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

Doppler and Spectral Ultrasound of Sacroiliac Joints in Pediatric Patients with Suspected Juvenile Spondyloarthritis

Background: Power Doppler ultrasound (PDUS) with spectral wave analysis (SWA) has been compared with magnetic resonance imaging (MRI) in documenting active sacroiliitis in early spondyloarthritis (SpA) but, to date, PDUS/SWA has not been yet applied to the study of sacroiliac joints (SIJs) in children. Methods: A group of 20 children (13 F/7 M, mean age 14.2 y) with suspected juvenile SpA (jSpA) underwent PDUS/SWA and, subsequently, MRI of the SIJs. SIJs PDUS scoring and resistance index (RI) of the SIJs flows were recorded. The accuracy of PDUS/SWA for the diagnosis of active sacroiliitis was evaluated, with MRI as the gold standard. Results: PDUS signals were detected in 19 patients and 30 SIJs. Bone marrow edema (BME) lesions on MRI were detected in 12 patients (diagnosed as jSpA) and 22 SIJs. PDUS scoring on SIJs were higher in patients with a final diagnosis of jSpA (p = 0.003). On SWA, the mean RIs in patients with or without final diagnosis of active sacroiliitis were, respectively, 0.604 and 0.767 (p = 0.005) at joint level. A RI &lt; 0.55 and PDUS &gt; 1 showed the higher specificity for sacroiliitis (AUROC curve 0.854 for PDUS and 0.920 for RI). SIJs PDUS/SWA showed an overall concordance of 82.35%, with substantial agreement (k = 0.627) with MRI on the diagnosis of sacroiliitis. Conclusions: In children with sacroiliitis, PDUS demonstrates a rich vascularization into SIJs and low RIs (&lt;0.55) have high specificity for this condition. SIJs PDUS/SWA could be useful as a screening method in children with suspected jSpA

Clinical, laboratory and ultrasonographic findings at baseline predict long-term outcome of polymyalgia rheumatica: a multicentric retrospective study : Polymyalgia rheumatica predicted by ultrasonographic findings polymyalgia rheumatica outcome predicted early by ultrasound

To assess the rate of PMR who, during the follow-up, undergo a diagnostic shift as well as to assess which clinical, laboratory and US findings are associated to a diagnostic shift and predict the long-term evolution of PMR. All PMR followed-up for at least 12 months were included. According to the US procedures performed at diagnosis, patients were subdivided into four subgroups. Clinical data from follow-up visits at 12, 24, 48 and 60 months, including a diagnostic shift, the number of relapses and immunosuppressive and steroid treatment, were recorded. A total of 201 patients were included. During the follow-up, up to 60% had a change in diagnosis. Bilateral LHBT was associated with persistence in PMR diagnosis, whereas GH synovitis and RF positivity to a diagnostic shift. Patients undergoing diagnostic shift had a higher frequency of GH synovitis, shoulder PD, higher CRP, WBC, PLT and Hb and longer time to achieve remission, while those maintaining diagnosis had bilateral exudative LHBT and SA-SD bursitis, higher ESR, lower Hb and shorter time to remission. Cluster analysis identified a subgroup of older patients, with lower CRP, WBC, PLT and Hb, lower PD signal or peripheral synovitis who had a higher persistence in PMR diagnosis, suffered from more flares and took more GCs. Most PMR have their diagnosis changed during follow-up. The early use of the US is associated with a lower dosage of GCs. Patients with a definite subset of clinical, laboratory and US findings seem to be more prone to maintain the diagnosis of PMR

Kjelland's forceps in the new millennium. Maternal and neonatal outcomes of attempted rotational forceps delivery

Background: The use of Kjelland's forceps is now uncommon, and published maternal and neonatal outcome data are from deliveries conducted more than a decade ago. The role of Kjelland's rotational delivery in the 'modern era' of high caesarean section rates is unclear. Aims: To compare the results of attempted Kjelland's forceps rotational delivery with other methods of instrumental delivery in a tertiary hospital. Methods: Retrospective review of all instrumental deliveries for singleton pregnancies 34 or more weeks gestation in a four-year birth cohort, with reference to adverse maternal and neonatal outcomes. Results: The outcomes of 1067 attempted instrumental deliveries were analysed. Kjelland's forceps were successful in 95% of attempts. Kjelland's forceps deliveries had a rate of adverse maternal outcomes indistinguishable from non-rotational ventouse, and lower than all other forms of instrumental delivery. Kjelland's forceps also had a lower rate of adverse neonatal outcomes than all other forms of instrumental delivery. Conclusions: Prudent use of Kjelland's forceps by experienced operators is associated with a very low rate of adverse maternal and neonatal outcomes. Training in this important obstetric skill should be reconsidered urgently, before it is lost forever

