for oocytes and blastocysts, together with the improvements made to the previous techniques, and show the results worldwide compared to fresh cycles. In this retrospective study we report patients undergoing IVF cycles during 2015-2017 with either oocyte or blastocyst vitrification in clinics worldwide. The modifications featured in this new technique yielded to a worldwide higher pregnancy rate (47% and 48%; n=4,673 and n=15,177 in oocytes and blastocysts respectively) compared to fresh cycles (39%; n=115,610; SART, 2016). These results are an evidence of the safety and effectiveness of this improved method. With this high survival rate and excellent clinical results, ordinary methods are becoming advanced in fertility facilities all around the world.

Objectives: To Describe the evaluation of posterior compartment defects. How to choose the surgical technique for your patient? Reiterate the evidence for the use or non-use of adjuvant grafts for repair of the posterior compartment.
Rectocoele: Prevalence POP 38-41%, Prevalence 12.9-18.6% (WHI), One of the most common gynecologic procedures, 40-69% of women undergoing PFD surgery, Prevalence expected to increase, Defect of the rectovaginal fascia.
Etiology of Rectocoele: During Valsalva (cough) the vagina becomes a high, pressure closed cavity due to BCM (bulbocavernousus) and PRM (puborectalis) reflex. Out of 23 women with rectocoele, 12 are healthy women, measured intra-vaginal, intra-rectal pressure, EMG responses and Decreased intravaginal pressure and longer latency of EMG response in women with rectocoele.
Treatment: Surgical repair, Management of constipation, Pelvic floor muscle therapy, Biofeedback, Balloon expulsion and Pelvic dyssynergia.

The present study was conducted by searching and reviewing the most recent medical literatures. Abdominal hysterectomy (AH) is the commonest route for surgical management of benign uterine disease that could be performed vaginally which has well-documented benefits. Abdominal hysterectomy (AH): vaginal hysterectomy (VH) is known to be 3:1. Evidence -Based Practice Guidelines for surgical management are defined by objective criteria - 'OUTCOME ' rather than subjective criteria - "Physician comfort, preference or experience ". But some gynaecologists remain reluctant to change their traditional “practice style” of performing hysterectomy abdominally giving priority to subjective criteria and ignoring objective criteria even without documenting vaginal route is contraindicated. Many publications confirm guidelines enable physicians to perform up to 90% hysterectomy vaginally, dramatically reversing AH: VH to 1:11. ACOG committee on gynecological practice recommended VH is the approach of choice whenever feasible. Laparoscopic hysterectomy (LH) is an alternative to AH when VH is not feasible or contraindicated.  Standard guidelines recommended AH are reserved for documented serious disease. A Cochrane review of 34 randomised trials of VH, LH, AH (4495 patients) concluded VH has the best outcome. AAGL recommended surgeons without requisites training and skills for safe VH or LH should take the aid of trained & skilled collegues or refer to such surgeons. Training on different routes of hysterectomy has been emphasised during residency courses.

We have developed a CE-IVD certified assay for the detection of HCV RNA in decentralised settings on the Genedrive® platform. The platform is an affordable, portable thermocycler that permits testing directly on plasma with results reported in less than 90 minutes, using ambient temperature stable assay reagents. To validate the Genedrive HCV ID Kit, we performed a three site retrospective clinical study on plasma and serum samples from Europe and Africa comparing Genedrive results with the Abbott RealTime platform as a benchmark. The assay is inclusive of all 6 major HCV genotypes, with a LoD of 2362 IU/ml (95% CI 1966 – 2788 IU/ml) in clinical specimens. Using 422 patients chronically infected with HCV and 503 controls negative for anti- HCV and HCV RNA, the Genedrive HCV assay showed 98.6% and 100% specificity to detect HCV. It was equally efficient on freshly collected or frozen plasma samples, and is exclusive of other BBV infections. Initial analysis indicates potential for viral semi-quantification through melting peak ratiometric analysis. Subsequent independent analysis of samples with HCV genotypes prevalent in Africa compared to Europe demonstrated 100% sensitivity and specificity. We report the clinical validation of a rapid affordable point of need HCV molecular test that meets the criteria decentralised HCV assays for use in low to middle income countries. The Genedrive HCV ID Kit is positioned to enable real-time treatment management of chronic HCV patients in decentralised settings.

