Fine Needle Aspiration Versus Open Biopsy for Testicular Sperm Recovery in Infertile Azoospermic Patients

Background and Objectives: This study aimed to develop a predictive model for sperm retrieval rate (SRR) sperm recovery by testicular fine-needle aspiration (TESA) & compare with (SRR) obtained by per cutanuose open biopsy sperm aspiration (PSA) correlating with hormonal parameters. Materials and Methods: This is a prospective study for sample obtained from 45 male patients during the period from January 2011 to March2012.Clinical, paraclinical, and histological information of patients were gathered. All patients underwent both TESA and PSA in a single operation. Predictors of SRR by TESA were identified comparing with predictive outcome of PSA. Statistical Analysis Used: Categorical and continuous variables were compared using independent t test and -chi-square test. Logistic regression model was applied to develop a predictive model for SRR by TESA & PSA outcome. Results: Sperm retrieval rate for TESA and PSA was 42.2% and 48.8%, respectively (P = 0.03).Regarding  age  group is more common in 4th  (50.3%), while  3rd  & 5th dacedes each of them (20%). The duration of infertility were variable ranging from (10-20) years. Testis volume, luteinizing hormone, prolactin, and testosterone did not differ between patients. Conclusions: Serum FSH and testicular pathology were predictors of SRR by TESA. Patients with FSH < 23 IU/l and/or testicular pathology of hypospermatogenesis had comparable SRR by TESA versus PSA

The Causality Between Agriculture, Industry, and Economic Growth: Evidence from Indonesia

The industry is the current engine of the Indonesian economy over the past three decades; the economic structure in Indonesia has the transformation from the agriculture sector to the industry sector. The objective of this study is to examine the causality between agricultural, industry, and economic growth in Indonesia. By using the vector error correction model (VECM), this research finds that in the long-term, there is directional causality from the industry added value, economic growth on the agricultural added value. Meanwhile, in the short-term, the variable of industry added value and economic growth has the two-way causality. Besides, the agricultural added value can only affect the industrial added value and economic growth in the short-term. These findings support the idea that the agricultural sector plays a vital role in the economy, such as increasing economic growth and growth in other sectors, especially the industrial sector in this case.JEL Classification: F40, L60, O13, O4

Maturation of arteriovenous fistula: Analysis of key factors

** From Crossref via Jisc Publications Router.The growing proportion of individuals suffering from chronic kidney disease has considerable repercussions for both kidney specialists and primary care. Progressive and permanent renal failure is most frequently treated with hemodialysis. The efficiency of hemodialysis treatment relies on the functional status of vascular access. Determining the type of vascular access has prime significance for maximizing successful maturation of a fistula and avoiding surgical revision. Despite the frequency of arteriovenous fistula procedures, there are no consistent criteria applied before creation of arteriovenous fistulae. Increased prevalence and use of arteriovenous fistulae would result if there were reliable criteria to assess which arteriovenous fistulae are more likely to reach maturity without additional procedures. Published studies assessing the predictive markers of fistula maturation vary to a great extent with regard to definitions, design, study size, patient sample, and clinical factors. As a result, surgeons and specialists must decide which possible risk factors are most likely to occur, as well as which parameters to employ when evaluating the success rate of fistula development in patients awaiting the creation of permanent access. The purpose of this literature review is to discuss the role of patient factors and blood markers in the development of arteriovenous fistulae.sch_pod36pub5109pub

Haemodialysis and Vascular Access in the End Stage Kidney Disease

The efficiency of haemodialysis treatment relies on a functional status of vascular access. A vascular access makes life-saving haemodialysis treatments possible. The efficiency of haemodialysis treatment relies on a functional status of vascular access. The purpose of this review was to discuss the role of haemodialysis and vascular access in end stage kidney disease. Vascular access and its related problems represent the main factors that determine a rise in the rate of incidence of the disease among haemodialysis patients and, consequently, a rise in the healthcare expenses. Vascular access can be divided into three categories: arteriovenous fistula, central venous catheter and arteriovenous graft. Central venous catheter has a number of disadvantages, including a considerable risk of infection and mortality. It also has negative implications for the use of a fistula for dialysis. In contrast, arteriovenous fistula is the most beneficial method, as it has a low risk of infection and mortality, and can ensure long-term functional access. Furthermore, there are three configurations of native arteriovenous fistula that can be used for haemodialysis providing flexibility of approach depending on risk factors of the individual patient.sch_pod3pub4864pub

