P–328 Dienogest significantly decreases the size of the cyst and alters Anti-Müllerian Hormone concentration in patients with endometrioma

Study question Does utilization of dienogest make any impact on the size of cyst and Anti-Müllerian Hormone (AMH) concentration in patients with endometrioma throughout 12-months? Summary answer Although dienogest makes a gradual reduction in the size of endometrioma cyst throughout 12-months, a significant drop in AMH serum concentration was also noticed. What is known already According to recent studies, pre-operative serum AMH levels might be illusively increased with parallel to the size of endometrioma which will be a misleading factor while deciding to operate the patient via cystectomy. Although dienogest is one of the medical options that might be commenced in patients with endometrioma cyst, there is limited data about its effect on the size of the endometrioma and hence serum AMH concentration throughout 12 months of follow up. Study design, size, duration The current observational cohort study was conducted among patients with endometrioma those treated with dienogest from January 2017 to January 2020. The primary outcome was alteration in diameter of endometrioma cyst at 6th and 12th months of treatment. Secondary outcome was alteration in serum AMH concentration in the same period. Of 104 patients treated with dienogest, 44 patients were excluded due to being treated with any type of surgical intervention during follow up period. Participants/materials, setting, methods A total of 60 patients were recruited for the final analysis. Of them, primary symptom was dysmenorrhea, chronic pelvic pain and menstrual irregularity in 16 (26.7%), 25 (41.7%) and 8 (13.3%) patients, respectively. Eighteen patients (30%) were asymptomatic. As 21 patients had bi-lateral endometrioma, size of the leading cyst was considered to be analyzed for the primary outcome measure. Paired-t test was used for comparison of numerical values and p ≤ 0.05 was taken as statistical significance. Main results and the role of chance The mean age was 31.5±8.0 years. In the time point when dienogest was started, the mean size of the endometrioma was 46.3±17.4 mm. The mean serum AMH concentration was 3.6±2.4 ng/ml. After 6 months of treatment, the mean size of the endometrioma decreased to 38.6±14.0 mm which corresponds to a mean difference of 7.8 mm (95% CI: 3.0 to 12.6; p: 0.003). The respective figure for AMH was 3.3±2.7 ng/ml which corresponds to a mean difference of 0.3 ng/ml (95% CI: –0.2 to 0.8; p: 0.23) at 6 months. After 12 months of treatment, the mean size of the endometrioma was 37.5±15.7 mm which corresponds to a mean difference of 8.9 mm (95% CI: 2.9 to 14.9; p: 0.005) at the end of 12 months. The respective figure for AMH was 2.7±1.9 ng/ml which corresponds to a mean difference of 0.9 ng/ml (95% CI: 0.1 to 1.7; p: 0.045) at the end of 12 months. The mean diameter of endometrioma and AMH concentration did not differ throughout the time period between 6th and 12th months of the treatment. Limitations, reasons for caution Although herein we present the largest data that depicts the alteration of endometrioma cyst and AMH concentration with the application of dienogest, the lack of control group is a limitation that avoids to perform any comparison. Wider implications of the findings: A shrinkage after commencement of treatment suggest that dienogest might present improvement in patients with endometrioma with respect to radiological findings, but further studies are required whether a decline in AMH concentration after 12 months refers to a genuine decrease in ovarian reserve or resolution of misleading high pre-treatment levels. Trial registration number not available

Case report of urinary tract infection in sows of a commercial pig unit

In this paper, a case of urinary tract infection in sows of a commercial pig unit is presented for the first time in Greece. Within a period of one year, 21 cases of specific infection were recorded, representing 5.8% of the farrowings in the farm. The symptoms were obvious around the 3rd to 4th week post mating and were keeping on for 2 to 7 days. Anorexia, thirst, blood in the urine and subsequent death or survival with gradual loss of body condition were the main findings. A significant correlation between the number of sows that died, and the number of sows showing anorexia (p<0,05), or showing hypothermia (p<0,05) was observed. The average number of live born piglets at the last parturition compared to the respective figure during the previous parturitions was markedly reduced (p<0,05). The findings of microscopic and biochemical examination of the urine were indicative of infection, while biochemical examinations of blood samples of diseased sows have shown significantly increased urea (BUN) and creatinine levels (p<0,05). Bacteriological culture of urine samples have shown the presence of increased numbers of bacteria (>106/ml) such as Escherichia coli and Actinomyces suis in almost all ill sows. It is concluded that porcine urinary tract infections may cause serious problems for pig enterprises as may be directly correlated with reproductive performance and viability of the sows.

PEMIKIRAN FIKIH SYAIKH MUHAMMAD ZAIN BATU BARA: Fidiah Salat dan Puasa

<strong>Abstrak: </strong>Artikel ini membahas pemikiran Syaikh Muhammad Zain Batu Bara, seorang ulama besar alumni Makkah awal abad 20 dan berasal dari Batu Bara yang namanya tidak dikenal, namun mempunyai kontribusi besar dalam perkembangan dakwah Islam di daerah tersebut. Salah satu kontribusinya adalah praktik dan tradisi Fidiah salat dan puasa bagi orang yang sudah meninggal, yang sampai sekarang masih dilestarikan oleh masyarakatnya. Dalam konteks wilayah Nusantara, kajian ini membandingkan pemikiran Syaikh Muhammad Zain dengan pemikiran-pemikiran ulama Nusantara lainnya baik sebelum, semasa atau sesudahnya, untuk menemukan titik persamaan dan perbedaan dan sejauhmana implikasinya, dengan menggunakan telaah kepustakaan karya-karya dan sejarah biografi masing-masing tokoh. Penulis menyimpulkan bahwa Syaikh Muhammad Zain Batu Bara adalah kelompok ulama Kaum Tua di Sumatera Timur yang tetap mempertahankan amaliah dan tradisi Fidiah salat dan puasa bagi orang yang sudah meninggal, dengan memilih pendapat mazhab Hanafi yang memasukkan masalah ini dalam pendapat yang dipedomani dan berkembang terus di masyarakat.<br /> <br /><strong>Abstract: Islamic Legal Thought of </strong><strong>Syaikh Muhammad Zain Batu Bara</strong><strong>: A Case of <em>Fidyah</em> for Fasting and Prayer</strong>. This article discusses the thought of Shaykh Muhammad Zain Batu Bara, a prominent scholar of early 20th century Mecca originating from Batu Bara whose name is unknown, but has a major contribution in the development of Islamic da'wah in the area. One of his contributions is the practice and tradition of <em>fidyah</em> for the five prayers and fasting for the dead, which until now is still preserved by the society. In the context of the archipelago territory, this study compares the thought of Shaykh Muhammad Zain with the thoughts of other learned Islamic thinkers of the archipelago throughout the history, to unveil the points of similarities and differences as well as the extent of their implications, using literature review of works and the biographical history of respective figure. The author concludes that Shaykh Muhammad Zain Batu Bara appears to be bounded by conventional school of thought in East Sumatra, who retains the tradition of <em>fidyah</em> for prayer and fasting of the dead person, by choosing the opinion of the Hanafi school that eventually developed in the society.<br /> <br /><strong>Kata Kunci:</strong> fikih, ulama, Nusantara, Syaikh Muhammad Zain, fidiah, salat, puasa