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Background Placenta accreta spectrum (PAS) disorders have become a significant life-threatening issue due to its increased incidence, morbidity and mortality. Several studies have tried to identify the risk factors for PAS disorders. The ideal management for PAS disorders is a matter of debate. The study objectives were to evaluate the incidence and risk factors of PAS disorders and to compare different management strategies at a tertiary referral hospital, Minia, Egypt. Methods This prospective study included 102 women diagnosed with PAS disorders admitted to Minia Maternity university hospital, Egypt between January 2017 to August 2018. These cases were categorized into three groups according to the used approach for management: Group (A) , ( n  = 38) underwent cesarean hysterectomy, group (B) , ( n  = 48) underwent cesarean section (CS) with cervical inversion and ligation of both uterine arteries and group (C) , ( n  = 16): the placenta was left in place. Results The incidence of PAS disorders during the study period was 9 / 1000 maternities (0.91%). The mean age of cases was 32.4 ± 4.2 years, 60% of them had a parity ≥3 and 82% of them had ≥2 previous CSs. Also, 1/3 of them had previous history of placenta previa. Estimated blood loss (EBL) and blood transfusion in group A were significantly higher than other groups. Group (C) had higher mean hospital stay duration. Group A was associated with significantly higher complication rate. Conclusions The incidence of PAS disorders was 0.91%. Maternal age > 32 years, previous C.S. (≥ 2), multiparity (≥ 3) and previous history of placenta previa were risk factors. The management of PAS disorders should be individualized. Women with PAS disorders who completed their family should be offered cesarean hysterectomy. Using the cervix as a tamponade combined with bilateral uterine artery ligation appears to be a safe alternative to hysterectomy in patients with focal placenta accreta and low parity desiring future fertility. Patients with diffuse placenta accreta keen to preserve the uterus could be offered the option of leaving the placenta aiming at conservative management after proper counseling. Trial registration Registered 28th October 2015, ClinicalTrials.gov NCT02590484 .

Background The incidence of post cesarean intra-abdominal infection (IAI) and the independent risk factors associated with it were retrospectively studied at a tertiary referral hospital in Egypt. Methods The study targeted the period between January 2014 and December 2017 (4 years) at Minia University Hospital for Obstetrics and Gynecology (a tertiary referral hospital), Minia Governorate, Egypt. All cases that developed IAI following cesarean section (CS) during the study period were included (408 cases, which served as the case group); in addition, 1300 cases that underwent CS during the study period and were not complicated by IAI or surgical site Infection (SSI) were randomly chosen from the records (control group). The records of cases and controls were compared and bivariate analysis and multivariate logistic regression were used to identify risk factors for IAI. Results During the studied period, there were 35,500 deliveries in the hospital, and 14200 cases (40%) of these were by cesarean section, producing a rate of 40%. The incidence of IAI post CS was 2.87%, and the mortality rate was 1.2% (due to septicemia). The most identifiable risk factors for IAI were chorioamnionitis (AOR 9.54; 95% CI =6.15–16.2; p  ≤ 0.001) and premature rupture of membranes (PROM) (AOR 7.54; 95% CI =5.69–10.24; p ≤ 0.001). Risk factors also included: prolonged duration of CS >  1 h (AOR 3.42; 95% CI =2.45–5.23; p  = 0.005), no antenatal care (ANC) visits (AOR 3.14; 95% CI =2.14–4.26; p  = 0.003), blood loss > 1000 ml (AOR 2.86; 95% CI =2.04–3.92; p  = 0.011), emergency CS (AOR 2.24; 95% CI =1.78–3.29; p  = 0.016), prolonged labor ≥24 h. (AOR 1.76; 95% CI =1.26–2.27; p  = 0.034) and diabetes mellitus (AOR 1.68; 95% CI =1.11–2.39; p  = 0.021). Conclusions The incidence of IAI post CS in our hospital was 2.87%. Identification of predictors and risk factors for IAI is an important preventive measure.

Purpose The study aims to elucidate the effects of single platelet-rich plasma (PRP) injection combined with rehabilitation exercises on growth factor concentrations and muscle strength following hamstring tear injury. Methods 17 physically active male athletes (22.3 years; 1.80 m; 74.7 kg; 24.9 kg/m 2 ) with a 2nd-grade acute hamstring tear were randomized to a treatment group ( n  = 8) or control group ( n  = 9). Both groups received the same physical rehabilitation program for 8 weeks; however, only the treatment group received an autologous single PRP injection. Growth factor concentrations, hamstring strength (HS), knee flexion range of motion (KF ROM ), and return time to play (RTP) were collected at baseline, and 4 and 8 weeks. Results Athletes in the PRP group demonstrated at 4 weeks a significantly higher concentration in IGF-1, FGF-2, VEGF, and PDGF than that the control group demonstrated ( p  < 0.004). However, neither HS nor KF ROM showed any significant differences between groups at 8 weeks ( p  > 0.05), but HS was significant at 4 weeks ( p  > 0.002). Conclusion PRP injection combined with physical rehabilitation for hamstring tear was more effective in growth factor concentration and return time to play than the physical rehabilitation alone.

Polyurethanes (PUs) based on poly(^-hydroxybutyrate) (PHB) and polycaprolactone diols of different contents were synthesized using hexamethylene diisocyanate (HDI). Nanocomposites based on the prepared PUs and chitosan nanoparticles (CsNPs) with different contents (0.3.5 and 7 wt%) using solvent intercalation technique are also prepared. The prepared samples were studied by FTIR and H NMR, TEM, SEM, XRD and thermogravimetric analysis. Both FTIR and 'H NMR verified the structure of the prepared samples. TEM confirmed the presence of Cs in the nanoscale while SEM showed a roughness increment with increasing the CsNPs content. Both DSC and XRD showed that the crystallization of PHB was retardedwith increasing both PCL and CsNPs. Thermogravimetric analysis showed that the thermal stability was decreased with CsNPs incorporation.