Complications of Stump Healing Among Diabetic Population

Lower limb amputation is a major procedure performed in diabetic patients with multiple comorbidities. Almost 10% of the National Health Service budget is taken up by diabetes, with diabetes-related complications accounting for 80% of the costs. The process of wound healing is complex and involves regenerating the cellular organization and the tissue layers. Diabetics are five times more predisposed to wound infection than patients without diabetes mellitus. The amputated stump frequently becomes infected due to inadequate blood circulation, a weak immune system, and poorly controlled diabetes mellitus. Pain, stump edema, and osteomyelitis are significant complications associated with lower limb amputation wounds. A number of factors may substantiate the need for re-amputation, such as stump pain and/or phantom limb pain, delayed stump infection, the formation of symptomatic bone spurs, assessment of the skin flap designed to preserve stump length, and preparation of the stump for the prosthetic device. There are currently no reliable standards that can be referred to prior to leg amputation. The clinicians, therefore, have to rely on their judgment and investigatory parameters. The main purpose of this review is to discuss the difficulties of stump healing in the diabetic population.sch_pod22pub5400pub

An overview of AVF maturation and endothelial dysfunction in an advanced renal failure

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Development of a prognostic model for stump healing in patients with advanced atherosclerosis

Introduction This study aimed to explore the role of haematological markers and predictive factors on the stump healing in patients who underwent lower extremity amputation surgery at the Royal Infirmary of Edinburgh. Methods Retrospective analysis of 300 patients was retrieved who had undergone lower extremity amputation surgery between 2006 and 2010. A predictive model was developed using backward stepwise logistic regression. The model discrimination was assessed by the receiver operating characteristics curve and its calibration by the Hosmer and Lemeshow goodness of fit test. Result Three variables were identified which influenced stump healing. Serum Sodium - The lower limb stump healing was 75% likely in patients with normal serum sodium compared to that of patients with abnormal serum sodium (odds ratio [OR] 1.756; 95% confidence interval [CI] 1.048-2.942) Serum Creatinine- Patients with normal serum creatinine were 66% more likely to have their stump healed (OR 1.664; 95% CI 0.94 to 2.946) Serum High Density Lipoproteins - A normal serum HDL resulted in a 75% more likely chance of healing compared to those with abnormal serum HDL (OR 1.753; 95% CI 1.061 to 2.895). There was a good calibration as indicated by Hosmer and Lemeshow goodness of fit test (P=0.879) and the c-index was 0.612. Conclusion Serum Sodium, Serum High Density Lipids and Serum creatinine are useful predictors of lower limb stump. The clinical utility of these risk categories in the healing of a lower limb stump requires further clinical evaluation in a prospective study.sch_podpub2782pu

Development of a prognostic model for fistula maturation in patients with advanced renal failure

Introduction This study aimed to explore the role of haematological markers and predictive factors on the maturation of arteriovenous fistulae in patients who underwent vascular access surgery at the Royal Infirmary of Edinburgh. Methods Retrospective analysis of 300 patients was retrieved who had undergone fistula creation between 2006 and 2009. A predictive model was developed using backward stepwise logistic regression. The model discrimination was assessed by the receiver operating characteristics curve and its calibration by the Hosmer and Lemeshow goodness of fit test. Results Three variables were identified which influenced fistula maturation. Gender - Males were twice as likely to undergo fistula maturation, compared to that of females (odds ratio [OR] 0.514; 95% confidence interval [CI] 0.308 to 0.857). Peripheral Vascular Disease - Patients with no evidence of PVD were three times more likely to mature their fistula (OR 3.140; 95% CI 1.596 to 6.177). Vein Size - A pre operative vein diameter &gt; 2.5mm resulted in a five fold increase in fistula maturation compared to a vein size less than 2.5mm (OR 4.532; 95% CI 2.063 to 9.958). There was a good calibration as indicated by Hosmer and Lemeshow goodness of fit test (P=0.79) and the c-index was 0.677. Conclusion Gender, PVD and vein size are useful predictors of arteriovenous fistulae maturation. The clinical utility of these risk categories in the maturation of arteriovenous fistulae requires further clinical evaluation in a prospective study.sch_podpub2775pu