Introduction: The Hepatitis C is one of the most important public health problems today due to the high proportion of chronic disease (about 80% of cases). The disease is usually asymptomatic, progressing slowly, producing cirrhosis in 20% of patients who harbor the virus for varying periods, and developing liver cancer, or needing a liver transplant.

Purpose: The idea is to demonstrate, using a case report, how the auricular pavilion can give us information of a possible liver disease in the patient, where it helped to diagnose hepatitis C.

Methods: Through a case report of a female patient of about 40 years which, were being treated because of an edema and fatigue by using acupuncture. In her physical exam, it was found a bulging in the area of the right and left ear, in the location corresponding to the area of the liver, according to the Auricular Acupuncture theory. We asked for laboratory exams, which confirmed she was carrying the hepatitis C virus. The PCR was the reagent for hepatitis C.Results:  With this diagnosis, it was possible to make the conventional treatment with interferon plus ribavirin in the patient, who after 6 months of treatment, negative serology and CRP, remaining negative until today, 10 years after.Conclusion:  The observation of the auricular pavilion can be a possibility of assisting the doctor to diagnose different pathologies, in this specific case, hepatitis C virus. The patient had the opportunity to have proper treatment, curing the disease, which could not happen without the Auricular diagnosis

Background and objective: The ovary has a biological age that does not always correspond to the chronological age; this may be of great importance for the evaluation of women reproductive outcome. This study aimed to determine the effect of maternal age on the pregnancy rate, and the ovarian reserve markers (antimullerian hormone, follicular stimulating hormone, and antral follicular count).Methods: A cross-sectional study was conducted in the in vitro fertilization center at the Maternity Teaching Hospital located in Erbil city, from January 1, 2015, to January 31, 2016. A convenience sample of 300 infertile women of different age groups was included in the study. Transvaginal ultrasound was conducted to determine antral follicular count, and blood test was done for determination of serum antimullerian hormone and follicular stimulating hormone. The study sample was divided into four age groups. Chi square test, ANOVA test, Pearson correlation, and logistic regression were used to determine the associations.Results: The biochemical pregnancy rate of the study population was 37% and the clinical pregnancy rate was 32%. The most common type of infertility among the studied sample was primary infertility (74%). Results showed a strong inverse significant correlation between antimullerian hormone and antral follicular count with age, but there was no statistically significant association between maternal age and serum follicular stimulating hormone.Conclusion: Maternal age is a significant factor that can affect ovarian reserve and causes ovarian aging. The pregnancy rate decreases with advanced maternal age. Keywords: Antimullerian hormone; Antral follicular count ; Female age; Ovarian reserve

Preeclampsia is a major cause of both maternal and perinatal mortality and morbidity. The pathopysiology of preeclampsia remain unclear but early placental dysfunction followed by oxidative stress, increased lipid peroxidation, and  reduced antioxidants play an important role. Malondialdehyde (MDA) is the final product of lipid peroxidation, commonly used as the oxidative stress marker. Prevention and treatment of oxidative stress in preeclampsia using antioxidant including melatonin, beta-caroten, vitamin C or E has been developed but none is yet recommended. Thus the efforts are continuing to find an effective antioxidant in preeeclampsia. Phaleria macrocarpa, a medicinal plant has long been used traditionally and known has high antioxidant capacity by in vitro and in vivo studies. HUVEC culture is an in vitro model widely used to study the preeclampsia pathogenesis. This study aims to determine the effects of Phaleria macrocarpa extract on MDA level in preeclampsia-induced HUVEC culture. Our results showed the Phaleria macrocarpa’s extract reduce MDA level siginifcantly at concentration of 0.977μg/mL in preeclampsia-induced HUVEC culture and at 15.625μg/mL reduce MDA level to control normal level. Thus, Phaleria macrocarpa’s extract might be used as agent to overcome oxidative stress in preeclampsia.