Evaluating DTN Routing Schemes for Application in Vehicular Networks

Vehicle-to-vehicle networks have gained significant interest in recent times from researchers all around the world. V2V/V2I are emerging as an efficient solution for achieving road safety and securely transmitting data from one vehicle to other. However, in such opportunistic environments such as a sparse vehicular network where disruption, dynamic network topology, fast vehicle movement, and environmental conditions are the major concerns, data forwarding is extremely challenging. Traditional ad-hoc routing protocols like Ad hoc On-Demand Distance Vector (AODV) and Dynamic Source Routing (DSR) fail to deliver in such laborious conditions. Routing protocols of Delay/Disruption Tolerant Networks(DTN) exploit the Store-Carry-Forward Mechanism (SCF) strategy in these cases. Taking advantage of temporary connections to disseminate information is the focus of DTN. DTN helps to increase information propagation coverage in sparse areas where there are very few devices. In this paper, we first compare the performance of AllJoyn framework and Direct Delivery protocol in a single-hop scenario and then draw the attention towards a multi-hop scenario by comparing other three routing protocols that use DTN as the underlying paradigm. These protocols are Flooding, Epidemic, and PRoPHET. The performances are evaluated by transmitting the files of size 1, 4, and 10 MB from a static sender to a mobile receiver in the multi-hop scenario. We also develop an Android application that contains the implementation of these routing protocols along with file sharing functionality. From the outcomes of this experiment, it can be said that Epidemic routing protocol performs the best in our considered multi-hop scenario in terms of transfer delay, coverage, and throughput whereas, Direct Delivery routing protocol performs better than AllJoyn in single-hop communication

Surface Modification of Wool Fabric with Chitosan and Gamma Radiation

Abstract Surface modification of wool was done with chitosan, gamma radiation and combined chitosan/gamma radiation to analyze how polymer loading%, k/s value, dye uptake% and wash fastness property vary of the dyed fabric. In this investigation scoured and bleached knitted wool fabric was treated with 0.1%, 0.3%, 0.5%, 0.7% and 1% chitosan and polymer loading was found as of 1.21%, 1.38%, 0.32%, 0.14% and 0.48% respectively. It was found that polymer loading % increase significantly with the decrease of chitosan concentration % up to a certain limit. Some samples were irradiated with 5kGy, 10kGy, 20kGy and 50kGy gamma radiation individually. Combined chitosan/gamma treatment was carried out by treating with 0.1% chitosan followed by treatment with 5kGy, 10kGy, 20kGy and 50kGy gamma radiation. The infrared spectrum of wool specimens were analyzed by Fourier Transform Infrared Spectrometer (FT-IR). It was found that the infrared spectrum of untreated and treated wool specimens were approximately same except the peak absorbs at 1340-1265 cm -1 which indicate the C-N stretch absorption of aromatic amines. After dyeing k/s value of untreated and treated wool specimens were measured using Data color 600 ® . There was a remarkable variation of k/s value on different treatment process. Dye uptake% of untreated and treated wool specimens were determined by using UV Visible Spectrophotometer in terms of absorbency. Color fastness to wash was measured using ISO standard. There was no significant change of wash fastness property of treated and untreated wool

Ultrasound evaluation of the scapholunate ligament and scapholunate joint space in patients with wrist complaints in a rheumatologic setting

AIM: The aims of the study were to perform an ultrasound assessment of the dorsal portion of the scapholunate interosseous ligament and scapholunate joint space in patients with wrist complaints in a rheumatologic setting, to describe ultrasound abnormalities about scapholunate interosseous ligament region, and to correlate them with clinical data, presence of dorsal ganglion cysts and diagnoses of rheumatic diseases. MATERIAL AND METHODS: Seventy-four consecutive patients with wrist pain and/or swelling were evaluated by routine power Doppler ultrasound. Forty normal wrists were studied to confirm the normality values of the scapholunate joint. RESULTS: The mean width of the normal scapholunate joint was 2.49 mm (±0.49 SD), with a coefficient of variation on repeated measurements of 3.662%. The best predictors of scapholunate interosseous ligament degeneration were: older age (p <0.0001), male gender (p = 0.0049), and radiocarpal effusion (p = 0.0156). The presence of osteophytosis and calcifications of the scapholunate joint were higher (p <0.001) in rheumatic patients. Scapholunate calcifications showed a sensitivity of 98.2% and a specificity of 61.1% for calcium pyrophosphate deposition disease. Dorsal ganglion cysts were more frequent in younger subjects (p <0.0012) without rheumatic conditions (p <0.0001) or midcarpal synovitis (p <0.0001). Larger cysts often exhibited power Doppler signal (p <0.0001). The best predictors of scapholunate dissociation were: male gender (p = 0.0002), presence of midcarpal synovitis (p <0.0137), and higher grade of scapholunate interosseous ligament degeneration (p <0.0001). Scapholunate widening was greater (p = 0.0419) in calcium pyrophosphate deposition disease or rheumatoid arthritis than in other rheumatic conditions. CONCLUSIONS: Ultrasound findings of scapholunate interosseous ligament degeneration and calcification, scapholunate space enlargement, and dorsal ganglion cysts should be considered in ultrasound reporting, since they add useful information about the diagnosis of associated rheumatic conditions